Anxiety
Anxiety is a normal human emotion which we all experience from time to time. It is usually triggered by a perceived threat either from our environment or from within i.e. negative thoughts, emotions and physiological sensations.
We all seem to deal with anxiety in similar ways by trying to control our environment or our internal processes: avoiding the perceived threat, reassuring ourselves or asking for reassurance from others, rationalising, trying to predict possible outcomes and so on.
However, sometimes the ways in which we respond to anxiety can become a problem when it starts interfering with our lives and our day to day activities. These problematic responses to anxiety are known as Anxiety Disorders.
Anxiety Disorders can often be treated using Cognitive and Behavioural.
What is Anxiety?
Anxiety occurring in stressful situations is natural and helpful. For example, most people feel anxious before sitting an exam, or when their life is threatened. The automatic rush of adrenaline and nerve impulses which we have in response to stress can help us “fight or flight”.
When we are anxious, we feel fearful and tense: the release of stress hormones such as adrenaline, causes physiological symptoms: fast heart rate, palpitations, feeling sick, shaking, sweating, dry mouth, chest pain, headache and muscle tension to name a few.
These intense internal experiences when misinterpreted can result in Anxiety Disorders.
Anxiety Disorders
You may have an anxiety problem if anxiety interferes with your life. It is a common problem in our society: about 1 in 20 people have an anxiety disorder at any one time (Mental Health Foundation Statistics 2005).
Anxiety problems have been classified into different disorders according to symptoms, triggers and thoughts. It is common to have features of more than one disorder since they all share the same symptom: i.e. anxiety.
Anxiety may be a reaction to Stress
Acute reaction to stress
Usually occurs after an unexpected life crisis: accident, bereavement, family problems, bad news, etc. Symptoms described above, settle quickly but can last a few weeks. One can also feel irritable, low in mood, poor sleep, poor concentration, emotional ups and down.
Adjustment reaction
Similar to the above, but symptoms can develop days or weeks after the stressful situation as a reaction or adjustment to the problem. Other symptoms can include depression. Again these symptoms improve quite quickly.
Post traumatic stress disorder (PTSD)
Usually followed by a severe trauma such as a serious assault or a life threatening accident. Symptoms last at least a month and years if not treated. Anxiety is only one symptom of PTSD, the others are:
- Recurring thoughts, memories, images, dreams, or “flashbacks” of the trauma which are extremely distressing.
- Avoidance of situations, thoughts, feelings, conversations, people or anything that may remind the person of the trauma.
- Feeling “numb”, “detached” from life and others
- Loss of enjoyment, interests and plans for the future.
- Depression
- Increased “arousal”: difficulties sleeping and concentrating and “increased vigilance”
- Panic Attacks.
Phobic Anxiety Disorders
Social Anxiety Disorder
Probably the most common anxiety problem, whereby one fears the negative evaluation of others and tends to avoid meeting people or “performing” in front of people. This problem is often accompanied with low self-esteem and people may believe that others think of them as “stupid, inadequate, weak, foolish, crazy, and inferior” and so on. When unable to avoid social contact, people describe feeling embarrassed and ashamed and very anxious and distressed.
Agoraphobia
Again this is a common problem, and best described as a fear of public places, open places and unknown places. People with this problem often feel safe at home and the further they go away from their place of safety the greater anxiety they experience. They fear that away from their safety zone, help will not be available, or they will not be able to escape. Hence, they often avoid shops, crowds, travelling in trains, tube, planes, being on a bridge or in a lift, being in a cinema, a restaurant and anywhere they feel trapped, unable to escape to safety. Again, when confronted by their fear, people will feel extremely anxious, panicky and have intense urges to get out.
Other phobias
There are so many other phobias of a specific thing or situation: claustrophobia (confined spaces), animal, insect and reptile phobias, fear of blood or injections, fear of vomiting, fear of being alone, fear of choking and many more.
Other Anxiety Disorders
Panic Disorder
It is better known as recurring panic attacks. A panic attack is a severe attack of anxiety which occurs suddenly, often without warning and for no apparent reason. The anxiety symptoms that accompany a panic attack are usually extremely uncomfortable and include: a thumping heart, trembling, shortness of breath, chest pains, feeling faint or dizzy, numbness or pins and needles. They usually last 5-10 minutes and can come in waves for up to two hours.
Generalised Anxiety Disorder (GAD)
It is best described as a general state of anxiety, feeling fearful, worried and tense most of the time for as long as one can remember. The anxiety tends to be about various life stressors, often minor. The symptoms which have been described in the above conditions often come and go and are persistent. People often describe GAD as always worrying about something: feeling restless, on edge, unable to concentrate, feeling irritable, muscle tension and poor sleep.
Mixed Anxiety and Depressive Disorder
Some people experience anxiety as a symptom of depression. Other symptoms of depression are: low mood, intense sadness, sleeps disruptions, poor appetite, irritability, poor concentration, and decreased sex drive, loss of energy, guilt feelings, headaches, aches, pains and finding no enjoyment in life. (see section on depression)
Obsessive Compulsive Disorder (OCD)
OCD manifests itself in recurring obsessions and compulsions. Obsessions are intrusive recurrent thoughts, images, or urges that causes anxiety and disgust. Common obsessions are fear of contamination and fear of causing harm to self or others. Compulsions are thoughts or actions that one feels compelled to do and repeat as a result of the obsessions. The aims of the compulsions are to keep them or others safe. For example, someone with a fear of contamination, will repeatedly wash, avoid contaminant, check, and try to reassure oneself that they or their loved ones are safe. Another person with a fear of harm to others may avoid contact with people and may want to confess their intrusive thoughts to keep others safe. This problem is accompanied with high level of anxiety, panic attacks and depression. The condition can be all consuming and can be extremely debilitating.
Cognitive and Behavioural Treatment of Anxiety Disorder
Cognitive and Behavioural Therapy define anxiety disorders as an unhelpful response to a naturally occurring emotion. The problem is not the anxiety per se but the response people have to their anxiety.
Cognitive and Behavioural Therapy teaches people to become aware of their automatic reactions to Anxiety: their thoughts, beliefs, and behaviours and the affect it has on maintaining anxiety. It also teaches people how to cope with anxiety in a way that does not interfere with their day to day activities and longer term plans.
Cognitive and Behavioural Therapy is a goal orientated approach. The first meeting aim at gaining an understanding of the problem and identifying goals for treatment. The subsequent meetings aim at learning new ways of coping with anxiety, practicing new skills between sessions and getting one’s life back.
Helpful Addresses
Triumph Over Phobia (TOP UK)
www.triumpheverphobia.com
No Panic (National Organisation For Phobias, Anxiety, Neuroses, Information &Care)
www.nopanic.org.uk
Anxiety Care
www.anxietycare.org.uk
OCD Action
www.ocdaction.org.uk
OCD-UK
www.ocduk.org
First Steps to Freedom
www.first-steps.org