Anxiety Disorder Guide

[Draft] Posted on 2020-05-18 12:04:52

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Anxiety by itself is not a disease or illness, but turns into a disorder when a person becomes physically, psychologically, emotionally, or spiritually symptomatic, fearful, or distraught because of it. When this occurs, normal anxiety becomes an anxiety disorder: a medical condition that involves a disturbance to the normal functioning of the mind or body. The good news is, anxiety is controllable and is best treated naturally (without medication) if long-term results are desired. Medication can often help to diminish the negative impact of symptoms.  However, when the underlying factors are properly addressed, anxiety disorders can be eliminated– and for good. Anxiety disorders persist only because the underlying factors aren’t properly addressed. That’s why those who take medication as their only form of treatment generally remain on medication long term, or find themselves going on and coming off over and over again. 

Working with an individual such as a counsellor produces the most effective results. Turn2Me offers free online counselling and has a wide range of individuals who are competent, caring and consistent in their treatment philosophy when it comes to treating Anxiety. 

The Three Tiered Model used by Turn2Me allows the client to engage on their own or with others experiencing anxiety. Alternatively, they can access support groups with one of the Turn2Me Clinical team. 

Before setting out some information on anxiety and its manifestations, please note that if your Turn2Me counsellor believes that your presenting condition/s may increase the risk of harm to yourself, they may be obliged to refer you to a more appropriate service. Turn2Me is not a crisis intervention service.

Types of Anxiety

Anxiety conditions, for the most part, can be divided into two main categories:

Circumstantial anxiety – this type of anxiety condition is characterized by symptoms that appear because of an acute stressful event(s), circumstance(s) or emotion(s). Examples include a relationship difficulty (fighting within or the break-up of an important relationship), career challenge (job loss or important job promotion), illness or death of a loved one, or educational stress (intense workload). Because stress is often the precursor to an anxiety condition, most early stress conditions fall within this category. Once the event, circumstance or emotion has passed, with sufficient self-help materials, rest and time, most anxiety conditions in this  category will resolve on their own. 

Chronic anxiety – this type of anxiety condition is characterized by symptoms that come and go over an extended period of time (from a few months to a year, or from a few months to many years). Examples include an individual who has symptoms come and go at different stages of their life (as early as 4 years of age), remain as an ongoing backdrop to their life, or have been on and off medication throughout their life. Chronic anxiety also has a deep-seated fear component. Many believe that they live in fear whenever their “episodes of illness” appear.  Others may have it as a constant companion as they journey through life. Episodes can last a few weeks to many years. Some can remain constant throughout their life. Conditions that last for an extended period of time can also be referred to as “entrenched” anxiety.

Within these categories, there are four types of anxiety:

  1. Spontaneous anxiety or panic – anxiety or panic that occurs regardless of where a person is.               
  2. Involuntary anxiety or panic – anxiety or panic that occurs involuntarily, by itself, or “out of the blue” that hasn’t been preceded by spontaneous, situational, or anticipatory anxiety.               
  3. Situational or Phobic anxiety or panic – anxiety or panic that occurs because of a particular situation or location.               
  4. Anticipatory anxiety or panic – anxiety or panic that occurs because of a thought that something “might” happen or a situation that “might” occur.

Different Levels of Anxiety

There are also different levels or degrees associated with anxiety conditions. These can be categorized as:     

  • Early-stage or onset anxiety – symptoms have just started to appear, and while they may be annoying and mildly distressing, they aren’t a reason for over concern. Often one trip to the doctor is reassuring enough that nothing more serious is going on. This is the best stage to address stress or anxiety, since the more entrenched the condition becomes, the more complex it becomes and the longer it will take to resolve. However, properly addressing an anxiety condition at any stage can bring about full recovery. Reading self-help materials  is most often sufficient for full recovery.
  • Mild severity – symptoms may be intermittent or persistent. However, their negative impact on an individual’s lifestyle is minimal. While the symptoms may be annoying and mildly distressing, they aren’t too restricting. Individuals at this stage may start to become fearful of their condition or their condition’s implications. The individual may make a few trips to the doctor in hopes of finding a solution. Addressing a condition at this stage also produces expedient results. Bibliotherapy (reading self help articles) is most often sufficient for full recovery.
  • Moderate severity – symptoms may be more complex, and may be more severe and impacting.  Often they will be more persistent, more concerning and worrisome. There is moderate lifestyle impairment. While the individual may be able to force themselves to do mandatory tasks, many activities are restricted. Fear of their condition is becoming more predominant. There may be repeated trips to the doctor in hopes of finding a resolution. Doctors often prescribe medications at this stage to help reduce symptoms and the negative impact they have on the individual’s lifestyle. Unfortunately, medication alone at this stage often only masks the underlying condition. This masking effect often enables the condition and its effects to continue to resurface time after time unless the underlying condition is properly addressed. Fortunately, more and more doctors are now recognizing the value of a comprehensive approach such as personal coaching, counselling, cognitive therapy and bibliotherapy. Working with a person who has skills to help you (someone with extensive experience) can produce significantly more effective and lasting results.
  • High anxiety – symptoms are dramatic, persistent and entrenched. Lifestyle is significantly impaired. Repeated trips to the doctor prove fruitless. Many at this stage are already on medication, yet their symptoms persist to varying degrees. They have a high level of fear about their condition and where it might lead. Many feel their condition is out of control. Recommended treatment at this stage should involve personal coaching in conjunction with good self-help materials. Self-help materials alone will most likely not produce full recovery or lasting healing. As previously mentioned, recovery can be attained at any stage, however, the road to recovery may be longer and more complex the longer a condition remains entrenched. Nevertheless, successful and lasting results make the recovery journey more than worthwhile.
  • Very high anxiety – intense and entrenched symptoms. Dramatic to full lifestyle impairment. This level of severity is more complex and often more difficult to address. It is highly recommended that the help of a counsellor, or mental health professional be involved at this stage. While self-help materials will play an important role in the recovery process, one-on-one assistance is most often required before normal and lasting health can be attained when severity has reached this level.

 Anxiety Disorders & Their Symptoms

There are several categories associated with anxiety disorder, each having their own specific causes and characteristics. The National Institute of Mental Health lists the six main categories of anxiety disorder as:

  1. Panic Disorders
    Panic disorder is described as a sudden attack of terror, intense fear, or feelings of impending doom that strike without warning and for no apparent reason. This can be immediately followed by a number of symptoms including pounding heart, rapid heart rate, nausea, hot or cold flashes, chest pain, hands and feet may feel numb, you may be lightheaded or woozy, irrational thoughts, fear of losing control and a number of other symptoms. The peak of an attack can range anywhere between 5 to 30 minutes, but the symptoms can last much longer. 
    While many people have at least one panic attack in the course of their lifetime, panic disorder affects approximately 3% of the population. Panic disorder often begins in adolescence or early adulthood, and as is reportedly more likely to develop in women than in men. However, the statistics may be misleading because men are more reluctant to seek professional help. 
    If diagnosed early, panic disorder can be treated successfully. But if left untreated, it can develop into a more complex and lengthy condition. However, with today’s treatments the success rate can be very high. Treatments include Cognitive Behaviour Therapy (CBT), Behavior Therapy (BT), and medication. Panic disorder often co-occurs with other disorders such as depression and GAD.
  3. Generalized Anxiety Disorders
    Most people experience anxiety on and off throughout the course of their life, but those who suffer with GAD do so on a day to day basis. Their anxiety becomes chronic and fills their life with exaggerated worry and tension, even though the subject they are wrrying about doesn’t warrant it. Individuals with this disorder are always anticipating doom, disaster, and ‘the worst’. They often worry aout their health, money, family, work, and the world in general. Often their reason for worry is hard to pinpoint. Even the thought of getting through another day can bring on anxiety. Individuals with GAD feel that they can’t stop worrying, even though they know the subject they are worrying about isn’t that serious.
    They can also experience accompanying symptoms such as fatigue, headaches, muscle tension, aches and pains, difficulty swallowing or as having something stuck in their throat, trembling, twitching, irritability, hot and cold flashes, profuse sweating for no reason, and often feel lightheaded or ‘dizzy’. They may also feel nauseated or that they have to go to the washroom frequently. Individuals with GAD feel that they can’t relax and startle more easily than others. They may also have difficulty in concentrating or that they feel joyless and frustrated. Often their sleep patterns are disrupted with their inability to sleep becoming yet another reason to worry or be anxious. 
    People with GAD often appear just fine and can go about their day seemingly normal. However, it’s their thought and internal life that undergoes the turmoil. GAD affects about 6% of the population and affects twice as many women as it does men. The disorder usually comes on gradually and can begin at any age, though it is more frequent between childhood and middle age. Those who experience incessant worry for six months or more are typically diagnosed as having GAD. GAD often co-occurs with other disorders such as depression, or substance abuse.
  5. Obsessive-Compulsive Disorders
    OCD involves anxious thoughts or rituals the individual feels they must do or can’t control. Individuals with OCD may be plagued by persistent, unwelcome thoughts or images, or by the urgent need to engage in certain rituals like repeatedly washing their hands, repeatedly checking things, counting things, organizing things, and so on. They may have relentless thoughts of violence or a fear that they may hurt someone they love or are close to. They may have a continual desire to touch things, to symmetrically organize things, repeated thoughts of sexual acts that are repugnant to them, or maybe troubled by thoughts that are against their religious beliefs. These disturbing thoughts or images are called obsessions, and the rituals that are performed to try to get rid of them are called compulsions. There is no pleasure in doing the rituals, but only temporary relief from the anxiety that builds when they don’t perform them. 
    A lot of healthy people can identify with some OCD symptoms, such as checking to make sure the door is locked when going to bed or leaving home, or double and often triple checking to make sure the iron is off. However, individuals with OCD spend hours doing this, and are very distressed because it interferes with their daily life. Most individuals with this condition recognize that what they are doing is senseless, but they feel they can’t stop themselves. However, some people don’t recognize that their behavior is out of the ordinary. 
    OCD affects approximately 4% of the population and it equally affects both men and women. One third of adults with OCD report having experienced their first symptoms as chldren. OCD can come and go over time, as well as it can ease or grow worse with age. Depression and other anxiety disorders most often co-occur with OCD. Like other anxiety disorders, OCD can be successfully treated.
  7. Social Phobia (or Social Anxiety Disorders)
    Social phobia, also called Social Anxiety Disorder (SAD), is a condition whereby the individual feels overwhelming anxiety and excessive self-consciousness in everyday social situations. In a sense, the individual becomes extremely self-conscious in social environments. People with SAD have a persistent, intense, and chronic fear of being watched and judged by others and being embarrassed or humiliated by their own actions. This fear may be so severe that it interferes with work, school, or any other ordinary activities. While many people with SAD recognize that their fear of being around people is unusually excessive, they are unable to overcome it. And often, they worry for days or weeks prior to a social situation. 
    SAD can be a limited to one type of situation, like speaking in public, or it can be as severe as to encompass many or all social situations. Symptoms can include any of the symptoms associated with anxiety disorder, and can often contribute to the anxiety of a social situation because of the fear associated with the symptoms coming at an ‘inopportune time’ or visible enough for others to notice. 
    SAD affects approximately 7% of the population and equally affects women and men. This disorder usually begins in childhood or early adolescence. SAD often co-occurs with other anxiety disorders such as depression, substance abuse and panic disorder. SAD can be successfully treated.
  9. Phobias (including specific phobias)
    A specific phobia is an intense fear of something that poses little or no actual danger. Examples include closed in spaces, heights, escalators, elevators, tunnels, driving, flying, spiders, snakes, and so on. In addition, these phobias aren’t just extreme fears but include irrational fears such as being able to skydive but can’t use an elevator. While the individual understands that these fears are irrational, they can’t do anything to change how they feel, and often just the thought of facing their feared object is enough to bring on intense anxiety and even panic attacks. 
    It is estimated that 6% of the population is affected by specific phobias while it is twice as common in women as it is in men. These phobias generally first appear during childhood or early adolescence. If the object of their fear is easy to avoid, most often the individual won’t seek treatment. Unfortunately, this usually influences the individual when making important life decisions such as not taking an important career advancement because of having to use an elevator. Specific phobias can be successfully treated.
  11. Post Traumatic Stress Disorder
    (PTSD) is a condition that can develop following a terrifying event. Often, individuals with PTSD have persistent thoughts and memories of this event and feel emotionally numb, especially with people they were once close to. PTSD can result from a number of traumatic incidents such as violent attacks, mugging, rape, torture, terrorism, being held captive, child abuse, serious accidents and natural disasters. The trigger event can be something that threatened the person’s life or the life of someone very close to them, or it could be something they had witnessed, such as a death and destruction from a plane crash, bombing or building devastation. Some individuals with PTSD repeatedly relive their trauma through dreams, nightmares and disturbing memories throughout the day. They may also experience sleep problems, feel alienated from reality, or easily startled. Other behaviours they may experience include the inability to show affection, have difficulty maintaining an interest in things they used to enjoy, they may feel irritable, more aggressive, and even violent. Memories of the trauma can be very distressing for them, and can lead them to avoid certain places or situations that bring back those memories. Anniversaries of the event are often difficult as well.
    PTSD affects approximately 6% of the population, and women are more likely than men to develop this condition. It can occur at any-time, including childhood. PTSD often co-occurs with depression, substance abuse and panic disorder. PTSD is diagnosed only if the symptoms last for more than a month. For those who develop PTSD, symptoms usually begin within three months of the event, and the course of illness varies from individual to individual. Occasionally, this condition doesn’t show up until years after the event.
    PTSD can be successfully treated. With today’s proliferation and promotion of new ‘designer’ and ‘social’ drugs, it’s vital that you be fully engaged in managing your personal health. Seek the best professional help, then, work closely with them to help address your anxiety disorder.

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