Doris Obinna

Amos Salawu started suffering from anxiety when he was around 16. And now 27, he said he has never really found a cure for it.

He said: “I would suffer from severe anxiety attacks to the point that I was unable to socialise and found it difficult to complete everyday tasks.

“For me, periods of anxiety would last one to two weeks, completely exhausting me and eventually bringing on an episode of depression. The depressive state would last for one to two months before eventually lifting and I would be seemingly back to normal again.

“When I was about 23 I had an anxiety attack that was so severe that it threw me into a mental breakdown, which was followed by a long and very dark period of depression. However, out of that event I was really able to grasp an understanding of my anxiety/depression and ever since have always been able to stay well and not slip back into the cycle that I had been going through for so long.

“As I became aware that my thoughts were the cause of my anxiety, not necessarily the situation at hand, I was able to disregard these patterns of thinking that seemed to be the catalyst for these episodes. It seems to me that anxiety and depression is completely connected to distorted patterns of thinking, whether they are worrying about the future or dwelling on a past event. Whatever it may be, the thinking is negative and fearful and generates stress and anxiety, which ultimately leads to periods of depression.

“So being able to recognise these patterns of thinking and knowing they are the trigger for anxiety is incredibly powerful (has been for me anyway). Whenever I feel an episode of anxiety starting to come on I simply know that my thinking is out of whack. At this point, I simply try and stay present, stay in the here and the now and completely disconnect from my thoughts. It can be a difficult task initially, but every time I do it I feel the anxiety slowly dissipate and eventually subside completely. Whereas in the past I would mull over the thoughts in my head, which would drive the anxiety up further and eventually throw me into a state of depression.

“Today I have no worry or fear for my anxiety or depression. I feel like I truly understand it and see what the cause of it is. For me, it is distorted patterns of thinking and identification with the thoughts (believing the thoughts to be true). As soon as I became disconnected from them and conscious of what was happening I was free from the cycle of anxiety/depression that has caused me immense suffering for many years.” 

New figures show prescriptions for anti-depressants have risen by 9.1 per cent in just 12 months, a significant proportion of which were given for anxiety.

Experts offer a number of reasons for this worrying trend, including the recession, the pressures of social networking and the 24-hour society in which mobiles and technology encourage us to be available at all hours. 

It’s also been suggested that more people are seeking help as depression and anxiety lose their stigma. 

But some campaigners warn that anxiety is rooted in everyday stress, and we are over medicalising the problem by reaching for ‘happy pills’ to manage it.

Anxiety shares some symptoms with depression and, indeed, one often precedes the other. 

However, the key differences in anxiety is the presence of physical symptoms, or panic attacks, says Beth Murphy, head of information at mental healthy charity Mind, which has seen calls about the condition double.

Anxiety disorders are one of the commonest types of mental disorder, and highly prevalent in the general population across many settings. However, disparate findings with regard to the burden of anxiety disorders have been noted across contexts; with up to 18.1 per cent incidence rate and 28.8 per cent lifetime prevalence observed in previous study.

Closely linked is that anxiety disorders contribute significantly to the global burden of diseases and are much more encountered in stress-related scenarios, including work and training settings. While anxiety can be a normal reaction to stress as well as enhance performance when faced with challenges; it is however counterproductive, distressing and impairs functioning if severed enough to constitute medical disorder, ‘anxiety disorders.’

While depression is rooted in a sense of failure and loss, anxiety is a feeling that everything will go wrong.

Not everyone who has anxiety experiences panic attacks, but a lot of people will. The symptoms include increased heart rate, a dizzy feeling, sweating, shaking and feeling you are going to be sick or faint.

According to an expert, Dr. Sunday Olalekan, anxiety disorders constitute the largest group of mental disorders in most western societies and are a leading cause of disability. The essential features of anxiety disorders are excessive and enduring fear, anxiety or avoidance of perceived threats, and can also include panic attacks.

“Although the neurobiology of individual anxiety disorders is largely unknown, some generalisations have been identified for most disorders, such as alterations in the limbic system, dysfunction of the hypothalamic-pituitary-adrenal axis and genetic factors. In addition, general risk factors for anxiety disorders include female sex and a family history of anxiety, although disorder-specific risk factors have also been identified.”

He continued: “The diagnostic criteria for anxiety disorders vary for the individual disorders, but are generally similar across the two most common classification systems: the diagnostic and statistical manual of mental disorders, and the International classification of diseases.

“Despite their public health significance, the vast majority of anxiety disorders remain undetected and untreated by health care systems, even in economically advanced countries. If untreated, these disorders are usually chronic with waxing and waning symptoms. Impairments associated with anxiety disorders range from limitations in role functioning to severe disabilities, such as the patient being unable to leave their home.”

According to the Anxiety and Depression Association of America, roughly 40 million Americans live with debilitating anxiety disorders. Those afflicted suffer from weakness, nausea, dizziness, tremors, breathing difficulty, and heart palpitations. In more severe cases, those with anxiety disorders experience seizures. Many people with anxiety disorders avoid social situations for fear of being judged, embarrassed or humiliated. Others have recurring nightmares or flashbacks related to a traumatic event in the past.

 Causes

Researchers don’t know exactly what brings on anxiety disorders. Like other forms of mental illness, they stem from a combination of things, including changes in your brain and environmental stress, and even your genes. The disorders can run in families and could be linked to faulty circuits in the brain that control fear and other emotions.

According to experts, stress around work or school can lead to an anxiety disorder. Anxiety disorders have a complicated network of causes, including: Environmental factors: Elements in the environment around an individual can increase anxiety.

“Other factors may increase the risk of anxiety disorder, trauma, stress due to an illness, stress buildup, personality, and mental health disorders, having blood relatives with an anxiety disorder and drugs or alcohol,” says an expert.

 Symptoms

Common anxiety signs and symptoms include: feeling nervous, restless or tense, having a sense of impending danger, panic or doom and having an increased heart rate, breathing rapidly (hyperventilation).

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Other signs are, sweating, trembling, feeling weak or tired, trouble concentrating or thinking about anything other than the present worry and having trouble sleeping. Also, experiencing gastrointestinal (GI) problems, having difficulty controlling worry and having the urge to avoid things that trigger anxiety are all signs associated with anxiety disorder.

 Treatment

Experts recommended psychological treatment (usually cognitive behavioural therapy). If this has not worked, or if you have very severe anxiety, your doctor might recommend medication as well.

It is best to try psychological treatments first. They can work just as well as medication. Discuss the options with your doctor.

Psychological treatment: The best type of psychological treatment for anxiety disorders is cognitive behavioural therapy (CBT). When you do CBT you will start by learning about healthy anxiety and the way our brains handle anxiety. Then you will learn how to challenge your unhelpful thoughts and control your anxious thoughts and behaviours.

If the treatment is working you should see an improvement in 4–8 weeks.

Online CBT: You can get self-guided CBT online. It can be low cost or even free, and you can do it where and when it suits you. Online CBT from these websites has been shown to work well for anxiety:

Face-to-face CBT: You can do CBT face-to-face with a qualified therapist – usually a psychologist or psychiatrist. Around 8–12 sessions are recommended.

Exposure therapy: Exposure therapy is sometimes part of CBT. It’s where you gradually confront a situation that makes you anxious.

First, you make a list of all the things you like to do, but currently can’t. Then you start by doing the easiest thing, and gradually work your way up to the hardest.

 Types of anxiety

According to Olalekan, experiencing occasional anxiety is a normal part of life. However, people with anxiety disorders frequently have intense, excessive and persistent worry and fear about everyday situations. Often, anxiety disorders involve repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks).

Said an expert: “These feelings of anxiety and panic interfere with daily activities. They are difficult to control. They are out of proportion to the actual danger and can last a long time. You may avoid places or situations to prevent these feelings. Symptoms may start during childhood or the teen years and continue into adulthood.

“Sometimes anxiety results from a medical condition that needs treatment. Whatever form of anxiety you have, treatment can help.”

Generalised anxiety disorder includes persistent and excessive anxiety and worry about activities or events — even ordinary, routine issues. The worry is out of proportion to the actual circumstance, is difficult to control and affects how you feel physically. It often occurs along with other anxiety disorders or depression.

Anxiety disorder: Due to a medical condition includes symptoms of intense anxiety or panic that are directly caused by a physical health problem.

Panic disorder: This involves repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks). You may have feelings of impending doom, shortness of breath, chest pain or a rapid fluttering or pounding heart (heart palpitations). These panic attacks may lead to worrying about them happening again or avoiding situations in which they’ve occurred.

Selective mutism: This  is a consistent failure of children to speak in certain situations, such as school, even when they can speak in other situations, such as at home with close family members. This can interfere with school, work and social functioning.

Separation anxiety disorder: This is a childhood disorder characterised by anxiety that’s excessive for the child’s developmental level and related to separation from parents or others who have parental roles.

 Why people develop anxiety

As with most mental illnesses, researchers believe anxiety is caused by more than just genetics. Anxiety disorders are likely developed from a complex set of risk factors, including brain chemistry, personality and life events. Less commonly, medical conditions are known to cause anxiety disorders.

A research shows that anxiety disorders are forged over years of experiences. In fact, any experience you have ever had can cause an anxiety disorder. And, despite how common they are, the specific causes of this mental illness are still unknown.

What studies do show, though, is that anxiety disorders appear to run in families. However, as with most mental illnesses, researchers believe anxiety is caused by more than just genetics. Anxiety disorders likely develop from a complex set of risk factors including brain chemistry, personality, and life events. 

Less commonly, medical conditions are known to cause anxiety disorders. Heart disease, diabetes, seizures, thyroid problems, asthma, drug abuse and withdrawal, rare tumors that produce certain “fight or flight” hormones, and muscle cramps or spasms are all possible medical causes of anxiety. Most anxiety disorders develop in childhood and young adulthood. Therefore, if an anxiety disorder develops later in life, a medical condition is likely the source.

Studies also suggest that a person’s environment can cause anxiety and, in some cases, may trigger anxiety disorders by themselves. Long-term stress, like one would experience in an unhealthy relationship or at a particularly stressful job, can lead to anxiety disorders. One’s upbringing and life experiences can contribute, too. Other environmental factors include trauma, especially in those with PTSD, change, such as with a significant move or a divorce, and abuse or neglect. 

Anxiety disorders are incredibly complex and finding out the exact reasons you have one can be difficult. However, the most important thing to understand is that no matter what causes your anxiety, it can always be treated.  

 Speak to a doctor

Your worries may not go away on their own and they may get worse over time if you don’t seek help. See your doctor or a mental health provider before your anxiety gets worse. It’s easier to treat if you get help early.

If you have symptoms, your doctor will examine you and ask for your medical history. He or she may run tests to rule out medical illnesses that might be causing your symptoms. No lab tests can specifically diagnose anxiety disorders.