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ANXIETY DISORDERS

by | Mar 2, 2021 | Mental Health, people, Self Esteem | 0 comments

ANXIETY DISORDERS, COPING MECHANISM AND HOW TO GET HELP

Anxiety refers to a sense of agitation or nervousness, which is often focused on an upcoming potential danger. We all as a living being often times feel afraid and anxious from time to time.

For instance: CASE A(extract from a client’s presenting complains)

Out of the blue, my heart started racing. I felt my chest. Then I broke into a cold sweat, began hyperventilating, and became convinced I was having a heart attack. The people in the car next to mine seemed totally unaware that anything was wrong. My heart just kept racing. I couldn’t stop it. I was going to die. How could I stop it? It was getting worse. I was dying! The driver behind me started blowing his horn. The light had turned green. I needed help. I couldn’t get out of the car. “God help me!” I prayed. Then it stopped—just like that, my heart stopped racing. I put my hand to my heart again. It felt normal. My hands and arms were covered with a cold clammy sweat. I wiped the perspiration from my face and look[ed] at myself in the rearview mirror.I didn’t like it .

From this case we noticed that this presenting symptom of this client are most atimes the every day bodily sensations, we develop whenever we are walking alone down a dark, quiet street late at night, first day at work, before a test etc.

Anxiety is a normal emotions which our brain’s way of reacting to stress and alerting us of a potential danger ahead. These feelings are adaptive, signaling the presence of a dangerous stimulus and leading us to be more alert.

Occasional anxiety is Ok. However, when levels of anxiety become inappropriately high, they stop being a proportionate response to the threats within the environment and become problematic to the individual experiencing them, that is ANXIETY DISORDERS.

ANXIETY DISORDERS  involves extreme anxiety, intense arousal that creates a  high level of distress and interfere with our normal functioning. Individuals with anxiety disorders typically overestimate the danger in situations they fear or avoid. These feelings of anxiety and panic interfere with daily activities, are difficult to control, are out of proportion to the actual danger and can last a long time. You may avoid places or situations to prevent these feelings. Symptoms may start during childhood or the teen years and continue into adulthood.

Anxiety disorders differ from normative fear or anxiety by being;

1.  excessive

2. Persisting beyond developmentally appropriate periods (typically lasting 6 months or more)

The excessive anxiety can make you avoid work, school, family get-togethers, and other social situations that might trigger or worsen your symptoms.

TYPES OF ANXIETY DISORDERS

1. Separation Anxiety disorders (SAD)

DSM-5 (APA, 2013), defines SAD as a developmentally inappropriate and excessive fear or anxiety concerning separation from those to whom the individual is attached.

Associated behaviours of children/adults with SAD

1. Children with SAD exhibit social withdrawal, apathy, sadness, or difficulty concentrating on work or play, school refusal which in turn leads to academic difficulties

2. Some individuals become homesick and uncomfortable to the point of misery when away from home.

3. When extremely upset at the prospect of separation, children may show anger or occasionally aggression toward someone who is forcing separation. When alone, especially in the evening or the dark, young children may report unusual perceptual experiences (e.g., seeing people peering into their room, frightening creatures reaching for them)

4. Children with this disorder may be described as demanding, intrusive, and in need of constant attention, and, as adults, may appear dependent and overprotective. The individual’s excessive demands often become a source of frustration for family members, leading to resentment and conflict in the family.

2. Selective mutism

DSM-5 (APA, 2013), defines selective mutism as a consistent failure to speak in specific social situations in which there is an expectation for speaking (e.g., at school) despite speaking in other situations.This  disturbance interferes with educational or occupational achievement or with social communication. Note that failure to speak is not attributable to a lack of knowledge of, or comfort with, the spoken language required in the social situation. The disturbance is not better explained by a communication disorder (e.g., childhood onset fluency disorder) and does not occur exclusively during the course of autism spectrum disorder, schizophrenia, or another psychotic disorder.

Associated behaviours may include excessive shyness, fear of social embarrrassment, social isolation and withdrawal, clinging, compulsive traits, negativism, temper tantrums, or mild oppositional behavior. Children with this disorder generally have normal language skills.

3. Specific phobias

 It is marked by fear or anxiety about a specific object or situation (e.g., flying, heights, animals,receiving an injection, seeing blood). Note: In children, thle fear or anxiety may be expressed by crying, tantrums, freezing, or clinging. The phobic object or situation almost always provokes immediate fear or anxiety and it is actively avoided.

CASE OF SPECIFIC PHOBIA (HYDROPHOBIA)

Kevin described an experience in which he almost drowned when he was 11. He and his parents were swimming in the Gulf of Mexico, in a place where there were underwater canyons with currents that would often pull a swimmer out to sea. He remembered the experience very distinctly. He was standing in water up to his neck, trying to see where his parents were. Suddenly, a large wave hit him and dragged him into one of the underwater canyons. Fortunately, someone on shore saw what had happened and rescued him. After the experience, he became very much afraid of the ocean, and the fear generalized to lakes, rivers, and large swimming pools. He avoided them all.

4. Social anxiety disorders

It is also called social phobia. It is marked by fear or anxiety about one or more social situations in which the individual is exposed to possible observation by others. Examples include having a conversation, meeting unfamiliar people,  being observed and performing in front of others. The individual fears that he or she will act in a way that will be negatively evaluated such as been humiliated or embarrassed or  will lead to rejection. The social situations almost always provoke fear or anxiety. In children, the fear or anxiety may be expressed by crying, tantrums, freezing, clinging, shrinking, or failing to speak in social situations.

Associated behaviours

1. Individuals with social anxiety disorder may be inadequately assertive or excessively submissive or highly controlling of the conversation.

2. They show overly rigid body posture or inadequate eye contact, or speak with an overly soft voice.

3. These idividuals may be shy or withdrawn, and they may be less open in conversations and disclose little about themselves.

4. They may seek employment in jobs that do not require social contact

5. Men may be delayed in marrying and having a family, whereas women who would want to work outside the home may live a life as homemaker and mother.

5. Self-medication with substances is common (e.g., drinking before going to a party).

6. Blushing is a hallmark physical response of social anxiety disorder.

CASE OF SOCIAL ANXIETY DISORDERS

Rachel was a twenty-six-year-old woman who worked as an assistant manager of a small bookstore. [She sought treatment] for her intense anxiety about her upcoming wedding. Rachel wasn’t afraid of being married (i.e., the commitment, living with her spouse, etc.); she was terrified of the wedding itself. The idea of being on display in front of such a large audience was almost unthinkable. In fact, she had postponed her wedding on two previous occasions because of her performance fears. . . .She reported being shy from the time she was very young. When she was in high school, her anxiety around people had become increasingly intense and had affected her school life. She was convinced that her classmates would find her dull or boring or that they would notice her anxiety and assume that she was incompetent. Typically, she avoided doing oral reports.

5.Panic disorders

It is a recurrent unexpected panic attacks. A panic attack is an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, and during which four (or more) of the following symptoms occur; palpitations, sweating, trembling or shaking, sensations of shortness of breath, feelings of choking, chest pain or discomfort, nausea or abdominal distress, feeling dizzy or faint, chills or heat sensations, numbness or tingling sensations, derealization or depersonalization, fear of losing control or “going crazy, fear of dying. The abrupt surge can occur from a calm state or an anxious state.

One type of unexpected panic attack is a nocturnal panic attack (i.e., waking from sleep in a state of panic, which differs from panicking after fully waking from sleep).

5. Agoraphobia

An intense fear of being in a place where it seems hard to escape or get help if an emergency occurs.  It is marked fear or anxiety about using public transportation (e.g., automobiles, buses, trains, ships, planes), being in open spaces (e.g., parking lots, marketplaces, bridges), being in enclosed places (e.g., shops, theaters, cinemas), standing in line or being in a crowd and being outside of the home alone. The individual fears or avoids these situations because of thoughts that escape might be difficult or help might not be available in the event of developing panic-like symptoms or other incapacitating or embarrassing symptoms (e.g., fear of falling in the elderly; fear of incontinence). The agoraphobic situations always provoke fear or anxiety and are actively avoided or require the presence of a companion.

6. Generalized anxiety disorder(GAD)

It is an excessive anxiety and worry (apprehensive expectation) about a number of events or activities. The individual finds it difficult to control the worry and to keep worrisome thoughts from interfering with attention to tasks at hand. Adults with generalized anxiety disorder often worry about everyday, routine life circumstances, such as possible job responsibilities, health and finances, the health of family members, misfortune to their children, or minor matters (e.g., doing household chores or being late for appointments). Children with generalized anxiety disorder tend to worry excessively about their competence or the quality of their performance.

7. Substance/Medication-Induced Anxiety Disorder

Anxiety is predominantly developed during or soon after substance intoxication or withdrawal or atter exposure to a medication such as alcohol, caffeine, cannabis, phencyclidine, other hallucinogens, inhalants, stimulants (including cocaine), and other (or unknown) substances.

Anxiety Disorder Symptoms

The main symptom of anxiety disorders is excessive fear or worry. Anxiety disorders can also make it hard to breathe, sleep, stay still, and concentrate.  Your specific symptoms depend on the type of anxiety disorder you have.

Common symptoms are:

  • Panic, fear, and uneasiness
  • Feelings of panic, doom, or danger
  • Sleep problems
  • Not being able to stay calm and still
  • Cold, sweaty, numb, or tingling hands or feet
  • Shortness of breath
  • Breathing faster and more quickly than normal (hyperventilation)
  • Heart palpitations
  • Dry mouth
  • Nausea
  • Tense muscles
  • Dizziness
  • Thinking about a problem over and over again and unable to stop
  • Inability to concentrate
  • Intensely or obsessively avoiding feared objects or places

RISK AND PROGNOSTIC FACTORS/ATIEOLOGY OF ANXIETY DISORDERS

The causes of anxiety disorders are yet to be ascertained by researchers/clinicians, but some factors  predisposes us to anxiety disorders and also worsen cases of anxiety disorder.

1. Genetic factors: Anxiety disorder can run the family and therefore makes it inheritable for next generations (e.g., an individual with a first-degree relative with a specific phobia of animals is significantly more likely to have the same specific phobia than any other category of phobia).

2. Biological factors: Research have suggests that anxiety disorders are linked to faulty circuits in the brain that control fear and emotions.

3. Environmental stress. This refers to stressful events you have seen or lived through. Life events often linked to anxiety disorders include childhood abuse and neglect, death of a loved one, or being attacked or seeing violence, childhood adversities(reduced warmth) and parental overprotection.

4. Temperamental. Underlying traits that predispose individuals to anxiety disorder include behavioral inhibition ( a personality type that shows a tendency toward distress and nervousness in new situations) and fear of negative evaluation.

5. Drug withdrawal or misuse. Certain drugs may be used to hide or decrease certain anxiety symptoms. Anxiety disorder often goes hand in hand with alcohol and substance use which in often times worsen cases of anxiety disorder.

6. Health conditions: For some people, anxiety may be linked to an underlying health issue. In some cases, anxiety signs and symptoms are the first indicators of a medical illness. Examples of medical problems that can be linked to anxiety include: Heart disease, diabetes, thyroid problems, such as hyperthyroidism, respiratory disorders, such as chronic obstructive pulmonary disease (COPD) and asthma, withdrawal from alcohol, anti-anxiety medications (benzodiazepines) or other medications, chronic pain or irritable bowel syndrome and rare tumors that produce certain fight-or-flight hormones. Sometimes anxiety are side effects of certain medications.

7. History of mental health disorder: Having another mental health disorder, like depression, raises your risk for anxiety disorder.

WHEN TO GET HELP

Your worries may not go away on their own, and they may get worse over time if you don’t seek help. See your doctor or a mental health provider if;

1. You feel like you’re worrying too much and it’s interfering with your work, relationships or other parts of your life

2. Your fear, worry or anxiety is upsetting to you and difficult to control.

3. You feel depressed, have trouble with alcohol or drug use, or have other mental health concerns along with anxiety.

4. You think your anxiety could be linked to a physical health problem

5. You have suicidal thoughts or behaviors — if this is the case, seek emergency treatment immediately.

The primary determination of whether the fear or anxiety is excessive or out of proportion is made by the clinician.

COPING MECHANISMS

It can be challenging and frustrating to live with an anxiety disorder. The constant worry and fear can make you feel tired and scared. If you’ve talked to a doctor about your symptoms, then you’ve taken the first step toward letting go of the worry.

These tips may help you control or lessen your symptoms:

1. Learn about your disorder. The more you know, the better prepared you will be to manage symptoms and roadblocks along the way.

2. Stick to your treatment plan. Suddenly stopping your meds can cause unpleasant side effects and can even trigger anxiety symptoms.

3. Cut down on foods and drinks that have caffeine, such as coffee, tea, cola, energy drinks, and chocolate. Caffeine is a mood-altering drug, and it may make symptoms of anxiety disorders worse.

4. Avoid  use of alcohol and recreational street drugs.

5. Brisk aerobic exercises like jogging and biking help release brain chemicals that cut stress and improve your mood.

6. Proper sleep hygiene

7. Learn to relax. Stress management is an important part of your anxiety disorder treatment plan. Things like meditation, or mindfulness, can help you unwind after a stressful day and may make your treatment work better.

8. Keep a journal. Writing down your thoughts before the day is down may help you relax so you’re not tossing and turning with anxious thoughts all night.

9. Manage your negative thought and  redirect your thoughts.

10. Get together with friends.

11. Seek support. Some people find it helpful and uplifting to talk to others who are experiencing the same symptoms and emotions. Self-help or support groups let you share your concerns and achievements with others who are or who have been there.

12. Ask your doctor or pharmacist before taking any over-the-counter meds or herbal remedies. Many have chemicals that can make anxiety symptoms worse.

ADVICE

Having an anxiety disorder does more than make you worry i.e it lead to, or worsen, other mental and physical conditions, such as: depression (which often occurs with an anxiety disorder), substance misuse, insomnia, digestive or bowel problems, headaches and chronic pain, social isolation, poor quality of life and possibly suicide.

Therefore it is advisable to get help early, participate in activities that you enjoy and makes you feel good about yourself, enjoy social interaction and caring relationships, and above all avoid substance/drug use.

ANXIETY DISORDERS IS A MENTAL HEALTH CONDITION BUT TREATABLE

IT IS NOT A DEATH SENTENCE BUT A MIRROR TO HELP.

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