Dr Jamuna Rajeswaran / Ms Ann Sarah Paul
“Worrying is like a rocking chair. It gives you something to do but doesn’t get you anywhere.” –Proverb
“Anxiety was born in the very same moment as mankind. And since we will never be able to master it, we will have to learn to live with it—just as we have learned to live with storms.” – Paulo Coelho
Fear is a phenomenon which is seen across species. It is generally understood that the purpose of fear is to protect one from immediate threats and to mobilize the body for quick action to avoid danger. Anxiety, while it is associated with fear, can often be experienced similarly. It is a future-oriented mood state in which the individual anticipates the possibility of threat and experiences a sense of distress focused on the upcoming negative event.
In other words fear is a normal emotion under circumstances of threat and is thought to be part of the evolutionary “fight, flight or freeze” reaction for survival. It is also normal and even adaptive to be anxious when we are facing certain events such as an exam or job interview. However, there are many circumstances in which the presence of anxiety is maladaptive or excessive and constitutes to become a disorder.
While everyday anxiety is generally occasional, mild and brief,the anxiety by a person occurs frequently, is more intense and lasts from hours to even days results in disorder.Anxiety is considered pathological when the response occurs in the absence of any realistic threat or out of proportion to the actual danger when it results in significant distress and leads to impairment in social, occupational, psychological or biological functioning.
Post COVID pandemic, anxiety disorders are common; research indicates that 1 in 4 adults have anxiety disorders sometime in their life. According to Indian studies, around 18.7%-22.7%, suffer from anxiety disorders, reported to be the highest among all mental health disorders. Rates are higher in urban communities than rural ones and significantly higher among females as compared to males.
People often live with anxiety disorders for years before they are diagnosed and treated. The symptoms often develop during early adulthood with the majority of people having mild or no impairment. Eventually, it can seriously restrict the individual’s education, work, recreation and social activities. Avoidance of situations becomes the hallmark which is a part of the disorder.
Individuals severely affected by anxiety disorders are also more likely to have another type of anxiety disorder, major depression, and alcohol or substance abuse thus compounding the impact of anxiety disorders and presenting challenges for effective treatment. Anxiety disorders have a major economic impact in terms of loss of productivity due to absenteeism and unemployment, heavy use of emergency department and primary care system contributing significant health care costs.
There are six categories of anxiety disorder; phobias, panic disorders, generalized anxiety disorder, obsessive-compulsive disorder, acute stress disorder and posttraumatic stress disorder. Though they manifest in different ways, they all share common features like irrational and excessive fear, apprehensive and tense feelings and difficulty managing daily tasks.
Whenever anxiety is activated by an anticipated danger, it leads to changes in three symptoms; cognitive (thinking) anxious thoughts, predictions and beliefs due to overestimation of danger and its potential consequences, physical (body reaction) such as increased heart rate, shallow breathing, shaking, feeling dizzy in excess relative to the context and finally, behaviour (actions) avoiding anxiety-provoking situations or objects.
Individuals who experience excessive anxiety fear the stigma attached to it and may try to ignore the seriousness of their condition and tend to suffer in silence. However, anxiety disorders are treatable and early treatment can help to ensure greater chances of treatment success and enhance the quality of life. But there is no one-size-fits-all when it comes to the treatment for anxiety; a combination of medicines and psychological treatment has proven to be efficient.
Psychological treatments like relaxation techniques, meditation and stress management can be beneficial for them along with supportive and family therapy. The most commonly used and most effective form of therapy for anxiety disorders is cognitive behaviour therapy (CBT) which works on the principle of helping people identify, question and correct their tendencies to overestimate danger and their belief that they are unable to cope with danger.
Another upcoming therapy modality is EEG Neurofeedback(EEG NFT), a state of art technology and non-pharmacological and non-invasive method that involves training through a brain-computer interface where both the person and the computer are involved in modifying neuronal activity thereby improving associated symptoms of anxiety.
Here are some tips to deal with anxiety symptoms:
Walk away: One of the best ways to stop anxious thoughts is to take a step back from the situation. Use this time to focus on your body and not your mind, this will also refuel you to handle the situation better.
Thought diary: Sometimes writing down your thoughts makes you realise that fears are bigger in your mind and in reality, may be improbable or may have manageable solutions.
Trigger Alert: Identify & learn to manage your triggers. Some are obvious like drinking alcohol, caffeine, or using tobacco. Some may be more occult like unexplored emotions, financial problems etc.
Routine: Get yourself in a routine, make a plan for the day, and don’t procrastinate, your anxiety is prone to worsen near a deadline, and avoid leaving things to the last minute.
Socialize: Spending time with friends and family on a regular basis may help you manage your anxiety. Socialization can help relieve stress, encourage feelings of laughter and togetherness, and decrease loneliness. Research has shown that social connectedness can help you become more resilient to stress in the long run.
Join support groups: These groups are available in-person and online. They encourage people with anxiety disorders to share their experiences and coping strategies.
Hobbies: Develop some kind of hobbies to keep yourself engaged and derive happiness.
Question your thought pattern: Not everything you believe is true, challenge your thoughts and see if it holds the test, the trick here is to take back control.
Practice focused, deep breathing: Try breathing in for 4 counts and breathing out for 4 counts for 5 minutes total. By evening out your breath, you’ll slow your heart rate which should help calm you down.
Anxiety is something we all come across in our lives at some point in time. As we discussed earlier if these symptoms start affecting your daily functioning, it might be a warning sign of it turning into a disorder.Early intervention & appropriate management are imperative. If you suspect you have an anxiety disorder you should take professional help at the earliest.