Anxiety

                           

• A= lack of Alertness
• N= Negative feeling

• X= loss of eXietment

• I= no Interest in life

• E= End

• T= Threat of life

• Y= worrY in life

The word anxiety itself is a heavy word, though it's not a disease but not less a disease. It's a garden or nursary of diseases, it is a disorder.

Anxiety disorders are often severe chronic conditions, which can be present from an early age or begin suddenly after a triggering event. 

They are prone to flare up at times of high stress and are frequently accompanied by physiological symptoms such as:Headache                  

• Sweating
• Muscle spasms
• Tachycardia
• Palpitations 
• Hypertension
• Fatigue.

In casual discourse the words "anxiety" and "fear" are often used interchangeably, but in clinical usage, they have distinct meanings: 

 

"anxiety" is defined as an unpleasant emotional state for which the cause is either not readily identified or perceived to be uncontrollable or unavoidable, whereas "fear" is an emotional and physiological response to a recognized external threat.

Anxiety is directly related with our daily activity and lifestyle. Anxiety is an emotional feeling  and it is a group of mental disorders in which a person have a feeling of unesiness and
worry.

Anxiety can be either a short-term "state" or a long-term "trait."

Anxiety disorders often occur with other mental health disorders, such as:

• Major depressive disorder
• Bipolar disorder
• Eating disorders
•  Certain personality disorders.
• Sexual dysfunction often accompanies with anxiety disorders.

Although it is difficult to determine whether anxiety causes the sexual dysfunction or whether they arise from a common cause.

The most common manifestations in individuals with anxiety disorder are avoidance of intercourse, premature ejaculation or erectile dysfunction among men and pain during intercourse among women. 

Cause of Anxiety disorder :-

 Genetic and environment factors are the major root cause of Anxiety disorders. But social and economic situation are also the cause of Anxiety disorders.

 Types of Anxiety Disorders: 
It is classifed as follows based upon the characteristics :

1.  Generalised Anxiety Disorder (GAD)
2. Specific Phobia  
3. panic Disorder.
4. Agoraphobia 
5. Social Anxiety Disorder  
6. Post-traumatic Stress Disorder
7. sepearation anxiety disorder
8. situational anxiety  
9. Obsessive-Compulsive Disorder
10. Selective Mutation Symptoms                                                                              General symptoms:

• Panic
•  Fear and uneasiness
•  Sleep problems 
• Not being able to stay calm and still
• Cold
•  Ssweaty
•  Numbnesd
• Loss of appetite 
• Weight gain
•  ingling hands or feet
•  Shortness of breath 
• Heart palpitations 
• Dry mouth
•  Nausea 
• Tense muscles
•  Dizziness.                                        

The disorders can run in families and could be linked to faulty circuits in the brain that control fear and other emotions.

Mechanism of Anxirty

 Biological mechanism
GABA, a neurotransmitter that reduces activity in the central nervous system, contribute to anxiety. 

Selective serotonin reuptake inhibitors (SSRI) 

Are the drugs which considered as a first line treatment for anxiety disorders.

Amygdala

The amygdala is central to the processing of fear and anxiety, and its function may be disrupted in anxiety disorders.

 Sensory information enters the amygdala through the nuclei of the basolateral complex (consisting of lateral, basal, and accessory basal nuclei). 

The basolateral complex processes sensory-related fear memories and communicates their threat importance to memory and sensory .

processing elsewhere in the brain, such as the medial prefrontal cortex and sensory cortices.

Another important area is the adjacent central nucleus of the amygdala, which controls species-specific fear responses, via connections to the brainstem, hypothalamus, and cerebellum areas.

 The amygdala areas have decreased connectivity with the insula and cingulate areas that control general stimulus salience, while having greater connectivity with the parietal cortex and prefrontal cortex circuits that underlie executive functions.

The dysfunctional amygdala processing to anxiety.

The diagnosis of anxiety 

The diagnosis of anxiety disorders is difficult because there are no objective biomarkers, it is based on symptoms, which typically need to be present at least six months, be more than would be expected for the situation, and decrease functioning.

Anxiety detection 

Several generic anxiety questionnaires can be used to detect anxiety symptoms such as:

• State-Trait Anxiety Inventory (STAI)
• Generalized Anxiety Disorder 7 (GAD-7)
• Beck Anxiety Inventory (BAI)
•  Zung Self-Rating Anxiety Scale
• Taylor Manifest Anxiety Scale.

•  Other questionnaires combine anxiety and depression measurement, such as
•  Hamilton Anxiety Rating Scale,
• Hospital Anxiety and Depression Scale (HADS)
• Patient Health Questionnaire (PHQ)

Patient-Reported Outcomes Measurement Information System (PROMIS)

• Examples of specific anxiety questionnaires include
•  Liebowitz Social Anxiety Scale (LSAS)
• Social Interaction Anxiety Scale (SIAS), 
• Social Phobia Inventory (SPIN)
• Social Phobia Scale (SPS)
• Social Anxiety Questionnaire (SAQ-A30).

Differential diagnosis 

The diagnosis of an anxiety disorder requires first ruling out an underlying medical cause.

Diseases that may present similar to an anxiety disorder, such as 

•  Certain endocrine diseases (hypo- and hyperthyroidism, hyperprolactinemia)
• Metabolic disorders (diabetes)
•  Deficiency states (low levels of vitamin D, B2, B12, folic acid)
•  Gastrointestinal diseases (celiac disease, non-celiac gluten sensitivity, inflammatory bowel disease)
•  Heart diseases
•  Blood diseases (anemia)
• Brain degenerative diseases (Parkinson's disease, dementia, multiple sclerosis, Huntington's disease)
• Several drugs can cause or worsen anxiety
•  Whether in intoxication, withdrawal, or from chronic use. These includes
• Alcohol
• Tobacco
• Cannabis
•  Sedatives
•  Opioids (including prescription pain Killers and illicit drugs like heroin)
• Stimulants (such as caffeine, cocaine)
• Hallucinogens
•  Inhalants.

Prevention

Edit

 There is tentative evidence to support of the use of cognitive behavioral therapy and mindfulness therapy. 

There are no effective measures to prevent GAD in adults.

Cognitive behavioral therapy (CBT)

CBT is a psycho-social intervention that aims to improve mental health. CBT focuses on challenging and changing unhelpful cpognitive distortions (e.g. thoughts, beliefs, and attitudes) and behaviors, improving emotional regulation, and the development of personal coping strategies that target solving current problems. 

Treatment

Treatment options include :

Lifestyle and food 

Therapies 

Medication 

Lifestyle and diet 

Life style changes includes :

• exercise
• regularizing sleep patterns
•  reducing caffeine intake
• stopping smoking
• Omega-3 polyunsaturated fatty acids (such as fish oil) may reduce anxiety.
• Take food on routine time
• Avoid spicy and junk food

Therapy  

Cognitive behavioral therapy (CBT) is a 1st line treatment and meditation are effective to managing anxiety disorder. 

Medications

SSRI or SNRI are the 1st line choices for generalized nxiety disorders  (GAD).
They have to be continued for at least a year.

 Stopping these medications results in a greater risk of relapse.

Buspirone and pregabalin are second-line treatments  who do not respond to SSRIs or SNRIs.

Benzodiazepines including diazepamAt and clonazepam are effective but have fallen out of favor due to the risk of dependence and abuse.

Medications need to be used with care among older adults, who are more likely to have side effects because of coexisting physical disorders. Adherence problems are more likely among older people, who may have difficulty understanding, seeing, or remembering instructions.

Alternative medicine Edit

Other remedies have been used or are under research for treating anxiety disorders. 

As of 2019, cannabis is specifically not recommended as a treatment .

Kava is under preliminary research for its potential in short-term use by people with mild to moderate anxiety.

Inositol has been found to have modest effects in people with panic disorder or obsessive-compulsive disorder.

Children's 

Edit

Cognitive behavioral therapy (CBT) is a good first therapy approach.

Family therap is a form of treatment .

Art and play therapy are also used. 

 This is often most effective when the family of the child plays a role in the treatment.

So,  this anxiety is a new threat for life. 

Though it's not a disease but it is a nursary of diseases. Don't let the nursary To grow because it will destroy our life