What Is Anxiety?
Overview of Anxiety
Anxiety, defined as “an emotion characterized by feelings of tension, worried thoughts and physical changes like increased blood pressure”, is actually a normal and healthy feeling. However, when one often feels increased levels of anxiety, it may be then seen as a medical diagnosis, termed “Anxiety Disorder”.
Learning about the normal feelings of anxiety and an anxiety disorder can help identify and treat the condition, allowing for a good quality of living.
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Where does Anxiety come from?
From our early days, sensing danger (such as predators) sets off signals in the body and allows us to take evasive action. These signals may present themselves in the form of a raised heartbeat, sweating, and increased sensitivity to surroundings.
The danger causes a rush of adrenalin, a hormone and chemical messenger in the brain, which in turn triggers these anxious reactions in a process called the “fight-or-flight” response. This prepares us to be able to physically confront or run from any potential threats and out of harm’s way.
In modern day circumstances, anxiety now revolves around work, money, family life, health, and other crucial issues that demand a person’s attention without necessarily requiring the ‘fight-or-flight’ reaction.
The nervous feeling before these potentially difficult situations is a related echo of the original ‘fight-or-flight’ reaction. It can still be useful to our survival, for example, having anxiety when you’re being robbed and instinctively being able to run away to avoid danger.
Anxiety disorder, also termed “Generalised Anxiety Disorder” is a mental health ailment that causes excessive nervousness, fear, apprehension, and worry.
This disorder alters how a person processes emotions and behave, also causing physical symptoms. Mild anxiety might be non-specific and unsettling, while severe anxiety may produce physical symptoms which seriously affect day-to-day living.
According to Business Insider, in a 2016 study, it was found that one in seven people in Singapore have experienced specific mood, anxiety, or alcohol use disorders in their lifetime.
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Symptoms of Anxiety Disorder
According to Medical News Today, while a number of different diagnoses constitute anxiety disorders, the symptoms of generalized anxiety disorder (GAD) will often include the following:
restlessness, and a feeling of being “on-edge”, uncontrollable feelings of worry, increased irritability, concentration difficulties, sleep difficulties, such as problems in falling or staying asleep.
While these symptoms might be normal to experience in daily life, people with GAD will experience them to persistent or extreme levels. GAD may present as vague, unsettling worry or a more severe anxiety that disrupts day-to-day living.
Types of Anxiety Disorder
The Diagnostic and Statistical Manual of Mental Health Disorders: Fifth Edition (DSM-V) classifies anxiety disorders into several main types.
In previous editions of DSM, anxiety disorders included obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD), as well as acute stress disorder. However, the manual now no longer groups these mental health difficulties under anxiety. Anxiety disorders now include the following diagnoses.
Generalized anxiety disorder: This is a chronic disorder involving excessive, long-lasting anxiety and worries about nonspecific life events, objects, and situations. GAD is the most common anxiety disorder, and people with the disorder are not always able to identify the cause of their anxiety.
Panic disorder: Brief or sudden attacks of intense terror and apprehension characterise panic disorder. These attacks can lead to shaking, confusion, dizziness, nausea, and breathing difficulties. Panic attacks tend to occur and escalate rapidly, peaking after 10 minutes. However, a panic attack might last for hours.
Panic disorders usually occur after frightening experiences or prolonged stress but may also occur without a trigger. An individual experiencing a panic attack may misinterpret it as a life-threatening illness, and may make drastic changes in behaviour to avoid future attacks.
Specific phobia: This is an irrational fear and avoidance of a particular object or situation. Phobias are not like other anxiety disorders, as they relate to a specific cause.
A person with a phobia might acknowledge a fear as illogical or extreme but remain unable to control feelings anxiety around the trigger. Triggers for a phobia range from situations and animals to everyday objects.
Agoraphobia: This is a fear and avoidance of places, events, or situations from which it may be difficult to escape or in which help would not be available if a person becomes trapped. People often misunderstand this condition as a phobia of open spaces and the outdoors, but it is not so simple. A person with agoraphobia may have a fear of leaving home or using elevators and public transport.
Selective mutism: This is a form of anxiety that some children experience, in which they are not able to speak in certain places or contexts, such as school, even though they may have excellent verbal communication skills around familiar people. It may be an extreme form of social phobia.
Social anxiety disorder, or social phobia: This is a fear of negative judgment from others in social situations or of public embarrassment. Social anxiety disorder includes a range of feelings, such as stage fright, a fear of intimacy, and anxiety around humiliation and rejection.
This disorder can cause people to avoid public situations and human contact to the point that everyday living is rendered extremely difficult.
Separation anxiety disorder: High levels of anxiety after separation from a person or place that provides feelings of security or safety characterise separation anxiety disorder. Separation might sometimes result in panic symptoms.
Causes of Anxiety Disorder
The causes of anxiety disorders are complicated. Many might occur at once, some may lead to others, and some might not lead to an anxiety disorder unless another is present.
Possible causes include:
environmental stressors, such as difficulties at work, relationship problems, or family issues, genetics, as people who have family members with an anxiety disorder are more likely to experience one themselves medical factors, such as the symptoms of a different disease, the effects of a medication, or the stress of an intensive surgery or prolonged recovery brain chemistry, as psychologists define many anxiety disorders as misalignments of hormones and electrical signals in the brain withdrawal from an illicit substance, the effects of which might intensify the impact of other possible causes.
Treatment of Anxiety Disorder
Treatments will consist of a combination of psychotherapy, behavioural therapy, and medication. Alcohol dependence, depression, or other conditions can sometimes have such a strong effect on mental well-being that treating an anxiety disorder must wait until any underlying conditions are brought under control.
Yoga can reduce the effects of an anxiety disorder.
In some cases, a person can treat an anxiety disorder at home without clinical supervision. However, this may not be effective for severe or long-term anxiety disorders.
There are several exercises and actions to help a person cope with milder, more focused, or shorter-term anxiety disorders, including:
Stress management: Learning to manage stress can help limit potential triggers. Organise any upcoming pressures and deadlines, compile lists to make daunting tasks more manageable, and commit to taking time off from study or work.
Relaxation techniques: Simple activities can help soothe the mental and physical signs of anxiety. These techniques include meditation, deep breathing exercises, long baths, resting in the dark, and yoga.
Exercises to replace negative thoughts with positive ones: Make a list of the negative thoughts that might be cycling as a result of anxiety, and write down another list next to it containing positive, believable thoughts to replace them. Creating a mental image of successfully facing and conquering a specific fear can also provide benefits if anxiety symptoms relate to a specific cause, such as in a phobia.
Support network: Talk with familiar people who are supportive, such as a family member or friend. Support group services may also be available in the local area and online.
Exercise: Physical exertion can improve self-image and release chemicals in the brain that trigger positive feelings.
A standard way of treating anxiety is psychological counselling. This can include cognitive-behavioural therapy (CBT), psychotherapy, or a combination of therapies.
CBT: This type of psychotherapy aims to recognise and change harmful thought patterns that form the foundation of anxious and troublesome feelings. In the process, practitioners of CBT hope to limit distorted thinking and change the way people react to objects or situations that trigger anxiety.
For example, a psychotherapist providing CBT for panic disorder will try to reinforce the fact that panic attacks are not really heart attacks. Exposure to fears and triggers can be a part of CBT. This encourages people to confront their fears and helps reduce sensitivity to their usual triggers of anxiety.
A person can support anxiety management with several types of medication.
Medicines that might control some of the physical and mental symptoms include antidepressants, benzodiazepines, tricyclics, and beta-blockers.
Benzodiazepines: A doctor may prescribe these for certain people with anxiety, but they can be highly addictive. These drugs tend to have few side effects except for drowsiness and possible dependence. Diazepam, or Valium, is an example of a commonly prescribed benzodiazepine.
Antidepressants: These commonly help with anxiety, even though they also target depression. People often use serotonin reuptake inhibitors (SSRI), which have fewer side effects than older antidepressants but are likely to cause jitters, nausea, and sexual dysfunction when treatment begins. Other antidepressants include fluoxetine, or Prozac, and citalopram, or Celexa.
Tricyclics: This is a class of drugs older than SSRIs that provide benefits for most anxiety disorders other than OCD. These drugs might cause side effects, including dizziness, drowsiness, dry mouth, and weight gain. Imipramine and clomipramine are two examples of tricyclics.
Additional drugs a person might use to treat anxiety include:
- Monoamine oxidase inhibitors (MAOIs)
Seek medical advice if the adverse effects of any prescribed medications become severe.
There are ways to reduce the risk of anxiety disorders. Remember that anxious feelings are a natural factor of daily life, and experiencing them does not always indicate the presence of a mental health disorder.
Take the following steps to help moderate anxious emotions:
- Reduce intake of caffeine, tea, cola, and chocolate.
- Before using over-the-counter (OTC) or herbal remedies, check with a doctor or pharmacist for any chemicals that may make anxiety symptoms worse.
- Maintain a healthy diet.
- Keep a regular sleep pattern.
- Avoid alcohol, cannabis, and other recreational drugs.
Anxiety itself is not a medical condition but a natural emotion that is vital for survival when an individual finds themselves facing danger.
An anxiety disorder, also known as General Anxiety Disorder, develops when this reaction becomes exaggerated or out-of-proportion to the trigger that causes it.
There are several types of anxiety disorder, including panic disorder, phobias, and social anxiety.
Treatment involves a combination of different types of therapy, medication, and counselling, alongside self-help measures.
An active lifestyle with a balanced diet can help keep anxious emotions within healthy limits.
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