ANXIETY

Introduction:

Anxiety is a common experience of modern society. It is so common that the

present age is called as the age of anxiety. More or less everyone experience
anxiety but it is not considered as abnormal unless and until it is functioning to
such an extent that the individual becomes incapacitated.

Anxiety is defined as an unpleasant feeling or vague fear that something bad

is about to happen. It is an uneasy mental state pertaining to an unknown fear the
cause for which is unspecific and unknown. The uneasy mental state cause
anxiety.

SYMPTOMS OF ANXIETY:

1. Fear of death or insanity.

2. Unwanted fear.
3. Irritability.
4. Excitement and depression .
5. Fatigue.
6. Gastro- intestinal trouble.
7. Feeling of insecurity.
8. Apprehension.
9. Sweating.
10.Drying of mouth.
11.Head ache.
12.Giddiness.
13.Stammering while talking. Etc.

CAUSES:

● Persistent state of apprehension due to continuous worry and

failure.
● Conflict between sexual desire and gratification.
● Sexual inhabitation through neurotic difficulties produces
sexual frustration which will psychologically converted into
anxiety.
● Self assertive tendency causes anxiety.
● Frustrating situation tends to make a child hostile and this
belief increases his helplessness and anxiety.
● Anxiety is produced by cultural pressures.

TYPES OF ANXIETY DISOEDERS:

Anxiety disorder suggests unrealistic, irrational fear or anxiety of disabling

intensity at its core and also its principles and most obvious manifestations. DSM-
IV recognizes seven primary types of anxiety disorders, phobic disorders of
specific or of social type , panic disorders with or without agoraphobic,
generalized anxiety disorder, obsessive compulsive disorder and post traumatic
stress disorder.

1. Generalized Anxiety Disorder (GAD): It is characterized by chronic

excessive worry about a number of events or activities. This state was
originally described as the floating anxiety because it was not anchored to
a specific object or situation as with special or specific phobia.
2. Phobia: phobia refers to peculiar fear, which the patient known about
but unable to explain or overcome. It is defined as an abnormal
uncontrollable , absurd and intense fear because if incapacitates or
distresses the individual normal work in such situations .
ex: Haemophilia, zoophobia, etc .
3. Obsessive Compulsive Disorder(OCD): It is defined by the
occurrence of unwanted and intrusive obsessive thoughts or
distressing images .These are usually accompanied by compulsive
behavior designed to neutralize the obsessive thoughts or images or to
prevent some dreaded events or situations .Obsession involves
persistent and recurrent intrusive thoughts and images or impulses that
are experienced as disturbing and inappropriate , compulsions involve
either over repetitive behavior or more covert mental acts.
4. Post Traumatic Stress Disorder (PTSD): It is the disorder that occurs
following an extreme traumatic stress or a event avoiding reminds of
the trauma and of persistent symptoms of increased arousal. The
individual may experience impaired concentration, memory and
depression.

Assessment and Management:

There are difference in features and treatment of various types of anxiety

disorders. There are also many common features. Treatments are tested in patients
who meet formal diagnostic criteria but many patients see help before their
symptoms meet these criteria and it is usually appropriate for short treatment
immediately based on clinical judgement . It is same for patient with anxiety
disorder to take care that is more intense than that provided on outpatient setting.

Anxiety disorder assessment:

A full psychotic history should be taken, including information from patients
, a third party information , primary cares , physician and old hospital notes.

● Current symptom and their effect on life at home , work, school life etc.
● Previous diagnosis on anxiety disorders , eating disorder , mood disorder
OCD and other psychiatric conditions are the current symptoms of these.
● Current medications.
● Pre-morbid personality traits.
● Previous psychiatric treatment and how successful they are.
● Current social situations ,accommodation ,employment and finances.

A risk assessment should be carried out focusing specially on risk of

self harm , exploitation , self neglect and psychological evolution
including use of standard scales for mood disorders and assessment of
the compact of symptoms should be undertaken along with baseline
laboratory tests.

GENERAL MEASURES:

✔ Agree to a clean plan: anxiety is prolonged by uncertainty end a clear

management plan agreed with patients helps to reduce It .Try to limit
contact with one named physician.
✔ Provide and discuss: Anxiety disorders are maintained by fear about
consequences of their symptoms . An explanation of condition should
be tailored to the particular concerns of individual patient but it is
usually necessary to explain how fear causes physical illness.
✔ Providing written information is important as anxious people often
suffer from poor concentration , involving a relative can also facilitate
understanding.
✔ Avoiding any stress: learning problem solving technique is an
important aspect.
✔ Advice about self-help methods: patients with anxiety disorders can
help themselves in simple ways , for eg: time management activities ,
scheduling , taking time off to relax and reducing caffeine intake .
Relaxation or training can be provided within a primary care team or
at times using yoga and meditations exercises some patients are better
motivated by training in group rather than individually ,patients
should be offered information about local support group and national
charities.

CONTROL OF ANXIETY:

⮚ Anxiety can be overcome by mind relaxation techniques.

⮚ Sometimes religious practices give a great relief from anxiety.
⮚ Writing all his feelings on a sheet of paper and reading it
alone may reduce anxiety.

Reference : Abnormal Psychology –Carson and Butcher.