It is usual for people to get anxious from time to time. But when the anxiety is so much that it stops you from having a normal life, then you need help.
What are they?
These are conditions characterised by the feelings of anxiety, worrisome thoughts, avoidance behaviour, and symptoms such as sweating, dizziness, fatigue and diarrhoea. There are three main categories of anxiety disorders:
- Generalised anxiety disorder: Prolonged and persistent anxiety associated with uncontrollable worry.
- Phobic anxiety disorder: An abnormal or excessive fear to an object or situation (such as excessive fear of dying in an air crash leading to avoidance of flying) A generalised phobia of going out alone or being in crowded places is called agoraphobia.
- Panic disorder: Repeated attacks of severe anxiety, which are not restricted to any particular situation or circumstances. It is often associated with agoraphobia.
Patients with anxiety often also have depression.
What treatments work?
Once a diagnosis of an anxiety disorder is made, your doctor will recommend treatment usually based on your preference, and on how severe your symptoms are.
Treatment options include psychological treatments (or ‘talking treatments’), medicines, or both, to help your anxiety.
For many people with brief episodes, discussion with a
doctor concerning the nature of anxiety is usually sufficient.
- Relaxation techniques such as yoga, muscle relaxation and mental imagery can be effective in mild/moderate anxiety.
- Behaviour therapies, intended to change behaviour and thus symptoms, may be used. The most common and successful is graded exposure to the source of fear so as to desensitize the individual. It is best used for phobias.
- Cognitive behaviour therapy (CBT), which is the treatment of choice for panic and general anxiety disorders, is also highly recommended.
These treatments don’t work instantly, and you will need to practise the things you learn in the sessions, while you’re at home. During these treatments you work with a therapist who has been trained in helping people with mental health problems.
Initial ‘drug’ treatment should involve advice to gradually stop taking recreational drugs such as caffeine and alcohol (which can cause a rebound anxiety and withdrawal). Prescribed drugs used in the treatment of anxiety include:
- Drugs called Benzodiazepines, such as Diazepam, which help remove the anxiety and calm your nerves. They act quickly on the central nervous system and thus may cause side-effects like drowsiness and memory loss. They can also cause dependence in some persons, so should be taken in as low a dose as possible when necessary and for not more than 4 weeks.
- Antidepressants like buspirone can help reduce feelings of anxiety, and help you sleep better and feel more comfortable around people. Side-effects include drowsiness, dizziness, nausea, or sexual problems. If these bother you, you might be able to switch to another drug and see if it is better. Antidepressants are a long-term treatment for anxiety. They start to work after a few weeks, but people usually take them for at least six months.
- Antipsychotics such as aripiprazole or olanzapine can be effective for more severe or difficult cases.
- Beta-blockers, used primarily in the management of hypertension are effective in reducing peripheral symptoms of anxiety such as awareness of heartbeat.
The treatment you are offered will depend on several things, including:
• How severe your symptoms are.
• The type of symptoms you have.
• Whether you have another condition as well as anxiety, such as depression.
• Whether you are taking any other drugs that might interact badly with certain medicines.
• Whether you are pregnant or planning to become pregnant. Some of the medicines
used to treat anxiety are not suitable for use during pregnancy
• Whether there are particular side effects that might affect you with some medicines.
Things you can do for yourself
The psychological treatment should continue even beyond the therapist. You may use it as a way to learn how to help yourself and be your own therapist.
Meditation or regular exercises may be an alternative to visiting a therapist. You might also try cutting down on alcohol and caffeine intake, especially later in the day.
Improving your sleep hygiene may help with anxiety. This involves things like not eating, or drinking alcohol or caffeine, near to bed time, and avoiding daytime naps.
Anxiety in children
Cognitive behaviour therapy and some antidepressants work for children with anxiety. But antidepressants may have serious side effects in children, so they’re not often used.
Anxiety during pregnancy
Medicines are not generally recommended for treating anxiety during pregnancy especially during the first three months. Non-drug treatments are recommended instead. If you become pregnant while taking medicine for anxiety, you’ll need to discuss this with your doctor so that necessary treatment adjustments can be made.