Worrying and anxiousness is a common human trait. It helps us prepare for the worst and hope for the best in any situation may it be exams or interviews or something else. It is necessary for survival since it triggers the flight or fight response in every situation. Anxiety becomes a disorder when it gets irrational and uncontrollable. One may be doing nothing and still find themselves worrying and stressing out for no reason. They start spending most of their time worrying and anxious. They sleep and wake up to it or stop sleeping because of it. This is when it is classified as Generalised Anxiety Disorder (GAD.) GAD is an overwhelming condition that affects one’s daily life, physiology, and metabolism. GAD is common in adults though it can also affect children. It is present at all different levels from acute to severe.
The symptoms are similar to depression and panic disorders. GAD is mostly related to thinking issues in a person although there are various physical symptoms to look at as well.
The cognitive symptoms include:
- Excessive, uncontrollable, and irrational worrying
- Overthinking and overplanning most situations
- Intolerance of uncertainty
- Difficulty in concentrating
- Irritability and nervousness
- Inability to relax, feeling edgy
- Unrealistic view of problems
- Sleep disorders
The physical symptoms include:
- Shortness of breath
- Bowel disorder
- Headaches and body aches
- High/low blood pressure
- Dry mouth (without dehydration) and acnes
- Numbness and sweating
- Muscle tension
Often people struggling with GAD have other disorders underlying like panic disorder, obsessive compulsive disorder, various phobias and substance abuse. It is necessary to understand if there are any other conditions fueling the anxiety disorder the person has.
- Imbalance in brain chemistry
There are various chemicals (neurotransmitters) like serotonin and dopamine in our mind that regulate how we feel, act, and think. Anxiety disorder involves the imbalance of mainly four such transmitters; Serotonin that regulates sleep, mood, appetite and various other regulatory functions, Dopamine that influences energy levels, movement and attention, Norepinephrine that manages flight or fight response and gamma-aminobutyric acid (GABA) that balances excitement, calmness and relaxation.
Although anxiety disorders are usually triggered by stressful situations, genes also influence a person to develop the disorder. A person who has a first degree relative having anxiety disorder is more likely to develop one than the person who doesn’t.
- Exposure to stressful situations
When a person has a history of traumatic experiences, like abusive childhood or death of a beloved, it is more likely for them to develop anxiety disorder. Various studies have found a childhood trauma leading to neural impairment in the brain increasing the risk of many mental disorders like anxiety. The feeling of danger and fright might stay with the person for a long time after the actual trauma and come back has flashbacks leading to different anxiety attacks.
- Personality Factors
A person who has negative temperament is more likely to develop anxiety disorder. These are usually people who are perfectionists, lack self esteem, or are timid.
GAD is a curable illness
There are various steps that both the victim and the people around them can take to control the symptoms. As a person around someone with GAD, the least we can do for them is to make them feel accepted for who they are and what they feel. Following are the other measures that can be used:
Psychotherapy is one of the most effective cures for reducing the symptoms. The victims are often given Cognitive Behavioral Therapy (CBT) which is a short term goal-oriented psychotherapy that mainly focuses on changing the patterns of thinking or behaviour and hence change the way a person feels.
People suffering from GAD often receive medication as the second line of treatment along with the therapy. Usually victims are given Selective Serotonin Reuptake Inhibitor (SSRI) or antidepressant. Though depression and anxiety are two different conditions, antidepressants are effective in managing anxiety symptoms.
There are various measures a person can take to keep track of the symptoms like journaling, meditating, yoga, acknowledging feelings, etc. Engaging oneself in improving physical health also helps improve the symptoms. Trying to cope with sleep issues is the most helpful. Asking for help is also an act of self help which is extremely important if you start feeling like things are getting out of your control.
- Caffeine and nicotine control
Caffeine, nicotine and alcohol act as immediate relief for anxiety. But they increase the symptoms in the bigger picture, so it’s necessary to control the intake of these substances.
Water may not treat anxiety totally but staying hydrated helps calm the symptoms. Various studies have shown water to have natural calming properties often leading your body to benefit from hydration during stressful situations.
— Karuna Kunwar, Psychologist Center for Mental health and Counseling Nepal
(Transcribed by Dikshya, Kathmandu)