Anxiety disorders are characterized by significant worries about current or future events causing physical symptoms as a fast heart rate and shakiness. The amygdala, an area within the temporal lobes seems to be responsible for emotional reactions. Low levels of the neurotransmitter GABA contributes to anxiety.

Anxiety disorders can affect anyone at any age. 5-30% of people are affected at some point in their life.

Classification

• Generalized anxiety disorder - chronic excessive worry about an everyday problem accompanied by restlessness, feelings of being wound-up or on edge, fatigue, concentration problems, irritability, muscle tension and sleep disturbance, difficulties controlling the worry, sleep problems.
• Specific phobia – excessive fear triggered by a specific stimulus e.g. flying, blood, water, highway driving and tunnels, anticipating terrifying consequences, associated with trembling, shortness of breath, or rapid heartbeat.
• Social anxiety disorder - intense fear and avoidance of performance situations in which they expect to feel embarrassed, judged, rejected or fearful of offending others, as public speaking or social interactions in general, triggering blushing, sweating, and difficulty speaking.
• Separation anxiety disorder - excessive anxiety over being separated from a person or place.
• Agoraphobia - specific anxiety about being in a place where escape is difficult/ embarrassing or unavailable. Often associated with avoidance behaviours.
• Panic disorder – sudden, brief attacks of intense fear that abruptly arises and peaks in less than 10 minutes, lasting for several hours with or without warnings, often marked by feelings of being out of control, trembling, shaking, confusion, dizziness, nausea, and/or difficulty breathing, triggered by stress, irrational thoughts, avoidance of places where panic attacks have occurred in the past.
• Selective mutism - a person who is normally capable of speech doesn’t peak in specific situations.
• Post-traumatic stress disorder (PTSD) was once an anxiety disorder but moved now to trauma- and stressor-related disorders that results from an extreme traumatic experience as combat/war, rape or natural disaster. Common symptoms include hypervigilance and flashbacks.
• Obsessive–compulsive disorder (OCD) - distressing, persistent, and intrusive thoughts and compulsions to repeatedly perform specific rituals which cause social dysfunction. The compulsive rituals are personal rules followed to relieve the anxiety.

Cause

A combination of genetic and environmental factors as life stresses such as financial worries or chronic physical illness, caffeine, alcohol or drug abuse and withdrawal, hypo- and hyperthyroidism, hyperprolactinemia, diabetes, anaemia, deficiency of vitamin D, B2, B12, folic acid, gastrointestinal diseases as celiac disease and non-celiac gluten sensitivity, heart diseases, Parkinson’s disease, dementia, multiple sclerosis, Huntington's disease, pheochromocytoma, sedatives, opioids.

Anxiety can be part of other disorders particularly depressions, personality disorders and substance use disorder.

Diagnosis

We at KindCare Medical Center are starting the diagnostic clarification by taking an extensive medical history addressing your symptoms, the trigger factors, the duration and the frequency, work environment, social habits, toxic exposure, risk of infectious diseases and family history of neurological disease. Checking the vital signs such as blood pressure and pulse, followed by a proper physical examination with focus on mental health are mandatory. To be diagnosed symptoms typically need to be present for at least 6 months and decrease functioning. In addition, laboratory tests and imaging of brain as MRI are offered for ruling out underlying conditions.

Treatment

Treatment options at KindCare Medical Center include apart from medications as Serotonin re-uptake inhibitors and Serotonin–norepinephrine reuptake inhibitors, Buspirone, Quetiapine and Pregabalin as second line treatments for people who do not respond to SSRIs or SNRIs, homeopathic medication, Neurofeedback, also called EEG biofeedback as proven helpful not pharmaceutical therapy. Our offer at KindCare Medical Center is getting completed by Stress management techniques, meditation, aromatherapy, physical therapy and acupuncture. Counselling with Cognitive behavioural therapy is as well an effective therapy how thoughts, feelings, and behaviours work together.

Lifestyle changes include

• Exercises.
• Reduction of caffeine intake.
• Stopping smoking (benefits are as per scientific studies as large as or larger than those of medications).

How can I help a loved one?

• Remind yourself that the illness is the problem—anger, frustration, or behaviours related to anxiety are nobody’s fault.
• Be patient—learning and practicing new coping strategies takes time.
• If your loved one is learning new skills, offer to help them practice.
• Listen and offer support but avoid pushing unwanted advice.
• Set boundaries and seek support for yourself, if needed.
• If other family members are affected by a loved one’s anxiet disorder, consider seeking family counselling.