Anxiety

1 What is anxiety?

Anxiety is a feeling of uneasiness about some stressful situation in life. It is normal for people to have anxiety at some point of life. Patients with anxiety disorder have anxiety for a longer duration and this is not related to an unusual or challenging situation. 

People with an anxiety condition have intense and consistent fear or worry about normal situations in life. The feeling of unease is so intense that it often affects their daily activities. They can have frequent anxiety attacks which appear suddenly and reach a climax within few minutes. 

Symptoms of anxiety disorder appear during childhood and continues in adulthood. There are different types of anxiety disorder like generalized anxiety disorder, phobias, or social anxiety disorder. Anxiety disorders are treated with a combination of psychotherapy and medications.

2 Symptoms

Some of the common signs and symptoms of anxiety disorder are:

  • Feeling uncomfortable, tense, or restless
  • Sense of danger
  • Increased heartrate
  • Rapid breathing
  • Sweating
  • Trembling and shaking
  • Weakness 
  • Difficulty in concentrating on anything other than the present worry
  • Difficulty in falling asleep
  • Tummy troubles
  • Persistent worry
  • Avoiding things or situations that trigger anxiety

Different types of anxiety disorders and their symptoms are below: 

  1. Generalized anxiety disorder: This type is characterized by excessive worry about certain activities. Patients may feel constantly on-edge, have difficulty concentrating, and experience irritability. They may also have dizziness, excessive sweating, abdominal pain, difficulty in breathing, headache, trembling, or shaking. 
  2. Panic disorder: This type is characterized by sudden feeling of uneasiness which peaks within a few minutes. Patients complain of chest pain, shortness of breath, rapid heartbeat, and feeling of impending danger. Patients with panic disorder often avoid situations that may trigger panic. 
  3. Separation anxiety disorder: This is typically seen in children who are anxious about separation from parents or others who are close to them. However, it can be experienced in adults too.
  4. Social phobia: Patients with a social phobia often avoid social situations as they have intense anxiety and fear of social situations. They are either embarrassed or overly conscious about being not accepted by others. 
  5. Phobias: Phobias are characterized by an intense fear of some specific object or a situation, usually irrational, such as clowns or spiders. Phobias may trigger anxiety attacks in some people. 
  6. Substance-induced anxiety disorder: This disorder is caused by substance like drugs, medications, or a toxic substance.
  7. Agoraphobia: This is type of anxiety disorder in which you fear certain situations in which you feel trapped. 

Anxiety attack symptoms and how to recognize them

Unpleasant anxiety attack symptoms can cause trouble beyond imagination. Being able to recognize them could help you cope better.

Anxiety attack symptoms can range anywhere from abnormal heartbeats to extreme fear. All these symptoms may be logically irrational, but once they start, it is difficult to stop them.

If you are having an attack, you will most probably experience many of the following:

  • Rapid heartbeats: The pace at which your heart beats can be so fast that you can literally listen to them. In addition, you may also feel as if you are going to die due to this.
  • Extreme dizziness and weakness: The weakness might be so severe that you start believing you will lose control and fall down. In fact, in some cases it leads to a loss of consciousness. This is particularly more likely to cause an injury if you are driving, using machines, or standing at an elevated height.
  • Unrealistic presumption of death: Undoubtedly, this can be really frightening to you. While such feelings may not be related to your current situation, this can cause problems and may also aggravate other symptoms.
  • Excessive sweating: Indeed, this is a physical response to the perceived threat of death or loss of oneself. It can also give you chills which typically last for no longer than a few minutes.
  • Chest pain: Extreme fear can cause a “rush” of various hormones in the body. Most notably, the levels of the stress hormone “cortisol” surges. This could cause an aching pain the chest. As with other physical symptoms, this does not mean you have a real condition, and it starts to wane after a few minutes.
  • Feeling numb: Numbness is one of the typical anxiety attack symptoms. It may occur alone or in combination with tingling sensations. In fact, they are most likely to affect your hands and fingers.

When to see a doctor

If you experience any of the above symptoms, you should consult your doctor who can advise the right course of treatment or refer you to a specialist.

One or two attacks may not indicate any serious problems with your health. However, recurring anxiety attack symptoms could signal something wrong that has not yet been diagnosed.

3 Causes

The actual cause of anxiety disorder is not known. Many traumatic events are implied in the development of an anxiety attack, particularly in people who have a high risk of anxiety. In some people anxiety disorder is caused by an underlying condition. 

Heart disease, diabetes, hyperthyroidism, respiratory disorders, drug abuse, alcohol withdrawal, and irritable bowel syndrome are all known to trigger anxiety. Certain medications cause anxiety disorder.

Some factors that increase the chance of anxiety include: 

  • Trauma
  • Stress
  • Personality 
  • Mental health disorders
  • Family history of mental illness
  • Substance abuse

4 How is anxiety diagnosed?

Making a diagnosis of anxiety is done during physical examination, which helps to rule out chances of any underlying conditions that result in anxiety. Severe anxiety is typically diagnosed by a mental health specialist. Psychological evaluation helps to analyze the patient’s thoughts, behavior, and feelings. 

The diagnostic criteria for anxiety disorder include: 

  • Worrying persistently about daily activities including work and social life
  • Worries or fear that are stressful and upsetting
  • Fear of impending doom
  • Uncontrollable sense of fear
  • Feeling of unease that is persistent for last six months or more

5 Treatment

Psychotherapy and medications are the treatment strategies for anxiety disorder. In most cases, a combination of the two methods is used. Psychotherapy or talk therapy is considered to be an effective way to control symptoms of anxiety. 

Cognitive behavioral therapy (CBT) is a type of psychotherapy which teaches skills for improving symptoms of anxiety. This helps the person to return to normalcy.

Gradual exposure can help the patient to develop the confidence to manage the symptoms of anxiety. Antidepressants, anti-anxiety medications, and some sedatives are prescribed to relieve the symptoms of anxiety.

6 Lifestyle and coping

Lifestyle changes are very important in reducing symptoms of panic attack and anxiety. Regular exercise, reducing alcohol intake, quitting smoking, managing stress, good sleep, and maintaining a healthy diet help to keep the mind calm. 

Being consistent with your treatment methods is effective in controlling symptoms and preventing attacks. Joining a support group helps in discussing experiences and understanding your individual situation better.

7 Risks and complications

There are several risks and complications associated with anxiety disorder.

Anxiety disorder may lead to depression, substance abuse, insomnia, headaches, social isolation, poor relationships, self-destructive thoughts, and poor quality of life.

8 What is an anxiety attack?

Anxiety attacks refer to an overwhelming experience of symptoms that cause an intense fear or feelings of losing the “self”. First and foremost, you should understand that anxiety and anxiety attacks are not the same.

Anxiety is an abnormal or at times a normal response to the perceived threat. However, anxiety attacks are more serious, restricting, and debilitating. No doubt, when you perceive a menacing situation, your body responds to it by releasing various chemicals in the body. They bring about widespread changes in a number of physiological functions.

On the other hand, anxiety attacks are short-term problems and are considered a subset of the anxiety disorder. In fact, they can come and go at any interval and tend to occur suddenly.

Furthermore, they can also result due to various physiological factors that act as a trigger.

They include:

  • Very low levels of glucose in the body: Also called hypoglycemia, it is one of the major triggers of an anxiety attack. It is more common in patients who have problems with glucose metabolism such as diabetes. Think of a diabetic who experiences extreme fear, pounding heart, and dizziness after going without food for a few hours. This is caused by abnormally low blood glucose levels. No doubt, it mostly occurs in patients who take insulin to control diabetes.
  • Overactive thyroid: The thyroid gland is an indispensable part of the hormonal system that secretes hormones. They are keys to controlling how your body metabolism works. Having an overactive thyroid may cause an anxiety attack.
  • Social phobia: This disorder which causes you to develop fast heartbeats during social interaction could also be the cause. Unlike the typical jitters before some important tasks like public speaking, it is more serious and encompasses both psychological as well as physical symptoms.
  • Problems with heart valve: A condition known as mitral valve prolapse could be another reason behind frequent anxiety attacks. Here, the valve between the left upper chamber of the heart (atrium) and the lower chamber (left ventricle) goes out of its original place. It slides into the left atrium for an unknown reason. It is common and usually not serious.

Besides, there are other factors that may cause anxiety attacks. If they recur or cause you significant problems, you should seek professional help.

9 How to stop an anxiety attack

While it may not be possible to completely stop an anxiety attack, taking a few steps could help you get out of the seemingly inescapable trap.

An anxiety attack brings a state of an intense fear and insecurity to the minds of those who experience it. Likewise, it also causes widespread physical symptoms. These can include palpitations, dizziness, numbness, breathing problems, and excessive sweating.

This problem lasts for a brief period. Nonetheless, it can be debilitating if it comes again and again. What makes worse is that it appears suddenly and often without any warning.

You should understand that anxiety is a treatable disorder. In fact, some cases improve with medications and lifestyle changes. Likewise, others may become manageable with the treatment of the underlying cause.

Medications to stop an anxiety attack

Many anxiety attack symptoms respond to medications that alter the levels of brain chemicals. These medications may help curb the frequency and severity of the symptoms.

Talk to your doctor to see if any of the following medications can help you:

  • Depression medications: The US FDA has approved a class of depression-treating medications called Selective Serotonin Reuptake Inhibitors (SSRIs) to treat an anxiety attack. They work by altering the levels of serotonin in the brain.
  • SNRIs: Serotonin and Norepinephrine Reuptake Inhibitors are a new class of depression medications. Like SSRIs, they cause changes in the levels of two brain chemicals, serotonin and norepinephrine.
  • Benzodiazepines or simply “Benzos”: These medications slow down excited brain cells and restrict their activity. Additionally, they also inhibit many associated body functions. However, long-term or inappropriate use can become habit-forming and can lead to addiction problems. Therefore, you should use them only as directed by your doctor, and follow instructions strictly.

Non-drug treatment

Medications are not always the first choice to treat an anxiety attack. There is no clear understanding of how an anxiety disorder occurs. Moreover, different people exhibit different responses to each of the medications. Therefore, many doctors often prefer a non-medical approach before starting the medications.

One such approach involves the use of Psychotherapy which is found to be effective in many cases.

Psychotherapy or simply talk therapy may help you understand an anxiety attack, its occurrence, and possible triggers. Then, a psychotherapist will teach you different ways to cope with the symptoms.

If needed, you may be exposed to the situations similar to those that cause problems in real life. Controlled and gradual exposure may enhance your ability to cope. However, this can be a dangerous approach and does not work for everyone. Similarly, you may also learn about different ways to modify your response to the triggers.

You should understand that it can be a long process and your response may vary compared to someone else.

10 What does an anxiety attack feel like?

Like pain, an anxiety attack is essentially a subjective experience. It feels different for everyone. You cannot measure the extent to which the symptoms affect you. In addition, every individual’s response to stressful stimuli is unique.

Therefore, you should understand that your friend’s experience may be of little relevance to your case. Nonetheless, having an idea of how anxiety attacks affect people can help you gain an understanding.

Stick to your treatment plan and practice stress management on a daily basis. The journey to a normal life after having an anxiety attack can be bumpy. However, commitment, determination, and discipline can go a long way.

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