For a normal human being, being anxious is a part of life. The main challenge is if you have an anxiety disorder in which the anxiety is regular, with no trigger, and is debilitating/ severe. Normal human emotion occurs in a period of uncertainty, when faced with a problem, or in the process of making a vital decision.
The body requires anxiety in areas with imminent danger for survival. Anxiety will probably occur when you are starting a new job, doing an interview, seeing a doctor, about to give a speech, or about to face an exam among other instances.
According to the American Psychological Association (APA), anxiety can be defined as “an emotion characterized by feelings of tension, worried thoughts and physical changes like increased blood pressure.”
Anxiety disorders on the other hand are a group of mental illnesses that give people repeated disturbing thoughts or fears.
The intrusive thoughts, fears, or worries sometimes make the person avoid certain situations. Anxiety disorders because of symptoms such as perspiring, trembling, dizziness, or rapid heartbeat reduce significantly the quality of life. Thus, an anxiety disorder can be disabling.
Treatment of anxiety disorders however helps people suffering from anxiety disorders enabling them to live a fulfilling life. Treatment enables the individual to manage feelings of fear, worry, and other disturbing thoughts.
Key takeaways
- What is an anxiety disorder?
- What are the 6 types of anxiety disorders?
- How do you diagnose anxiety disorders?
- What are the treatment options available for anxiety disorders?
- How can anxiety disorders be prevented?
Types of anxiety disorders
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), our founder David H. Barlow, Ph.D., explained anxiety disorders as an umbrella of different conditions including:
- Generalized Anxiety Disorder (GAD)
- Panic Disorder
- Social Phobia (or Social Anxiety Disorder)
- Specific phobias
- Separation Anxiety Disorder
- Agoraphobia
- Selective mutism
Initially, the two disorders below were part of anxiety disorders but were grouped in other classifications of mental disorders. According to DSM-5, even though they share commonalities with anxiety disorders, they were grouped in different classes of mental disorders.
- Obsessive-Compulsive Disorder (OCD)
- Post-Traumatic Stress Disorder (PTSD)
Of all the anxiety disorder types above, generalized anxiety disorder and panic disorders are the most common among the populace in the U.S.
Generalized Anxiety Disorder (GAD)
This is a chronic anxiety disorder (must affect a person for a period of not less than 6 months) and is characterized by excessive fear or anxiety feeling on a variety of general events.
The word on the street for people with this disorder is worrywarts or neurotics. They are always worried that something will happen to their disadvantage.
To classify someone as having generalized anxiety disorder requires an assessment that checks for the following anxiety symptoms:
- Relentless edginess.
- Having a constant difficulty paying attention or concentrating.
- Continually feeling tired. This also includes getting fatigued easily
- Constantly having muscle tightness
- Always being restless
- Constantly having issues with falling asleep or staying asleep.
According to APA, an adult must express 3 or more of these symptoms for 6 months or more for a generalized anxiety disorder diagnosis. For generalized anxiety disorder in children, an expression of one of the symptoms above for a similar period is a clue for diagnosis.
Some of the causes or risk factors of a generalized anxiety disorder include tobacco use, genetics, prolonged exposure to traumatizing situations, and childhood abuse.
Panic Disorder
This is a random extreme feeling of terror or fear. The symptoms of panic disorder are panic attacks which in most anxiety patients come with sweating, trembling, chest pains, a feeling of choking, or irregular heartbeat (palpitations).
Experiences from several people who visited our clinic define the feeling as a heart attack feel. Other symptoms experienced during panic attacks are nausea, dizziness, and chills.
The emotional function is also affected by feeling as if you are going crazy, fear that you will die, or having someone else’s body and losing control of your body and mind.
For a person to be diagnosed as having panic disorder the person must have experienced repeated panic attacks and worry associated with the fear of getting another attack lasting for more than a month. Panic attacks can occur at any time even during sleep.
According to the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5), regular panic attacks are indicative of a panic disorder. However, a panic attack does not mean that the individual has a panic disorder.
Panic disorders affect roughly 1.7% of adults in the U.S. Of note is that women are twice as likely to develop panic disorder as compared to men.
Also, studies appear to show that panic disorder risk increases if any person in your lineage had the condition.
Studies also appear to show that panic disorder may be associated with disorders of the endocrine system, cardiovascular system, or other serious medical conditions. If the underlying issue is diagnosed, management of the condition and treatment of panic disorder should result in a better prognosis.
The studies also show that disorders for example depression and substance abuse coexist naturally in most people with panic disorders.
Social Phobia (or Social Anxiety Disorder)
Social phobia is a feeling of overwhelming anxiety or worry or fear concerning social situations. Social situations are situations where scrutiny is expected.
Anxiety is about being judged, ridiculed, embarrassed, or scrutinized. You will always hear people talking about fearing being left alone with unfamiliar people or people scrutinizing how you eat or how to speak in public. The social anxiety symptoms are similar to those of other disorders as discussed below.
In most people being embarrassed by people will make them fixated with fear and thus avoid such situations. If the situation is a must, it is always done because of extreme pressure.
For persons with social phobia, the brain might even be over-judging a situation. In some instances, like in public speaking, a person might see two people in the audience talking and think that they are talking about them.
In that instance or others the actual threat may be very small but registered as extreme by the individual.
Because every person has a fear of new situations, the level of anxiety must be extreme for a person to be suspected of having a social anxiety disorder. The possible causes of social anxiety disorders range from environmental causes, bad parenting, and genetics. Environmental causes include abuse, bullying by age-mates, family conflicts, death or losing a parent, and maternal stress among others.
The person must also be employing some abnormal behaviors to try to avoid or cope with the situation.
Specific phobias.
Phobias are excessive or intense fear about a specific situation or object markedly beyond what is appropriate for the actual threat involved.
Specific phobia, for example, may be for situations like height, flying, darkness, insects, and others. Some of the fears are threatening situations or objects like the fear of snakes, spiders, and being in enclosed spaces.
The situation or objects that generate the fear is thus avoided in dysfunctional ways. The behavior of avoiding or coping with fear is always in most individuals accompanied by an excessive fear of a similar situation for a period of not less than 6 months to be defined as a phobia.
Some people may have fear of poisoning or nosophobia among other phobias that may be debilitating to the individual. However, phobias can be managed with great success.
Agoraphobia
Agoraphobia is the anxiety about being in situations or a place where fleeing is difficult, uncomfortable, or in cases where if support is required it is unavailable.
The condition is strongly related to panic disorder. This is because it is mostly caused by the concern about getting a panic attack. People with agoraphobia can be identified by their constant checking of escape routes or having to position themselves in an area where they can always see the door if they are in a room.
The same individual in addition to the fear also has avoidance behaviors. This avoidance behavior causes serious consequences or at times adds to the fear.
Examples of situations that are avoided by people suffering from agoraphobia include:
- Using communal transport
- Boarding a taxi alone
- staying in enclosed spaces
- Being in open spaces or a crowd
- Standing in a line with other people
- Being in the house alone or out of the home alone.
Agoraphobia is suspected when some of those or other fears together with the avoidance behaviors manifest for over 6 months. The fear is disproportionate when checking the dangers posed by the source of the fear.
If the fear and the accompanying behaviors are upsetting and or interfere with daily activities, then agoraphobia is confirmed. The said individual will most of the time request a companion in any of the instances above.
Separation Anxiety Disorder (SepAD)
This disorder is the extreme and inappropriate fear of being separated from a person or place that he/she is attached to. For babies and children, it is normal for them to have separation anxiety. The condition is diagnosed as separation anxiety disorder if the anxiety is excessive or inappropriate.
Separation anxiety disorder affects around 4% of children in the U.S and 7% of adults with severity being more in children than in adults.
The fear of losing a person or a place where a relationship has been formed is one of the main symptoms of the disorder. The person may refuse to leave a person or a place he/she is accustomed to. They may not sleep or have nightmares when that individual is not around.
The disorder may develop in childhood and persist to adulthood if not managed. For children, early diagnosis and treatment will prevent serious problems. One of the ways to treat the condition is to train the parents on how to resolve the anxiety in their children.
In addition to training the parents, family therapy, and medications can be used to treat the anxiety.
Selective mutism
Selective mutism is a childhood anxiety disorder where a person who has speaking capabilities is unable to speak in certain circumstances or to some people. In most instances, the disorder co-exists with social anxiety or being shy. Children with selective autism communicate well with people and in settings where they are comfortable, safe and relaxed.
For the people suffering from selective mutism, silence is maintained even when they are sure that they will be ridiculed, shamed, punished, or socially ostracized. About 0.8% of people suffer from selective mutism at one point in their lives.
For those children, selective mutism symptoms can be quite devastating and painful. In most instances, their social skills are affected. The extremeness of the mutism varies from child to child with some children standing paralyzed while others can mute a few words or whisper.
Adults with selective mutism may be unable to speak just like the children with selective mutism.
In most cases, children inherit selective mutism from someone in their lineage who had anxiety problems. These children from infancy have extreme anxiety tendencies, are moody and shy, throw tantrums often, and have sleeping problems.
Obsessive-Compulsive Disorder (OCD)
Obsessive-Compulsive Disorder is a personality disorder characterized by recurrent obsessive thoughts otherwise called obsessions or performing certain routines or behaviors (compulsions). Compulsions and unwanted thoughts make life unbearable.
According to DSM-5, obsessive-compulsive disorder is not classified as an anxiety disorder but as an obsessive-compulsive and related disorder.
Some of these compulsions include counting, hand washing, cleaning, or checking to see if for example the door is locked and are carried out to try and cope with the unwanted thoughts or to relieve them of the thoughts.
The obsessive-compulsive disorder symptoms are associated with the fear of dirt (germs), losing control, religion, sexual explicit thoughts, and lacking of needs.
These repetitive behaviors however offer temporary relief and for individuals suffering from OCD, not performing the so-called “rituals” increases anxiety altogether.
Obsessive-Compulsive Disorder is associated with tics and an increase in the risk of suicide.
Even though the obsessive-compulsive disorder cause is unknown, genetics and certain infections play a major role in having the disease. In addition, a history of child abuse and exposure to stress-inducing occasions may increase the risk to contract the condition.
Post-Traumatic Stress Disorder (PTSD)
Post-Traumatic Stress Disorder, PTSD, is a mental health condition that develops after exposure to a terrifying event in which severe physical injury occurred or was threatened. The exposure means that the event may have occurred to you or someone while you were witnessing it.
According to the DSM-5 classification of anxiety disorders, PTSD is classified under trauma and stressor-related disorders.
Some of the events that may trigger post-traumatic stress disorder include violent personal assaults, disasters either natural or mad made, military battles, and accidents.
The most common post-traumatic stress disorder symptoms include nightmares, flashbacks, and terrible anxiety while also having repeated thoughts about the event.
All these symptoms can be grouped into avoidance, intrusive memories, foul moods and thoughts, and variations in emotional and physical reactions.
These PTSD symptoms may start within a month of exposure to the devastating event but in some instances, they may start years after the exposure.
The symptoms of PTSD cause major problems at work, with family, or in any other social situation. In most instances, a person suffering from post-traumatic stress disorder may have problems performing daily tasks.
Most people who are exposed to traumatic events may feel unable to adjust or cope momentarily. However, with time and self-care, the individuals heal.
Those who are unable to heal thus develop PTSD may require effective treatment to enable them to cope and improve the day to day functioning.
Anxiety disorder Symptoms
How do I know if I suffer from an anxiety disorder? It all starts with checking the anxiety disorder symptoms.
Almost all anxiety disorders manifest with some common symptoms. Adults must have at least 2 of these anxiety symptoms running for a period for an anxiety disorder to be suspected.
The symptoms of anxiety disorders include:
- Panic, fear, and uneasiness
- Sleep problems
- Memory problems
- Irritability and inability to stay calm and still (restlessness)
- Cold, sweaty, numb, or tingling feet or hands
- Shortness of breath and anxiety chest pain
- Heart palpitations
- Dry mouth
- Nausea
- Tense muscles and getting fatigued easily
- Dizziness, or faintness
- Feeling of detachment
In most cases, a person suffering from an attack thinks that they are suffering a heart attack. These symptoms may be associated with other medical conditions and thus it would be nice to see a doctor.
Most of the anxiety disorder signs above are symptoms of a panic attack which is “an unexpected occurrence of forceful and devastating worry and terror that activates a severe physical response in instances of minimal or no real danger or apparent cause.”
A panic attack lasts for a short duration of time with 10-15 minutes of intense symptoms and may be one of the indications of an anxiety disorder. A panic attack may be followed by periods of intense fear which leads to reduced quality of life.
How long does an anxiety attack last?
An anxiety attack is a prolonged period of intense anxiety symptoms. It is different from a feeling of anxiety in that it is more intense and prolonged but not as debilitating as a panic attack.
An anxiety attack can last for a period of minutes or hours but in some situations, it can last for days or weeks. An anxiety attack has the following symptoms:
- Difficulty in controlling worry, panic, fear, and uneasiness
- Memory problems and difficulty in concentrating
- Irritability and inability to stay calm and still (restlessness)
- Having difficulty getting sleep, staying asleep, or getting enough satisfying sleep
- Tense muscles and being fatigued easily
An anxiety attack may not imply that you have an anxiety disorder, unlike a panic attack. This is because it is merely a period of intense anxiety. Since anxiety is normal, an anxiety attack may be an indication of intense emotion or may point to an anxiety disorder.
A panic attack on the other hand is a sign that you may have an anxiety disorder. A panic attack is an intense and debilitating occurrence of intense anxiety symptoms which last for 20 to 30 minutes. The panic attack signs and symptoms develop abruptly and peak within 10 minutes. Of note is that a panic attack can happen anytime and anywhere.
Anxiety disorder in children
Children always experience anxieties over several events, people, and the environment. Anxiety in children is common and should not be deduced to be an anxiety disorder.
Children however have been seen to suffer from almost all the above anxiety disorder types. The children can suffer from generalized anxiety disorder, panic disorder, separation anxiety disorder, social anxiety disorder, selective mutism, specific phobias, obsessive-compulsive disorder, and posttraumatic stress disorder.
It is always good to detect the symptoms of anxiety disorder in your child early and see a doctor for diagnosis and treatment. The different anxiety disorders in children present with different symptoms but mostly are followed by a period of intense fear.
A child with an anxiety disorder will have difficulties in concentrating, will live every day with fear, and will feel like they are losing control. The anxiety disorder in children is treatable by the treatment methods available. However, these children require a lot of support from family and friends.
Anxiety disorder Causes
Results from various researches have not conclusively pinpointed what causes anxiety disorders to develop. The information available however show a relationship between all anxiety disorders and some diseases, environmental stress, changes in the brain, and genetics.
These anxiety causes are classified as follows:
- Environmental stress: Anxiety can be increased by environmental factors. Stress at work, from school, in personal relationships, finances, and emotional trauma like the death of a close friend or relative contribute markedly to developing an anxiety disorder. These stresses also include low oxygen levels, especially at high altitudes.
- Genetics: A person whose family members have suffered from an anxiety disorder is more at risk of developing an anxiety disorder. In 2015, a study explored mental illnesses and concluded that the RBFOX1 gene increases the risk of developing generalized anxiety disorder. GAD is a heritable condition with a moderate genetic risk according to a more recent study conducted in 2017. Additional studies in 2016 concluded that panic disorder, generalized anxiety disorder, and social anxiety disorder are linked to the genetic make-up of our bodies.
- Withdrawal or use of an illicit drug like cocaine: A combination of the stress-causing daily activities discussed above when combined with the use or withdrawal from an illicit substance may contribute markedly to developing an anxiety disorder.
- Medical factors: Some ailments can increase the risk of anxiety disorder in addition to the side effects of medications taken. In addition, stress from a serious illness may trigger an anxiety disorder. Ailments having symptoms like chronic pain and restricted movement may be what causes anxiety disorders to develop.
- Brain Chemistry: Exposure to very stressful and traumatic events can alter the brain function and structure to cause increased susceptibility to anxiety. With the change in the brain chemistry, individuals get anxiety from circumstances that in normal persons do not cause anxiety. The disruption of hormonal balance and electrical signals in the nervous system is how many neurologists and psychologists define anxiety and mood disorders.
Diagnosis
The first pointer for diagnosis of any anxiety disorder is having symptoms of anxiety disorder that have been regular for a period of time. The Doctor will always check your medical history.
After the medical history, the doctor will examine you to rule out other medical conditions that may present with the same symptoms. This may involve blood, urine, or other tests to check for a medical condition. It should be noted that there are no specific laboratory tests to diagnose anxiety disorders.
A psychologist or psychiatrist may be consulted once the doctor has ruled out the other possible medical conditions. These mental health specialists use a questionnaire to check and analyze the symptoms and medical history.
The answers to the question are combined with some tests and using tools will help to narrow down to the anxiety disorder you are suffering from. The longer the period in which the symptoms have been manifesting is very important in the diagnosis.
All anxiety disorders affect the quality of life and interfere with day-to-day activities. The doctor will also analyze the impact of the symptoms on your daily life.
Finally, doctors employ the anxiety disorder diagnostic criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as published by APA (American Psychiatric Association).
Treatment of Anxiety Disorders
Anxiety disorders are treated using one or a combination of the following methods:
- Medication
- Psychotherapy
- Self-treatment (managing Symptoms)
These methods are described in detail below.
Before getting the anxiety disorder treatment option, or choosing a doctor for anxiety disorder it is important to consider the following factors:
- Training and experience of the doctor in managing anxiety disorders
- Discuss with your family about the needs for the treatment and ensure they are comfortable with it
- Analyze the treatment type and format to understand the nitty-gritty details of the treatment. These include how long it takes to act, course, length, frequency, procedures, and potential effects of the treatment.
- Check on the treatment costs and if they are covered by your insurance provider.
- Find out if you are comfortable and confident with the doctor performing your treatment course.
- Check if your doctor will be comfortable communicating freely with your family doctor. This enables one to have checks by a person who knows you better.
In most anxiety disorders the following are the most commonly used therapies. Kindly note that the doctor may prescribe one or more of the following anxiety remedies:
Medication for anxiety disorders
There are three main types of medications prescribed to treat anxiety disorders; antidepressants, anxiolytics (anti-anxiety drugs), and beta-blockers. The medication used may depend on the type of anxiety disorder.
Both anxiolytics and antidepressants target the balance of neurotransmitters (chemicals in the brain that are used to pass messages around). Therefore, Antidepressants can be used to treat both depression and anxiety.
Beta-blockers, first-generation antihistamines, and other drugs target the physical symptoms associated with the anxiety disorder.
In anxiety disorders, the best treatment is as recommended by the doctor after several deliberations.
Antidepressants
Since several neurotransmitters are involved in both normal and anxiety disorders, targeting them plays a huge role in anxiety management. To target these neurotransmitters the following drugs for anxiety are used:
- Selective Serotonin Reuptake Inhibitors (SSRIs): These antidepressants are used mainly as the first-line treatment for anxiety. They include fluoxetine (Prozac), sertraline (Zoloft), citalopram (Celexa), escitalopram (Lexapro), fluvoxamine (Luvox), paroxetine (Paxil), and vilazodone (Viibryd).
The SSRIs are the first line in the treatment of a panic disorder, obsessive-compulsive disorder, social anxiety disorder, general anxiety disorder, and post-traumatic stress disorder.
- Serotonin–Norepinephrine Reuptake Inhibitors (SNRIs): This class of antidepressants inhibits both serotonin and norepinephrine transporters. They include venlafaxine, desvenlafaxine (Pristiq), and duloxetine. Milnacipran (Savella) is not recommended for anxiety but for fibromyalgia even though it is an SNRI. They are the second-line treatment for anxiety and thus are used when there is a treatment failure or insufficient response to SSRIs.
These drugs are very effective in the treatment of panic disorder, obsessive-compulsive disorder, social anxiety disorder, general anxiety disorder, and post-traumatic stress disorder.
- Benzodiazepines: These medications were previously used as the first line for treatment of
anxiety but not anymore. This is because chronic use of benzodiazepines has so many risks.
The anxiolytic works by boosting the action of gamma-aminobutyric acid (GABA), a neurotransmitter.
They are one of the most prescribed anxiolytics though. For acute anxiety though, they are very effective but long-term use or high doses increases dependence and withdrawal symptoms. Other symptoms of note include reduced reasoning and coordination, and the potential danger of death if mixed with opioids or alcohol. Benzodiazepines include alprazolam (Xanax XR), diazepam, flurazepam, Lorazepam, Oxazepam, clorazepate, clonazepam, midazolam, triazolam, and temazepam. These drugs are prescribed majorly for generalized anxiety disorders and panic attacks.
- Monoamine oxidase inhibitors (MAOIs). MAOIsinhibits the effects of a brain enzyme called monoamine oxidase, whose action is to metabolize neurotransmitters like serotonin. This inhibition ensures more serotonin is circulating thus calming moods and reducing anxiety. They are prescribed mainly for panic disorder, social anxiety disorder, and post-traumatic stress disorder.
For those cases of anxiety, Monoamine oxidase inhibitors are prescribed where SSRIs are not effective. One of the main reasons for this is that MAOIs have interactions with foods and a number of drugs. phenelzine (Nardil), tranylcypromine (Parnate), isocarboxazid (Marplan), and selegiline (Emsam).
- Tricyclic Antidepressants (TCAs): All tricyclic antidepressants are norepinephrine reuptake inhibitors while most of them also facilitate serotonin reupdate inhibition. The TCAs have far more adverse reactions as compared to SSRIs and SNRIs even though their efficacy is comparable. TCAs are also deadly in case of an overdose.
Due to the adverse reaction and the lethal nature of overdose, TCAs are rarely used to treat anxiety disorders. However, for patients with OCD, clomipramine (Anafranil) is potentially more efficacious than SSRIs and SNRIs. They are used to treat panic disorder, post-traumatic stress disorder, and general anxiety disorder in the few cases where they are used.
- Tetracyclic antidepressants: Tetracyclic antidepressants regulate the levels of neurotransmitters in the brain. Their mode of action is almost similar to tricyclic antidepressants but has fewer side effects.
The antidepressant is useful in treating post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and other anxiety disorders though on an “off-label” model.
Some of the commonly used tetracyclic antidepressants include Mirtazapine (Remeron), and maprotiline (Ludiomil).
Anticonvulsants:
Anticonvulsants/ antiepileptic drugs/ antiseizure medications have been put more into use due to the potential side effects of benzodiazepines. These antiepileptic drugs were in the past used as mood stabilizers in mood disorders. These days, however, they are used as anxiolytics.
These drugs are mainly used in an off-label fashion for the treatment of anxiety. Examples include gabapentin (Neurontin), Pregabalin (Lyrica), topiramate (Topamax), Lamotrigine (Lamictal), and valproate (Depacon). These drugs are taken in low doses since higher doses lead to similar side effects to benzodiazepines.
Alpha-blockers:
These are drugs that prevent the hormone norepinephrine from constricting the muscles in the body. Alpha-blockers are not primarily prescribed for most anxiety disorders except post-traumatic stress disorder. They generally prevent nightmares.
Alpha-blockers are normally used for benign prostatic hyperplasia (BPH) and high blood pressure. Examples of Alpha-blockers are Doxazosin (Cardura), Prazosin (Minipress) and Terazosin
Beta-blockers:
This class of medication is also known as beta-adrenergic blocking agents. They function by hindering the effects of adrenaline (epinephrine). This results in the opening of arteries and veins, in addition to allowing the heart to beat more slowly and with reduced force. They treat performance anxiety disorder and panic disorder.
Examples of beta-blockers are propranolol (Inderal), Acebutolol (Sectral), Atenolol (Tenormin), Bisoprolol (Zebeta), Metoprolol (Lopressor), Nadolol (Corgard), Nebivolol (Bystolic). Propranolol is the most commonly used beta-blocker for anxiety disorders.
How long do beta-blockers take to work for anxiety? Beta-blockers like propranolol will start acting in your body almost immediately after swallowing them but the full effects on anxiety will be felt within an hour or two.
During that time, they will work to reduce the heart rate and give you a calm, relaxed feeling. Doctors examine your symptoms and determine if the beta-blockers will be taken just before a stressful event or regularly.
Buspirone
Buspirone’s mechanism of action is not well known even though it acts on the chemicals in the brain. These chemicals are serotonin and dopamine. This anxiety drug belongs to the class of compounds called azaspirodecanedione.
It does not sedate the user, unlike benzodiazepines.
Buspirone is very effective in treating anxiety disorders including generalized anxiety treatment. The anxiolytic works on the following anxiety symptoms:
- Fear
- Tension
- irritability,
- dizziness
- pounding heartbeat
The side effects of buspirone include vertigo, nausea, headache, edginess, lightheadedness, excitement, and insomnia.
Additional Medications
First-generation antihistamines are sometimes prescribed for GAD. Examples of antihistamines used to treat anxiety are Hydroxyzine (Atarax), and diphenhydramine.
The medication is mainly used for allergies, insomnia, coughing, Parkinson’s disease, and motion sickness. However, some of the properties of the drug are useful for anxiety.
GABA for anxiety: are supplements containing the hormone Gamma-aminobutyric acid (GABA), recommended for anxiety, sleep, and stress.
Psychotherapy
Psychotherapy is a type of counseling that helps to resolve the emotional response to mental illness rather than using anxiety drugs. The collaborative process is carried out by a mental health specialist who discusses with you how to deal with anxiety disorder.
The patient is supposed to practice the learned anxiety coping skills and techniques away from the therapy session to deal with anxiety.
Cognitive-behavioral therapy (CBT)
CBT is one of the approaches used to treat anxiety. CBT, psychotherapy, helps a patient to understand and alter their (cognitions)/ thoughts and behaviors that start a panic or nervousness. The commonly used CBT methods are exposure and cognitive therapy.
In addition to cognitive behavioral therapy, psychologists apply group psychotherapy and family psychotherapy to help the patient deal with anxiety. The two enable you to get help from a group of individuals suffering from anxiety disorders or from family members.
CBT is efficacious in all anxiety disorders treatment. It improves the quality of life for most anxiety disorders in addition to other mental illnesses.
CBT can either be diagnostic-specific CBT (the current gold standard) or transdiagnostic CBT. Recent studies have shown that both are effective in the treatment of anxiety disorders.
While being compared to diagnostic-specific CBT, Transdiagnostic CBT is easier to disseminate thus increasing access to evidence-based therapy for anxiety disorders and other mental disorders without
reducing efficacy.
Transdiagnostic Treatment of Anxiety Disorders, depression and other disorders
What is the transdiagnostic treatment of emotional disorders? They are revolutionary treatment methods that focus on the theoretical and practical commonalities of different disorders to treat emotional disorders and other related disorders.
Some of the disorders treated by the use of transdiagnostic treatment include anxiety disorders, depression, eating disorders, and other related disorders.
According to recent studies, different psychiatric disorders have similar fundamental underlying susceptibilities. Because of this, currently, there has been developed of transdiagnostic treatment focuses on the underlying susceptibilities of different disorders.
Some of the core features and susceptibilities of anxiety disorders are targeted by transdiagnostic treatment include:
- Anxiety signals and triggers (e.g. situational, perceptive, and interoceptive signals or cues)
- Perceptive or mental processes and biases (e.g., intolerance of uncertainty)
- Avoidance behaviors (e.g., situational, interoceptive, cognitive, and emotional avoidance)
- Physical signs and symptoms, and amplified arousal
- Compulsions/ impulses and safety behaviors
- Skills and competencies deficits
Each of the 5 core features has a detailed diagnosis and treatment plan which is done in modules to ensure the prognosis is good.
This approach is different from the single-diagnosis protocol where the focus is on one disorder only. The Transdiagnostic approach has improved the treatment prognosis of different emotional disorders.
The making of transdiagnostic treatment can happen through three (3) separate methods giving rise
to three clear categories:
- Modular/common elements
- Universally applied therapeutic
- Mechanistically transdiagnostic
For anxiety, transdiagnostic treatment like cognitive therapy, MATCH, CETA, and Unified Protocol (UP) are very successful in treating all anxiety disorders including PTSD. Transdiagnostic treatment methods are also effective in other mental disorders too.
One of the strengths of transdiagnostic treatment is that it can be used in clinics with limited resources. This is because it can be effectively disseminated and thus easily accessed.
To get more insights on the Unified Protocol and anxiety disorders kindly get our founder’s books on Amazon.
How to Manage Anxiety Disorder Symptoms/ home remedy
There are several life hacks that can be employed in anxiety management. The life-hacks work in relieving the symptoms and improving the quality of life. These methods can be used for anxiety treatment at home.
Most of the tips try and make you look at life positively. The tips to manage the symptoms include:
Learn relaxation techniques: It is always great to take time out and acquire some skills to help you relax. These include meditation, yoga, listening to your favorite music, get a massage. The skills help to clear your brain from negative thoughts that can lead to anxiety. Some of these techniques can be read from anxiety books.
Minimize the use of alcohol and caffeine: Alcohol and caffeine can worsen anxiety attacks or even trigger them. Caffeine alters moods and thus it is good to avoid taking coffee, tea, energy drinks, cola sodas, and chocolate.
Get enough sleep: In most anxiety disorders, getting enough quality sleep is always a problem. To get enough sleep there are laid down procedures that can help a person with anxiety to get good enough sleep.
These procedures include having a bedtime routine, exercising before sleep, avoiding blue light-emitting devices just before bed, eating at least 2 hours before sleep, and others.
It should be noted that when you are stressed, the body needs enough sleep to regenerate and heal. For most people, weighted blankets can manage anxiety.
Exercise daily: Exercise helps to regulate the brain chemicals in your body thus reducing stress. Exercise is also important for a good night’s sleep especially when anxious. Exercises like jogging, biking, and running are very helpful in stressful situations.
Always eat a balanced diet: Having a balanced diet helps to maintain energy levels and body shape in times of stress and anxiety. These help to reduce instances of hypoglycemia which can trigger anxiety attacks. Kindly make sure that you do not skip meals and have a healthy snack available all the time.
Talk about the anxiety: “A problem shared is a problem halved.” This applies even to anxiety disorders. Talking to family, colleagues and even a doctor will help in times when you feel overwhelmed.
Learn more about your anxiety: Learning about your anxiety disorder can help to prevent exposure to triggers or manage the symptoms when an anxiety attack happens. Learning about the anxiety may involve recording instances when the attacks happen, what was happening at the time, who was present, and the results. After some time, a pattern may emerge which can be discussed with others or researched from psychology materials.
There are several anxiety books that can help in understanding anxiety and give you practical solutions to prevent or manage the anxiety. Some people also use audio messages and games to get more accustomed to anxiety.
Do something: Anxiety may happen when you have nothing to do and have time to think and overthink. To mitigate against this, you should work or be active wherever you are. This may even include volunteering.
Do not take anxiety medications before consulting: Even though there are enough materials to read about anxiety disorders, it is always right to talk to a doctor or a pharmacist before taking any medication.
The meds may include both over-the Counter (OTC) medication, herbal medication, or prescription medication. This is because some drugs may counteract with others or even some may worsen your anxiety.
Be proud of yourself: Most people beat themselves up when they don’t achieve perfection. This may be one of the main triggers of your anxiety. It is good to be proud of your achievements at school, at work, or even at home.
Laugh: Humor and laughter help to relieve stress and anxiety symptoms. This is because laughter
enables the brain to regulate the neurotransmitters thus improving the mood.
Practice stress management techniques: Stress management techniques help to alleviate anxiety symptoms. Some of the management techniques include taking deep breaths and counting to 10. It is important to take deep breaths during an anxiety attack.
This process should involve deep breaths and breathing out slowly. This improves blood flow thus helping the moods. Counting helps to calm the brain down. If counting to 10 does not help, try counting up to 20.
Accept that stress may not be bad as you envisage: To help in anxious moments, it is good to know that no one has control over everything. Thus, as much anxious as you are, note that the stressful situation might not be as bad as you think. Try not to overreact or overthink situations.
Limit social media: Social media has been shown to be a source of anxiety, especially for the youth. This is because it is giving untold pressure on the youth to shine or perform like their role models or peers on social media platforms.
Alternative treatment methods
Acupuncture for anxiety disorders: Acupuncture is an ancient treatment for several medical conditions where sterile needles are inserted into pressure points in the body. It is gaining ground in the treatment of anxiety. According to research, acupuncture helps to relieve some of the symptoms of anxiety.
According to some research, acupuncture starts giving relief for generalized anxiety disorder symptoms within 10 weeks. This applies when you get a 30 minutes acupuncture session 10 times within the period. The studies however are not very conclusive on how acupuncture helps to relieve the symptoms and also is not so clear for other anxiety disorders.
Acupuncture comes with its own side effects like soreness of the pricked area but that can be mitigated if a qualified acupuncturist is used. It is not recommended for people with bleeding problems of people using a pacemaker.
Use of toys and games: New and innovative techniques for anxiety relief are coming up every day. Games like CBT games have been developed to help children deal with anxiety disorders. Other toys like fidget toys can also help with anxiety for children and adults.
Anxiety in children can be stressful to the child or the parents and thus having toys and games that can help with anxiety can greatly improve the quality of life.
Use of anxiety supplements: There are several natural vitamins and supplements that can be used to treat anxiety. These supplements work on different symptoms that are associated with anxiety disorders. However, it is important to ensure that the supplements have both FDA and third-party certifications before taking them.
Complications of anxiety disorders
An anxiety disorder may do a lot more damage to your social life, mental health, and physical health. It may lead to the following complications:
- Depression. Anxiety disorders may lead to the development of stress or exacerbate existing depression or any other mental disorder.
- Drug and substance abuse: People with an anxiety disorder may seek refuge in drugs and substances leading sometimes to addictions.
- Insomnia: Sleep problems and anxiety disorders go hand in hand. The constant worry does a lot in making sleep to disappear.
- Gastrointestinal or bowel problems: Constant worrying is one of the major causes of ulcers and hyperacidity.
- Chronic pain including headaches
- Loneliness or social separation
- Poor performance in school or at work
- Diminished quality of life
- Having suicidal thoughts or even committing suicide
Summary of Anxiety Disorders
Anxiety disorders are very common mental illnesses affecting 18.1% of the United States adult population every year. This translates to around 40 million Americans affected every year.
The disorders even though treatable, are not treated for over 60% of the cases leading to poor quality of life. The disorders majorly share symptoms and treatment regimes.
Anxiety disorders treatment enables you to manage the symptoms and also live your life to the fullest. The treatment options available for anxiety disorders are either medications, Psychotherapy, or management of symptoms.
According to David H. Barlow, using transdiagnostic treatment approaches like the unified protocol offers advantages for both the clinician and patient.
The treatment options can be used separately but mostly are used together for better results as prescribed by doctors.
Citation:
https://www.bu.edu/psych/profile/david-h-barlow/
https://scholar.google.com/citations?user=yQv1g1QAAAAJ&hl=en