Anxiety is a normal part of life, everyone feels nervous before an exam, a job interview, or a major life event. However, when anxiety becomes persistent, excessive, and difficult to control, interfering with daily activities, it may be a sign of Anxiety Disorder. While occasional anxiety is a normal stress response, anxiety disorders involve intense and often irrational fear or worry that is out of proportion to the actual situation and lasts for months or longer.

About 25–30% of adults will experience an anxiety disorder at some point in their lives. In this post, we’ll explore what anxiety disorder is, how it is classified, and how it can be managed according to current medical guidelines.

Common Types of Anxiety Disorders

• Generalised Anxiety Disorder (GAD): Persistent and excessive worry about various aspects of daily life, often without a specific cause.
• Panic Disorder: Unexpected sudden episodes of intense fear that peak within minutes, often with physical symptoms like chest pain, shortness of breath, or palpitations.
• Social Anxiety Disorder (Social Phobia): Intense fear of social situations where one may be judged, embarrassed, or scrutinised by others.
• Phobias: Extreme fear of specific objects or situations (e.g., heights, flying, animals) that leads to avoidance behaviours.
• Agoraphobia: Fear and avoidance of places or situations where escape might be difficult or help unavailable in the event of panic-like symptoms.
• Separation Anxiety Disorder: Excessive fear or anxiety about being separated from attachment figures.
• Selective Mutism: Consistent inability to speak in certain social situations, despite speaking comfortably in others (mainly children).

The most common anxiety disorder overall is Specific Phobia. Social Anxiety Disorder and Generalised Anxiety Disorder (GAD) follow closely behind. Specific Phobia often begins in childhood and can persist if untreated. GAD tends to have a later onset (20s–30s) and is more chronic and disabling over time if untreated. Panic attacks occur in 2-3% of the population.

Generalised Anxiety Disorder

Generalised Anxiety Disorder (GAD) is a chronic mental health condition characterised by excessive, uncontrollable worry about a variety of everyday things, such as health, work, social interactions, or routine life circumstances, for at least six months.

Panic Attack and Panic Disorder

• A panic attack is a sudden episode of intense fear or discomfort that peaks within minutes and often occurs unexpectedly.
• Symptoms of a panic attack include:
  • Rapid heart rate, chest pain, palpitations
  • Shortness of breath, hyperventilation
  • Trembling, sweating, chills or hot flushes
  • Nausea, abdominal distress, dizziness
  • Fear of losing control, going crazy, or dying
  • Detachment from reality (depersonalization or derealization)

Panic disorder is diagnosed when a person has recurrent, unexpected panic attacks and persistent concern about having more attacks.

Which Groups are More Affected?

• Females > Males (about 2:1 ratio)
• Younger adults (late teens to 30s) are more commonly affected.
• People with chronic physical illnesses (e.g., cardiovascular disease, diabetes) have higher rates.
• Those with a family history of anxiety or mood disorders have a higher risk.

Treatment Approaches

1. Psychotherapy

• Cognitive Behavioural Therapy (CBT) is the first-line treatment. CBT helps patients recognise, understand, and modify patterns of thinking and behaviour that contribute to anxiety.

2. Pharmacotherapy:

Medications are considered when symptoms are moderate to severe, or psychotherapy alone is insufficient.

• First-line:
  • Selective Serotonin Reuptake Inhibitors (SSRIs) like sertraline, escitalopram.
  • Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) like duloxetine.
• Second-line or adjunctive:
  • Pregabalin
  • Benzodiazepines (only short-term use due to risk of dependence)
  • Beta-blockers and other medications may help with physical symptoms

3. Lifestyle Modifications

• Regular physical activity (aerobic exercise)
• Adequate sleep hygiene
• Stress management techniques (like yoga, meditation, and deep breathing exercises)
• Limiting caffeine and alcohol intake.

Conclusion:

Anxiety disorder is a common but treatable condition. If left untreated, anxiety disorder can cause dysfunction in various organs (like the heart, brain, endocrine, metabolic, etc.) in our body. Early recognition, proper classification, and evidence-based treatment are key to improving outcomes.

Citations:

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