By: Stephen Brockway, MD
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Anxiety is often manageable and mild. But sometimes it can present serious problems. A high level or prolonged state of anxiety can be very incapacitating, making the activities of daily life difficult or impossible.
Besides generalized anxiety, other anxiety disorders are panic, phobia, obsessive-compulsive disorder (OCD), and posttraumatic stress disorder.
Phobias, which are persistent, irrational fears and are characterized by avoidance of certain objects, places, and things, sometimes accompany anxiety.
A panic attack is a severe form of anxiety that may occur suddenly and is marked with symptoms of nervousness, breathlessness, pounding heart, and sweating. Sometimes the fear that one may die is present.
Panic Disorder- Repeated episodes of intense fear that strike often and without warning. Physical symptoms include chest pain, heart palpitations, shortness of breath, dizziness, abdominal distress, feelings of unreality, and fear of dying.
Obsessive-Compulsive Disorder- Repeated, unwanted thoughts or compulsive behaviors that seem impossible to stop or control.
Post-Traumatic Stress Disorder- Persistent symptoms that occur after experiencing a traumatic event such as rape or other criminal assault, war, child abuse, natural disasters or crashes. Nightmares, flashbacks, numbing of emotions, depression and feeling angry, irritable, distracted and being easily startled are common.
Phobias- Two major types of phobias are specific phobia and social phobia. People with specific phobia experience extreme, disabling, and irrational fear of something that poses little or no actual danger; the fear leads to avoidance of objects or situations and can cause people to limit their lives unnecessarily. People with social phobia have an overwhelming and disabling fear of scrutiny, embarrassment, or humiliation in social situations, which leads to avoidance of many potentially pleasurable and meaningful activities.
Generalized Anxiety Disorder- Constant, exaggerated worrisome thoughts and tension about everyday routine life events and activities, lasting at least six months. Almost always anticipating the worst even though there is little reason to expect it; accompanied by physical symptoms, such as fatigue, trembling, muscle tension, headache, or nausea.
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Fears come from the unusual behavior accompanied with panic attacks. When a friend or family member has a panic attack he or she may suffer any of the following physical symptoms:
1. shortness of breath
2. increase of heart rate and blood pressure
3. vomiting or dry heaves
4. uncontrollable shaking
5. crying
6. dizziness
7. feelings of unreality (a feeling like nothing around them is
real)
8. paranoia
9. a desperate need to run or yell
10. fainting
11. confusion
It is important to understand if this person is suffering from anxiety or panic he or she WILL NOT DIE although they will claim they are doing just that. Here are some things you can do to help people through such episodes:
1. reassure them that you are there
2. remind them that it is a panic attack and that they are NOT
going to die
3. hold their hand or cradle them until the first wave of
intense fears begins to subside
4. help them take long deep breaths (much like recovering
from hyperventilation)
5. give them water
6. fan them with a shirt or other material
7. call their doctor or 911-IF NEEDED
8. bring them to a place where they feel less conspicuous (i.e.:
a rest room)
9. remind them that the feelings will pass
10. let them know you love them in spite of the problem
It is extremely important for people with anxiety to know their friends and family members love them and care about them even though they suffer with this problem. Many people with anxiety will suffer with self-esteem problems and the reassurance of love and acceptance is very important for the patient to have the confidence to seek proper help to become better.
More medications are available than ever before to effectively treat anxiety disorders. These include antidepressants or benzodiazepines. If one medication is not effective, others can be tried. New medications are currently being tested or are under development to treat anxiety symptoms.
The two most effective forms of psychotherapy used to treat anxiety disorders are behavioral therapy and cognitive-behavioral therapy. Behavioral therapy tries to change actions through techniques such as diaphragmatic breathing or through gradual exposure to what is frightening. In addition to these techniques, cognitive-behavioral therapy teaches patients to understand their thinking patterns so they can react differently to the situations that cause them anxiety.
It is common for an anxiety disorder to accompany another anxiety disorder, or in some cases depression, eating disorders or substance abuse. Anxiety disorders can also coexist with physical disorders. In such instances, these disorders will also need to be treated. Before undergoing any treatment, it is important to have a thorough medical exam to rule out other possible causes.
Panic disorder is frequently complicated by major depressive disorder and alcoholism and substance abuse disorders.