Anxiety Disorders

Anxiety is a complex topic. It comes in many different forms and can also accompany other mental health issues. Left alone, anxiety can significantly impact your ability to think clearly, make good decisions, or even sleep at night.

Many anxiety medications are available, but these drugs alone won’t necessarily help the problem in the long term. Initially, these drugs relieve symptoms. But once they are discontinued, the anxiety often returns in full force. Some anxiety meds also have significant side effects such as sleep disruption, memory loss, and increased risk for addiction.

Research shows that psychotherapy, particularly cognitive behavioral therapy, is often more effective in the long run than medication. Sometimes medications are helpful in the short term, but treatment of anxiety should also include psychotherapy. Lifestyle habits like exercise, sleep, and avoiding caffeine also go a long way to reducing anxiety. Let’s take a look at some of the common forms of anxiety:

Sudden and overwhelming anxiety that causes you to feel like you will die or go crazy

This type of anxiety often comes suddenly and unexpectedly, and people experience extreme fear during the episode.  People frequently notice their heart racing, sweating, difficulty breathing, chest pain, nausea, dizziness, or hot flashes.  This type of anxiety is called a “panic attack.”  The attack itself lasts only minutes, but the person often feels uneasy or nervous for several hours afterwards.

Treatment for panic disorders usually involves a combination of medications and therapy.  Therapy often focuses on dealing with anxiety “triggers” that have been identified.

Intense fear from a traumatic event

This is anxiety in someone who has experienced a traumatic event where they felt that they might die. People with this type of anxiety re-experience the event over and over again through distressing memories, flashbacks, or nightmares. Because of their fear, they often avoid people, situations, or thoughts that will remind them of the experience. Many people feel detached from others or see no hope for their future. They may have difficulty sleeping and concentrating. Other people might notice that they are more irritable or angry than before the event. This type of anxiety is called posttraumatic stress disorder (PTSD).

Treatment for PTSD includes anti-anxiety and mood stabilizer medications along with psychotherapy. A specific type of therapy called exposure and response prevention can be helpful.

Worrying about one thing over and over

This type of worry is not merely excessive worry about real-life problems.  Instead, it is usually an irrational worry that is intrudes into your mind and is very difficult to push away.  The psychiatric manual describes these types of worries as “obsessions.” Many people who have these types of worries will feel that they need to perform certain actions over and over to reduce the distress from the worry or to prevent something bad from happening.  These actions are called “compulsions.” Obsessions and compulsions often go together.

Examples of obsessions include:

  • Cleanliness
  • Order
  • Symmetry
  • Intrusive Sexual Thoughts
  • Intrusive Religious Thoughts
  • Horrific Images
  • Fear that a mistake will harm a loved one

Examples of compulsions include:

  • Hand washing
  • Checking
  • Ordering or counting
  • Repeating words silently
  • Praying

Therapy for this type of disorder includes cognitive behavior therapy and medications that work on the serotonin receptors in your brain.

Worrying about many things for a long period of time

Generalized anxiety is a low level, fairly continuous anxiety that lasts for a long period of time (at least 6 months). For these people, everyday life produces anxiety. People with this type of anxiety are chronic worriers that often ask “what if” questions (e.g. “What if my husband divorces me?” “What if I lose my job?”).

Although medications can be used to treat this type of anxiety, psychotherapy can often be just as effective and decreases the risks of side effects.

Anxiety that is related to a medical disorder or medication

Certain medical conditions can cause symptoms of anxiety. There are also medications and over the counter drugs that can provoke anxiety. When this is the case, the treatment would be to address the medical illness or stop the medication that is causing these symptoms. Finally, withdrawal from certain drugs such as alcohol or caffeine can cause marked anxiety symptoms.

Medical Disorders that may cause anxiety:

  • Alcoholism
  • Heart problems
  • Adrenal gland diseases
  • Low blood sugar
  • Thyroid disease
  • Certain seizures
  • Premenstrual syndrome

Medications that may cause anxiety:

  • Amphetamines
  • Appetite suppressants
  • Asthma medications
  • Caffeine
  • Cocaine
  • Nasal decongestants
  • Steroids
  • Stimulants

Anxiety that is part of another mental health disorder

Anxiety is often present along with other mental problems. For example, many people with depression also have agitation and obsessive thoughts. It’s important to discuss these concerns with your mental health provider so that the correct treatment can be prescribed to treat the underlying mental health disorder.

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