Anxiety

All of us experience anxiety at different times in our lives. Anxiety is a common emotion and part of a repertoire of emotions such as joy, sadness and anger. We experience all these emotions at varying levels on a day to day basis. The extent of each emotion experienced on any particular day is dependent on our circumstances at home, work and other factors.

Anxiety

So when does Anxiety become a problem? When to seek help?

Anxiety becomes a problem when we are overwhelmed with daily life, worry excessively over trivial matters, become easily irritable or annoyed, unable to relax and have difficulties with sleep.

There are several other symptoms that indicate clinical anxiety, however the above symptoms are most commonly experienced. There are several types of anxiety disorders such as Generalized Anxiety Disorder, Social Phobia, Specific Phobia , Post Traumatic Stress Disorder and Obsessive Compulsive Disorder.

Anxiety Disorders are one of the most common medical conditions. In Adolescents, about 30% of them meet clinical criteria for Anxiety, and, in Adults 1 in 4 people meet criteria for an Anxiety Disorder in their lifetime. Given this high prevalence, what prevents people from seeking help?

The stigma of having ‘mental illness’ is still very prevalent, in spite of the tremendous advances made in diagnosing and treating psychiatric disorders such as Anxiety, Depression, OCD, Autism and other conditions. We have a huge body of literature on the etiology of these conditions. Valid diagnostic assessments and treatments that work have been developed.

Regardless of the advances made in Neuroscience, pharmacological treatments and empirically validated therapies, people still feel a sense of shame about seeking help for psychiatric disorders. Many feel they have failed themselves and their families as they experience debilitating symptoms of anxiety and/or depression. They do not realize that this feeling of failure/shame/guilt is itself a symptom that needs intervention.

I have patients come in and say they do not know what depression is, and who were told by their counselor or family member to seek help for their problems. Many of them are quite successful in their careers and have families. This makes it harder for people to think they may have an Anxiety Disorder or Depression. For many, clinical Anxiety/Depression makes it harder to be successful at work, school, in social settings and in relationships.

What causes Anxiety?

What causes anxiety? Anxiety is a heritable condition, meaning if someone in the family has an Anxiety Disorder, there are high chances that their children and grandchildren will inherit those genes. This is called genetic predisposition to a condition. Other risk factors include medical illnesses, workplace stress, school stress, relationship issues, financial stress and history of abuse ( verbal, physical, sexual).

The onset of symptoms of clinical anxiety is gradual and builds to a point where a person finds it difficult to function, may have frequent meltdowns (in public or private), not enjoying life as they used to, less interest in activities and generally trudging through life. A serious symptom of severe anxiety and depression is the occurrence of suicidal thoughts. Again, many feel this is a failing on their part and do not realize that feeling suicidal or wishing they were dead is a symptom of severe Anxiety/Depression. Most often, depression accompanies Anxiety and one needs to be assessed for both conditions and treatment planned accordingly.

Anxiety and depression, if left untreated, can lead to serious consequences that include failed relationships, loss of employment/productivity, divorce and poor health overall. Most psychiatric disorders including Anxiety and Depression start before age 14, and most often continue into adulthood if not treated.

Mild anxiety and depression symptoms can be treated by counseling. There are several modalities of therapy such as Cognitive Behavioral Therapy and Interpersonal Therapy. With moderate to severe anxiety, medications such as SSRIs are beneficial to reduce anxiety symptoms. The best treatment regimen is a combination of medication and therapy by a trained professional and close monitoring. It is important to continue treatment until most symptoms are resolved and quality of life has improved.