Your Health

Anxiety Disorders

What are anxiety disorders?

We all feel anxiety or worry at times, often in response to stressful situations — this is normal. Anxiety can be mild or intense, and some people may tend to feel more anxiety than others.

Usually anxiety is temporary, but when it lasts an unexpectedly long time or is so severe that it interferes with your life, it may be considered an anxiety disorder. Anxiety disorders are relatively common — as many as 25% of people may experience an anxiety disorder at some point in their lives. There are many different types of anxiety disorders, including the following examples: 

  • Post-traumatic stress disorder is related to long-term symptoms following exposure to a life-threatening situation. 
  • Generalized anxiety disorder refers to excessive, chronic daily anxiety. 
  • Panic disorder refers to recurrent, spontaneous episodes of panic.

One current theory about the cause of anxiety disorders is that there may be an imbalance of neurotransmitters, the molecules in the brain involved with thoughts and feelings. In other cases anxiety may be caused by a medical condition, medication side effects, or drug abuse.

What are the symptoms of anxiety disorders?

The symptoms of an anxiety disorder may be psychological (for example, feelings of uneasiness or apprehension) or physical (for example, muscle tightness).

Psychological symptoms

Psychological symptoms may include: 

  • restlessness 
  • irritability 
  • difficulty concentrating 
  • apprehension 
  • tremors or shaking 
  • fear 
  • panic 
  • trouble getting to sleep or staying asleep

Physical symptoms

Physical symptoms may include: 

  • muscle tension 
  • rapid or irregular heartbeat 
  • dry mouth 
  • nausea 
  • lightheadedness 
  • diarrhea 
  • hyperventilation or shortness of breath 
  • excessive sweating

What are the risk factors for anxiety disorders?

The major risk factor for anxiety disorders is a history of an immediate family member (parent or sibling) having an anxiety disorder. In addition, people who are diagnosed with major depression, chronic alcohol abuse, or chronic pain are more likely to have an anxiety disorder. Certain drugs may increase your risk of having an anxiety disorder.

The following substances may cause anxiety symptoms: 

  • prescription and over-the-counter medications (ask your Peoples pharmacist about specific medications) 
  • illegal drugs such as amphetamines (“speed” or “crystal meth”) or cocaine 
  • high daily doses of caffeine Heart conditions, breathing disorders, and glandular problems such as hyperthyroidism (overactive thyroid) may also cause anxiety symptoms.

How are anxiety disorders diagnosed?

Doctors and psychologists diagnose anxiety disorders by interviewing the patient to review possible anxiety symptoms. Occasionally, they may use a written questionnaire or test.

How can I prevent anxiety disorders?

There is little definitive research that demonstrates effective methods for preventing anxiety disorders. However, the following may help protect against anxiety disorders: 

  • regular exercise 
  • good coping skills
  • training in stress management techniques 
  • positive social connections

How can I treat an anxiety disorder?

Treatment may include lifestyle modifications, psychological treatments, and medications. Work with your health-care provider to form an effective personal treatment plan for your particular diagnosis, symptoms, personality, and lifestyle.

Lifestyle modifications

Regular vigorous exercise has been shown to be effective in temporarily lowering anxiety levels. Before starting regular exercise, fill out a Physical Activity Readiness Questionnaire (PAR-Q). Talk to your doctor if you are over 69. The PAR-Q is available from: 

Relaxation-type exercises such as deep-breathing techniques can temporarily reduce anxiety symptoms. If practiced daily, they may help reduce anxiety long-term.

Psychological treatments

Cognitive behavioural therapy (CBT)

Cognitive behavioural therapy is based on the idea that automatic negative thoughts may cause anxious feelings, even if you are not fully aware of the thoughts at the time. In CBT treatment, an individual learns to recognize these anxiety-provoking thoughts and, with practice, to replace them with positive and more realistic thoughts. CBT can also help prevent some psychiatric symptoms from recurring. A personal treatment plan may combine CBT with anti-anxiety medications.

Interpersonal psychotherapy

In interpersonal psychotherapy, an individual first learns how his or her relationships may contribute to anxiety symptoms, and then learns new, more effective ways of coping with difficult relationship issues.

Medications

There are prescription medications that are effective in treating anxiety disorders. Some medications are thought to work by changing the levels of two neurotransmitters that occur naturally in the body — serotonin and norepinephrine. After starting a medication, it may take anywhere from a few weeks to a month to notice a change in your anxiety symptoms. Be patient and follow the advice of your health-care provider. If you stop taking your medication once it starts helping with your disorder, your anxiety symptoms may come back.

Side effects

Some medications may cause drowsiness or other side effects. If you are involved in safety-sensitive activities at work or you drive a car, talk to your health-care provider about possible side effects. If you have any concerns about potentially uncomfortable side effects, talk to your health-care provider or Peoples pharmacist. Most side effects will pass with time.

Antidepressant medications

Antidepressant medications such as selective serotonin reuptake inhibitors (SSRIs) may help reduce anxiety by increasing levels of serotonin in the brain. Although originally developed to combat depression, these medications have been found to be effective in controlling or eliminating excess anxiety symptoms and in treating anxiety disorders.

Benzodiazepines

Benzodiazepines are effective medications for many anxiety disorders and have been routine treatments for years. They may present a risk of dependency and abuse in some patients, however, so ideally they should only be used for a few weeks while waiting for other longer-term medications such as antidepressants to start working. There are several other types of medications that may also be helpful in reducing anxiety symptoms. Ask your doctor or Peoples Pharmacist about them.

Where can I find out more about anxiety disorders?

For more information about your medications or other health issues: 

  • talk to your Peoples pharmacist 
  • read People First, a health magazine of practical information available free from your neighbourhood Peoples Drug Mart or Peoples Pharmacy

Other resources

Canadian Mental Health Association 

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