What is Anxiety?
Anxiety is a condition in which the individual suffers from stress under various circumstances like taking a test, giving a stage performance, attending an interview etc. While short time stress improves alertness as well as memory keeping us motivated; there are times when stress moves from being a motivator to a totally overwhelming situation and it isn’t a pleasant experience. This is called anxiety disorder and leads to panic attacks, palpitations, confusion, sleeplessness, fainting, trauma and lack of confidence. These symptoms are mutually exclusive (not dependent on one another) and one may or may not experience all of them. They are categorised according to the conditions that cause anxiety.
What are the types of anxiety?
- Generalized anxiety disorder:
GAD (Generalized Anxiety Disorder) is a diagnosable condition characterised by repetitive, excessive, unrealistic worry and a cluster of physical symptoms as muscle tension, restlessness, fatigue, irritability and sleep difficulty.
- Social anxiety disorder:
Anxiety restricted to specific PERFORMANCE and acting in a way showing symptoms of extreme discomfort fearing that you will be NEGATIVELY SCRUTINIZED by others is termed as social anxiety disorder.
- PTSD (Post Traumatic Stress Disorder):
Post Traumatic Stress Disorder ,also called PTSD, happens when some memory of a past traumatic event- like war or sexual assault-causes recurrent mental and physical distress. Now the Diagnostic and Statistical Manual (DSM 5th edition) categorises PTSD as “trauma-and –stress- related –disorder” that happens when the symptoms of an acute stress response persist for over a month.
- Panic disorder:
Panic disorder is a condition that has frequent and repeated episodes of something called panic attacks. These panic attacks are periods of intense fear and discomfort that something bad is going to happen. These panic attacks may occur even in familiar places where no real threats exist. They usually come about suddenly and peak within the first ten to twenty minutes. But sometimes symptoms can last about one hour or more. They feel that there is some real threat or danger. This reflects on the body giving an experience of a heart- attack or serious life-threatening illness. But they are actually not.
What makes anxiety a threat to mental health?
When the anxiety caused due to day-to-day disturbances at home and workplace becomes so unbearable that you are not able to carry on with your normal work then it becomes more complicated and bothersome. It is at this stage that you need some support from your friends and family. With their guidance and help, most of us are able to find a solution. In some chronic cases, we may need medical intervention to find symptomatic relief from acute anxiety. The medicines however cannot be consumed without any consultation. A good psychologist will help you understand your mental health through some analysis and questionnaires and may recommend consultation from a psychiatrist. The psychiatrist may prescribe a few drugs to reduce your suffering due to stress and anxiety.
What causes anxiety?
- Impractical expectations
- Unwillingness to change
- Absence of achievements
Is Anxiety a chemical imbalance?
Recent studies have shown that both anxiety and depression are caused by prolonged stress on brain due to several internal and external reasons discussed above which further causes a chemical imbalance in our brain. Studies suggest that an imbalance of certain substances called neurotransmitters (chemical messengers in the brain) may contribute to anxiety disorders. The neurotransmitters targeted in anxiety disorders are gamma-amino butyric acid (GABA), serotonin, dopamine, and epinephrine.
Just like the occipital lobe handles vision and the temporal lobe processes sounds, our emotional responses have their own brain regions. The limbic system is a complex set of structures deep inside the brain that includes the hippocampus, amygdala, hypothalamus, and thalamus. This circuit is believed to handle most of our emotional processing and the prefrontal cortex is responsible for integrating this emotional information into our decision making.
Scientists believe that anxiety disorders pop up when there are changes in the signalling of the limbic system. Of course, we can’t go digging around in living people’s brains to see how their neurons are firing, but scientists can study this theory using non-invasive imaging techniques, like FMRI and PET scans. This kind of research has found out patients with anxiety disorders have more activity than normal in the limbic system.
Importantly, there is a trend for these patients to have hyperactive amygdala, which is interesting because the amygdala is sometimes considered as the” fear centre” of the brain. Each disorder has its own quirks, too.
Patients with Generalized anxiety disorder also seem to have larger amygdalas than controls. So their brains have more machinery to process fear information which then reacts more strongly to negative emotional stimuli. Like in PTSD, this might be a result of excessive excitatory signalling in the limbic system
In social anxiety disorder, being exposed to images of faces leads to extra activity in the amygdale. So people who are anxious in social situations are processing social information through a layer of fear making those environments stressful for them.
PTSD, on the other hand, might be a result of too much excitatory signalling in the hippocampus and amygdala, leading to intense emotional reactions to triggering stimuli. PTSD might be partially caused by our logical brain regions being forced to process emotional information, giving our brain a harder time controlling those thoughts.
In Panic disorder, the amygdale hyperactivity might be caused by less GABA, the main inhibitory neurotransmitters in some areas of the brain. This could lead to less inhibitory signalling in the emotion circuits making it harder to confront panicky feelings.
Researchers are still working out a lot of the details on how differences in the brain lead to these conditions.The limbic system has a lot of parts and there’s a lot of variations in the symptoms and severity of each of these disorders.
How to treat Anxiety Disorders?
CBT and Medication
CBT(Cognitive Behaviour therapy): This is a talk therapy involving psycho-social intervention in which there is an interaction between the therapist and us to find out the way we look at our problems and try to work out a way to come out of the repetitive pattern of anxiety.
The most common drugs prescribed for anxiety disorders are
SSRI: selective serotonin reuptake inhibitors, or SSRIs,
which are also commonly prescribed for depression.
How does SSRI work on one’s Brain?
SSRIs function by inhibiting the reuptake of serotonin, a neurotransmitter. In the brain, serotonin is known to be involved in mood, sleep and appetite regulation.
SSRIs block neurons from reabsorbing serotonin after its released, leaving it lingering in the
synapse, where it can repeatedly stimulate the receiving neurons and push the neighbouring neurons to adjust their serotonin signalling SSRIs are used for long term anxiety management.
Though it’s not known completely how SSRIs work it seems to help.
SNRI: Alternatives to SSRIs are serotonin-norepinephrine reuptake inhibitors or SNRIs. They not just block the reuptake of serotonin but also block absorption of serotonin and norepinephrine, also called noradrenaline. This neurotransmitter is linked to alertness, attention and action readiness.
Benzodiazepines: Benzodiazepines or else called Benzos may be prescribed for crisis management in anxiety disorders. These medicines have a sedative effect and act as muscle relaxants.
Unlike SSRIs and SNRIs, Benzos are addictive because of their immediate relaxing effect and can be easily abused.
Natural medicines :
about three cups of Chamomile per day,
1-3 gms of omega-3s,
breathing in lavender,
adding L –lysine to your diet,
getting natural sunlight for about 15 minutes in a day,
exercises for at least half an hour a day
Yoga and meditation are a part of life for their excellent calming effects on mind , body and soul.
Ayurvedic medicines through some reliable consultant Ayurveda practitioners could really help in a rapid mental clarity and good health.
I would like to thank all the researchers and scientists who work day and night to find out ways to cure our problems through advanced medicines and treatments. Being a depression patient myself, I have been under SSRIs and CBT for the past seven years, until recently, due to the severity of my symptoms , it was extremely difficult for me to carry on my normal life but gradually I have come to a lot better lifestyle changes due to medical intervention.