ANXIETY – Being afraid of your own mind!
Published on: 30 June, 2019
Anxiety - Symptom or Disorder?
Sometimes a symptom and at other times a disorder, anxiety itself is not a medical condition but a normal reaction, that is vital for survival when people find themselves in a dangerous situation. The American Psychological Association (APA) refers to anxiety as, "an emotion characterized by feelings of tension, worried thoughts and physical changes like increased blood pressure." However, when a person regularly feels disproportionate levels of anxiety, it potentially becomes a medical disorder. The APA describes a person with anxiety disorder as "having recurring intrusive thoughts or concerns”, that interfere with day to day functioning of a person.
Due to functional and structural imaging, pathophysiology of anxiety disorders is perceivable. Fear and anxiety are modulated by a region of brain known as amygdala. The enhanced response to anxiety signals is often associated with hyperresponsiveness of amygdala. This over activity of the amygdala may also reduce the responding threshold levels for anxiety cues. The major symptoms of anxiety disorders are mediated via norepinephrine, serotonin, dopamine, and gamma-aminobutyric acid (GABA). Other neurotransmitters and peptides, such as corticotrophin-releasing factor (CRF), may also be involved. Peripherally, the autonomic nervous system, particularly the sympathetic nervous system, is responsible for many of the symptoms.
Following are a few symptoms of anxiety disorders:
- Excessive worrying: The worrying associated with anxiety disorders is highly significant as compared to the events that trigger it, and typically occurs as a result of normal routine situations.
- Agitated behaviours: During an anxiety attack, part of sympathetic nervous system becomes super-activated resulting in racing pulse, sweaty palms, shaky hands and dry mouth. Body shunts blood away from digestive system, and towards the muscles in case of the fight or flight response. It also increases heart rate and enhances sense. All these responses are very beneficial in the case of an actual threat, but are equally incapacitating, if the fear exists just in the head.
- Restlessness: It is often described as the feeling of being “on the edge” or having an “uncomfortable urge to move.” While restlessness does not manifest in all the people with anxiety, it is one of the major symptoms doctors consider when making a diagnosis.
- Fatigue: For some, fatigue can follow an anxiety attack, while for others, it can be chronic.
- Difficulty concentrating: Anxiety can interrupt short-term memory functions.
- Irritability: Anxiety is associated with too much worrying. Hence, it is not unexpected that irritability is a very common symptom.
- Trouble sleeping: Sleep problems are very common in people with anxiety. Treating the cause can usually help improve quality of sleep as well.
- Panic attacks: They produce a strong, overpowering sensation of fear that can be often incapacitating.
- Avoiding social situations: People may appear exceptionally shy and quiet in gatherings, or when meeting new people. While they may not look distressed at all, deep inside they feel extremely fearful and anxious.
- Irrational fears: Irrational fears that interfere with daily functioning may prove to be a sign of a phobia. All phobias lead to avoidance behaviour, and the state of being very fearful.
- Generalised Anxiety Disorders (GAD): A person has general feelings of worry and spends most of his/her days worrying about plethora of different matters, for a period of six months or more.
- Social Anxiety: A person is very fearful of being criticised or humiliated, even in the case of day to day situations, such as in gatherings, eating in public, being assertive at work, or making small talk.
- Specific Phobias: A person feels very fearful about a specific object or condition, and may go to great extent to avoid it. There are many types of phobias. For example, the fear of dogs (cynophobia), fear of confined spaces (claustrophobia), fear of heights (acrophobia) or water (aquaphobia) etc.
- Panic Disorder: A person experiences panic attacks, which is an uncontrollable feeling of anxiety, also exhibiting physical symptoms such as shortness of breath, chest pain, dizziness and excessive perspiration.
- Obsessive Compulsive Disorder: A person has unwanted bad thoughts and fears that cause anxiety. They often try to lower their anxiety by performing certain behaviours repeatedly. For example, a fear of germs (mysophobia) can cause excessive washing of hands and clothes.
- Post-Traumatic Stress Disorder (PTSD): This can happen after a traumatic event (e.g. war, assault, accident, disaster). PTSD is diagnosed when a person has symptoms for at least a month.
Antidepressant class of drugs are prescribed to control the symptoms of anxiety disorders as seen suitable by a psychiatrist. Anxiolytics are used to lower anxiety levels of patients. Along with the medication, psychotherapy is also very beneficial for such patients. A mental health specialist will help patients in coping with anxiety via counselling and cognitive behavioural therapies.
POLHN’s Contribution to the Cause:
Pacific Open Learning Health Net (POLHN) is working in collaboration with WHO to provide a free mental health course for healthcare professionals, and train them for treating patients who need mental healthcare.
POLHN also offers free online mental health courses with certificates to encourage health workers to scale-up care for mental, neurological and substance-abuse problems.
The mental health course for healthcare professionals not only helps health workers in learning more, but also assists everyone in better serving the humanity. POLHN’s free online mental health training courses are recognised worldwide. Students/professionals who enrol, gain a significant scope of knowledge that is widely applicable in the domain of medical sciences. POLHN targets the Pacific Island region to deliver optimum medical facilities and enhance health standards in the area.
Significant Features of the Course:
The purpose of this course is to enable students in developing their understanding regarding:
- Strategies for the establishment of communication, and building of trust
- Different mental health conditions prevalent across the globe
- The physical conditions underlying these mental health conditions
- Protecting the user of various psychotic drugs from drug abuse and self-harm
- Tools for the establishment of the basic psychological support levels
- First-line medication treatment
- Brief motivational interventions
- Management of clinical emergencies
- Follow-up and referral systems