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Everyone feels anxious at times. Challenges such as workplace pressures, public speaking, highly demanding schedules or writing an exam can lead to a sense of worry - even fear. These sensations, however uncomfortable, are different from the ones associated with an anxiety disorder. People suffering from an anxiety disorder are subject to intense, prolonged feelings of fright and distress for no obvious reason. The condition turns their life into a continuous journey of unease and fear, and can interfere with their relationships with family, friends and colleagues. Anxiety disorders are the most common of all psychiatric illnesses. It is estimated that they affect approximately 1 in 10 people. They are more prevalent among women than among men, and they affect children as well as adults.

Anxiety disorders are medical illnesses - they can be diagnosed; they can be treated. But all too often, they are mistaken for mental weakness or instability, and the resulting social stigma can discourage people with anxiety disorders from seeking help. Understanding the facts about anxiety disorders is an important step. Realizing that they are medical disorders which can be treated will help to remove the stigma, and encourage people with anxiety disorders to explore the treatments available.

Types of Anxiety

Generalized Anxiety
People with generalized anxiety disorder (GAD) have ongoing, severe tension that interferes with daily functioning. They worry constantly and feel helpless to control these worries. Often their worries focus on job responsibilities, family health or minor matters such as chores and deadlines. The individual anticipates the worst, even if others would say they have no reason to expect it. They may have problems sleeping, muscle aches/tension, and feel shaky and weak. Frequent headaches are a common symptom. People with GAD easily lose their patience, and often have problems concentrating and working effectively.

Panic Disorder
The core symptom of panic disorder is the panic attack, an overwhelming combination of physical and psychological distress. During an attack several of these symptoms occur in combination:

  • Pounding heart or chest pain
  • Sweating, trembling, shaking
  • Shortness of breath, sensation of choking
  • Nausea or abdominal pain
  • Dizziness or lightheadedness
  • Feeling unreal or disconnected
  • Fear of losing control, "going crazy," or dying
  • Numbness
  • Chills or hot flashes

Because symptoms are so severe, many people with panic disorder believe they are having a heart attack or other life-threatening illness.

Agoraphobia develops often, but not always, with panic disorder. Agoraphobia is a fear of having a panic attack in a place from which escape is difficult, such as public transport or using a lift. Many people with agoraphobia refuse to leave their homes, often for years at a time. Others develop a fixed route, or territory, from which they cannot deviate, for example the route between home and work.

Some general guidance on panic attacks will be:

  • No matter how bad it feels, panic attacks cannot actually harm you or make you go mad.
  • Panic attacks do not last forever - they always pass after a while.
  • The way you think will affect how bad the panic attack is and how long it lasts.
  • If you run away from a panic attack, you are making things harder for yourself in the long term in that your life will become more and more restricted.
  • During a panic attack, remind yourself that you are not going to die, go mad or lose control. Let the panic attack wash over you without fighting it Ė just wait for it to subside by itself.

Phobias
A phobia is excessive and persistent fear of a specific object, situation, or activity. These fears cause such distress that some people go to extreme lengths to avoid what they fear.

There are three types of phobias:

Specific Phobia -An extreme or excessive fear of an object or situation that is generally not harmful. Patients know their fear is excessive, but they canít overcome it. Examples are fear of flying or fear of spiders.

Social Phobia - Also known as social anxiety disorder. Significant anxiety and discomfort about being embarrassed or looked down on in social or performance situations. Common examples are public speaking, meeting people or using public restrooms.

Agoraphobia - This is the fear of being in situations where escape may be difficult or embarrassing or help might not be available in the event of panic symptoms. Untreated agoraphobia can become so serious that a person may refuse to leave the house. A person can only receive a diagnosis of phobia when their fear is intensely upsetting or if it significantly interferes with their normal daily activities.

Obsessive - Compulsive Disorder (OCD)
Obsessions are upsetting and irrational thoughts which keep reoccurring. They cause great anxiety, which cannot be controlled through reasoning. Common obsessions include preoccupations with dirt or germs, nagging doubts and a need to have things in a very particular order. To minimize these obsessions, many people with obsessiveĖcompulsive disorder engage in repeated behavior or compulsions. Examples include repeated hand washing, constant rechecking to satisfy doubts and following rigid rules of order. Compulsive behavior can be very disruptive to normal daily routines and social relationships.

Post-traumatic Stress Disorder
Posttraumatic stress disorder (PTSD) occurs in individuals who have survived a severe or terrifying physical or emotional event. People with PTSD may have recurrent nightmares, intrusive memories or even have flashbacks, where the event seems to be happening all over again. They feel extreme distress when in circumstances that remind them of the trauma, and go to extremes to avoid these situations. Additional symptoms include:

  • Feeling numb or detached
  • Trouble sleeping
  • Feeling jittery or on guard
  • Irritability
Events that can trigger PTSD include military combat, a violent personal attack, natural disasters, tragedies (e.g. plane crash), physical or sexual abuse during childhood or witnessing another personís serious injury.

Trichotillomania (TTM, Hair Pulling)
Despite the misleading name, this is not a mania at all, but a compulsive disorder. It is a disorder that involves irresistible urges and can occur with OCD. A person with TTM sometimes experiences a build up of tension before pulling hair out that is then relieved by this behavior. The pulling can be done consciously or unconsciously. Even if there is no tension prior to pulling, the person may find pulling pleasurable, which makes the behavior difficult to stop.

The most common places that people with TTM pull hair from are the scalp, eyelashes and eyebrows. They may also pull hair from the face, arms, legs, abdomen and pubic area, and even from family members and pets. Hair sucking or chewing (sometimes resulting in hair ingestion) may also occur and this may lead to intestinal problems requiring surgery. People with TTM will usually have tried stopping the behavior themselves in a variety of ways, including taping their fingers together, or wearing hats and gloves Ė usually to no avail. The disorder can be treated and controlled.

Treating the illness...
Unfortunately, many people with anxiety disorders donít seek help. They donít realize that they have an illness that has known causes and effective treatments. If you have - or someone you know has - any of the symptoms described above, consult your family physician or a psychiatrist.

Although each anxiety disorder has its own unique characteristics, most respond well to medical treatment. Treatment usually gives significant relief from symptoms. In addition to medicines, some people will also need psychotherapy. Because treatment often requires several weeks to work best, a doctor should follow the patientís progress and make necessary changes.

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