Lets learn about anxiety before learning about its management!

We all experience anxiety and unpleasant or scary circumstances. Anxiety is a sensation of fear that often disappears when a crisis is resolved. It is the protective biological response to danger that boosts heartbeat and breathing pumping oxygenated blood to your muscles as your body prepares to flight or fight called anxiety.

A certain amount of anxiety can even be helpful. The issue is that the system underpinning our anxiety response can occasionally become dysregulated, causing us to overreact or react inappropriately. If anxiety is persistent, excessive or routinely triggered by situation that aren’t an actual threat then it is anxiety disorder.

Definition

According to WHO, “Anxiety disorder is a mental illness characterized by excessive fear and worry and related behavioral disturbances.”

The Diagnostic and Statistical Manual (DSM-5) specifically describes anxiety as excessive worry and apprehensive expectations, occurring more days than not for at least 6 months, about a number of events or activities, such as work or school performance.

Anxiety in our brain

An anxiety attack starts with our sensory receptors; eyes, ears, nose receives the message, then the neurons in the brain steam begins to fire more intensely causing the neurotransmitter such as norepinephrine sends message to parts of brain to be alert while a typical response can be one of surprise or excitement but we interpret this experience as anxiety, which starts the cycle that increase the level of arousal.

The amygdala receives the information delivered to the brain, and the hippocampus, which is buried deep inside, picks up incoming signals and alerts the rest of our brains to danger. You never experience anxiety without it since it quickly processes feelings, emotions, and fear.

The hippocampus, on the other hand, records hazardous experiences as memories and evaluates impending dangers in light of previous encounters. When the threat is sensed, our hippocampus exchanges messages with other parts of our brain (such as our prefrontal cortex, which is responsible for planning) to decide whether to send a signal for the body to respond.

Anxiety in your body

When the brain makes a decision to act, the sympathetic nervous system is activated. Adrenaline and other hormones surge through the body. The heart rate increases, blood pressure rises, and breathing becomes rapid .Our body is now ready to fight or flee in the event of a real threat. Unfortunately, there is no actual bodily danger to us, so worry develops instead.

Forms of anxiety

Anxiety is not a one-size-fits-all disorder; it can manifest in many different ways. Some of the type of anxiety are listed below;

Generalized anxiety disorder (GAD)

A pattern of excessive worry about a variety of issue on most days for at least six months, often accompanied by physical symptoms such as muscle tension, a hammering heart and dizziness. People with GAD worry about health, finances, family member, having an accidents-nearly everything. When one worry goes away another takes place.

Social anxiety disorder (SAD)

People with social anxiety disorder have intense fear of being embarrassed or judged during social situation like going to a party or giving a speech. The fear may cause blushing, shaking or acting in ways that will make other think they are strange or anxious.

Panic disorder

Panic attacks are sudden, intense episodes of panic with physical symptoms such as racing heart, chest pain, breathlessness, dizziness and dread. “It’s the feeling you’d have if you just missed being hit by a truck but for people with panic disorder there is no truck ”

Phobias

People with specific phobias fear objects or situation such as animals or heights. Most phobias are about things most people fear; however the fear or anxiety is out of proportion to actual danger in those with anxiety. A particular animal, insect, object or situation causes substantial anxiety.

Agoraphobia

People with agoraphobia often avoid these situations, in part, because they think being able to leave might be difficult or impossible in the event they have panic-like reactions or other embarrassing symptoms. In the most severe form of agoraphobia, an individual can become housebound.

Where does anxiety stem from?

Like other types of mental illness, anxiety disorders are unpleasant. They don’t come from personal weakness, character flaws or problems with upbringing. Some people don’t have anxious feeling their entire lives; other do not experiences anxiety until after an event or trauma triggers it. But the specific source of anxiety problems is unknown to academics. Each person’s unique combination of factors is thought to contribute to anxiety. They suspect a combination of factors plays a role:

• • Chemical imbalance: Severe or long-lasting stress can change the chemical balance that controls your mood. An anxiety disorder might develop if you are under a lot of stress for an extended length of time.

• • Environmental factors: Experiencing a trauma might trigger an anxiety disorder, especially in someone who has inherited a higher risk to start.

• • Heredity: There is a familial tendency for anxiety problems. You may inherit them from one or both parents, like eye color.

• • Brain injury: If a person had injury in head that affected cells and production and proper development  of cells that can lead to have poor communication between body and brain causing the person to have anxiety.
    
    

Symptoms

We must be able to identify the signs that an anxiety disorder sufferer exhibits in order to treat them before it is too late. 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. Our specific symptoms depend on the type of anxiety disorder you have .Some of the common symptoms are :

Physical

• • Cold, sweaty, numb, or tingling hands or feet

• • Shortness of breath

• • A churning feeling in your stomach.

• • Feeling light-headed or dizzy.

• • Feeling restless or unable to sit still.

• • Headaches, backache or other aches and pains.

• • Faster breathing.

• • A fast, thumping or irregular heartbeat.

• • sweating or hot flushes

• • Heart palpitations

• • Dry mouth

• • Nausea

• • Tense muscles

• • Dizziness
    
    

Emotional symptoms

• • Not being able to stay calm and still

• • Panic, fear, and uneasiness

• • Feelings of panic, doom, or danger

• • Difficulty controlling feelings of worry.

• • Having sleep problems, such as difficulty falling or staying asleep.

• • Needing reassurance

• • Lack of patience
    
    

Mental symptoms

• • Thinking about a problem over and over again and unable to stop (rumination)

• • Inability to concentrate

• • Feeling tense

• • Nervous most of the time

• • Unable to relax

• • Memory issue

    As we have finally learnt about what the anxiety means, we now can carry out the management skills to deal with anxiety.

Anxiety management

We don’t get rid of anxiety by trying to get rid of it, truth is we can’t get rid of anxiety at all. Anxiety is not an illness it is an emotion and every emotion is important. Every emotion has a purpose. We just need to learn to manage it. The cycle of anxiety includes four stages:

• • Stage 1. Feeling anxious and wanting to deal with it.

• • Stage 2. Attempting to avoid the situation.

• • Stage 3. Feeling a temporary sense of relief

• • Stage 4. Returning to a state of heightened anxiety.

To break this cycle of anxiety one must feed in their mind that avoidance feed disordered anxiety. It’s possible to break the cycle of anxiety by reversing it. We can consider the following 4-step reversal process:

• • Step 1. Try to confront feared situations without the help of “safety behavior” situations (or unhealthy coping mechanisms).

• • Step 2. Allow yourself to experience a short-term or slight increase in anxiety, followed by a decrease in physical symptoms.

• • Step 3. Lean into healthy coping skills to help you reduce your anxiety to a manageable level.

• • Step 4. Consider your ability to control your reactions and responses.

With this simple step we can manage the anxiety level in our body maintain our usual productive selves before turning it to anxiety disorder. 

Coping with anxiety

A person’s ability to cope separates worries or anxious moment from anxiety disorder so it is really important to find out the coping method that fits you the most. Coping method with anxiety varies from person to person. Some of the common healthy coping method are listed below:

Changing lifestyle: Changing the busy and unhealthy lifestyle with lifestyle with enough sleep, healthy diet and alone quality time can help reduce anxiety in person.

Social support: People with good social life is less like to have anxiety disorder. If person with anxiety disorder get good amount of social support then their anxiety can be managed. So surrounding yourself with good people can be beneficial for mental health.

Self-care and self-help: Self-care and self-help can help the person boost the selfconfidence which changes thinking themselves and lowers the chances of anxiety disorder.

Meditation and relaxation: Meditation and relaxation can be helpful in coping with anxiety by reducing stress and it is also helpful for development of happy hormones which are ultimately responsible for mood balance and positivity.

Treatment for anxiety disorder

With increasing in the number of anxiety disorder among the people. Researchers have found various psychotherapy and medication for the disordered anxiety. Some are explained below:

Psychotherapy

Psychotherapy that is considered best for the anxiety disorder are explained in brief:

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) is a treatment approach that helps you recognize negative and unhelpful thoughts and behavior patterns. CBT aims to help you identify and explore the ways your emotions and thoughts an affects your action.

Exposure therapy

Exposure therapy is a psychological treatment that was developed to help people confront their fear. It recommended in order to help break the pattern of avoidance and fear by exposing individual to things they fear and avoid. It is scientifically demonstrated to be helpful for all kind of anxiety.

Acceptance and commitment therapy (ACT)

Acceptance and commitment therapy is an action oriented approach to psychotherapy in which clients learn to stop avoiding denying and struggling with their inner emotion and instead accept that these deeper feeling are appropriate responses to certain situation that should not prevent them forward in their lives. This therapy encourages people to embrace their thoughts and feeling rather than fighting or feeling guilty for them.

Medication

There are medication that are proven to cure the anxiety if taken under observation of your psychiatrist. But it is believed to be highly effective if one tends to go through counseling and medications side by side.

Around 23% of Nepal’s population is affected by anxiety. Anxiety is not inherently bad. It can be uncomfortable and disordered when it interferes with our ability to function but we all experience anxiety because it is supposed to serve a really important function, to motivate us to avoid real danger. So we must learn the best coping method for anxiety to make anxiety our plus point instinct of body to protect than the hindrance to our productivity.

Reference

 Harvard health publishing, WHO, Researchgate.com, national institute of mental health, Cleveland clinic, psyche central, the anxiety workbook by Arlin Cuncic.