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Anxiety

Anxiety

What is Anxiety?

The body’s natural response to either stress or strain is called anxiety. A feeling of fear or apprehension about the outcome and about what is there to come next is the feeling during anxiety. Feeling worried about the first day of school, for a job interview, a speech at the stage, or any problem at work either with a boss or with colleagues, all bring butterflies in your stomach. People either feel nervous or fearful of the upcoming situation and remain worried about the result. Some people feel anxiety for the things which we feel minor in our minds as traffic hazard on the roads or too many people moving in the supermarket etc.

Everyone experiences a bit of anxiety from time to time either in adult life or a child but for some people the episodes of anxiety may vanish off after the occasion but for others, it may continue for longer. Few minutes to a few days or months or maybe a part of life as long as a decade. Chronic anxiety becomes severe with each passing day and interferes with our everyday life. The chronic anxiety situation which lasts for years and years may be considered as an anxiety disorder, a disorder, or disturbed mental state that needs to be dealt with either with lifestyle changes or medication.

Origin of anxiety disorder:

To feel a bit anxious for a new living place, a new work area, or appearing in exams is very normal anxiety which may be regarded as consciousness and awareness of the new environment and your responsibility. It is the motivational approach that compels you to work harder for yourself and to prepare your skills and knowledge according to the competition level. This kind of ordinary anxiety may come and go by itself but it doesn’t bother your everyday life.

The feeling of anxiety overhauls your mind and soul with continuous fear and makes you debilitated with the intensity of anxiety feeling. It may cause aversion feelings to your mind and heart, letting least to enjoy within normal life. These feelings may intervene in your daily routine life as preventing you from entering an elevator, crossing the street, leaving your home, sleeping properly, etc. This type of anxiety may worsen with the passage of time if left untreated. The feeling of anxiety is a type of emotional disorder that may occur at any stage of life, either due to an arousing situation or a complex family drama or may become a part of life due to some prolonged residential situation at a certain place. Women are more likely to face the issue of anxiety disorder than men due to several reasons as emotional disturbances, hormonal fluctuations, etc.

Types of anxiety disorder:

Anxiety is a type of disorder that has certain types and kinds depending upon the duration, intensity of disturbance, causes of disturbance, and underlying reasons. These types may be treated according to the reason and base on lifestyle changes, home treatments as well medicated treatments. Anxiety may become the key disorder that may play a role to result in certain other disorders and effects. These are as under:

  • Pain disorder:

Panic disorders are experienced by the patient as a recurring attack of pain and fear at unexpected times when the patient or the attendant may have the least idea of the attack. The anxiety and fear as well as uncertainty of the next upcoming panic attack may create panic in the patient.

  • Phobia:

Phobia may be considered as an abnormal mental situation in which the patient may become incapable to come out of certain feelings like fear or aversion or prohibited feeling from any particular situation, activity, or a certain object.

  • Social anxiety disorder:

A very uncommon anxiety disorder in which the sufferer may become fearful to attend any social activity, any function, any type of gathering, or to face people socially due to extreme fear of being judged by others in any social situation.

  • Obsessive-compulsive disorder:

An anxiety disorder that may cause irrational thoughts in people creating compulsion and obsession in their minds. This obsession for a certain place, object, and even sometimes people may lead you to perform specific, repeated behaviors that may irritate others around you.

  • Separation anxiety disorder:

An anxiety disorder that may cause you to experience fear of getting away from your home or your habitat or loved ones. This type of anxiety may create homesickness or certain other conditions as nausea, vomit, or vertigo that may be the reaction of the body against anxiety.

  • Illness anxiety disorder:

Anxiety feeling about your health condition is known as hypochondria. It may be the outcome of awareness about any serious disease overcoming you or the after-effects of any serious illness about which you get an idea before starting treatment.

  • Post-traumatic stress disorder (PTSD):

The anxiety stage comes as an aftershock of a traumatic event or any stressful occasion that may have affected your body and soul.

Effects of anxiety on the physiological systems of the body:

Anxiety may impart a number of effects on different physiological systems of the body. Some of the effects are listed below:

Effect on central nervous system:

Stress hormones are released on regular basis by the brain by effects of long-term and prolonged anxiety. The symptoms that may appear as a result like dizziness, depression, and headaches may become more frequent.

Any type of threat, fear, stress, or agitation gets a response from your body in the terms of release of chemicals and hormones released by the brain making a flow towards the nervous system. The main hormones and chemicals are cortisol and adrenaline. Occasional release of these hormones and chemicals gives a precise back up to you to fight against these symptoms but long-term release may cause damage to the physical health of the patient in the long run. As an example, you can watch the effect of cortisol on the anxiety patient, the patient gains high weight, and his/her body mass index increases as a result.

Effect on the cardiovascular system:

Long-term anxiety or uneasiness may cause a negative effect on the cardiovascular system as palpitations, chest pain, rapid heart rate or sudden cardiac arrest feelings, shortness of breath, and many other outcomes. Increased blood pressure, heart diseases, or other coronary events may be provoked due to the effects of anxiety disorder.

Effect on excretory and digestive system: The excretory and digestive systems are directly under the supervision of the parasympathetic nervous system, the system of rets and digest network. Any changes either negative or positive have a direct effect on the digestive systems. Loss of appetite, diarrhea, nausea, stomachaches, and other digestive issues may cause concern for the patient. Anxiety disorders and irritable bowel syndrome are interrelated and may result in prolonged nausea, vomit, diarrhea, or constipation.

Effect on the immune system:

The fight and flight system of the body or the sympathetic nervous system is triggered by any negative stimulus as anxiety, fear, stress, or any other mental state that arouse the fighting spirit of the body. Anxiety may also cause the trigger and stimulate the sympathetic nervous system of the body to release a flood of hormones and chemicals as adrenaline stimulated by the sympathetic neurotransmitters as epinephrine or nor-epinephrine.

Initially, as a response to the short-term stimulation, the pulse rate and breathing may enhance to provide more oxygen to the brain. The brain and body get prepared for a bout of anxiety, direct response as a reaction, a brief boost of the immune system to face the challenge, accept it and respond to it. When the occasional stress episodes are repeated, the immune system of the body responds normally and gets back to a normal state once anxiety is over. But if the exposure to stress and fear become routine work, then the body’s system becomes tolerated and it never comes back to its normal functioning. This scenario causes a weakening effect on the immune system, making your body more vulnerable to any attack of viruses or bacteria, or any other pathogens. Vaccines and drugs may not get the normal response of the body if the body is suffering through physiological changes caused by anxiety.

Effect on respiratory system: As a first response to the anxiety effects, the breath may become rapid and shallow to cover the fear. Patients suffering from either respiratory illness like chronic obstructive pulmonary disorder (COPD) or asthma may have a high risk for hospitalization during anxiety-related complications.

Effect on the overall condition of the body: Insomnia, muscle tension, depression, headaches, social isolation, and many other symptoms might appear as a result of the worsening effects of anxiety on the normal physiological functions of the body.

General causes of anxiety:

Although yet the research and the scientists have not carved out the complete background and reasons for anxiety and its disorders. The exact cause may be unknown but a combination of different environmental and health factors as well as genetic ones may become the underlying cause of the effects of anxiety and its display of symptoms.

Traumatic injury or experiences: Any traumatic history or event or injury may cause anxiety in people who are prone to it and may create anxiety years after the event at its slightest recall.

Genetics: Genetically, few people are prone to the development of anxiety symptoms and they face fears and stress more than others.

Underlying health issues: Any underlying health issues as cancer, cardiac disease, renal issues or any other may become the underlying reason for the anxiety disorder and its symptoms.

Hormonal fluctuations: Any imbalances in the hormones acutely or chronically at a certain stage as pregnancy, periodical menstruation, menopause, or any other such condition that may cause stress may prompt anxiety.

Allergic reaction to food: An allergic reaction to certain food may create anxiety and fear to face the after-effects of that food taken either by mistake or willingly.

Change of sleeping habits: Travelling to another area than the original habitat may alter the gastric habits and digestion processes with changes in time and sleeping habits. This may cause anxiety or distress, sometimes depression that may alter the mental state of the patient.

Accompanied disorders: Anxiety along with bipolar disorder or any other accompanied disorder may synergize to arouse and enhance the symptoms of anxiety and fear, a distressed mental state.

Amygdala: Scientists and researchers do believe that the part of the brain responsible for the development of feelings of fear may be the reason behind anxiety development and that is the amygdala.

Symptoms of anxiety:

The normal response to certain changing environments or jobs or homes is a normal state of anxiety that vanishes with the passage of time. It doesn’t need any treatment. But, if it prolongs with the passage of time and causes irreversible changes on normal physiological systems of the body then you may have to observe its proper onset, signs, and symptoms to let it be diagnosed properly and then treated. The most common signs and symptoms of anxiety are:

  • Excessive worrying: Excessive worrying is one of the leading symptoms of anxiety. Normal worrying about an upcoming event, a wish, or something you are waiting for is a normal response and is disproportionate with the triggering events in everyday situations. Prolonged worrying for more than six months and uncontrollable worrying that is recorded as unusual is considered anxiety symptom. Worrying may be intrusive and severe that makes your concentration and ability to accomplish daily tasks quite tough. The highest risk is to the patients under the age of sixty-five for generalized anxiety disorder. These people become more prone to anxiety disorder if they have many life stresses and lower socioeconomic status since it may enhance their life worries and anxieties.
  • Feeling agitated: Feeling of anxiousness imparts change to the normal parasympathetic system of the body causing a shift of the curve towards arousal and activation of the sympathetic nervous system which runs into overdrive. A cascade of events becomes activated by this action throughout the body resulting in a racing pulse, shaky hands, dry mouth, sweaty palms, and perspiration on the forehead, etc. Your brain senses danger around and inside the body and these symptoms occur as a preparatory stage to react to the threat. In case you need to run or fight, your body shunts away blood from your digestive system and towards your muscles to make them prepared for fight and flight.

 Your heart rate increases and your senses become heightened. These all are the mechanistic symptoms that help your body to get the immune system activated to fight off all incoming true threats as anxiety and fear. But if the fear is only in the head then it causes debilitation in the whole body without any physical outcome and use of that fear. People with anxiety disorders are unable to reduce their arousal as fastly as people without anxiety disorders. It means that people with anxiety disorders feel the effects of anxiety and fear for a very long time.

  • Restlessness sensation: Another common symptom of anxiety in children and teens is restlessness sensation. An uncomfortable urge to move, irritability to sit at one place, feeling on edge are the symptoms of restlessness sensation. It is reported to be present in seventy-four percent of patients with anxiety. You cannot assign the symptom for all patients yet it becomes a red flag symptom for doctors to get it diagnosed as an anxiety symptom. If restlessness continues for more than six months on the majority of days, it’s a clear-cut sign of anxiety disorder.
  • Fatigue: Another potential symptom of generalized anxiety disorder is fatigue. Anxiety is normally associated with hyperactivity or arousal normally so it becomes surprising to consider fatigue as an anxiety symptom. Fatigue may follow an anxiety attack in few people while for a few it may become chronic. The underlying reasons may be unknown but we may assign certain features for its occurrence as muscle tension, insomnia, or hormonal fluctuations. Fatigue alone cannot be considered as an anxiety disorder diagnostic feature since it may also be a sign of depression or other medical conditions.
  • Difficulty concentrating: Once the mind is affected, the concentration and direction of the mind becomes a difficult thing. Several patients report the loss of concentration, almost referring to two-thirds of the people. More is the severity and intensity of anxiety, more is the difficulty in concentrating. Short-term information is held by the working memory that becomes interrupted by anxiety disorders. The more is the level of worsened anxiety, the more difficult it becomes to concentrate. During the high anxiety phase, people experience a dramatic decrease in performance. Although difficult concentration is an important symptom of few other disorders as depression or attention deficit disorder, so it cannot be considered evidence for anxiety disorder alone.
  • Generally irritability:

Excessive irritability is being experienced by anxiety patients because of the fluctuations in the level of mediators during anxiety. The middle-aged patients and the young ones face more irritability in their day-to-day lives than the old-age patients during anxiety. Since arousal and excessive worrying are associated with the rise in anxiety disorder so irritability is the symptom accompanying anxiety.

  • Tense muscles:

Another important symptom of anxiety is tense muscles and stiffness in all muscles of the body. The muscles become stiff as a response to the increased flow of adrenaline or epinephrine due to the activated sympathetic nervous system. Epinephrine or nor-epinephrine are the neurotransmitters of the sympathetic nervous system which cause increased energy activation and flow of blood towards muscles. The patient feels fearful and to compensate for that fear and restlessness, the body muscles get tension. If muscle relaxation therapy is used to decrease muscle tension during anxiety, it indirectly affects the anxiety and ultimately controls the severity of anxiety disorder.

In generalized anxiety disorder too, muscle relaxation therapy reduces worry in people as it is effective in cognitive behavioral therapy.

  • Trouble falling or staying asleep: Any disturbance physiologically, pharmacologically, socially, mentally, or due to any other reason causes a direct effect on the sleep patterns, sleep frequency, and sleep duration directly. Anxiety disorders have a more strong connection with sleep troubles, either to fall asleep initially or once slept then to stay asleep for long. Patients have reported waking up in the middle of the night and they feel impossible to fall asleep again. Few cohort studies have reported the anxiety development in people at a later age to be associated with insomnia conditions during childhood. Insomnia may be related to anxiety development or anxiety may be related to insomnia situations and vice versa. It may change according to the situation and these may be interrelated always.
  • Panic attacks: Recurring panic attacks are associated with anxiety disorders. The fear of upcoming panic attacks may produce an intense and overwhelming sensation of debilitating fear. Other accompanying symptoms are sweat, rapid heartbeat, breath shortness, shaking, nausea, fear of dying, losing control and chest tightness, etc. Isolation provokes panic attacks to a higher degree but if the panic attacks occur frequently and unexpectedly, it may be considered a panic disorder.
  • Avoiding social gatherings:

Patients with anxiety feel anxious or fearful about social gatherings or social situations. They feel scrutinized by others unwillingly and feel worried about being judged. They may feel humiliated and embarrassed in front of others so try to avoid social gatherings and events. They don’t want to face people due to self-made assumptions about them. The patients suffering from anxiety may feel shy and quiet to avoid confrontation with people who may get an idea about their fearful and anxious nature avoiding moving in groups or with relatives even. Although most of them are capable to hide their feelings of fear and anxiety and don’t appear distressed but inside they burn like a fire to hide their stress.

  • Irrational fears: Anxiety patients may feel or face phobias about certain things, living or non-living, heights, odd situations, enclosed spaces, or other unknown fears or phobias. Phobia is a severe condition of fear or anxiety that interferes with your ability to perform your functions normally and in a precise way. Some of the commonly associated phobias may include:

Phobia of animals: Fear from certain animals, insects, or living beings.

Phobia of natural environments: Fear from natural calamities as floods, tsunamis, hurricanes, etc.

Phobia of blood-injection-injury: Fear from injections, needles, injuries, or blood.

Phobia of certain situations: Fear from certain situations as elevator ride or airplane, heights, lifts or high bridges.

Agrophobias: Fear from using public transportation, being in open or enclosed spaces, standing in queue or crowd, being alone at home, etc.

These all symptoms may vary from person to person, and even in the same person on varying days. The reasons for variation maybe your individual immune system, mental level, and your lifestyle habits that may either promote or demote your diseased condition. Try to adopt healthy lifestyles and nutritious diets to prevent anxiety and other disorders. Try to stay away from stress and stressful situations, try to indulge in family talks and family gatherings to combat the isolation and other situations that may enhance the symptoms of anxiety. If your child is suffering from anxiety, then give him/her more attraction, love, and affection to prevent the anxiety from converting into an anxiety disorder. A visit to a psychologist must be done to take guidance for permanent eradication of the symptoms of anxiety or other mental issues. Take proper sleep and try to remain calm and in a serene environment to make a healthy atmosphere for yourself, and your family members.

Treatment strategies for anxiety:

Anxiety may attack at any stage of life and after the tough time passes, the symptoms often go themselves. But an anxiety disorder is different and needs to be managed properly. Psychotherapy and medication, as well as lifestyle changes, are typical types of treatment used to treat. Over- the counter drugs, as well as prescription drugs, are used for patients with severe symptoms

Prescription medicines available for anxiety:

Normally it is difficult to cure anxiety disorder completely, but the symptoms can be managed to make you feel better and enhance the physiological functions of the body. Several types of medications are available to counter the effects of anxiety and relieve its symptoms to a large extent. Every person is different in symptoms and perception of disease severity as well as symptomatology. Some of the drugs that are used frequently include:

Benzodiazepines:

Sedatives that help muscles to relax and calm your mind are benzodiazepines. Certain neurotransmitters of the brain named GABA neurotransmitters are controlled with the help of these benzodiazepines. The effects of inhibitory GABA receptor is increased under the influence of benzodiazepines which bind with the benzodiazepine receptors inside the brain and relay the messages of inhibition through these receptors producing calming effects and sedation.

Many anxiety disorders can be treated with benzodiazepines as panic disorder, generalized anxiety disorder, and social anxiety disorder. Examples of the drugs are alprazolam, chlordiazepoxide, clonazepam, diazepam, and lorazepam. Benzodiazepines induce drowsiness and sedation but are used for short-term treatment of anxiety. Benzodiazepines can be misused for their characteristic properties. Side effects of benzodiazepines cannot be ignored. These include vision problems, headaches, confusion, and depression. If the doctor has given you benzodiazepines regularly for more than two weeks or more then must not leave the tablets immediately otherwise seizure can occur. So must reduce the dose slowly tapering off the dosage to reduce the risk of seizure.

Buspirone:

Short-term as well as long-term anxiety can be treated with Buspirone which increases the number of inhibitory neurotransmitters similarly to benzodiazepine but at a different receptor. It regulates the mood in the brain through the release the chemicals. It takes several weeks to h=gain full efficiency of the drug. The side effects include nausea, headaches, and dizziness.  Sometimes difficulty sleeping and strange dreams also occur as side effects.

Antidepressants: The anti-depressants bind to the receptors of depression in the brain and block the release of neurotransmitters that mediate the effect of anxiety. They take four to six weeks to produce noticeable results of anti-depression. Certain types of anti-depressants are available depending upon the types of receptors.

These types are:

SSRIs (Specific Serotonin Receptor Inhibitors): Specific serotonin receptor inhibitors block the receptors of serotonin, thereby increasing the levels of serotonin in the blood. Serotonin is a neurotransmitter that affects appetite, sexual desire, memory, and sleep activities. These specific serotonin receptor inhibitors are started with a low minimal loading dose that is gradually increased as a maintenance dose. Examples of specific serotonin receptor inhibitors are fluoxetine, escitalopram, paroxetine, and sertraline, etc. The side effects may occur with prolonged use as nausea, dry mouth, muscle weakness, diarrhea, dizziness, drowsiness, and sexual dysfunction which may occur due to blockage of serotonin receptors and dilation of smooth muscles of male genitalia. Despite all these effects, the specific serotonin receptor inhibitors are tolerated well.

Tricyclics: Tricyclics are a type of antidepressant that works well to combat anxiety disorders except for obsessive-compulsive disorder. Just similar to SSRIs, these work to block receptors in the brain and are given at low doses initially, later increased gradually. Specific examples of these tricyclics are clomipramine and imipramine. Now, these tricyclics are less used since new ones have been discovered with fewer side effects. The side effects of these tricyclics include drowsiness, lack of energy, constipation, nausea, blurred vision, weight gain, constipation, and vomit.

MAOIs(Monoamine oxidase inhibitors):

Monoamine oxidase inhibitors or MAOIs treat social phobias and panic disorders. The monoamine oxidase inhibitors inhibit the monoamines, the neurotransmitters that regulate mood and behavior. Typical examples include isocarboxazid, phenelzine, selegiline, tranylcypromine, etc. The side effects of monoamine oxidase inhibitors are more pronounced than those of newer drugs so these are used with certain restrictions. You are prohibited to take certain food items like cheese and red wine with monoamine oxidase inhibitors. Using monoamine oxidase inhibitors with cheese or other foods may cause a rise in blood pressure of the patients and other life-threatening side effects. Monoamine oxidase inhibitors are very reactive so they may possess drug-drug interaction with few other medications as specific serotonin receptor inhibitors, ibuprofen, acetaminophen, both of which are pain relievers, some birth control pills, some cold and allergy medications, etc.

Beta-blockers: Effective treatment for heart conditions is carried out with the help of beta-blockers since we have bet-receptors on our heart, beta-1 receptors. Off-label they help to combat the effects of anxiety by producing calming effects on the heart and thereby relieving the symptoms of anxiety, especially in social anxiety disorder. Propranolol, a beta-1 and beta-2 blocker may be used to reduce the anxiety symptoms in stressful situations as preparing for a speech on stage or appearing for an interview, or attending a family gathering. Although beta-blockers are well tolerated most of the time some side effects may occur in certain patients as fatigue, dizziness, drowsiness, dry mouth, trouble sleeping, nausea and shortness of breath, etc.

DIY Treatment Strategies and Methods for Anxiety:

Stress and anxiety can be relieved by making changes in everyday lifestyle and participating in healthy mental as well as physical activities eliminating the unhealthy ones. Natural remedies and DIY strategies help to improve your everyday life to fight against anxiety symptoms

These include:

  • Exercise: By regular exercise in your everyday routine and following a healthy active lifestyle imparts quite a positive impact on your overall health including any diseased state as anxiety and uneasiness. Endorphins are the neurotransmitters that are produced by regular exercise. Endorphins act as natural pain killers of the body and help to improve your sleep and rest. Long-time regular routines of exercise, as well as short exercise sessions, help to elevate your mood generally and decrease stress levels and anxiety.
  • Meditate Isolated quiet time to meditate and focus on your own at least for fifteen minutes is meditation, the best way to eradicate the symptoms of stress and anxiety. Deep breathing and focusing on yourself with relaxation help calm your anxiety. You may repeat a motivational mantra, any recitation, or listen to certain music of your choice regularly to stay away from all stress and depression. Yoga helps greatly to relieve stress.
  • Chamomile tea: Chamomile tea is a natural ingredient in the form of a chamomile supplement or chamomile tea to ease anxiety symptoms. An intake of chamomile supplement at least three times a day on regular basis may reduce the symptoms and adverse effects of severe generalized anxiety. Chamomile tea twice a day may decrease anxiety.
  • Aromatherapy oils: Diluted aromatherapy oils can be smelled and inhaled which helps to reduce anxiety. Examples of such oils are lavender, neroil, and chamomile.
  • Avoid caffeine: More caffeine intake may make a person feel jittery and more anxious. Caffeine arouses the nicotinic receptors in the brain and skeletal muscles making you more active and more responsive to surroundings increasing your consciousness and elevating anxiety symptoms. Avoiding caffeine can help anxious patients get rid of it.
  • Avoid alcohol: Alcohol may interact with dopamine receptors and inhibit the reward system of the body thus imparting negative effects on the anxiety and moods of the patient. Avoiding alcohol may help anxiety patients.
  • Quit smoking cigarettes: Smoke cigarettes act in the same way as caffeine by interacting with nicotine receptors. Avoiding cigarette smoke may relieve anxiety and uneasiness.
  • Staying active: Healthy mind bears healthy life and healthy life is associated with activeness. Staying active keeps you alert and helps to promote endorphins and will for life and smile. It may help to demotivate the symptoms of anxiety and make your life better.
  • Healthy diet: Avoiding narcotics, alcohol, smoke, tea, caffeine, and all unhealthy food and replacing it with healthy fresh fruits, vegetables, white meat, and other healthy juices may alleviate your energy levels to combat the effects of anxiety, etc.

What is an anxiety attack:

An overwhelming feeling of apprehension, distress, worry, or fear is the state called attack of anxiety. Most people feel the attack slowly and steadily and it may worsen with the approach of stressful events. The anxiety attacks may vary greatly and there may a lot of differences in the display of symptoms among individuals depending upon their age, severity, immunity level, mental level, and ability to cope up with the situations. These symptoms change over time and they don’t happen to everyone in the same capacity. Common symptoms of an anxiety attack include:

  • Faint or dizzy: The patient may fall suddenly due to dizziness or faintness initiating from the mind and ultimately ranging to the whole body.
  • Shortness of breath: The patient may suffer from chest tightness or shortness of breath making it difficult to breathe easily.
  • Dry mouth: The patient may suffer from dry mouth and lips due to blockage of the parasympathetic system and activation of the sympathetic nervous system.
  • Sweating: Sweat attacks and perspiration may be a leading symptom of an anxiety attack.
  • Chill or hot flashes: Sudden changes in mood and temperature causes cold or hot flushes.
  • Apprehension or worry: The patient becomes fearful and feels worried unknowingly.
  • Restlessness: Unknown feeling of uneasiness and restlessness continuously accompanies the patient until he or she is made to sleep.
  • Distress: All the changes make the patient feel distressed and worried due to pressure on the brain and body.
  • Fear: Fear is the leading symptom of the anxiety attack making the patient fearful.
  • Numbness or tingling: Numbness or tingling feeling occurs due to activated sympathetic nervous system for a long time.

Diagnosis of anxiety:

An anxiety diagnosis may not be certified by a single test rather it may require quite a lengthy test process including physical examinations, mental health evaluations, and psychological questionnaires as well as family history. Levels of anxiety are tested by a number of scales and tests to assess its severity and then prescribe the required treatment plans.

Physical examination for diagnosis:

Your check-up with a doctor must be based on honesty and straightforwardness since it is very important to differentiate and discuss each and every feeling to assess the original reason behind anxiety development. Several features may be and may affect the anxiety including alcohol consumption, certain medication, coffee consumption, hormonal fluctuations, any underlying illness, etc. The symptoms of anxiety sometimes can be misunderstood or wrong estimated resembling other medical conditions. The symptoms which may create confusion may include shortness of breath, racing heart, chills, hot flashes, chest pains, dry mouth, nausea, vomit, frequent urination, or diarrhea.

Other medical conditions that may be confused with anxiety symptoms may be angina, heart attack, marital valve prolapse, tachycardia, adrenal gland tumors, hyperthyroidism, menopause, side effects of certain drugs of hypertension or diabetes, with drawl of certain drugs as sleeping pills, etc.

Diagnostic tests for diagnosis:

Several tests are available and are performed by your physician to confirm the presence of anxiety and its severity. These include:

  • Zung self-rating anxiety scale: A twenty-item questionnaire is the Zung test that asks you to assess the rate of your anxiety from “a little of the time” to “most of the time” on different topics as anxiety, nervousness, shaking, rapid heartbeat, fainting, frequent urination, nightmares, etc.
  • Hamilton anxiety scale(HAM-A): A questionnaire of fourteen questions that may revolve around mood fluctuations, tension, fear, and physical, mental, behavioral traits is called the Hamilton anxiety scale. The test must be performed by a professional.
  • Beck Anxiety Inventory: BAI (Beck anxiety inquiry) is a test to measure the severity and intensity of anxiety. A test of twenty-one multiple-choice questions that ask your opinion of self-assessment about the experience of symptoms during the past week. These symptoms may be numbness, fears, tingling, etc. The answer options include “moderate”, “severe” or “mild”.
  • Social phobia inventory: The level of social phobia of the patient is assessed with the help of the social phobia inventory by a seventeen-question assessment. The level of anxiety is rated in relation to social situations on a scale from zero ( no anxiety) to four (extreme anxiety).
  • Penn State worries questionnaire: A widely used measure of worry is the Penn State worry questionnaire. It is used to diagnose the distinguishing features of social anxiety disorder and generalized anxiety disorder. A questionnaire of sixteen questions is used to assess your uncontrollability, generality, and excessiveness.
  • Generalized anxiety disorder scale: A screening tool for generalized anxiety disorder is a seven-question test. It inquires about botheration of your feelings in past two weeks about fear, nervousness, irritability, etc. Options are given to indicate “several days”, “more than half the days”, “nearly every day”, or “not at all”.
  • Yale-brown obsessive-compulsive scale: YBOCS or Yale-brown obsessive compulsory scale is a diagnostic test to measure levels of obsessive-compulsive disorder. It is a one-on-one interview between you and a mental health professional during which you have to choose three items out of a symptom checklist that is the most disturbing factors and then rates their severity. You may be asked about your past obsessions or compulsions. The psychologist may grade you under stage of “moderate”, “mild”, “ severe”, ”subclinical” or “extreme”.

How to help children with anxiety:

Several children of age ranging from small to teens may suffer from anxiety, the ratio being one in every eight children. The children may learn in their society from friends, parents, and caretakers and develop skills to calm themselves under stressful situations and cope up with feelings of anxiety. Sometimes children may face chronic and persistent developing an anxiety disorder. If their anxiety interferes with their daily activities then they may become isolated and avoid interaction with their peers or family members.

Symptoms of anxiety disorders in children may include:

  • irritability
  • sleeplessness
  • fear feelings
  • shame
  • feelings of isolation

Talk therapy and medications are used for the treatment of anxiety disorders in children.

Anxiety and alcohol:

Very often the people undergoing depression and anxiety may use alcohol to calm their nerves and soothe their fearful feelings.  Alcohol is a great sedative that depresses the activity of the nervous system to make you feel relaxed and euphoric. You try to avoid your situation by taking alcohol in a gathering thinking that it might help you to remain unnoticed but it’s not the best solution. Some people end up using alcohol or other abusive drugs in an effort to feel better regularly. It may cause dependency and addiction if you use it for a long time. Chronic use makes it worse even more and you may become patient of not only anxiety but also addiction.

Prevention from anxiety:

Stress reduction methodologies must be adapted as calming techniques, deep breathing, meditation, and journaling. Such methods neutralize any abnormal stress hormones from developing and provide a peaceful environment giving relief from anxiety.

Some of the steps to be followed to prevent anxiety development are:

Avoid Stress: Stress is the leading cause of any type of problem to develop and make an outgoing source to relieve the problem… Stress must be avoided to prevent the development of abnormal mental states, worry, and anxiety.

Nutritious diet: Highly nutritious diet must be preferred to avoid any kind of discrepancy of minerals, vitamins, or any other food to decrease the formation of endorphins or other hormones that may arouse anxiety.

A proper routine of eating habits: Must not stay hungry and must adapt proper routine of eating habits to avoid stress and worry etc.

Proper sleep: Not taking proper sleep and disturbance of sleeping patterns may give rise to stress that ultimately may lead to anxiety that must be avoided by following proper sleep patterns. Follow proper routine as:

  • Sleep at night only when tired completely.
  • Do not read or watch TV in bed.
  • Do not use a computer, tablet, or mobile in bed.
  • Do not toss and turn in bed if not sleepy just move to another room to get sleep.
  • Avoid caffeine, large meals, nicotine before bed.
  • Keep your room dark and cool.
  • Write down your worries before sleep.
  • Try to go to sleep each day same time.

Stay active: Emotional and mental health must be maintained by staying active and regular exercise. Anxiety gets relieved for hours after working out.

Avoid alcohol: A glass of wine or a finger of whiskey may calm you at first when your nerves feel stressed but once the buzz is over anxiety may return with severity and vengeance. Alcohol dependence may occur as alcohol is a sedative.

Stop smoking: Often people consider cigarette smoking to get rid of anxiety symptoms. Like drinking alcohol, it may become a quick fix and with the passage of time may worsen your anxiety. Nicotine and other chemicals alter the release of neurotransmitters and pathways of the brain linked to anxiety symptoms.

Ditch caffeine: Caffeine binds with nicotinic receptors and may worsen anxiety disorders causing panic attacks in people. It may cause jitters and nervousness so must avoid it completely.

Meditate: Remove chaotic thoughts from your mind and replace them with calm cool feelings and mindfulness. Meditation relieves anxiety and stress. It acts as a great anti-depressant and anti-anxiety.

Practice deep breathing: Fast and shallow breathing is a common symptom of anxiety. It may also lead to dizziness, fast heart rate, panic attack, or lightheadedness. These deep breathing exercises may help to restore normal breathing patterns and reduce anxiety.

Try aromatherapy: Fragrant aroma oils and essential oils may promote the healing and wellbeing of a patient to a large extent. Oil may be inhaled either directly or added to a warm bath or diffuser. These oils may help you to sleep properly, relax, boost your moods, reduce blood pressure and heart rate. Common essential oils used for the purpose may be bergamot, clay sage, lavender, grapefruit, or ylang-ylang.

Drink chamomile tea: A common home remedy to calm frayed nerves and irritation as well as to promote sleep is a cup of chamomile tea. It must be taken frequently to prevent anxiety and its disorder. It may be a powerful ally against generalized anxiety disorder.

CBD for anxiety:

Cannabidiol is a very common and new treatment being used in certain forms for light attacks of anxiety and as a mood elevator. It may interact with CB1 and CB2 receptors which are present in the nervous system, both peripheral nervous system, and central nervous system. These receptors are protein-based chemical structures like all other receptors of the body and are attached to the cells. Their function is to receive the signals and retrieve them from certain stimuli. Serotonin plays an important role in sleep patterns as well as general mental health being a neurotransmitter of the brain. Low serotonin indicates depression in people as well as anxiety. Selective serotonin reuptake inhibitors as fluoxetine are used as conventional treatment of anxiety. Few people try to use cannabinoid oil instead of specific serotonin reuptake inhibitors to manage their condition. But you must consult your physician before taking any of these.

Some of the associated side effects of cannabis oil may be fatigue changes in appetite, weight, or diarrhea. You should not leave cannabis immediately as it may cause drawl symptoms like irritability, dizziness nausea, or fogginess.

Relation of stress and anxiety:

Both stress and anxiety produce psychological and physical symptoms. People feel both differently. Common physical symptoms of both include stomachache, muscle tension, headache, rapid breathing, fast heartbeat, sweat, shaking, dizziness, frequent urination, change in appetite, trouble sleeping, diarrhea, fatigue. Emotional or mental symptoms in addition to physical ones are impending doom feelings, panic or nervousness, especially in social settings, irrational anger, restlessness. Negative health outcomes are experienced by long-time stress and anxiety. They become more prone to diabetes, blood pressure, heart disease, and panic disorder.

Common causes of stress may be moving to a new place, starting a new school or job, an illness or injury, a friend or family member who is injured, getting married, or having a baby.

What anxiety chest pain feels like:

Anxiety symptoms change from person to person. Depending upon the circumstances, immunity level, and lot many other symptoms, even for the same person some days the symptoms may differ from other days. Anxiety can appear in a number of ways due to which its detection becomes a difficult task.

Chest pain is the major symptom that can be associated with each person with a different intensity and severity. The pain may be unexpected and sudden and may be mixed with certain other health problems. The anxiety chest pain is described as:

  • A sharp shooting pain,
  • Persistent chest aching,
  • An unusual muscle twitch or spasm in the chest,
  • Burning, numbness, or a dull ache,
  • Stabbing pressure,
  • Chest tension or tightness.

You must be alarmed if you don’t have chest pain with anxiety. Most people misunderstand heart attack with chest pain or anxiety they rush to the hospital emergency department for treatment. If the doctors don’t find a specific cause for chest pain, you may see other possible causes including anxiety. Almost twenty-five to fifty percent of patients in the emergency department experience moderate to severe anxiety.

Anxiety chest pain vs. Heart attack chest pain:

A main concerning symptom of both anxiety and heart attack is chest pain. Even if you are sure to feel the chest pain to be of anxiety, you must not take the risk and must confirm whether you have a heart attack or anxiety. The chest pain of a heart attack can be described in a number of ways as:

  • Chest pain that radiates to another part of the body as up to the jaw or down to arms.
  • Chest pain worsening with exertion
  • Nausea accompanying chest pain
  • Pressure in the chest as of some heavy load on the chest is placed
  • Rapid heart rate
  • Breath shortness
  • Squeezing sensation in the chest

It is not every time that people report back pain and fatigue as part of their heart attack symptoms. Doctors have knowledge of the connection between anxiety and chest pain, still, you should not ignore your symptoms and must seek immediate medical attention and try to visit the hospital for a complete diagnosis.

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