Anxiety Disorders

Anxiety is normal physiological phenomenon. Anxiety becomes disorder when it is excessive and starts affecting our functioning. Anxiety disorder can manifest in various ways: panic disorder, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), generalized anxiety disorder, and phobias (social phobia, agoraphobia, and specific phobias). More than 20 million Indians adults suffer from an anxiety disorder in a given year, and many people have more than one anxiety disorders. Anxiety disorders frequently co-occur with depressive disorders, eating disorders, or alcohol and other substance of abuse. Anxiety disorders are very much treatable conditions. Currently very safe medications are available depending on the type of anxiety disorder. The commonly used medications are: Sertraline, Clonazepam. Psychotherapy and relaxations techniques are also very useful. The best outcome of treatment can be achieved when medication and psychotherapy techniques are combined.

Panic Disorder

What's happening?

• Imagine you've just stepped into an elevator and suddenly your heart races, your chest aches, you break out in a cold sweat and feel as if the elevator is about to crash to the ground. Can you imagine what's happening? heart disease ? perhaps no!
• Imagine you are driving home from the grocery store and suddenly things seem to be out of control. You feel hot flashes, things around you blur, you can't tell where you are, and you feel as if you're dying. Can you imagine what's happening? What's happening is most likely a panic attack, an uncontrollable panic response to ordinary, non threatening situations. Panic attacks are may leads to constant fear of having another panic attack and that may leads to panic disorder.

What is panic disorder?

A person who experiences recurrent panic attacks, at least one of which leads to at least a month of increased anxiety or avoidant behavior, is said to have panic disorder. Panic disorder may also be indicated if a person experiences fewer than four panic episodes but has recurrent or constant fears of having another panic. The most important part is that there is remarkable difficulty in maintaining ones social and occupational functioning.

Doctors often try to rule out every other possible alternative before diagnosing panic disorder. To be diagnosed as having panic disorder, a person must experience at least four of the following symptoms during a panic attack: sweating; hot or cold flashes; choking or smothering sensations; racing heart; labored breathing; trembling; chest pains; faintness; numbness; nausea; disorientation; or feelings of dying, losing control, or losing one's mind. Panic attacks typically last about 10 minutes, but may be a few minutes shorter or longer. During the attack, the physical and emotional symptoms increase quickly and then subside. A person may feel anxious and jittery for many hours after experiencing a panic attack.

Panic attacks can occur in anyone. Chemical or hormonal imbalances, drugs or alcohol, stress, or other situational events can cause panic attacks, which are often mistaken for heart attacks, heart disease, or respiratory problems. Panic attacks are very much treatable condition with medications.

What are phobias?

Phobias are irrational, involuntary, and inappropriate fears of (or responses to) ordinary situations or things. People who have phobias may experience panic attacks when confronted with the situation or object about which they feel phobic.

Types of Phobias:--

• Specific (simple) phobia: an unreasonable fear of specific circumstances or objects, such as traffic jams or snakes, blood.
• Social phobia: extreme fear of looking foolish or stupid or unacceptable in public places that causes people to avoid public occasions or areas (e.g. public speaking)
• Agoraphobia: an intense fear of feeling trapped in a situation, especially in public places, with an overwhelming fear of having a panic attack in unfamiliar surroundings. This word means, literally (in Greek), "fear of the marketplace.” In this condition person may become homebound and if they go out they would always try to accompany someone close to them. Phobias are usually chronic (long-term), distressing disorders that keep people from ordinary activities and places. They can lead to other serious problems, such as depression. In fact, at least half of those who suffer with phobias and panic disorders also have depression. Alcoholism, loss of productivity, secretiveness, and feelings of shame and low self-esteem also occur with phobic illness. Some people are unable to go anywhere or do anything outside their homes without the help of others they trust.

Am I the only one?

It is estimated that 8.8 million Indians have panic disorder, so you are not alone if you, too have these symptoms. Usually panic disorder first strikes people in their early twenties. Severe stress, such as the death of a loved one, can bring on panic attacks.

What causes panic disorder?

Exact mechanism that causes panic disorder are not known but several hypothesis are being researched. Panic disorder seems to run in families, which suggests that it has at least some genetic basis. Some theories suggest that panic disorder is part of a more generalized anxiety in the people who have panic attacks or that severe separation anxiety can develop into panic disorder or phobias, most often agoraphobia.

Research suggest that possible physical defects in a person's autonomic nervous system. General hypersensitivity in the nervous system, increased arousal, or a sudden chemical imbalance can trigger panic attacks. Caffeine, alcohol, and several other agents can also trigger these symptoms.

Is panic disorder treatable?

Recovery from panic disorder can be achieved either by taking medication or by cognitive behavioral therapy that is specific for panic disorder. Studies suggest that medication and cognitive behavioral therapy are about equally effective and the decision about which to take depends largely on the preference of the person with the panic disorder. Medication probably works a bit faster. The medications commonly used to treat panic disorder are: Sertraline etc. For immediate relief Clonazepam or Alprazolam can also be used. There is some evidence that the combination of cognitive behavioral therapy and medication may offer some benefits over either one alone.

Cognitive Behavior therapy is used to help people think and behave appropriately. Patients learn to make the feared object or situation less threatening as they are exposed to, and slowly get used to, whatever is so frightening to them. Family members and friends help a great deal in this process when they are supportive and encouraging.

Medication is most effective when it is used as part of an overall treatment plan that includes supportive therapy. Antidepressants and Anxiolytic medications (Clonazepamand SSRI) are the most successful medications for this disorder.