Anxiety Disorders
• Fear and worry are the cardinal features of an anxiety disorder.
• A worried and anxious person may know what it is they are worried about but sometimes they cannot put a finger on what they are anxious about.
• Anxious people tend to have many physical symptoms such was sweating, increased heart rate, shortness of breath, dizziness, loose motions, stomach upsets, and increased breathing rate.
• Other common symptoms of worry and anxiety include tiredness, weakness and poor sleeping habits, especially inability to fall asleep, remain asleep or get refreshing sleep, because they cannot relax.
• Also common are poor appetite, difficulty having sex, headaches, and aches and pains which seem to migrate from one part of the body to another (In Kenya, this phenomenon is described in Kiswahili as the “hapa na hapa syndrome”).
• Other physical symptoms which may arise include trembling, twitching, muscle tension, irritability, sweating and/or hot flushes, light-headedness, feeling out of breath, nausea, a feeling of a lump in the throat, and increased frequency of passing water. Anxious people tend to have poor concentration, tire easily, and sometimes suffer depression.
Types of Anxiety Disorders
There are some specific types of anxiety or fears. These include:
• Generalized anxiety disorder (GAD),
• Social phobia,
• Agoraphobia
1. Generalized Anxiety Disorder (GAD)---GAD is much more than the normal anxiety people experience day to day. It is chronic and exaggerated worry and tension, even though nothing seems to provoke it. People with this disorder always anticipate disaster, often worrying excessively about almost anything such as health, money, family, or work, though often it is hard to pin-point the justifications for the worry. The thought of simply getting through the day provokes anxiety. People with this disorder usually realize that their anxiety is more intense than the situation warrants. The symptoms are similar to those already described for anxiety disorders in general. GAD has a gradual onset going back to childhood or adolescence, but can also begin in adulthood. It affects women more than men and often occurs in relatives of affected persons. In general, the symptoms of GAD seem to diminish with age.
2. Simple phobia---anxiety caused by a specific object or circumstance such as fear of heights, or flying or specific animals. It is one of the most common anxiety disorders for both young and old. When one is not in the feared situation, then the person is free of symptoms which may include shortness of breath, trembling, and muscular aches.
3. Social phobia---This is anxiety associated with social situations, such as being in a social gathering, in an enclosed place (claustrophobia) such as a classroom, public theatre, or speaking in public.
4. Agoraphobia---the fear of being in open public places. It may cause people to refuse to leave their homes. Indeed the term “agora” is derived from an ancient Greek name for a market place.
5. Panic disorder---These attacks are episodic and are characterized by increased sweating, increased heartbeat and breathing and the fear that something terrible, including death is going to happen. There may or may not be a precipitant for the attack. Panic attack is not the same as agoraphobia, although a great deal of people with panic disorder also suffers from agoraphobia.
Treatment for Anxiety Disorders
Many people with anxiety disorders can be helped with treatment. This includes medication or specific forms of psychotherapy:
a) Medications can be very effective at relieving anxiety symptoms rather than curing them. There is a very wide selection of such medication. Different people respond differently to the various medications. These are usually started on a small dose before gradually increasing to a full dose. Every medication has side effects, but they usually become tolerated or diminish with time. The side effects are best discussed with the doctor who can either vary the dose or type of medication.
b) Cognitive-behavioural therapy (CBT) teaches patients to understand how their thinking patterns contribute to their symptoms and how to change their thoughts so that symptoms are less likely to occur. They are also taught how to relax. This awareness of thinking patterns is combined with well thought-out exposure to the feared situations to help people confront their feared situations positively and constructively.
c) Group therapy (or self-help groups) involves people suffering from the same condition getting together. They support each and share their experiences, especially those that work. Group therapy is a very effective form of treatment.
