when worry gets out of control...anxiety disorders
We all get worried and anxious, and as described in the page on stress, this is normal and adaptive for the most part...but what happens when it gets out of control and overwhelming?
The result can be recognised illnesses such as panic disorder, generalised anxiety disorder, and the related obsessive-compulsive disorder.
Panic attacks are the main symptom of panic disorder. These consist of:
- a subjective sense of sudden, intense and overwhelming panic, often provoked by a seemingly innocuous situation - eg. crowded shop, driving over a high bridge, getting on a tube train, addressing a meeting
- racing, thumping heart
- feeling breathless
- tremulousness
- sweating
- numbness or pins and needles in toes, fingers or lips
- feeling as if you are about to faint, collapse, be incontinent or have a heart attack
- spasm in the hands or feet
Panic attacks can last for a minute or two or sometimes considerably longer. They are terrifying to experience and sufferers often at first don't know what they are and assume that they are having a life-threatening event such as a heart attack, and may even call an ambulance and get taken to the Casualty dept! Thankfully, although extremely distressing, they are physically harmless.
Untreated, panic attacks can lead to a secondary component of the condition known as agoraphobia.
Agoraphobia is the situation where the sufferer of panic attacks, quite understandably, starts avoiding situations that provoke them, eventually leading to a markedly reduced repertoire of activities. Unfortunately, avoidance only serves to reinforce the panic disorder and tends to spread the reaction to occur with new situations.
So the sufferer can end up a virtual prisoner in their own home.
Generalised anxiety disorder is a condition where instead of the sudden surges of anxiety spikes in panic disorder, the sufferer has persistently raised levels of anxiety, often irrespective of their life situation (known as free-floating). The anxiety levels are such that they are constantly on edge, nervous and worried and this has a preoccupying and disabling intensity and quality to it.
There may be some of the physical symptoms listed above in panic disorder but usually of a lesser severity.
Obsessive-compulsive disorder is an anxiety-related condition where the sufferer has repetitive, intrusive, worrying thoughts or urges, associated with high levels of anxiety, which can result in the need to carry out repetitive actions or rituals in order to relieve the anxiety. The relief gained is usually only temporary, and so the cycle repeats itself. This can vary from very mild to severe, and at its worst, can be very disabling due to the amount of time devoted to the thoughts, actions and rituals, at the expense of normal activities.
..and now the good news: these conditions can be treated!
Treatment can help a great deal in controlling symptoms and reducing the distress and real disability that these conditions can create. We tend to use cognitive behavioural therapy, and this is sometimes combined with medication, in the form of anti-anxiety/anti-obsessional antidepressants or anti-anxiety agents such as pregabalin.