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Overview

Anxiety disorders are a group of psychological traits characterized by excessive anxiety fear worry avoidance and compulsive rituals. They are the most common of all mental health problems affecting 1 in 10 Canadians. Women are more likely than men to experience anxiety disorders. Children as well as adults are affected. When diagnosed they are among the most successfully treated of all emotional disorders.

Causes

Anxiety has primitive roots. When a caveman came across a saber-toothed tiger he had two choices run away or confront the beast. This is called the "fight or flight response". We all have it and we need it to steer us away from real danger. The anxiety that comes with real fear helps gear up our bodies by getting our heart pumping faster to get more blood into our muscles to give us strength and energy. In modern-times however our bodies sometimes act as if there is a real threat when in fact there is only a perceived one. The same primitive response kicks in when we have to give a speech or worry about our jobs or a myriad of other tasks which are not at all life-threatening. This is normal if it occurs from time to time and then goes away when the perceived threat disappears. But if it occurs frequently or is inappropriately severe to a point where it interferes with your normal daily activities you may be suffering from an anxiety disorder.

• Heredity: Anxiety disorders tend to run in families. Researchers believe that a genetic factor possibly activated in combination with life experiences predisposes some people to these disorders.

• Brain chemistry: Symptoms of anxiety disorders are often relieved by medications that alter levels of chemicals in the brain therefore scientists believe that brain chemistry plays a role in their onset.

• Personality: People who have low self-esteem and poor coping skills may be more prone to anxiety disorders.

• Life experiences: Life experiences such as exposure to abuse violence or poverty may affect an individual's susceptibility to the anxiety disorders.

Symptoms

According to the College of Family Physicians of Canada symptoms vary according to the type of anxiety disorder:

Generalized anxiety:

Generalized anxiety disorder is ongoing worry or fear that isn't related to a particular event or situation or is way out of proportion to what you would expect - for instance constantly worrying about the health of a child who is perfectly healthy.

Symptoms of generalized anxiety disorder include muscle tension trembling shortness of breath fast heartbeat dry mouth dizziness nausea irritability loss of sleep and not being able to concentrate.

Panic disorder:

Panic disorder occurs when you have repeated periods of extreme panic called panic attacks.

Suppose one day you're getting out of your car and about to go to work. Suddenly your chest feels tight and your heart races. You begin to feel dizzy and think you might faint. You start to choke. You feel as if the end is near. Was it all in your head? No. most likely you had a panic attack.

Panic attacks last about five to 30 minutes and may include all or any of the symptoms listed. Panic attacks have often been confused with heart attacks brain tumors or other disorders. They can lead to phobias if they aren't treated.

Panic attack symptoms:

• Feeling like you're going to choke
• Chest pressure or chest pain
• Pounding heart
• Racing pulse
• Dizziness or lightheadedness
• Shortness of breath
• Sweating
• Trembling or shaking
• Nausea
• Tingling or numbness in the hands or feet
• Hot flashes or chills
• Sense of unreality or dreamlike sensations
• Fear of losing control doing something embarrassing going "crazy" or dying

Obsessive-compulsive disorder:

Obsessive-compulsive disorder is the type of anxiety in which you have certain thoughts or ideas over and over or do certain things over and over (rituals).

The thoughts may be unrelated to what you're doing. They may be violent or somehow distasteful or frightening to you. The rituals may include washing your hands because of a fear of getting an infection constantly checking windows or doors because of a fear they may not be locked or straightening objects because of a fear something bad might happen if they aren't in just the right place.

Most people with obsessive-compulsive disorder know the rituals aren't normal but they can't seem to stop themselves.

Phobias:

Phobias are when you have a lot of fear and anxiety in response to something specific. Examples include fear of crowds bridges snakes spiders heights open places or social embarrassment.

A phobia is only considered a disorder when it keeps you from living a normal life. An example is being so afraid of open places that you can't leave home. This is called agoraphobia.

Post-traumatic stress:

Post-traumatic stress disorder is the type of anxiety that can happen if you've had a physically or emotionally traumatic experience such as serving in a war suffering a violent crime such as assault or rape or surviving an airplane crash car wreck flood tornado or torture.

People with post-traumatic stress disorder re-live the traumatic event through flashbacks dreams or memories. If they don't get help they may become withdrawn or emotionally numb and avoid any event that reminds them of the trauma.

Treatment

A proper diagnosis is the key to putting a person with an anxiety disorder on the right treatment path. According to the Canadian Mental Health Association many people go undiagnosed for 10 years or more.

Most anxiety disorders have at least some biological component so anti-depressants and anti-anxiety drugs are generally prescribed. They are often more effective in combination with cognitive behavioural therapy (CBT) a type of counseling which helps people turn their anxious thoughts into more rational ones.

There are specific CBT techniques aimed at different anxiety disorders. People with panic disorder for instance can learn to breath slowly and use a specific drug when they're feeling anxious. Controlled exposure to feared objects or situations may also be beneficial.

Your doctor may also suggest a support group or a specialized clinic. The Centre for Addiction and Mental Health has a clinic in Toronto. You can find similar specialized clinics throughout Ontario.

Control your worry. Pick a place and time to do your worrying. Make it the same time in the same place every day. Spend 30 minutes thinking about your concerns and what you can do about them. Try not to dwell on what "might" happen. Focus more on what's really happening instead of what might happen.

Relax. You may learn techniques to help you relax. These may include muscle relaxation yoga biofeedback and deep breathing. Muscle relaxation is simple. Start by choosing a muscle and holding tight for a few seconds. Relax the muscle after a few seconds. Do this with all of your muscles. Try starting with your feet and working up your body.

Steps to deep breathing:

• Lie down on a flat surface.
• Place one hand on your stomach just above your navel. Place the other hand on your chest.
• Breathe in slowly and try to make your stomach rise a little.
• Hold your breath for a second.
• Breathe out slowly and let your stomach go back down.

You might find it helpful to make a list of things that cause you to feel anxious. Begin by confronting the thing that causes you the least anxiety and work your way up the list.

If you feel yourself getting anxious practice one of your relaxation techniques or focus on a simple task such as counting backward.

Although the feelings of anxiety are scary they won't hurt you. Label the level of your fear from zero to 10 and watch it go up and down. Notice that it doesn't stay at a very high level for more that a few seconds. When the fear comes accept it. Wait and give it time to pass without running away from it.

Don't be surprised if you have bouts of anxiety even after it begins to go away. This is normal.

More tips:

• Exercise regularly. People who have anxiety often quit exercising. But exercise can give you a sense of well-being and help decrease feelings of anxiety.
• Get plenty of sleep.
• Avoid alcohol or substance abuse. It may seem that alcohol or drugs relax you. But in the long run they worsen anxiety and depression.
• Avoid caffeine. It's found in coffee tea soft drinks and chocolate. Caffeine may increase your sense of anxiety. Also avoid over-the-counter diet pills and cough or cold medicines.

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