Anxiety is a common experience and it's a normal experience.
We tend to feel anxious when we are faced with a threat.
It's actually an important mechanism, because anxiety prepares our body
to manage the threat and to either fight or flight. Anxiety sometimes can persist and be disabling.
And if this persists, the normal anxiety experience becomes an anxiety disorder.
Now, depending on what the anxiety manifests as, there are different kinds of disorders.
The most common is called generalised anxiety disorder, which happens in about six in 100 people.
It's characterised by a sense of general anxiety, free-floating anxiety,
a sense of unease and apprehension, and can be quite disabling to function in daily life.
The other kind is called panic disorders, where people can feel an extreme surge in anxiety.
So, they experience an acute spike and severe anxiety characterised by
psychological and physical symptoms.
They might feel that the world is about to end or they're about to die and it can be quite hard to manage that.
In my clinical practise, when I explore anxiety disorders,
sometimes they lead back to a traumatic point in the person's history.
Anxiety that stems from trauma can be quite disabling as well and
people can experience flashbacks and nightmares of previous trauma.
That condition is called PTSD or post-traumatic stress disorder.
People can also have avoidance of things which remind them of the trauma.
And they can also be hyper-aware of situations.
There are other less common disorders of anxiety, such as social phobia and agoraphobia.
Anxiety can manifest in different ways.
So, two people having anxiety disorders can have two different experiences.
Generally speaking, we can think about symptoms in two broad categories.
First of all, there's psychological symptoms, which include feeling anxious, feeling nervous,
a sense of apprehension and unease. There are also a set of physical symptoms, which
are mainly due to adrenaline, which is increased in a body at times of anxiety.
The physical symptoms include palpitations, shortness of breath, sweating, dry mouth and nausea.
The psychological and physical symptoms can have significant impact on our lives.
It can affect home life, it can affect work and relationships, and also it can affect productivity.
Now, sometimes anxiety stems from a past traumatic event.
In this case the anxiety symptoms can be quite specific.
For instance, people can have flashbacks and nightmares of the traumatic event
and can also avoid triggers which remind them of the trauma.
In addition, people can feel hyper-anxious and hyper-vigilant, which means that
they're more aware of what's going on around them and they're easily startled by small sounds.
Anxiety and depression are two separate conditions, although they can have a similar mechanism in the brain.
In my clinical practise, I find that there can be an overlap between depression and anxiety.
Like I've said before, anxiety can manifest in different ways, and the overlap
with depression can make it harder to manage.
It's important to remember that depression is not the same as feeling sad.
Feeling sad is a normal experience; it is a normal response
to something that we might have lost or something that is troubling us and upsetting us.
Depression, on the other hand, is a medical condition. It's a clinical disorder.
It's characterised by feeling low in mood, not being able to enjoy things, and feeling easily fatigued.
People with depression can also have difficulty with sleep, appetite, and concentration.
In addition, if the depression can prolong and persist, people start having difficulties
with their relationships and productivity.
In some cases, depression also presents with what we call cognitive symptoms.
These include a sense of hopelessness, worthlessness, and pessimism.
People can also experience a sense of guilt and the world can look a lot bleaker and more pessimistic.
It's not uncommon for people with depression to experience thoughts of suicide and self-harm.
Anxiety is treatable. What you need initially is a good clinical assessment.
A good assessment will focus on your individual symptoms. It will also look at what is really going on.
For example, is it just anxiety or is there depression along with anxiety, or is something else going on.
Sometimes medical conditions like a thyroid problem can manifest as anxiety.
And also, sometimes you can learn to use certain substances or alcohol to manage anxiety, and
this can actually make things worse. So, the first step is to have a good clinical assessment.
There are some general strategies that can be used to manage anxiety.
I recommend that people with anxiety try and manage their stress levels and try and manage work/life balance.
A good diet and regular exercise can also help.
In addition, maintaining a good sleep routine and avoiding tablets and computers at night can help,
and also, having good social contact and good relationships can help.
Moving on to more specific management: the best way to manage anxiety
is through a combination of medication and psychological techniques.
So, a specialist would recommend these strategies, and I will touch upon briefly, first of all,
the psychological techniques.
Based on your individual set of symptoms, there are a number of different models of psychological therapy.
CBT, also called cognitive behavioural therapy has got good evidence for anxiety and depression.
It works on challenging negative thoughts
and implementing certain behavioural changes to manage physical and cognitive symptoms.
The other model of therapy that I find quite helpful is called EMDR, which stands for eye
movement desensitisation and reprocessing. This is a specific therapy aimed at people
with traumatic histories and where anxiety stems from a traumatic event.
There is a third model of therapy which I use in my practise and that's called CAT,
also known as cognitive analytic therapy.
This specialised therapy works with people's relationships; both with themself and others,
and that can also help in trying to understand certain behaviours which can lead to reinforcing anxiety.
Now, the last bit would be around medication.
Medication is quite helpful as well and it works quicker than therapy.
Generally, we aim to use medication, which helps restore the balance of two particular chemicals in the brain.
These are called serotonin and noradrenaline.
Medication can have good effects within a couple of weeks, but usually
it can take up to six weeks for medication to start working properly.