Post Traumatic Stress Treatments and Medication
Anxiety Disorders: Types, Symptoms, Treatment
Anxiety is a normal emotion that everyone experiences at times. Many people feel anxious, or nervous, when faced with a problem at work, or before taking a test or making an important decision. But when anxiety becomes an excessive, irrational dread of everyday situations, it has become a disabling disorder.
Anxiety is a feeling of apprehension, fear, or worry. Most everyone experiences temporary anxiety, a feeling of nervousness or fear, as a normal reaction to a stressful situation at some point in life. While anxiety is a natural response to some situations, it can develop into a debilitating disorder in some people. It is estimated that about 13% of the United States population has anxiety. Most people suffering from anxiety do not consult a doctor as they believe only "mentally sick" people need to visit a psychiatrist.
The important thing is to understand that anxiety can be treated and that living with constant anxiety is not necessary. Untreated anxiety disorders can push people into avoiding situations that trigger or worsen their symptoms. People with anxiety disorders are likely to suffer from depression, and they also may abuse alcohol and other drugs in an effort to gain relief from their symptoms. Job performance, school work, and personal relationships can also suffer.
Types of anxiety disorders
There are several different anxiety disorders:
- Generalized Anxiety Disorder - an anxiety disorder characterized by chronic, exaggerated worry and tension that is unfounded or much more severe than the normal anxiety most people experience. Worrying is difficult to control. Symptoms of generalized anxiety disorder include muscle tension, trembling, shortness of breath, fast heartbeat, dry mouth, dizziness, nausea, irritability, loss of sleep and not being able to concentrate.
- Panic Attacks and Panic Disorder - an anxiety disorder characterized by unexpected and repeated panic attacks along with intense anxiety between attacks and possible avoidance of situations where attacks may occur. Panic attacks last about 5 to 30 minutes. Panic attacks can lead to phobias if they aren’t treated.
- Phobias. A phobia is an extreme, unreasonable fear in response to something specific. Examples include fear of crowds, bridges, snakes, spiders, heights, open places or social embarrassment. A phobia is only considered a problem when it keeps you from living a normal life.
- Obsessive-Compulsive Disorder - an anxiety disorder characterized by recurrent, unwanted thoughts (obsessions) or rituals (compulsions), which feel uncontrollable to the sufferer.
- Post-Traumatic Stress Disorder - a debilitating anxiety disorder that may develop following a terrifying event. It is characterized by persistent frightening thoughts and memories of the ordeal.
- Social Anxiety Disorder or Social Phobia - an anxiety disorder characterized by a persistent, intense, and chronic fear of being watched and judged by others and of being embarrassed or humiliated by one’s actions.
Symptoms of anxiety disorders
Physical symptoms:
- rapid or irregular heartbeat, feeling as if you are having a heart attack
- stomach problems (gnawing feeling, nausea, diarrhea, irritated bowel syndrome)
- breathing heavily, shortness of breath
- difficulty in swallowing
- sweating, or feeling cold and clammy
- headaches, lightheadedness or dizziness
- muscle tension and pains
- chronic fatigue
- difficulty falling or staying asleep
- insomnia
- hot flashes or chills
- chest pain
- rubbery legs, tingling in fingers or toes
- frequent urination
Emotional and psychological symptoms:
- general sense of apprehension and dread
- nervousness
- jumpiness
- poor memory
- lack of concentration
- extreme exhaustion
- fearfulness or terror
- isolation from others
- strong desire to escape
- feeling incredibly self-conscious and insecure
- feeling of being overwhelmed
- fear that you are losing your mind
- fear of going crazy, of dying
- fear of losing control
- frequently feel like crying for no reason
- feeling angry and lack of patience
- fear of madness, impending death
- feelings of being outside yourself, being cut off from reality
- feeling worried all the time, tired, irritable
Treatment options
In general, anxiety disorders are treated with medication, psychotherapy, or both.
Medications for anxiety
Medications may be especially helpful for people whose anxiety is interfering with daily functioning. According to the National Institute for Mental Health, the types of medications often prescribed for anxiety disorders include:
- Antidepressants: SSRIs (selective serotonin reuptake inhibitors), SNRIs (serotonin-norepinephrine reuptake inhibitors), Tricyclic antidepressants.
SSRIs are helpful in a variety of anxiety disorders, including generalized anxiety disorder, panic disorder, OCD, and social phobia.
The FDA has granted specific indications to the following disorders and antidepressants: generalized anxiety disorder (venlafaxine, buspirone, escitalopram, paroxetine), social phobia (paroxetine, sertraline, venlafaxine), OCD (fluoxetine, sertraline, paroxetine, fluvoxamine), and PTSD (sertraline, paroxetine). - Anti-Anxiety Medications: Benzodiazepines, Azipirones.
Benzodiazepines are especially useful in the management of acute situational anxiety disorder and adjustment disorder where the duration of pharmacotherapy is anticipated to be 6 weeks or less and for the rapid control of panic attacks. If long-term use of benzodiazepines seems necessary, obtaining a confirmatory opinion from a second physician may be helpful because chronic benzodiazepine use may be associated with tolerance, withdrawal, and treatment-emergent anxiety.
Benzodiazepines include clonazepam, which is used for social phobia and GAD; alprazolam, which is helpful for panic disorder and GAD; and lorazepam, which is also useful for panic disorder. - Buspirone is a newer anti-anxiety medication that is used to treat GAD. Unlike the benzodiazepines, buspirone must be taken consistently for at least two weeks to achieve an anti-anxiety effect.
Cognitive-behavioral therapy (CBT)
Cognitive behavioral therapy, which is considered to be one of the most effective forms of psychotherapy for treatment of anxiety, is also the most studied psychotherapy. In this type of therapy people suffering from anxiety disorders learn to recognize and change thought patterns and behaviors that lead to troublesome feelings. This type of therapy helps limit distorted thinking by looking at worries more realistically.
By Katie Bennett
Published: 8/25/2008
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