Anxiety disorders and phobias
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What is an anxiety disorder?
Everyone experiences anxiety at some point in his or her life. People become
anxious when they have to face a highly stressful situation like taking a test,
going for a job interview or getting married. When one is anxious and under
stress, the body reacts; hands become clammy, the heart beats a little faster;
one can even feel lightheaded or dizzy. Some people become preoccupied with
fear and worry, and the intense feelings of anxiety continue. If this happens,
an individual may have an anxiety disorder.
One in six Canadians is affected by an anxiety disorder. Anxiety can take the
form of panic disorder, phobia or obsessive-compulsive disorder. Without treatment
an individual’s physical, mental and emotional health may be in jeopardy. Anxiety
disorders can also lead to alcohol and/or drug abuse, family problems, depression,
and in some cases, suicide.
What is obsessive compulsive disorder?
People with obsessive compulsive disorder experience unwanted thoughts that make no
sense but nevertheless cause the individual to feel anxious. Irrational thoughts
may concern contaminating themselves or others with dirt or germs, or they may be
obsessed about their own safety or the safety of a loved one. In response to
their obsessive thoughts, individuals may need to think neutralizing thoughts
or to perform certain compulsive rituals, including repetitive hand washing or
counting.
As with phobias, a traumatic event can trigger obsessive thoughts or
behaviour. People who are described as perfectionists however seem more prone
than others to develop obsessions. If untreated, this condition can result in
severe impairment in many psychological areas as well as affect relationships
and life at school or work.
What are phobias?
A phobia is an irrational and uncontrollable fear of an object or a situation. It
is unclear how phobias start, but if an individual is prone to excessive anxiety
and stress, he or she is more likely to be vulnerable to panic attacks and phobias.
People with phobias experience feelings of intense panic when confronted by
whatever it is that frightens them and go to considerable lengths to avoid the
object or situation. An individual with a phobia may experience the physical
feelings of panic when confronted with the feared situation. Types of phobias are:
- Agoraphobia: Agoraphobia is fear of fear itself. Individuals develop agoraphobia
out of the fear of a panic attack occurring in any situation where help is unavailable
or escape difficult. People with agoraphobia associate places or feelings as the
cause of their panic attacks so they try to avoid the place and/or situation that
they think is the cause. People with agoraphobia become highly dependent. This can
be exhausting and frustrating for family members and friends. People with agoraphobia
may confine themselves to their homes, become very worried about their health,
abuse alcohol or become suicidal. The rate of attempted suicide for people with
agoraphobia is about 20%. Agoraphobia and depression are closely related.
- Social Phobia: People with social phobias have had life experiences that
render them hypersensitive to criticism and rejection. They have difficulty
starting a conversation, asking questions, making friends or joining groups. The
anxiety produced by a social phobia can be so intense that it provokes blushing,
stammering, sweating, stomach upsets, a racing heart, trembling limbs or trigger
a full-scale panic attack. Social phobias are one of the most common psychiatric
disorders, which may be associated with other conditions like depression,
specific phobias (fear of spiders, heights, water, etc.) and agoraphobia.
- Specific Phobia: People with a specific phobia experience anxiety only when
confronted with the thing they most fear. Common fears are thunderstorms, heights
and certain animals like snakes and spiders. Of all the anxiety disorders,
specific phobias are the most responsive to therapy.
What is panic disorder?
On average, 1 out of 3 young adults reports having had a panic attack in the last
year. During a panic attack, sensations such as sweating, nausea, trembling and
numbness in the legs or hands, dizziness, hot or cold flashes, a feeling of tightness
or pressure in the chest, hyperventilation, "jelly" legs or blurred vision can develop.
Individuals may even feel like they are going to die of a heart attack or lose control
of their body functions. These intense feelings of panic usually do not last for very
long and most people brush off the episode as a momentary "freak out." Some people
become very agitated however, and develop a fear of it happening again.
If an individual has more than four panic attacks within a month or a panic attack occurs
when the individual is not in an anxious or stressful situation, it is probable that
the individual has a panic disorder. Individuals who are susceptible to panic
attacks are more likely to be concerned with illness, death or losing control.
Panic disorders usually begin before the individual is 20 - 30 years old.
Other forms of anxiety disorders
Post Traumatic Stress Disorder: PTSD is an anxiety reaction to a real or life-threatening,
traumatic event (ie. a car accident, rape or war). Individuals with PTSD may also suffer
from nightmares and insomnia, flashbacks, hypervigilance (always being on alert),
irrational outbursts of anger and depression.
Generalized Anxiety: People with generalized anxiety disorder often worry excessively
about things, that to others, seem illogical. Their bodies also react to an ongoing
state of tension and anxiety. They may experience tightness and pain in their muscles,
lack of concentration, shakiness, insomnia, irritability and irritable feelings.
What are the treatments for anxiety disorders and phobias?
There has been a lot of progress in the understanding and diagnosis of the various forms
of anxiety disorders. Treatment is specific to the severity of the disorder. The most
effective forms of therapy are based on cognitive and behavioural approaches. Individuals
may also learn calming techniques and meditative therapy and anti-depressant medication
can be prescribed to help their anxiety. In most cases therapy will help the individual
get better and lead a productive life.
Where can I get help?
If you or a loved one appears to be suffering from an anxiety disorder, you should
contact your family physician, the Ontario Psychiatric Association or the Freedom From
Fear Foundation in Toronto which is an organization established to help people with
anxiety disorders. They have a network of support groups set up throughout Ontario –
(416) 761-6006.
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