Anxiety Causes, Symptoms and Treatment
Treating anxiety symptoms is often complex and involves several approaches.
One of the most fascinating explanations I’ve heard comes from Dr. J. Shedler, who compared anxiety and depression to fever. “Anxiety and depression are a psychological equivalent to fever as they represent nonspecific reactions which stem from a broad spectrum of underlying conditions”. Therefore, while focusing on easing anxiety symptoms like feeling constantly on edge or prone to agitation, restlessness or irritability, it is crucial to address the root causes of these reactions.
What is Anxiety?
Anxiety is a primary emotion that has long been considered an adaptive resource for danger and threats. Charles Darwin maintained that reactions to fear are essentially the product of natural selection. Sigmund Freud saw fear and anxiety as aversive and universally experienced emotions distinct from other negative emotions. He argued that a certain degree of anxiety is normal. However, traumatic experiences, repressed memories, emotions and poor coping skills give rise to neuroses (pathological anxiety or worry). From the cognitive behaviour perspective, anxiety is seen as the tendency to overestimate a potential danger.
Epidemiologists and anthropologists have since confirmed the commonness of anxiety as a human experience. Although people from all cultural backgrounds have been seen to experience anxiety, there are huge individual differences in the strength of the anxiety response and in the circumstances in which certain stimuli can induce anxiety.
Proponents of the dimensional understanding of anxiety occasionally make fun of any efforts to specifically categorise anxiety disorders, arguing that there are significant similarities across the disorders. Conversely, experts who work closely with people seeking treatment for anxiety are fascinated with being able to cluster anxiety symptoms into readily distinguishable syndromes.
Diagnostic classifications are products of cultural clarification
Therefore, identifying when the feeling of anxiety is severe enough to be extreme can be an ambiguous process. Clinically significant anxiety symptoms usually interfere with people’s daily functioning. Yet, there are individuals suffering from anxiety whose functioning does not appear to be impaired. These people have adjusted their lifestyles to the point of being able to contain the symptoms, which can nevertheless remain problematic.
Anxiety Symptoms and the Major Types of Anxiety Disorders
According to The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), anxiety disorders share features of extreme anxiety, fear and associated maladaptive behavioural responses.
Anxiety disorders include a set of interconnected conditions, each presenting certain symptoms. However, they all share a common characteristic: an enduring, excessive sense of fear or worry in non-threatening situations. In all anxiety conditions, people usually experience one or more of the following symptoms:
Emotional Symptoms of Anxiety
Sensations of unease
Feeling on edge
Restlessness
Persistent preoccupation with potential threats, leading to hyper-vigilance
Physical Symptoms of Anxiety
Rapid or irregular heartbeat and breathlessness
Perspiration, muscle tremors, and twitches
Headaches, fatigue, and disrupted sleep
Digestive issues like upset stomach, frequent urination, or diarrhoea
Anxiety disorders include:
- generalised anxiety disorder (GAD),
- social anxiety disorder (social phobia),
- agoraphobia,
- specific phobia,
- panic disorder,
- separation anxiety disorder,
- anxiety disorder induced by medication or similar,
- anxiety disorder induced by another medical condition,
- selective mutism.
- Posttraumatic stress disorder (PTSD) and obsessive-compulsive disorder (OCD) no longer fall under the category of anxiety disorders in the DSM-5 and sit under their own categories. Nevertheless, they have a close relationship with anxiety disorders. The sequential order of these sections in the DSM-5 points to this close relationship.
Risk Factors for Anxiety
Research in anxiety points out that both the environment and genetic predisposition comprise the risks for anxiety conditions. Although the risk factors for each anxiety disorder can differ, some shared perils for all types of anxiety include
- traumatic life events;
- a history of an anxiety disorder or other mental health issues in genetic relatives;
- certain somatic conditions, such as thyroid problems or heart arrhythmias
- behavioural inhibition in childhood or an overexpressed personality trait of shyness.
In addition, caffeine or certain medicines can trigger or exacerbate a feeling of anxiety. In assessing an anxiety condition, a full health examination is beneficial.
Comorbidity of Anxiety with Depression
The coexistence of depression and anxiety (referred to as comorbidity) is rather prevalent. Research shows that around 60 per cent of people with anxiety also display symptoms of depression, and vice versa. This demonstrates the close relationship between the two. When anxiety and depression co-occur, treatment can become more challenging. The symptoms of both disorders tend to be more persistent and intense when they interact, making intervention more complex.
As a result, individuals dealing with both anxiety and depression may require more specialised treatments. Professionals delivering treatment might need to adopt creative approaches, such as combining different therapies to address both underlying disorders. For instance, if antidepressants relieve the person’s mood but not their anxiety, cognitive-behavioural therapy could be added to the treatment plan.
Further research is crucial to understand better why certain people experience comorbid conditions while others do not. Until then, early engagement in treatment and finding a compatible therapist to work towards their goals are crucial for individuals experiencing one or multiple mental illnesses.
Addressing and Treating Anxiety Symptoms
Anxiety treatment usually comprises psychological therapy in-person or online via internet-based video communication platforms, pharmacological therapy or both. There are various therapeutic approaches to treating anxiety. A person can determine which option is most effective for them with the help of their psychotherapist, counsellor or psychiatrist.
Anxiety Therapy – Counselling and Skill Training
Counsellors usually provide explorative counselling and coping skills training, which are crucial for enhancing coping mechanisms and preventing symptom return in the long term.
Cognitive Behaviour Therapy for Anxiety (CBT)
CBT is an evidence-based psychological intervention widely recognised for its success in managing anxiety. Therapists effectively deliver cognitive behaviour therapy for anxiety and other mental health conditions onsite or online via Zoom or other internet-based communication platforms that allow users to connect with video.
Cognitive behaviour therapy for anxiety educates people on how to start thinking differently and how to interpret anxiety-producing stimuli more adaptively. Moreover, it teaches people how to start acting rationally and stop being preoccupied with uncertainties and fears. In addition, cognitive behaviour counselling or therapy for anxiety aids people in acquiring and exercising social skills critical for overcoming anxiety, especially in the context of addressing social anxiety disorder. Exposure and cognitive reappraisal stand out as two particularly potent CBT techniques for managing anxiety.
Anxiety Therapy – Medication
Psychopharmacological interventions can reduce anxiety symptoms. Anxiety medications are usually prescribed by psychiatrists and often include anxiolytics, antidepressant medications and beta-blockers. Yet, it is necessary to discuss with the psychiatrist what must be avoided during the pharmacological anxiety treatment.
Stress Management
In cases of prolonged, chronic stress lasting for days or longer, elevated cortisol levels can result in excitotoxicity and damage to brain cells. The subsequent overexposure to cortisol and other stress hormones can disrupt nearly all bodily processes. Excessive cortisol release increases the risk of various health problems, including anxiety and depression. Mindfulness and relaxation techniques are widely acknowledged as effective strategies for managing stress and enhancing the effectiveness of anxiety therapy.
Summing up Anxiety Causes, Symptoms and Therapy
Causes of Anxiety
Anxiety is a complex emotion that has both adaptive and pathological factors. While a certain degree of anxiety is considered normal, traumatic life events, repressed memories and a lack of coping skills may give rise to pathological anxiety. From a cognitive-behavioural perspective, anxiety is viewed as an overestimation of possible danger. Both genetic predisposition and environmental factors contribute to the risk of developing anxiety disorders. Traumatic experiences, family history of anxiety disorders or other mental health issues and certain somatic conditions may increase the chance of developing anxiety symptoms. Dependencies and certain medications can also initiate or aggravate anxiety.
Anxiety Treatment
Treatment options for anxiety may include in-person psychological treatment or online anxiety therapy conducted through internet-based platforms, possibly added by pharmacological interventions. Cognitive behavioural therapy (CBT) is an evidence-based approach that helps people reframe their thoughts, manage anxiety-provoking stimuli and develop rational behaviours. Medications, such as anxiolytics and antidepressants, may be prescribed to alleviate symptoms, but it’s critical to consult with a psychiatrist or your doctor regarding potential interactions and contraindications. Depression is known to be highly comorbid with anxiety, and people dealing with both depression and anxiety may need combined treatments.
Stress management techniques, such as mindfulness and relaxation practices, play a crucial role in managing anxiety. They help reduce the impact of chronic stress on the organism, including the harmful effects of cortisol overexposure, which happens during prolonged stress.
As highlighted earlier, the integrative approach to managing anxiety entails not only dealing with immediate anxiety symptoms but also addressing the root causes to prevent the recurrence of symptoms in the long term. Thus, this process might demand a commitment of time and dedication.
Bibliography:
- Anxiety Disorders in Adults. DOI: 10.1093/med:psych/9780195116250.001.0001