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Over the last two weeks, how often have you felt nervous, anxious or on edge? How often have you felt that you weren’t able to stop or control worrying?
If your answer to these questions is half or more than half the days, it’s possible that you may be troubled by, or contending with, some anxiety. These simple questions, as benign as they sound, are adapted from an anxiety screen (GAD-2) that should be administered to patients at each primary care physician visit. The purpose of this screen, far from labeling someone as mentally unwell or ascribing a diagnosis, is to identify patients who are possibly having trouble dealing with day-to-day stressors, life events, or are suffering from a mental illness and could be helped in feeling and functioning better through therapy.
As a nurse, and now a medical student, I have often encountered patients who are extremely apprehensive about labels: depressed, anxious, obsessive, manic. The stigma around these labels and fear of being labelled as someone who has mental illness limits patients’ answers to clinician questions. “No! I am not depressed”, “I don’t have those problems” or “I can deal with it”. This patient perspective often leads to the patient continuing to silently suffer with symptoms of anxiety: constant worry about work, poor sleep, irritability, difficulty focusing or concentrating or feeling fatigued.
According to the National Institute of Health (NIH) more than 1/5th (19.1%) of the American population above the age of 18 has had some form of anxiety disorder in the past year. While research on the South Asian community is limited, the prevalence of anxiety in the South Asian community mirrors that of the general American population, 20.8% of South Asians meet criteria for having an incident of anxiety, substance abuse, or affective disorder in their lifetime. Importantly research specific to South Asians has identified that, as a group, they are less likely to seek and utilize mental health services and that stigma around mental illness in the community may be a reason for this phenomenon.
Admitting to anxiety, worry, or feelings of dread is not a sign of weakness. Similar to having a fever, pain in your knee from arthritis, or trouble swallowing, anxiety is a real medical condition for which you should be able to seek and receive care and help. Treatment for anxiety starts with a visit to your doctor. In collaboration with your doctor, and based on screening questionnaires and conversations with him/her, you can chart a plan for yourself. Anxiety comes in many forms; Social anxiety, Generalized Anxiety Disorder, Panic Disorder, Post Traumatic Stress Disorder, and Obsessive-Compulsive Disorder. However, a plan of care for all of them can begin simply: a referral to Cognitive Behavioral Therapy with a qualified healthcare professional and/or picking from possible drugs that modulate the amount of neurotransmitters in your brain (aka SSRIs or SNRIs).
Kultaj Kaleka is a third-year medical student at Central Michigan University’s College of Medicine, and a student delegate to the AMA. He aspires to pursue Psychiatry. Prior to medical school, Mr. Kaleka worked as a registered nurse at Mt. Sinai Hospital.
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