Anxiety
- uyyarvu
- Jan 13
- 6 min read
“Just because I can’t explain the feelings causing my anxiety, doesn’t make them less valid.” - Lauren Elizabeth
Anxiety is the belief that there is a threat in the near future. There are a variety of theories on how anxiety stems and develops. The most common perception is anxiety acts as a prevention mechanism allowing individuals to avoid any dangerous stimuli. However, this defence mechanism can become restrictive to one’s day-to-day activities and relationships when it occurs on a regular basis despite the lack of threats.
The causes of anxiety can vary from biological factors to genetic inheritance to traumatic experiences in one’s life. The causes of anxiety typically align with the types of anxiety that one experiences. There are multiple types of anxiety such as: generalized anxiety disorder, specific phobias, social anxiety, panic disorder, obsessive-compulsive disorder and post-traumatic stress disorder.
Generalized Anxiety Disorder (GAD)
The onset of GAD is more unclear than other anxiety disorders, resulting in a delayed diagnosis. The symptoms of GAD are inability/difficulty controlling their worry, irritability, difficulty concentration, muscle tension, dry mouth, sweating, nausea, diarrhea, frequent urination and sleep issues.
Specific Phobias
Specific phobias can be caused through traumatic events but there are cases where children develop specific phobias for unknown reasons. Phobias are viewed as continuous fear triggered by the expectation or presence of a certain thing or circumstance. According to the DSM-IV TR, there are five types of specific phobias: animal type, natural environment type, blood-injection type, situation type and other type.
Animal Type: The phobia of animals (e.g. dogs, cats, sharks, lions, bear).
Natural Environmental Type: The phobia of heights, storms or large bodies of water (e.g. rivers, lakes, oceans).
Blood-Injection Type: The fear of witnessing blood, there are more severe levels of the phobia where the individual cannot withstand seeing it in media or hearing about it.
Situation Type: The fear of certain situations or experience (e.g. riding an elevator, driving a car, flying in airplanes).
Other Type: This type refers to any other specific fear of certain activities, things or experiences (e.g. choking, vomiting, clowns, etc).
Social Anxiety
An individual who experiences social anxiety will typically undergo a prominent level of fear or avoidance in social scenarios. This fear can present itself differently through heart palpitations, sweating, trembling of hands, difficulty speaking (e.g. stuttering) and abdominal distress (i.e. digestive issues).
In addition, social anxiety presents itself as a symptom in two developmental disorders, Autism and Aspergers Syndrome.
Autism Spectrum Disorder (ASD)
ASD revolves around a spectrum of neurodevelopmental conditions, it can present itself in varying extents. The social communication and interpersonal challenges children face act as the identifiers for the varying extents. The disorder is often confused with Asperger Syndrome, which falls under the same classification.
Asperger Syndrome (AS)
AS refers to significant struggles with social communication and interaction. However, the disorder revolves around superior intelligence and language delay as well.
Comorbidity is a prevalent factor in diagnosing disorders and finding the appropriate treatment approach. Comorbidity refers to the presentation of more than one disorder simultaneously.
It is crucial to have a general understanding of the differences between disorders. There are certain disorders where the classification system (e.g. DSM-IV) may imply zero correlation. In these cases, the belief that an individual has a comorbid condition would be an inaccurate diagnosis. In addition, it is important to be aware of the sequence of comorbidity. There could be an instance where a certain condition presents itself initially and another condition follows. This understanding is important for diagnosis and treatment, allowing physicians to determine what to address first.
The following disorders are known to have a comorbid diagnosis with anxiety:
Panic Disorder
Panic attacks occur along with another type of anxiety disorder. The most common symptoms of panic attacks are sweating, trembling, sensation of shortness of breath, heart palpitations (i.e. pounding heart) and fear of dying.
Obsessive-Compulsive Disorder (OCD)
The presentation of OCD can vary on different spectrums for individuals. Obsessions typically involve unwanted thoughts, images and impulses. The individual struggles with repressing and ignoring these negative thoughts. Compulsions are believed to prevent or reduce the occurence of a drastic event. The correlation of the action and the events can be relatively low or non-existent. However, it provides the individual with a sense of relief and control.
Post-Traumatic Stress Disorder (PTSD)
PTSD occurs after an individual experiences a traumatic or highly threatening event. It occurs when they witness another individual’s traumatic event as well. The individual will avoid anything that triggers the memory of the event. They become unresponsive but highly reactive to their environment.
Treatment
There are a variety of treatments available to individuals who suffer from anxiety disorders. They can undergo psychosocial treatments such as cognitive behavioural therapy, individual/group/family therapy, etc. They can utilize pharmacotherapy where they can consume medication to help relieve their physical symptoms or balance their chemical imbalances.
Pharmacotherapy
The use of medication has provided efficient results for certain disorders such as GAD or social anxiety disorder. A few common medications used to treat anxiety are Selective Serotonin Reuptake Inhibitors (SSRIs), Pregabalin, Tricyclic Antidepressants. SSRIs can result in an initial increase of symptoms, but they produce a selective increase in serotonin (i.e. happy hormone). SSRIs are known to have effective results for OCD, panic disorder and social phobia, along with a reduced risk of overdosage. Pregabalin acts as a sedative, allowing the patient to relax. The drug aids with sleep disturbance, which is a common symptom for anxiety disorders. Studies have shown the use of pregabalin reduces the occurrence of sleep disturbance significantly. Tricyclic antidepressants are a second-generation of antidepressants. It is highly effective for patients where anxiety and depression coexist. They act as inhibitors of both serotonin and norepinephrine. Unfortunately, there are various side effects when using medication along with risk of addiction and substance abuse.
Psychosocial Treatments
The use of pharmacological treatment is not preferred by all patients as they do not want to incur the side effects. Hence, they opt for psychosocial treatments such as CBT, group/family/individual therapy, etc. CBT revolves around recognizing anxious feelings, planning different coping strategies, and incentives are created to avoid & reduce unhealthy coping mechanisms.
Below are guides to help utilize different coping strategies to manage your anxiety:
Are you able to connect to these symptoms? Take a look at the resources below!
Anxiety Canada
Phone: 604-620-0744
CAMH
Phone: 1-800-463-2338
Canadian Mental Health Assocation
Phone: 1-800-875-6213
Resources
Baldwin, D., Ajel, Nowak, Rafiq, & Masdrakis, V. (2013). Pregabalin for the treatment of
generalized anxiety disorder: An update. Neuropsychiatric Disease and Treatment, 883. https://doi.org/10.2147/ndt.s36453
Ballenger, J. C. (2000). Anxiety and Depression: Optimizing Treatments. Primary Care
Companion J Clin Psychiatry.
Bandelow, B., Michaelis, S., & Wedekind, D. (2017). Treatment of anxiety disorders.
Dialogues in Clinical Neuroscience. https://doi.org/https://doi.org/10.31887/DCNS.2017.19.2/bbandelow
Bill Pelz, H. C. C. (2017, March 16). Specific Phobia (300.29). Lumen.
Caballo, V. E. (2007). International Handbook of Cognitive and behavioural treatments
for psychological disorders. Elsevier.
Craske, M. G., Rauch, S. L., Ursano, R., Prenoveau, J., Pine, D. S., & Zinbarg, R. E.
(2011). What is an anxiety disorder? Focus, 9(3), 369–388. https://doi.org/10.1176/foc.9.3.foc369
Fallow, K. (2007). Improving outcomes and preventing relapse in cognitive-behavioural
therapy Martin M. Anthony, Deborah Roth Ledley and Richard G. Heimberg (eds.) New York: The Guilford Press, 2005. pp. 432. £32.75 (HB). ISBN: 1-59385-197-9. Behavioural and Cognitive Psychotherapy, 35(02), 256. https://doi.org/10.1017/s1352465806223567
Feighner, J. P. (1999). Overview of Antidepressants Currently Used to Treat Anxiety
Disorders. J Clin Psychiatry.
Himanshu, Dharmila, Sarkar, D., & Nutan. (2020). A review of behavioral tests to
evaluate different types of anxiety and anti-anxiety effects. Clinical Psychopharmacology and Neuroscience, 18(3), 341–351. https://doi.org/10.9758/cpn.2020.18.3.341
Hosseini, S. A., & Molla, M. (2024, January). Asperger syndrome. National Center for
Biotechnology Information. https://pubmed.ncbi.nlm.nih.gov/32491480/
McElroy, E., Fearon, P., Belsky, J., Fonagy, P., & Patalay, P. (2018). Networks of
Depression and Anxiety Symptoms Across Development. Journal of American Academy of Child & Adolescent Psychiatry, 57(12).
Mera, J. (2023, July 29). How to calm anxiety (4 methods by dr. Mera). Health Learner.
Muris P;Rapee R;Meesters C;Schouten E;Geers M; (2003). Threat perception
abnormalities in children: The role of anxiety disorders symptoms, chronic anxiety, and State anxiety. Journal of anxiety disorders. https://pubmed.ncbi.nlm.nih.gov/12727122/
Rose, M., & Devine, J. (2014). Assessment of patient-reported symptoms of anxiety.
Dialogues in Clinical Neuroscience, 16(2), 197–211. https://doi.org/10.31887/DCNS.2014.16.2/mrose
Shelton, C. I. (2004, March). Diagnosis and Management of Anxiety Disorders.
Stewart, J. (2021). Bronze sculptures with enormous heads held down by the “Weight of thought.” My Modern Met. https://mymodernmet.com/thomas-lerooy-oversized-head-sculptures/
Strongman, K. T. (1995). Theories of Anxiety. New Zealand Journal of Psychology,
24(2).
Valderas, J. M., Starfield, B., Sibbald, B., Salisbury, C., & Roland, M. (2009). Defining
comorbidity: Implications for understanding health and health services. The Annals of Family Medicine, 7(4), 357–363. https://doi.org/10.1370/afm.983
White, S. W., Conner, C. M., & Maddox, B. B. (2017). Behavioral treatments for anxiety
in adults with autism spectrum disorder. Anxiety in Children and Adolescents with Autism Spectrum Disorder, 171–192. https://doi.org/10.1016/b978-0-12-805122-1.00009-0
