Spotlight on Anxiety

Let’s talk about anxiety. As a headline mental illness this is something a lot of people know a bit about. The feeling of panic that can be so overwhelming is fairly common in our western world.

I am inclined to split anxiety into two classes. There’s the anxiety that warrants its own diagnosis (for example, Generalized Anxiety Disorder or Social Anxiety Disorder), and there’s anxiety coexisting with another mental illness. I’ve experienced a little Generalized Anxiety Disorder (GAD), but mostly anxiety has been as a by-product of psychosis.

GAD is defined by excessive and irrational worry about events and activities, to a point where it interferes with daily life. The gold standard test for diagnosing this disorder is the GAD-7, which rates daily experiences of anxiety and assigns a score. Essentially, the more anxiety affects your functioning in life, the higher the score is. People with GAD often struggle to remember the last time they felt relaxed.

Anxiety is also a primary symptom of many psychiatric conditions; notably phobias and post-traumatic stress disorder. In these cases the anxiety is less generalised – it tends to relate to specific circumstances that trigger the panicked feelings.

Alongside the diagnosis of anxiety disorder often comes depression. Comorbidity of depression and anxiety exists in between 5% and 10% of the population each year (based on those seeking primary care services for these issues). The existence of these disorders together is probably the most common presentation, but not the only one. Bipolar mania can cause a state of agitation and worry that is uncomfortable. Psychotic symptoms such as paranoia can also manifest in a specific anxiety about given situations, as I’ve touched on elsewhere on the site.

The symptoms of anxiety are not just mental. It affects the body in many ways. Stomach upset, heart palpitations, headaches, dry mouth, sweating and more are common presentations of anxiety, as well as the general feeling of fear and tension. Interestingly, as a nurse explained to me, many of these symptoms come down to the flight-or-fight response. As she explained it, the body begins to divert key resources (such as oxygenated blood) to key areas in preparation for flight – as well as the increased adrenaline that floods the system.

Treating anxiety comes down to personal choice. Anti-anxiety medications such as benzodiazepines can be very helpful in the short term when taken as needed. They have a sedative effect on the mind and body that helps with finding calm and relaxation. Unfortunately benzodiazepine medications such as temazepam and diazepam (Valium) can be highly addictive and are a stop-gap solution that deals with the immediate effects of the anxiety.

In the long term, treatment of anxiety with talk therapies can be very productive. CBT (cognitive behavioural therapy) seeks to understand ones’ thoughts (cognition) and re-program the behaviours that result from the pattern of thinking. CBT uses exercises to identify and change key thought processes, and those exercises can be used outside of the therapeutic setting. For example, STOPP is one such exercise, and one I’ve found personally very helpful.

I would welcome comments and questions below, on Facebook or via Twitter (@dontsayimcrazy).

Spotlight on Anxiety

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