Anxiety Disorders
Anxiety Disorders Types
Anxiety Disorder Flow Chart
Anxiety Treatments
Definition
Treatment ( Psychotherapy )
Treatment ( Pharmacotherapy )
Definition.
Anxiety is a group of disorders ( Anxiety Disorders Types ) characterized by a
number of both mental and physical symptoms, with no apparent explanation. Apprehension, fear
of losing control, fear of going "crazy", fear of pending death or impending
danger, and general uneasiness are among the most common mental symptoms. Common physical symptoms
include dizziness, lightheadedness, chest / abdominal pain, nausea, increased heart
rate, and diarrhea. Because there are so many physical symptoms, anxiety disorders may not
be recognized and the symptoms only treated as physical disorders. Doctors and researchers
believe that with both psychotherapy and medication over 80% of persons with anxiety disorders can
be helped. Anxiety can also be one of the common symptoms of psychiatric disorders.
Anxiety disorders appear to have become more common in recent years , though this may be due to
better diagnostics. And although women are treated for these disorders more often, psychologists
believe that this is simply because men are less likely to seek treatment.
An anxiety disorder should not be confused with everyday stress and worry which, due to
circumstances, can affect everyone at one time or another. Anxiety disorders, however, are
persistent conditions, and should be diagnosed carefully by a licensed mental health professional
after a full evaluation. While self care-options can benefit ordinary stress or anxiety,
prescription treatments should only be used in clear cases of chronic and ongoing anxiety.
According to the National Institute of Mental Health, 19 million adults in the US suffer from one
form of anxiety or another. Sleep disorders or early awakening, depression, tension, muscle aches,
and fatigue can all accompany chronic anxiety.
Chronic anxiety, also referred to as Generalized Anxiety Disorder, manifests as persistent worries,
fears and negative thoughts which last a minimum of six months. Excessive worry over daily
activities, and a tendency towards headaches and nausea are common.
Acute anxiety, or Panic Disorder, comes on as a sudden attack of fear accompanied by symptoms that
may resemble a heart attack ( palpitations, chest pain, dizziness ). Shortness of breath, stomach
upset, chills, cold sweats, hot flashes, or irrational fears of death can combine with these
symptoms to create a terrifying experience for the individual experiencing them. Excessive levels of
norepinephrine increase the rates of breathing and pulse in panic attack sufferers
Post-Traumatic Stress Disorder is also classed as an anxiety disorder, and can be triggered in
anyone who has experienced or witnessed a deeply traumatic event. Anger, depression, emotional
numbness, flashbacks, nightmares, and a tendency to startle easily may be seen.
Phobias, or irrational fears, and Obsessive Compulsive Disorder, a tendency towards repetitive or
uncontrollable behavior, are also classed with anxiety disorders. These may co-exist, as many
individuals with obsessive compulsive disorders have phobias about germs or un cleanliness and
may wash their hands or bathe excessively.
Anxiety disorders, like many other conditions, are an example of normal responses that appear at
inappropriate times. Our fight-or-flight response, characterized most strongly by increased
adrenaline or norepinephrine production, allows us to react promptly to dangerous situations. When
lives are in danger we react quickly and get to safety or defend ourselves. But when we experience
these reactions frequently during daily life, they can be very disruptive.
Chemical imbalances, allergies, nutritional deficiencies and other health problems, environmental
influences, and stressful life events may worsen or trigger some of these conditions. Anxiety
disorders may co-exist, or occur alongside other conditions, like depression, bipolar disorder, ADD
/ ADHD, an eating disorder, or a major life-threatening illness. If an anxiety disorder is severe
enough to require prescription treatment, other conditions should be ruled out or treatment geared
to avoid interfering with pre-existing health issues.
Even with a psychological condition like anxiety, the physical body is involved. Improved nutrition,
adequate exercise, and relaxation techniques can significantly improve a person's sense of
well-being. When the body is more resistant to the effects of stress, emotional stress may be easier
to deal with.
Anxiety Disorders Types
Acute Stress Disorder
Agoraphobia
Agoraphobia Without History of Panic
Disorder
Anxiety Disorder Due to a General Medical
Condition
Anxiety Disorder Not Otherwise
Specified ( Anxiety Disorder NOS )
Generalized Anxiety Disorder ( GAD )
Obsessive-Compulsive Disorder ( OCD
)
Panic Attack
Panic Disorder With Agoraphobia.
Panic Disorder Without
Agoraphobia.
Posttraumatic Stress
Disorder
Social Phobia
Specific Phobia
Substance-Induced Anxiety Disorder.
Treatment ( Psychotherapy )
Adlerian
Therapy
Behavior Therapy
Cognitive-behavioral Therapy
Existential Therapy
Gestalt Therapy
Person-centered Therapy
Psychoanalytic
Rational-emotive Therapy
Reality Therapy
Transactional Analysis
Treatment ( Pharmacotherapy )
Alprazolam Intensol
Ativan
BuSpar
Centrax
Equanil
Inderal
Klonopin
Lexapro ( Lexaprotm )
Libritabs
Librium
Luvox
Meprospan
Miltown
Novo-Alprazol
Paxil
Paxipam
Serax
T-Quil
Tranxene
Valium
Valrelease
Versed
Xanax
Anxiety Treatments
There are many care options that you can take advantage of if you suffer from excessive anxiety,
from self-care to prescription treatments. The self-care options can and should be combined with any
treatment suggested by your doctor, and can help some individuals regain a sense of control over
their lives. Below are some self-care suggestions.
Diet
Anxiety disorders are conditions where the chemical flight-or-fight response may be tuned to react
very strongly to minimal stress. Because of this physical component, some individuals find that they
become far less anxious when they identify and remove allergens from their diet or eat a healthier
diet. Any foods that are hard to digest or process strip nutrients from the system, and may
themselves trigger an adrenalin response and contribute to muscle tension.
Avoid refined sugar, soft drinks, white flour products, and sweetened fruit juice. These high
carbohydrate foods contain few nutrients and can cause blood sugar to fluctuate wildly . If you are
hypoglycemic, this can be especially important as high sugar foods may trigger unpleasant side
effects. Whole fruits and unprocessed fruit juices, however, are important sources of nutrients and
contain substances which make their sugar content less problematic. Include more whole fruit in your
diet as often as possible, and try to get used to substituting it for sweet snacks and desserts.
Fresh or lightly cooked (but not boiled) vegetables and whole fruit should be eaten as often as
possible. When eating grain products, try to choose whole grain foods over refined foods. While
organic produce and grain may have a higher nutrient content, all fresh whole foods are better
sources of nutrition than highly processed or refined foods. If your susceptibility to stress is
worsened by a depletion of vitamins and minerals, you can improve the situation by replacing empty
calories with useful ones.
Try drinking more mineral water, which can improve the balance of trace minerals. Naturally
sparkling water or spring water is preferred; avoid sweetened or artificially carbonated water
drinks.
Exercise Lifestyle
A regular exercise program has proven beneficial for many mood disorders, including anxiety and panic
attack. The chemicals released in the body during exercise have a positve and stabilizing effect on mood
and a person's sense of well-being.
Participating in an aerobic activity such as brisk walking, jogging, swimming, bicycling, racquetball,
or tennis for 30-40 minutes three times per week is a healthy goal. Exercise can help the production of
chemicals in the body that make people feel good naturally, and helps many feel truly relaxed when not
exercising.
Be sure to pay attention to your sleeping habits as well. When subjects are deliberately deprived of
adequate rest their emotional wholeness begins to deteriorate. If you consistently feel tired, even in
the morning, or have difficulty sleeping or staying asleep, consider getting evaluated for a sleep
disorder. Waking early is sometimes considered to be a marker for anxiety, but can be caused by other
conditions.
Tobacco and caffeine are both stimulants. Avoiding these substances can
have a positive influence on the steadiness of your mood and thoughts. While a feeling of well-being
may result when caffeine and tobacco peak in your system, they cause your pulse to rise, blood
vessels to dilate, and generally put your body in a state of over-heightened alertness. They may
interfere with digestion by diverting blood away from the digestive system after a meal, which can
create significant physical stress and malabsorption. Detoxifying these substances also strips
valuable nutrients out of the body, and this can make the body more vulnerable to stress.
Try to remove stress from your personal life by eliminating unnecessary activities, taking time to
enjoy a private hobby, or relaxing more often with loved ones. A counselor can often help you
identify the areas of your life that cause the most concern to you, and may be able to help you come
up with creative ways to improve your situation. It can be particularly helpful to have an objective
opinion if you feel that you need to make major changes in your life to reduce tension, or if you
feel that working on your communication skills could help you resolve certain difficulties.
Prescription Treatments
The following medications may not be suitable for all patients. Check with your doctor to ensure
that you receive the most appropriate treatment possible:
- Benzodiazepine Sedatives act as nervous system depressants, reducing the effects of tension and
over- stimulation by increasing the activity of the neurotransmitter GABA. This class of
medications carries a risk of chemical dependence if use exceeds prescription guidelines. These
treatments may cause drowsiness. They should be avoided by people with other psychiatric
conditions ( borderline personality, depression, or psychosis ), brain disease, porphyria,
glaucoma, breathing difficulties, or sleep apnea.
- Benzodiazepine Sedatives:
- BuSpar ( buspirone ) is an anti-anxiety treatment
that acts on the neurotransmitters dopamine, norepinephrine and serotonin to calm the mind. It
is considered an effective treatment for mild to moderate anxiety or tension, and may take a
couple weeks for the full effects to be realized.
Interactions
- Alcohol - Anxiety medications are nervous system depressants, and tend to react badly with
alcohol. Unconsciousness, coma, and possibly death, could result from an overdose following this
combination.
- Antibiotics, anti-fungal, anti-infection agents - Medications falling into these categories
should always be checked with a doctor and pharmacist to be sure that they will not cause a
dangerous interaction with your treatment. If you need to be prescribed any treatment to fight
fungal or bacterial infection, tell the prescribing physician about any and all other
medications you are using.
- Any medication which may cause drowsiness should be taken with caution when using nervous system
depressants.
- Anti seizure medication like Cerebyx ( fosphenytoin
), Dilantin ( phenytoin ), or Tegretol ( carbamazepine ) may build up to toxic
levels when taken with some of the above medications.
- Benzodiazepines of any other type such as Ativan (
lorazepam ), Halcion ( triazolam ), Restoril ( temazepam ), Xanax ( alprazolam ), Tranxene-SD ( clorazepate ), Paxipam ( halazepam ), ProSom ( estazolam ), Klonopin ( clonazepam ), and others, should
not generally be mixed with Valium ( diazepam ). This
could lead to extreme oversedation, overdose, or possibly death.
- Beta blockers like Lopressor ( metoprolol ) or Inderal ( propranolol ) may interfere with
heart rhythms when combined with these medications.
- Coumadin ( warfarin ) – There is an increased risk of uncontrolled bleeding when mixed
with BuSpar treatment.
- Desyrel ( trazodone ).
- Ephedra - This stimulant may reduce sedative effects.
- Herbs: The following herbs may cause sedatives to be less effective: ginseng, gotu kola, kola
nut, ma huang and mate. The following herbs should NOT be taken while taking sedatives: kava
kava, St. John’s wort, valerian.
- MAO inhibitors - None of the above medications should be mixed with MAO ( monoamine oxidase )
inhibitors, a class of antidepressants and anti-senility drugs, such as Eldepryl ( selegiline ), Furoxone ( furazolidone ), Nardil ( phenelzine ), Marplan ( isocarboxazid ), or Parnate ( tranylcypromine ). The combination may prove fatal.
- Morphine and Valium must not be administered together.
- Narcotic analgesics of any kind, like Darvon ( propoxyphene ), Darvocet ( propoxyphene,
acetaminophen ), Demerol ( meperidine ), Codeine, Percocet ( oxycodone, acetaminophen ), Vicodin ( hydrocodone and acetaminophen ),
Vicoprofen ( hydrocodone and ibuprofen ), or OxyContin ( oxycodone ) may accelerate
central nervous system or respiratory depression when taken with sedatives, and an overdose could prove fatal. Also, sedatives may decrease the
effectiveness of these medications as pain relievers.
- Nicotine may reduce the effectiveness of sedatives.
- Nizoral ( ketoconazole ) - Either medication may build up to undesirable levels, increasing the
risk of overdose.
- Norflex ( orphenadrine ) – There is a risk of oversedation.
- Oral contraceptives may cause Valium to build up in the body, potentially increasing side
effects.
- Provigil ( modafinil ) - Dosage adjustments may be necessary.
- Rifamate ( isoniazid ), Rifater or Rifadin ( rifampin ), or Mycobutin ( rifabutin ) - Either
medication may build up to undesirable levels, increasing the risk of overdose.
- Sedatives like Fioricet ( butalbital, acetaminophen, and caffeine ), Fiorinal ( butalbital,
aspirin, and caffeine ), Phenobarbitol, Seconal, or other barbiturates should not be mixed with
anxiety treatments.
- Selective serotonin re uptake inhibitors ( SSRIs ) like Celexa
( citalopram ), Paxil ( paroxetine ), Prozac ( fluoxetine ), Luvox ( fluvoxamine ), or Zoloft ( sertraline ) should not be mixed with
the above drugs.
- Skeletal muscle relaxants such as Flexeril ( cyclobenzaprine ), Skelaxin ( metaxalone ), Soma
(carisoprodol), or Robaxin (methocarbamol) may cause oversedation in combination with these
medications.
- Sleep medication like Ambien ( zolpidem ), Sonata ( zaleplon ), or over-the-counter
sleeping pills should be used with these treatments only as, and if, advised by your doctor.
- Sporanox ( itraconazole ) –is an antifungal treatment that may cause other medications to
build up in the body.
- Tagamet ( cimetidine ).
- Tranquilizers such as Haldol ( haloperidol ), Mellaril ( thioridazine ) and Thorazine ( chlorpromazine ) may cause
oversedation.
- Tricyclic antidepressants such as Elavil ( amitriptyline
), Asendin ( amoxapine ), Anafranil ( clomipramine ), Pertofrane or Norpramin ( desipramine ), Sinequan ( doxepin ), Tofranil ( imipramine ), Aventyl or Pamelor ( nortriptyline ), Vivactil ( protriptyline ), and Surmontil ( trimipramine ) may increase the risk
of side effects from these treatments.
- Ultram ( tramadol ) - This pain reliever may over-sedate you if taken in combination with
nervous system depressants.
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