Dr Tariq Jagnarine
Fam Medicine, Endocrinology / Diabetes

It’s normal to feel anxious about moving to a new place, starting a new job, or taking a test. This type of anxiety is unpleasant, but it may motivate us to work harder and to do a better job. Ordinary anxiety is a feeling that comes and goes, but does not interfere with our everyday life.
In the case of an anxiety disorder, the feeling of fear may be with people all the time. It is intense and sometimes debilitating.
This type of anxiety may cause individuals to stop doing things they enjoy. In extreme cases, it may prevent them from entering an elevator, crossing the street, or even leaving their home. If left untreated, the anxiety will keep getting worse.
Anxiety disorders are the most common form of emotional disorder and can affect anyone at any age. According to the American Psychiatric Association, women are more likely than men to be diagnosed with an anxiety disorder.

Anxiety is a key part of several different disorders. These include:
• Panic Disorder: experiencing recurring panic attacks at unexpected times. A person with panic disorder may live in fear of the next panic attack.
• Phobia: excessive fear of a specific object, situation, or activity
• Social anxiety disorder: extreme fear of being judged by others in social situations
• Obsessive-compulsive disorder: recurring irrational thoughts that lead you to perform specific, repeated behaviours
• Separation anxiety disorder: fear of being away from home or loved ones
• Illness anxiety disorder: anxiety about your health (formerly called hypochondria)
• Post-traumatic stress disorder (PTSD): anxiety following a traumatic event

Researchers are not sure of the exact cause of anxiety. But, it’s likely a combination of factors plays a role. These include genetic and environmental factors, as well as brain chemistry. In addition, researchers believe that the areas of the brain responsible for controlling fear may be impacted.
Current research of anxiety is taking a deeper look at the parts of the brain that are involved with anxiety.
The causes of anxiety disorders are complicated. Many might occur at once, some may lead to others, and some might not lead to an anxiety disorder unless another is present.
Possible causes include:
• Environmental stressors, such as difficulties at work, relationship problems, or family issues
• Genetics, as people who have family members with an anxiety disorder are more likely to experience one themselves
• Medical factors, such as the symptoms of a different disease, the effects of a medication, or the stress of an intensive surgery or prolonged recovery
• Brain chemistry, as psychologists define many anxiety disorders as misalignments of hormones and electrical signals in the brain
• Withdrawal from an illicit substance, the effects of which might intensify the impact of other possible causes

Anxiety feels different depending on the person experiencing it. Feelings can range from butterflies in one’s stomach to a racing heart. Feeling out of control, like there’s a disconnect between a person’s mind and body.
Other ways people experience anxiety include nightmares, panic attacks, and painful thoughts or memories that can’t be controlled. A general feeling of fear and worry, or may fear a specific place or event.
Symptoms of general anxiety include:
• Increased heart rate
• Rapid breathing
• Restlessness
• Trouble concentrating
• Difficulty falling asleep
Anxiety symptoms might be totally different in persons. That’s why it’s important to know all the ways anxiety can present itself.

An anxiety attack is a feeling of overwhelming apprehension, worry, distress, or fear. For many people, an anxiety attack builds slowly. It may worsen as a stressful event approach.
Anxiety attacks can vary greatly, and symptoms may differ among individuals. That’s because the many symptoms of anxiety don’t happen to everyone, and they can change over time.
Common symptoms of an anxiety attack include:
• Feeling faint or dizzy
• Shortness of breath
• Dry mouth
• Sweating
• Chills or hot flashes
• Apprehension and worry
• Restlessness
• Distress
• Fear
• Numbness or tingling
A panic attack and an anxiety attack share some common symptoms, but they’re not the same.
A single test can’t diagnose anxiety. Instead, an anxiety diagnosis requires a lengthy process of physical examinations, mental health evaluations, and psychological questionnaires.
Some doctors may conduct a physical exam, including blood or urine tests to rule out underlying medical conditions that could contribute to the symptom’s persons are experiencing.
Several anxiety tests and scales are also used to help your health care providers assess the level of anxiety you’re experiencing.

Once diagnosed with anxiety, treatment options can be explored with one’s health care provider. For some people, medical treatment isn’t necessary.
• Lifestyle changes may be enough to cope with the symptoms.
In moderate or severe cases, however, treatment can help to overcome the symptoms and lead a more manageable day-to-day life.
Treatment for anxiety falls into two categories: psychotherapy and medication. Meeting with a therapist or psychologist can help learn tools to use and strategies to cope with anxiety when it occurs.
Medications typically used to treat anxiety include antidepressants and sedatives. They work to balance brain chemistry, prevent episodes of anxiety, and ward off the most severe symptoms of the disorder.
Treatments will consist of a combination of psychotherapy, behavioural therapy, and medication.

Alcohol dependence, depression, or other conditions can sometimes have such a strong effect on mental well-being that treating an anxiety disorder must wait until any underlying conditions are brought under control.

In some cases, a person can treat an anxiety disorder at home without clinical supervision. However, this may not be effective for severe or long-term anxiety disorders.
There are several exercises and actions to help a person cope with milder, more focused, or shorter-term anxiety disorders, including:
• Stress management: Learning to manage stress can help limit potential triggers. Organize any upcoming pressures and deadlines, compile lists to make daunting tasks more manageable, and commit to taking time off from study or work.
• Relaxation techniques: Simple activities can help soothe the mental and physical signs of anxiety. These techniques include meditation, deep breathing exercises, long baths, resting in the dark, and yoga.
• Exercises to replace negative thoughts with positive ones: Make a list of the negative thoughts that might be cycling as a result of anxiety, and write down another list next to it containing positive, believable thoughts to replace them. Creating a mental image of successfully facing and conquering a specific fear can also provide benefits if anxiety symptoms relate to a specific cause, such as in a phobia.
• Support network: Talk with familiar people who are supportive, such as a family member or friend. Support group services may also be available in the local area and online.
• Exercise: Physical exertion can improve self-image and release chemicals in the brain that trigger positive feelings.
A standard way of treating anxiety is psychological counselling. This can include cognitive-behavioural therapy (CBT), psychotherapy, or a combination of therapies.
This type of psychotherapy aims to recognize and change harmful thought patterns that form the foundation of anxious and troublesome feelings. In the process, practitioners of CBT hope to limit distorted thinking and change the way people react to objects or situations that trigger anxiety.
For example, a psychotherapist providing CBT for panic disorder will try to reinforce the fact that panic attacks are not really heart attacks. Exposure to fears and triggers can be a part of CBT. This encourages people to confront their fears and helps reduce sensitivity to their usual triggers of anxiety.
A person can support anxiety management with several types of medication. Medicines that might control some of the physical and mental symptoms include antidepressants, benzodiazepines, tricyclics, and beta-blockers.
Anxiety itself is not a medical condition but a natural emotion that is vital for survival when an individual finds themselves facing danger. An anxiety disorder develops when this reaction becomes exaggerated or out-of-proportion to the trigger that causes it. There are several types of anxiety disorder, including panic disorder, phobias, and social anxiety. Treatment involves a combination of different types of therapy, medication, and counselling, alongside self-help measures. An active lifestyle with a balanced diet can help keep anxious emotions within healthy limits.