anxiety

 the different types of anxiety

Anxiety can range from the constructive kind that elevates performance as with performance anxiety, to disorders of anxiety, in that the individual suffers from a level of fear, angst, or dread that interferes with his or her ability to function. The most common anxiety disorders are specific phobias. Other anxiety disorders include social anxiety disorder, panic disorder, generalized anxiety disorder, obsessive compulsive disorder, and posttraumatic stress disorder.

anxiety symptoms and signs

Common symptoms and signs of anxiety can include

• restlessness or feeling edgy,
• becoming tired easily,
• trouble concentrating,
• feeling as if the mind is going "blank,"
• irritability,
• muscle tension,
• sleep problems (trouble falling or staying asleep or having sleep that is not restful).

Anxiety that is associated with specific (specific or simple phobia) or social fears (social phobia) may also result in avoidance of certain situations or an elevation to the level of panic symptoms. In addition to the more general symptoms of anxiety previously described, worry that is associated with a traumatic event (posttraumatic stress disorder) may also result in the following symptoms:

• Avoidance of people, places, or situations that are reminiscent of the traumatic event
• Re-experiencing the trauma in repeated nightmares or flashbacks
• Difficulty trusting others
• Excessive attention to staying safe or keeping loved ones safe (for example, hypervigilance)
• A tendency to startle easily
• A sense of a bleak or foreshortened future

When anxiety intensifies to the level of becoming a panic attack, signs and symptoms can include

• palpitations;
• chest pain, chest tightness, feeling like one is having a heart attack;
• shortness of breath or trouble breathing;
• sweating of the palms;
• nausea or other stomach upset;
• trembling or shaking;
• feeling dizzy, unsteady, lightheaded, or faint;
• derealization (feelings of unreality) or depersonalization (feeling detached from oneself);
• fear of losing control or going insane;
• numbness or tingling sensations;
• chills or hot flashes;
• feeling like one is choking;
• a sense of impending doom;
• feeling like one is dying.

treatment for anxiety

There are a variety of treatments available for controlling anxiety, including several effective medications and specific forms of psychotherapy. In terms of medications,buspirone (Buspar) is known to be quite effective for treating GAD. However, it seems to be less effective in managing many other disorders that often co-occur (are comorbid) with GAD. Therefore, specific members of the selective serotonin reuptake inhibitor (SSRI) and the selective serotonin and norepinephrine reuptake inhibitor (SSNRI) drug classes, which are also approved by the U.S. Food and Drug Administration (FDA) for effective treatment of GAD, are prescribed more often. Examples of SSRI medications includefluoxetine (Prozac), sertraline (Zoloft),paroxetine (Paxil), citalopram (Celexa), andescitalopram (Lexapro). Examples of SNRI medications are duloxetine (Cymbalta) andvenlafaxine (Effexor). Although buproprion (Wellbutrin) is primarily known to primarily treat depression, preliminary research suggests that it may also be helpful in the treatment of anxiety.

Benzodiazepine medications likeclonazepam (Klonopin) and lorazepam(Ativan) are more useful in stopping severe anxiety symptoms, like those that occur in panic disorder or in posttraumatic stress disorder rather than the ongoing worry that is usually associated with GAD. Althoughalprazolam (Xanax) is often used to treatpanic attacks, its short duration of action can sometimes result in having to take it several times per day. Medications from the beta-blocker family (for example,propranolol [Inderal]) are sometimes used to provide rapid relief of the physical symptoms associated with a panic attack. Some individuals who suffer from severe panic attacks may benefit from treatment with neurontin (Gabapentin), which was initially developed to treat seizures, or may benefit from a neuroleptic medication like risperidone (Risperdal), olanzapine(Zyprexa), quetiapine (Seroquel), or aripiprazole (Abilify). Zolpidem (Ambien) has been found helpful in treating the insomnia that can often be a symptom of anxiety.

Before SSRIs and SSNRIs became available, medications from the group known as the tricyclic antidepressants (TCAs) were often used to address panic disorder. Although TCAs have been found to be equally effective in treating panic attacks, SSRIs and SSNRIs have been proven to be safer and better tolerated. Therefore TCAs are used much less often than they used to be. When used in the appropriate person with close monitoring, these medications can be quite effective as part of treatment for panic disorder.

For individuals who may be wondering how to avoid panic attacks using treatment without prescribed medications, natural remedies may be an option. While treatment like hypnosis and herbal supplements that containkava have been found to be helpful for some people with some anxiety disorders, the research data are still considered to be too limited for many physicians to recommend treatment with other natural remedies like valerianor passionflower. Also, care should be taken when taking any dietary supplements, since dietary supplements and "natural" remedies are not regulated in terms of quality, content, or effectiveness.

The psychotherapy component of treatment for anxiety disorders is at least as important as the medication treatment. In fact, research shows that psychotherapy alone or the combination of medication and psychotherapy treatment are more effective than medication alone in overcoming anxiety for both adults and children. It has also been found to be potentially effective for people with autism in addition to anxiety. The most common type of therapy used to treat anxiety is cognitive behavioral therapy (CBT). This form of therapy seeks to help those with an anxiety disorder identify and decrease the irrational thoughts and behaviors that reinforce anxiety symptoms and can be administered either individually, in group therapy, and even in partner-assisted therapy. CBT that seeks to help the anxiety sufferer decrease the tendency to pay excessive attention to potential threats has also been found to be helpful.

Behavioral techniques that are often used to decrease anxiety include relaxation techniques and gradually increasing exposure to situations that may have previously precipitated anxiety in the individual. Helping the anxiety sufferer to understand and how to handle the emotional forces that may have contributed to developing symptoms (anxiety-focused psychodynamic psychotherapy) has also been found to be effective in teaching an individual with panic disorder how to prevent an anxiety attack or to decrease or stop a panic attack once it starts.

Often, a combination of psychotherapy and medications produces good results. Improvement is usually noticed in a fairly short period of time, about two to three months. Thus, appropriate treatment for anxiety can prevent symptoms or at least substantially reduce their severity and frequency, bringing significant relief to many people with anxiety. There are also self-care measures that people with anxiety can do to help make treatment more effective. Since substances like caffeine, alcohol, and illicit drugs can worsen anxiety, those things should be avoided. Other tips to prevent or manage anxiety symptoms include engaging in aerobic exercise and stress-management techniques like deep breathing, massage therapy, and yoga, since these self-help activities have also been found to help decrease the frequency and severity of symptoms. Although many people breathe into a paper bag when afflicted by the hyperventilation that can be associated with panic, the benefit received may be the result of the individual believing it will remedy the symptoms (placebo effect). Also, breathing into a paper bag when one is having trouble breathing can make matters worse when the hyperventilation is the result of conditions of oxygen deprivation, like anasthma attack or a heart attack.

People with an anxiety disorder may also need treatment for other emotional problems. Depression has often been associated with anxiety, as have alcohol and drug abuse. Recent research also suggests that suicideattempts are more frequent in people with an anxiety disorder. Fortunately, these problems associated with panic disorder can be overcome effectively, just like panic disorder itself. Sadly, many people with anxiety do not seek or receive treatment.