What is anxiety?

There is a distinction between panic attacks and anxiety disorders. For practical reasons, without delving into complicated medical definitions and science, the distinction can be summed up as follows:

Panic attacks are sudden feelings of such intense fear that the person loses partial control over their emotions and reactions. Panic attacks last for relatively short periods (a few minutes to a few hours) before they subside.

Anxiety disorders cover a number of conditions that make people more susceptible to panic attacks. An anxiety disorder may last for years, unless treated. Anybody can have a normal panic attack once in a while, but frequent panic attacks point to an underlying anxiety disorder.

There is also a difference between normal anxieties and pathological anxiety disorders:

Normal anxieties are responses to realistic threats or concerns. Fear and horror pop up when, for instance, you are confronted by a vicious animal. Nervousness prior to making a public speech is normal, as are other mundane worries, such as a dip in your finances, or trepidation while watching a horror movie. Normal anxieties are those deemed fairly common to all people.

Pathological anxiety is an abnormal or irrational response to vague or non-existent threats. There is no justifiable threat, yet the person is overwhelmed by an inexplicable feeling of dread, doom or panic. It includes excessive fear of harmless animals, open spaces or small spaces, social events, or being a passenger in a car to name a few. There may even be no threat at all. Pathological anxiety can affect a person’s life negatively for a very long time. It can last for many years, if not treated.

Stimulants like caffeine and other substances, especially some illegal drugs and some medications, make panic attacks and anxiety disorders worse.

Pathological anxiety is a common disorder. About one in ten people are afflicted with it at some point in life. Anxiety disorders can be effectively treated with cognitive behavioural therapy and, if necessary, supportive medication.

Anxiety Types

There are several types of anxiety disorders:

Generalised anxiety disorders are present all the time, to a varying degree. The person feels constant mental and physical tension about a vast variety of things that may never happen. They persistently stress, for no apparent reason or without knowing exactly what they are worried about.  They simply expect that something, somewhere, will go wrong. They are unable to shake off the feeling. This is the most common anxiety disorder.

Panic disorders are actually feelings of doom, rather than panic. They are unexpected bouts of intense fear of something that is not a realistic concern. Healthy people can fear they may have a potential illness and actually land in hospital, not because they had the feared illness, but because of disorders brought on by their intense worries about it.

Specific phobias refer to excessive dread of clearly defined phenomena. Sufferers strenuously avoid these things. Example are: certain animals, insects, reptiles, blood, heights, thunderstorms, tight spaces, wide open spaces, flying, being a passenger in a car, etc. Sometimes the fear seems outrageously irrational, such as a fear of pigeons.

Social phobia is worse than shyness or stage fright. You stress even when just having a peaceful, private conversation with two or three people. You feel that you are being closely observed and negatively judged by them. The larger the gathering, the more the fear of public humiliation and the need to avoid it.

Separation anxiety happens when someone is separated from a person or place and they feel unsafe or insecure because of the separation. It may also come from a major lifestyle change. Mild insecurity may be normal, but excessive reaction is a disorder that results in trauma and panic attacks.

Post traumatic stress disorder  (PTSD) results from an extremely unpleasant event experienced by a person. It may be a natural disaster, combat duty, rape, serious accident, etc. The event is relived in the mind and brings on bouts of panic. Sufferers also live in fear of a real world repetition. They anxiously avoid things that remind them of, or expose them to, such an event.

Obsessive-compulsive disorder is symptomised by repetitive, intrusive actions. The actions are unnecessarily repeated, over and over. It involves things like constantly checking if machines are switched off, washing hands, checking door locks, etc. Sufferers do it to soothe a simmering anxiety about the possibility that something may go wrong.

What are the symptoms of anxiety?

Some symptoms and signs of anxiety disorders:

• Frequently experiencing sudden, strong fears
• Unjustifiable feelings of danger or impending doom
• Ongoing irrational fear of certain objects, places, situations
• Losing control of emotions and reactions
• Shaking, trembling, sweating, weakness in limbs
• Rapid pulse, irregular heartbeat
• Shortness of breath or hyperventilation
• Choking, dry mouth, nausea, stomach upset
• Strained vocals, difficulty talking (or, conversely, yelling and screaming)
• Poor concentration, dizziness, lightheadedness, feeling detached
• Chest pain and discomfort
• Clenching of hands or jaw, twitching facial muscles
• Asthma and allergy symptoms
• Muscular tension and pain (especially neck, shoulders and back)
• Anger, impatience, fatigue,
• Insomnia, nightmares, depression, isolation (urge to escape)
• Changes in lifestyle, behaviour and habits
• Abuse of alcohol, medication or illegal drugs

Anxiety brings more than panic or stress. It leads to, or worsens, other mental and physical conditions. Apart from these additional ailments, the frequent panic attacks also create a feeling of “fight or flight” – the person may over-react to this and inflict some form of injury or damage. Someone who has an anxiety disorder is repeatedly exposed to this risk.

There are many other symptoms, and not all are present at the same time.

What causes anxiety?

Anxiety disorder is not a mental illness. Given that every person on earth has a degree of anxiety, it simply means that the disorder is somewhat outside the average. Anxiety disorder is just a particularly unpleasant quirk for those who live with it and that is why research and treatment methods have been developed.

Anxiety disorders have a complex array of causes, including genetics, brain chemistry, personality traits and incidents that have influenced the sufferer. The causes also vary according to the type of anxiety. In many cases it is difficult to pin down the cause. Here are some known origins:

People develop phobias from unpleasant experiences. For instance, if a person is caught in a stopped elevator once or twice, they can develop a fear for using elevators or entering confined spaces. This also applies to other types of stressful incidents that people experience or witness and which leaves a lasting impression on them.

If, during childhood, you were punished for displaying certain emotions, you may, as an adult, experience anxiety when you feel those emotions or when someone else displays them. This may even manifest later in life if sensitive people feel compromised about their emotions.

Anxiety can result from a medical disorder that leaves a person physically or emotionally vulnerable to abuse or worries about their future.

Other mental disorders, like depression, can cause anxiety. The abuse of drugs and medications also play a role.

Inherited genes (genetics) can make you more susceptible to anxiety.

Selective mutism is a disorder that impels children to speak only in certain places or under certain conditions and to stay silent in other situations.

Thousands of words have been written about anxiety disorders, but the general wisdom for people who suffer from anxiety quirks which are difficult to pinpoint, is to focus on overcoming their fears with methods that can be employed without having to unravel the original cause. Such remedies exist and they are quite effective.

What treatment is available?

To gain control over anxiety, you have to learn techniques that give you control over the conditions that cause the anxiety, rather than relying too heavily on medication. Medication suppresses the symptoms, rather than curing the root causes. However, some medication may be required for certain conditions.

Benzodiazepines (tranquilisers) are effective, but they should only be used in the event of very severe panic, as they are addictive and this can become a bigger problem than the anxiety itself. Less risky solutions should be explored before turning to benzodiazepines.

Antidepressants have shown good results in some cases, but it requires experimentation to find one that works for you. Although some brand named products portent to be identical solutions, in real life they cause different side effects for different people. There is a bit of scientific uncertainty about the usefulness of antidepressants for anxiety treatment, yet anxiety often goes hand-in-hand with depression, so it may be worth your while to experiment with it.

Beta blockers prevent rapid heartbeat. This will work if you find a pounding heart troublesome, but it does not help for the other symptoms of anxiety. Beta blockers are not addictive, as they do not induce you to take bigger doses as time goes by. However, if you use them for a while you can not suddenly stop using it – you have to taper off slowly.

So-called exposure treatment for phobias involves gradually exposing sufferers to what they are afraid of. In this way, they are conditioned to whatever triggers the anxiety and the unfounded fear gradually disappears.

Psychotherapy is usually the most effective method for treating long term anxiety. For example, one such method, called cognitive therapy, is used to uncover inappropriate thought patterns and ways to change them, thus averting the need for medication. In cases where medication may be required, psychotherapy will still enhance your life and reduce your reliance on constant pill popping.

What are the long term prospects?

Anxiety disorders respond very favourably to cognitive therapy with an emphasis on trauma treatment, with or without medicinal support. The patient learns to master the problematic triggers and to deter relapses. It requires modern techniques, sensitivity and solid experience to apply it without exposing the patient to further traumatisation.

The patient also learns how to reduce fear avoidance behaviour. Avoidance behaviour restricts the way they live. They must learn how to handle situations, without restricting their lives and without stirring fears again.

Some people with anxiety discover that alcohol or drugs can soothe their symptoms. This works briefly, but helps them from the frying pan into the fire. (See alcohol abuse). It is very important to start effective treatment before desperation lures them astray. Dial the number at the top of this page for advice or to arrange a confidential appointment with a qualified counselor. It’s that easy to kickstart the journey to long term bliss.