We have all heard individuals use the phrase “it was an anxious moment when” . Anxiety is a normal human response to some specific events but it does not last and is resolved within minutes or a few days. We also term these events stressful and involve the emotions of fear and uncertainty. If anxiety lasts six months or longer it is termed an anxiety disorder and becomes debilitating interfering with normal life and requires appropriate treatment. The major anxiety disorders are; panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder, social anxiety disorder, specific phobias and generalised anxiety disorder. About one in five have been found to suffer some degree of anxiety disorder in any given year.

Panic disorder- Characterised by a pounding heart, sweatiness, weakness, faintness or giddiness. Chest pain is common and many believe they are having a heart attack. Panic attacks stimulate fear and can last from 10 minutes to hours in duration. It is readily treatable with some drugs but cognitive therapy is most effective as it changes the thought patterns that are the essence of the fear and anxiety.

Obsessive-compulsive disorder- Characterised by persistent upsetting thoughts and rituals (compulsions) to relieve the anxiety produced by the thoughts. In the end the rituals take control of one’s life. It is controlled by some medications but cognitive behaviour therapy provides long term relief.

Post-traumatic stress disorder- Develops after a terrifying ordeal or event. This can include witnessing a distressing event that happened to another. Individuals become emotionally numb, lose interest in popular pastimes, may become aggressive, and avoid situations that remind them of the original event. The event is often relived in thoughts that intrude unexpectedly (as flashbacks) and in dreams. Certain medications alleviate the symptoms but cognitive therapy to change thinking patterns produces a long term reduction in symptoms in most cases.

Social phobias- Individuals are overwhelmed by anxious self-conscious thoughts in everyday social situations. They believe they are being watched and judged by others. Most realise their fears are irrational but have difficulty overcoming them. Again medications may help but cognitive therapy changes the thinking and belief patterns and produces long term relief.

Specific phobias- Specific phobias refer to specific situations where the individual is overcome with uncontrollable fear. These include escalators, animals, insect, water or flying etc. Most individuals are aware that the fear is irrational but are overcome by anxiety or develop panic attacks. Most take steps to avoid the situation involved. Specific phobias respond well to targeted cognitive techniques.

Generalised anxiety disorder- Individuals spend their days filled with worry and tension even though nothing provokes it. They anticipate disaster and have symptoms typical of the stress response. Bodily aches and pains, irritability, nausea, sweating, breathlessness etc. Medications can relieve the symptoms but long term relief is achieved by cognitive behavioural therapy.

Consequences of Anxiety disorders. Mild anxiety and the more severe disorders often impact severely on an individual’s quality of life, interfering with normal day to day activities and limiting choice. Long term relief is not achieved by medication but by cognitive behavioural therapy (CBT) which changes both the thoughts and behaviour. The skills can be learnt over a weekend but the individual must practice and apply them to their lives.
As quality of life deteriorates negative thoughts begin and this is the start of depression which often complicates anxiety.