Analysis Of Anxiety Disorder, Its Types, Symptoms, And Treatment

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Most of us, if not all of us, experience anxiety at some point in our life whether it be starting a new job, your wedding day, sitting exams, new social settings, meeting your partners parents. It is a feeling of worry, dread, uncertainty and perhaps fear of what if? Although anxiety is usually future focused, it can also present in experiences happening now. Short-term anxiety, which is the type that usually comes with the above mentioned events (sitting exams, attending an interview), can often be useful. That type of anxiety is more feeling nervous than fearful, which can in fact enhance your performance as you become more alert. However this is not always the case. When your anxiety gets to the point where it begins to overwhelm you that is when it starts really affecting your life. Your sleep may be disrupted, your ability to concentrate can deteriorate, you may lose your appetite and relationships may start to breakdown. Anxiety can get to the point where your entire day-to-day life is affected, and if it is severe then you may even have frequent panic attacks. Being one of the most common mental health conditions in Scotland, and in the UK, statistics show that 1 in 4 people in the UK suffer from anxiety, with it striking 8.2 million people alone in 2013. This essay is going to look at what anxiety is, some different types of anxiety disorders, symptoms, types of treatment and other contributing factors. The Mental Health Foundation UK define anxiety as ‘anxiety is a type of fear usually associated with the thought of a threat or something going wrong in the future, but can also arise from something happening right now.’. However, before this essay was written, the writer interviewed 25 volunteers to answer some questions around their anxiety, their treatment and their opinions on how society views anxiety. One thing that almost each person agreed on was the lack of support available for those suffering from mental health issues, and society’s views on same.

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Anxiety is such a large spectrum of symptoms, forming different types of anxiety disorders, such as panic disorder, generalised anxiety disorder (GAD), social anxiety disorder, post-traumatic stress disorder (PTSD) and obsessive compulsive disorder (OCD). Panic disorder is anxiety that results in frequent panic attacks, which is an exaggerated response of the body to stress, fear and/or excitement. Panic attacks usually come on suddenly, and can often have no apparent trigger. During a panic attack you may feel overwhelming sensations of dizziness, heart palpitations, sweating, the feeling of dread, chest pains to the point of thinking you are going to have a heart attack, amongst many other symptoms. This can be very frightening to someone who is suffering from panic disorder and can affect their day-to-day life in a way that prevents them from achieving their desires. Generalised Anxiety Disorder (GAD), the most commonly diagnosed anxiety disorder, is when you feel anxious most of the time. You may be more sensitive to your surroundings, and this impacts your life in a more significant way. For example it can affect your ability to do everyday things like work, social gatherings or simply leaving the house. You may feel that these restrictions are out-with your control. Those diagnosed with GAD can also experience physical symptoms such as tension, hot flushes, and possible disruption of sleep and/or feeling tired more often. This disorder can be exhausting on the mind and the body. Because GAD does not have specific symptoms like panic disorder has, it is often much harder to diagnose, therefore a diagnosis may come from an assessment of how often you have felt anxious over a 6-month period. If the answer is most days, then it is more likely you will be diagnosed with GAD. Social Anxiety Disorder is self-explanatory, it is anxiety before, during and/or after social events. Although many of us feel nervous at some social events, if you have social anxiety disorder you will feel a very intense feeling of fear/dread in a social setting. Experiencing social anxiety can be when you are meeting new people, speaking and/or performing in public, giving group presentations, or simply going out for dinner. A sense of embarrassment also comes with this, by feeling anxious that you might do something embarrassing or be fearful that you act in a way that does not meet the ‘criteria’ for the setting. Some of the symptoms of social anxiety can trigger more anxiety, for example you might worry that those who are with you may notice that you’re sweating, or that you are struggling to talk etc. This type of anxiety can lead to social exclusion because you may end up avoiding social events to prevent these feelings. Although often those who suffer from social anxiety acknowledge that their feelings are excessive, it is also difficult to redirect them. Post-Traumatic Stress Disorder is a type of anxiety that is caused by a traumatic experience in your life. This event will have provoked a sense of helplessness and fear in relation to life or injury. Experiences that can lead to PTSD include bereavement, miscarriage, serious assault, active duty in the military, abuse (emotional and physical) amongst many others. Obsessive-Compulsive Disorder (OCD) is when you have obsessions and/or compulsion that is out-with your control. Types of OCD include the constant need to clean things because of fear of contamination, constantly over-checking things to ensure safety and prevent harm to yourself or others, intrusive thoughts which can often be disturbing, and being unable to discard items that are no longer required or are broken, in other words hoarding. There are many more anxiety disorders out there, however just by highlighting the most common ones you will notice that a lot of symptoms overlap, thus making the diagnosis a little harder.

Medication is often offered firstly as treatment for those who suffer with anxiety. Serotonin-specific inhibitors (SSRIs) such as sertraline, paroxetine and citalopram, as well as Serotonin and norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine and duloxetine, are common treatments for anxiety and depression. Given the level of serotonin increase with these medications, an immediate side effect of these drugs can often be anxiety, and therefore the individual must be introduced gradually with this medication. These are usually longer-term solutions with benzodiaziepines being used for short-term anxiety, such as diazepam and lorazepam. Whilst medication is the most common treatment of anxiety, therapy is another. Different theoretical approaches investigates the origins of anxiety and treatment of same differently. A person-centred approach believes that anxiety is a natural process. It also believes that self-actualisation will occur through therapy when the internal and external states are brought together. A psychodynamic approach believes that the source of our anxiety is through our life experiences. Cognitive Behavioural Therapy (CBT) approach believes that anxiety is cause by a trigger to our fight or flight responses. This is also recommended by NICE (National Institute for Health and Care Excellence) as the psychological treatment for many anxiety disorders. However each individual is different and one approach alone may not work for an individual. A pluralistic approach looks at the individuals needs and therapist tailors the type of therapy to those specific needs. Along with medication and therapy, self-care is a significant piece of the puzzle into recovery. Because anxiety can affect an individual in so many different ways, it is often difficult to look after yourself. Getting out of the house, socialising with friends, doing what makes you happy – these can be difficult when you suffer from anxiety. There is so much online that is so easily accessible for self-care and anxiety, with apps being developed for your phone so that you don’t even need to leave the house to perform self-care. With their headline being ‘Live a healthier, happier, more well-rested life with Headspace.’, Headspace is an app designed for exactly what it says. That app in particular has so many different options to use it for, such as stress, anxiety, sleep and focus. There are meditation guides and also emergency exercises in case of sudden meltdowns. Self-help is a great tool in aiding recovery in mental health because its natural, and also mostly free. Another form of self-help, also being the most common type, is getting out in the fresh air and/or exercising. When you are doing this, it releases serotonin which helps improve your mood. Exercising, aerobic in particular, helps release stress and tension in your body. Going for a hike, playing tennis/football, cycling, or even walking can release that stress and tension that you hold on yourself, and it is recommended that you do 20 minutes per day of aerobic exercise to aid keeping good mental health. Of course, this is not always easily as anxiety can affect your motivation and/or your ability to carry out these types of tasks.

While there is no actual direct cause of anxiety disorders, there are many factors that can contribute to the development of an anxiety disorder. The development of an anxiety disorder can relate to a traumatic experience, underlying health issues, biological factors, stress, genetic pre-disposition, family members with anxiety and co-morbidity with other mental health issues. Looking at anxiety post traumatic experience, it does not always develop immediately following that event. Individuals who experience a traumatic event(s) in childhood are more likely to develop an anxiety disorder later in life. Experiencing one, or in fact multiple traumatic events, can reduce the individuals response to stress, and their ability to deal with stressful situations, which can then lead to an increase in their anxiety.

In many cases, anxiety can be related to underlying health issues/long-term health conditions, and it is very important to rule out medical factors when diagnosing anxiety disorders. According to the Mayo Clinic, a non-profit academic medical centre in the United States, these medical issues are often related to heart disease, thyroid problems, respiratory disorders, drug use and many more. Medication side effects can also have an impact on the individual causing them to develop anxiety. Along with the illness itself and its medication, the stress that relates to these illness can also have a significant impact on the individual, leading them to develop anxiety. The Writer in fact had a personal experience of this with a family member who developed COPD. The family member, who had never suffered from anxiety in the past and who was a very strong, outgoing individual, started to isolate themselves after a decline in their condition and later developed anxiety. Having long-term health conditions can have this affect on an individual, especially if the condition is life-threatening, with having concerns about treatment, fear of death, and worry of the impact their condition has on their family and friends. In addition to stress related to a health condition, life stressors and chronic illnesses can also lead to the development of an anxiety disorder. When a person continuously experiences stress, small or large, this can lead to an increase of worry. Stressors can be anything from work, relationships and finances, to the death of a family member. People who experience this type of stress on a regular basis are more likely to struggle with anxiety because there is potential for that type of regular stress to weaken their ability to cope. Because stress can be very overwhelming, it can also be that the brain has a more difficult time managing the stress which can lead to disordered ways of managing that stress – which can then lead to the development of an anxiety disorder.

Many studies show that chemical imbalance is a likely factor in people who develop anxiety disorders. Research shows that those who suffer from anxiety often have an imbalance of serotonin and norepinephrine. These chemicals influence your mood, sleep and emotions. Having this imbalance would lead to the development of an anxiety disorder. This can be treated by way of SSRIs and SNRIs, and benzodiazepines for shorter-term anxiety. Having said that, anxiety does often come along with other mental health disorders, such as depression, alcohol and drug misuse etc. When anxiety is present with conditions like this, the effectiveness of the anxiety treatment is reduced.

Many people who have relatives with anxiety disorders are also at a higher risk of developing an anxiety disorder. Although there still needs to be a lot more research done to determine how genetics are related to the development of anxiety, anxiety does often run in the family. There is current research that is looking for biomarkers for anxiety by using brain imaging technology as well as neurochemical measurements. This research is primarily focused on the genetic development of Generalised Anxiety Disorder (GAD).

As previously mentioned, before writing this essay the Writer met with people to discuss anxiety. Each person was asked the same ten questions; to rate their level of anxiety out of 10, what sort of things makes them feel anxious, have they been diagnosed with a specific anxiety disorder, are they receiving treatment (if so what type), do they feel that the treatment helps, does their condition effect their relationships with family/friends, does their condition impact their ability to work, how they feel society views anxiety, if they think there is enough support and lastly just to add any comments they had in relation to how they feel ‘the system’ is working. One thing that was consistent with everybody was that there was not enough help for people who suffer with anxiety, and mental health in general, unless you are literally on deaths door. It was said by 24 out of the 25 people that the support is not there for people, especially if you are undiagnosed. 23 out of the 25 people also said that when they first went to their doctor about their anxiety, it was a 5 minute appointment and they were offered anti-depressants without a length discussion into what exactly they were feeling. The volunteers were aged between 21 and 35, 24 of which had a diagnosis of an anxiety disorder and one who just manages it themselves due to the fear of medication. Another thing that came up with all volunteers was that society views anxiety poorly, as ‘attention seeking’ and/or being ‘dramatic’. It was the consensus between all individuals that there is a lack of education of mental health, which makes it a lot harder for people to come forward and admit they’re struggling and/or ask for the help that they need. They feel it is viewed by a large percentage of the population (in the areas that they live – which is Dundee and Glasgow) negatively in that it is seen as a weakness and a sign of the lack of ability to cope. After reading all responses and comments from the task, the Writer agrees with the general consensus of the lack of education of mental health, paying close attention to anxiety.

Anxiety is such a broad spectrum of symptoms that it can often be difficult to pin point the exact disorder. It is important that you are diagnosed correctly in order to receive the best and most effective treatment for you. There should be more education on mental health, what that looks like and where to seek help. There needs to be more support available in communities, with a much bigger public discussion of mental health. The stigma needs defeated, and discrimination abolished. Almost everyone will suffer from a mental health condition at some point in their life and it is so important that they receive the help that they need, when they need it. Society fails its people massively on this topic, and the NHS – although over-stretched financially, and lacking in space and staff, really need to do better. The government should allow more funding for the NHS as there is a massive increase of mental health in the UK, especially amongst young adults. Further research should be carried out into the biological side of anxiety to help early intervention where possible. Anxiety is a difficult condition to live with if you are not receiving help and the writer believes it to be true that if society were to be better educated on this issue, then society would be in a much better mental state. 

16 August 2021

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