Tag: anxiety

Fear is something that everybody experiences. We all have fear, and fear is a normal response to a threat. The difference with anxiety is that anxiety is more diffuse. It’s not specific to a threat. It’s more global and it’s more vague and general. A fear of elevators could be rational if you know that the elevator reached the maximum capacity or you know for sure that it’s been failing or is shaking strangely, that’s rational, and avoiding that is normal. But anxiety would be for someone to be afraid of elevators, even though it’s a perfectly functioning elevator you know has been recently installed and checked and technically is flawless, and you still have anxiety about that. Anxiety disorders are a large family with several individual disorders, but it’s important to know that sometimes they happen together or you may have one and a little bit of another one. But the most common are panic disorder, social anxiety disorder, we have also generalized anxiety disorder, separation anxiety disorder, and the last one is selective mutism. It’s a rare disorder that is mostly seen in children. In psychiatry, probably the most successful group of illnesses or disorders that we can treat successfully are anxiety disorders. The treatment of choice is therapy. Multiple therapies are validated by research that can be effective. In addition to that, we can use medications that are just as needed, for example, panic attacks. Many people use a type of medication called benzodiazepine. There’s a family of anti-anxiety medications. They can work for someone who has only sporadic attacks, but not for someone who has chronic, what is called generalized anxiety disorder, because it’s easy to become dependent on those medications. The other mainstay type of treatment in terms of medications is antidepressants, specifically the so-called serotonergic antidepressants. Some of them, for example, are sertraline or paroxetine and these medications increase the transmission of serotonin in the brain and can alleviate some of the symptoms of anxiety. When we are thinking of treatment for anxiety disorders without medication, we have therapy, but also we have self-help. So we can do a lot with self-help. Probably the most effective are all kinds of activities that tend to reduce the activation of the stress response system in the body. So the stress response system releases several chemicals, like cortisol and adrenaline, but also changes the heart rate, breathing, and so forth. And so there are many activities, including meditation, yoga, tai chi, and sports in general, aerobic exercise, that can down-regulate the activation of the stress response system. In addition to self-help, another type of non-medication, non-pharmacological treatment for anxiety disorders is therapy. Counseling. And several types are specific for anxiety and they’re being developed through research and they are highly effective. One of the most common and most well-known is cognitive behavioral therapy, which is a systematic training of the patient to identify certain thoughts and beliefs that can be challenged, and the challenging of switching reframing, and changing those thoughts can alleviate anxiety. The main coping skill for anxiety is avoidance. Unfortunately, avoidance is the worst thing that we can do because it will perpetrate and make it chronic. The more we avoid something, the more powerful that fear becomes, or that anxiety. Therefore, one of the treatments for anxiety is to try not to avoid the triggers, is to expose ourselves as much as we can tolerate that. For example, if public speaking is a source of anxiety, some of us can get trained and go to Toastmasters, and go to a setting where we feel safer and slowly and progressively expose ourselves. Because the brain learns not to react. With more practice, we lose that fear. If you believe that you have an anxiety disorder, I would say the first thing to do could be a screening for that. That could be done by your primary care physician or yourself. One of the most common tools to screen for anxiety disorder is called General Anxiety Disorder-7. GAD-7. And that’s widely available in the public domain on the Internet. And if you have a suspicion of an anxiety disorder, I would go to your primary care doctor. Alternatively, you can go to a therapist because this, can be very effective and the therapist would be prepared to tell you, “I think you need medication in addition to therapy.”.

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