While getting ready to go to university on a regular, sunny day, Maya feels her sense of dread intensifying. Her palms go sweaty, she feels queasy and all she wants to do is to get back into her pyjamas and stay at home. With no obvious reason for feeling this way, why does this familiar experience plague her every day?
HERE’S WHY…
“Anxiety is ‘worry’ or ‘apprehension’ of a future outcome,” says Dr Subathra Jeyaram, chartered psychologist and psycho-oncologist at Bahrain Specialist Hospital. “It’s the mind and body’s natural response to stress – the first day at a new workplace, giving a speech, taking an examination or attending a job interview. It manifests as sweating, increased heart rate, rapid breathing and butterflies in the stomach.”
Anxiety becomes a disorder when the mind and body start perceiving ‘normal’ situations as stressful. Dr Subathra explains: “Feelings of anxiety can be intense, long lasting and debilitating. If they increase in intensity over a period of six months and interfere with normal functioning in day-to-day life, it becomes a disorder.”
She goes on to say that the human body is beautifully designed, enabling the nervous system to handle its stress response, and also quickly repair and clean up after. “But the body can only take so much wear and tear, and is equipped to deal with occasional stress. Multiple stress responses within a day, every day, can take a toll on the body and mind.”
THE LOWDOWN
‘Anxiety disorder’ is an umbrella term for a group of mental maladies: generalised anxiety; panic (where panic attacks strike); post-traumatic stress; and social anxiety disorders, as well as specific phobias, separation anxiety and obsessive-compulsive disorder (OCD).
Chronic worrying can be a genetic predisposition, learned based on life experiences or an outcome of a traumatic experience or grave illness. It can also be secondary to another mental illness or substance abuse.
THE PRICE PAID
Common short-term effects of anxiety are sleep disturbance, changes in appetite, low energy and fatigue, headaches, poor concentration and social isolation; all leading to poor quality of life. This results in long-term illnesses, especially heart, immune and digestive disorders. Untreated anxiety can also cause secondary depression and other mental illnesses.
Dr Subathra says: “An anxious person typically engages in maladaptive behaviours. They tend to avoid people, places, situations or experiences that may induce anxiety, or abruptly escape such settings, often leading to social awkwardness. The distress caused by anxiety may lead them to unhealthy and risky behaviours such as substance abuse, unhealthy consumption of alcohol, binge eating and/or purging. Anxiety can severely limit their day-to-day functioning, and lead to social withdrawal and isolation.
“People with anxiety disorder often engage in some form of ‘safety behaviour’. They will engage in a potentially anxiety-inducing task if they have a safety object, person or factor that they think protects them. For example, a patient perpetually fearing contamination (a form of obsessive-compulsive disorder) will quickly wash their hands immediately after touching what they perceive as ‘contaminated’ or ‘dirty’, reasoning that to protect themselves, they must wash their hands a certain number of times or in a certain way.”
THE STATISTICS
Anxiety disorders are some of the most common forms of mental illness affecting one in 13 people worldwide, according to the World Health Organisation (WHO). Although highly treatable, less than 40 per cent of sufferers receive treatment. Untreated anxiety is the sixth leading cause of disability worldwide and is associated with poorer quality of life, higher rates of unemployment and divorce.
THE SOLUTION
Anxiety disorders can be treated with medication, psychotherapy (talk therapy), or both. A combination of medication and therapy is recommended for recurrent and resistant cases. Dr Subathra elaborates: “Cognitive Behaviour Therapy (CBT) is regarded as the most evidence-based form of psychotherapy, particularly for emotional disorders such as anxiety and depression. It is particularly effective for phobias, panic disorders and OCD where medication alone is not effective. CBT is a time-bound, scientific and structured form of psychotherapy and has shown success in recovery and relapse prevention. It is the choice of treatment for patients who cannot take medication due to other physical illnesses, or special groups such as pregnant women and children.”
DR SUBATHRA’S SELF-HELP SUGGESTIONS
1. Regular aerobic exercise such as brisk walking, running, cycling, swimming or aerobics enables the brain to produce the chemical serotonin, which alleviates the mood and helps relieve stress and anxiety.
2. Deep muscle relaxation, yoga, meditation or similar activities help to unwind.
3. Caffeine can spike anxiety, disrupt sleep, cause fatigue and interfere with one’s ability to manage anxiety further. Consider switching to decaf or avoid caffeine after 2pm, if you cannot completely skip it.
4. Alcohol and tobacco are known to worsen symptoms of anxiety – so steer clear.
5. Regulating sleep reduces symptoms and a healthy diet with fresh vegetables, fruits and high-quality protein can improve the mood.
Dr Subathra says: “The only thing that is more exhausting than a mental illness is pretending you don’t have it. Anxiety is treatable and should be treated.”
Did you know?
Anxiety attacks are often used interchangeably with panic attacks. However, they are different and represent different intensities and durations.
Panic attacks are the hallmark of panic disorder. They are characterised by sudden, intense fear that peaks rather quickly within minutes and is accompanied by multiple physical symptoms – palpitations, increased heart rate, shortness of breath, choking, sweating, nausea or abdominal discomfort, fear of losing control, dizziness or light headedness, fear of dying, chest pain or discomfort and derealisation (unreal perceptions). Panic attacks last for 15 to 20 minutes and then subside. Owing to multiple physical symptoms, panic disorder patients often report to the ER, convinced they have a physical illness (often a heart attack).
