Global Health Asia-Pacific July 2020 July 2020 | Page 14
You Ask, They Answer
Q
: What is clinical anxiety?
A
: Broadly speaking, patients can present with five
types of anxiety disorder, covering chronic anxiety
and obsessive-compulsive disorders (OCD) to panic attacks,
post-traumatic stress, and social anxiety.
Anxiety disorders are the most common psychiatric illness,
affecting about 20-25 percent of people in developed nations.
Richer countries tend to have higher proportions
of anxiety patients than developing ones, with
China, for example, reporting a far lower prevalence,
according to World Health Organization data.
Though occasional anxiety is expected in life,
someone with an anxiety disorder will not see it
improve over time, and their condition could quite
possibly get worse without treatment.
The symptoms for generalised anxiety disorder
are recognisable for most people, and they can
experience months of feeling restless, tense, or
on-edge. Patients can be easily fatigued, may be
irritable, and have tension in the muscles. They have difficulty
controlling their worries, leading to sleep problems and
further fatigue.
Patients with OCD have uncontrollable thoughts and
compulsions that are repeated over and over again. They may
have a fear of germs, insist on organising objects in perfect
order, and have aggressive thoughts towards themselves and
others.
Those with panic disorder suffer from periods of intense
fear that can occur unexpectedly or can be brought on
by a trigger object or situation. Symptoms include heart
palpitations, sweating, and feelings of impending doom.
Post-traumatic stress disorder develops in some people who
have experienced a shocking or dangerous event. The signs
usually begin within three months of a traumatic incident.
Those with panic
disorder suffer
from periods
of intense fear
that can occur
unexpectedly or
can be brought
on by a trigger
object or
situation.
Though some patients recover within six months, for others
with symptoms that last much longer, the condition can
become chronic.
And people with social anxiety disorder suffer an intense,
persistent fear of being watched and judged by others, often
causing them to avoid social situations and withdraw into a
shell at school and work.
Q
: What causes anxiety?
A
: The causes of anxiety are not fully understood,
though traumatic events from the past do tend to act
as triggers for anxiety disorders in patients already prone to
anxiety. Inherited traits are also a significant risk factor.
For some people, their anxiety may be linked to an
underlying health condition, such as heart disease, diabetes,
thyroid problems, and respiratory disorders. People recovering
from addictions may also find they have anxiety.
Because of these links, general practitioners may look for
unfulfilled risk factors that would make a simple diagnosis of
anxiety less likely. These include not having blood relatives
with an anxiety disorder, not experiencing an anxiety disorder
as a child, not giving certain situations a wide berth to avoid
anxiety, and experiencing sudden bouts of anxiety that appear
unrelated to life events.
Q
: How is anxiety treated?
A
:
It’s important to get help as early as
possible as anxiety can become more
difficult to treat the longer it manifests. Treatment is
in the form of psychotherapy and medication, with
some patients benefiting most from a combination
of the two, but it may take some trial and error to
discover which treatments work best.
Cognitive behavioural therapy is the most
effective form of psychotherapy for anxiety
disorders. It focuses on teaching patients specific skills to
improve their symptoms and includes exposure therapy,
which helps build confidence in managing an anxiety trigger
over time by gradually exposing the patient to it.
Certain antidepressants are also used to treat anxiety
disorders along with the anti-anxiety medication buspirone.
In some circumstances, other types of medication may be
prescribed, such as benzodiazepines or beta blockers. These
are for the short-term relief of symptoms and not intended for
long-term use.
Dr Dougal Southerland
Dr Dougal Southerland is a practicing clinical psychologist in
Wellington.
12 JULY 2020 GlobalHealthAndTravel.com