BeWell Health Clinic

Anxiety is a feeling of fear, nervousness, or worry about a situation or event. Occasional anxiety is a normal emotion that keeps you alert and helps you cope with challenging situations. With anxiety disorders, you experience excessive, intense, and persistent fear and worry about everyday situations in a way that becomes pervasive or intrusive. However, with treatment, you can manage the feelings and live a fulfilling life.

 

Types of Anxiety Disorders

 

Anxiety disorders are a group of related conditions whose common characteristic is excessive, persistent worry or fear in non-threatening situations. They include:

Generalized Anxiety Disorder (GAD)

 

This disorder features chronic anxiety, tension, and exaggerated worry with little or no cause. Patients with GAD fret about regular things like work responsibilities, or minor issues like appointments. Children may worry about their performance or abilities. 

 

Diagnosis Criteria for GAD.

 

  1. You spend most of your time worrying about various activities, or topics, for over six months.  

  2. The worry is uncontrollable and quickly switches across different topics.

  3. Three or more of the following symptoms are present (children need only one sign). 

  • Feeling more fatigued than normal

  • Impaired concentration

  • Restlessness or edginess 

  • Sore or aching muscles

  • Problems sleeping

  • Irritability

  • Sweating, nausea or diarrhea

  1. The symptoms interrupt your daily activities

  2. The symptoms do not arise from another mental or medical condition, or substance use.

 

Panic Disorder

 

This disorder exhibits recurrent incidents of intense fear, also known as panic attacks. The panic attacks are expected or unexpected, with significant psychological and physical distress. 

 

Diagnosis criteria for Panic Disorder

 

  1. After an attack, you spend at least one month fearing another episode. You change your behaviour and purposely avoid triggers.

  2. The attacks are not a result of a medical condition, substance use, or other mental disorder. 

  3. During an attack, you experience at least four of the symptoms below. 

 

  • Increased heart rate, pounding or palpitations

  • Shaking or trembling

  • Sweating

  • Chest discomfort or pain

  • Smothering sensations or shortness of breath

  • Feeling of choking

  • Feeling light-headed, unsteady, or faint 

  • Hot flashes or chills

  • Tingling sensations or numbness

  • Abdominal pain or nausea

  • Fear of losing control or dying

  • Depersonalization

 

Social Anxiety Disorder

 

The critical element of this disorder is a pronounced and continuous fear of social situations in which embarrassment is probable. You may fear a single type of social situation, or you may experience the symptoms every time you are near other people. 

 

Diagnosing Social Anxiety Disorder

 

  1. You experience significant fear when you are exposed to potential scrutiny by others or to unfamiliar people. Children must demonstrate age-appropriate social interactions with familiar people, but become anxious around unfamiliar peers and adults.

  2. Exposure to situations you fear almost always triggers anxiety. Children express anxiety through tantrums, freezing, crying, or shrinking away from unfamiliar people.

  3. You recognize that your fear is extreme or irrational, but children cannot. 

  4. You fear social situations or endure them with distress

  5. The anxiety interrupts your routine.

  6. The symptoms last more than six months if you are under 18 years.

  7. The anxiety does not arise from a mental disorder, medical condition, or substance use.

 

Separation Anxiety Disorder

 

This disorder makes you extremely fearful about separation from people to whom you are attached. The feeling surpasses what is age-appropriate and interferes with your function. Clinical diagnosis features three of the following symptoms.

 

  • You always worry about losing the closest person or people to you

  • You may refuse or hesitate to sleep outside the home or go out without the person

  • You have recurring nightmares about separation

  • You worry about events that may separate you from an attachment figure

  • Another disorder cannot explain your behaviour.

  • The symptoms last beyond six months in adults and four weeks in children.

 

Specific Phobia

 

Specific phobia is a significant and perpetual fear of clearly identifiable situations or objects. DSM stipulates the following criteria for the diagnosis of specific phobia. 

 

  1. You experience panic attacks almost every time you are exposed to the phobic stimulant. Children may cling, freeze, cry or throw tantrums

  2. You recognize that your fear is irrational or extreme, but children may not realize this.

  3. You avoid the phobic situation or endure with great distress 

  4. The anxiety is noticeable, and it interferes significantly with your routine. 

  5. If you are below 18 years, the duration must be longer than six months

  6. No other mental disorders can better explain the fear.

 

Agoraphobia 

 

This disorder is apprehension about situations where you may find it embarrassing or challenging to escape, or get help. The fear disrupts your daily activities, does not match reality, and extends beyond six months. You experience anxiety in at least two of the following circumstances.

  • Being in an enclosed place

  • Being in an open space

  • Being away from home alone

  • Using public transportation

  • Being in crowds or standing in a queue

 

Diagnosis criteria of Agoraphobia

.

  1. You fear to experience panic-like symptoms.

  2. Your symptoms do not meet the criteria for panic disorder.

  3. Your condition is not an effect of a medical condition or substance use

  4. If a medical condition exists, the fear exceeds what is normal for that illness.

 

Typical Pharmacological Treatment of Anxiety

 

Medications will work if you take them according to your doctor’s instructions. Types of anxiety medications are:

 

  • Selective Serotonin Reuptake Inhibitors (SSRIs): These medications block the reuptake and reabsorption of serotonin in the brain, which enhances your mood. They are useful in treating all anxiety disorders and have fewer side effects than tricyclic antidepressants. The side effects include sleepiness or insomnia, weight gain, and sexual dysfunction. 

 

  • Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): These drugs inhibit the reabsorption of neurotransmitters into brain cells and are useful as a first-line treatment for all anxiety disorders. Potential side effects include insomnia, stomach upset, headache, weight gain, a minor rise in blood pressure, and sexual dysfunction. 

 

  • Benzodiazepines: These drugs are a short-term remedy for anxiety or add-ons for treatment-resistant anxiety. They enhance relaxation, relieve muscular tension, and alleviating other physical symptoms. Long-term use requires increased dosage, which may create dependence and tolerance. 

 

  • Tricyclic Antidepressants: Tricyclic antidepressants treat many anxiety disorders except social anxiety disorder. The drugs are preferable to Benzodiazepine. However, they have substantial side effects such as constipation, a drop in your blood pressure upon standing, urinary retention, blurry vision, and dry mouth.

 

Therapy for Anxiety

 

Licensed professionals use different types of therapy to treat anxiety. These include:

 

  • Cognitive Behavioral Therapy (CBT): CBT focuses on recognizing, understanding, and changing your thought and behavior patterns that relate to anxiety. During regular meetings, a CBT-trained and licensed therapist will use interpersonal therapy to help you develop skills to cope. The therapist will encourage you to record your thoughts as they come and possibly use exposure therapy when appropriate.

 

  • Exposure Therapy: Your therapist gradually exposes you to the situations you fear in a controlled, safe environment. The goal is to eliminate your fear. The therapist begins by having you imagine the object or situation and your potential response. They may also incorporate computer simulations or virtual reality to create a realistic but safe exposure method.

 

  • Dialectical Behavioral Therapy (DBT): DBT is a form of CBT that combines acceptance with change. It helps you to accept where you are in your life and also motivates you to improve your situation. The emphasis is on mindfulness to enable you to recognize your thoughts and understand them as they occur.

 

  • Group Therapy: Group therapy refers to a therapeutic environment with more than one patient and counselor. It normalizes your experience through interacting with others and provides opportunities for you to share your experiences. You foster relationships with people facing similar issues by participating in support groups. The goal is to develop friendships among group members and address anxiety triggers as they emerge.

 

Supplements for Anxiety

 

Supplements help relieve symptoms of anxiety, especially when combined with talk therapy, social support, or medications. However, it is crucial to consult your doctor before using supplements.

 

Some supplements for anxiety are:

 

  • Amino acids: These include Gamma-aminobutyric acid (GABA), Omega-3 fatty acids, L-Theanine, and 5-HTP. They are essential for cognitive functioning, increasing serotonin production, improving focus, and promoting relaxation. They also stabilize your mood, which alleviates anxiety symptoms.

 

  • Herbs: They include sunflower, valerian root, and Rhodiola which improve sleep quality, promote positive moods, and relax your mind and body. Valerian root also naturally increases GABA levels in your brain. Licorice root controls the production of stress hormones and soothes gastrointestinal upset, an anxiety symptom. Ashwagandha regulates your body’s natural processes.

 

  • Vitamins: Vitamin A and C are antioxidants that prevent oxidative damage to your nervous system and manage anxiety symptoms. B vitamins are critical to a healthy nervous system, mental health, and mood stabilization. Vitamin D helps in the absorption of other vitamins to prevent vitamin deficiencies. Vitamin E supplements helps replenish the Vitamin E that your body quickly exhausts when you are anxious.

 

Acupuncture for Anxiety

 

Acupuncture is an ancient Chinese practice that alleviates numerous mental and physical conditions by unblocking energy. Before treatment, you give the practitioner a detailed medical history. The acupuncturist painlessly sticks fine needles on acupuncture points under your skin as you lie down. 

 

Depending on your symptoms, the needles go into specific points where energy blockage may occur. They open up and stimulate energy channels to restore your health. These points include insides of your wrists, between your eyebrows and on your breastbone. However, you cannot have acupuncture if you suffer from hemophilia or if you have a pacemaker. 

 

Help is Available for You

 

Anxiety can prevent you from living a happy, healthy life. Although it is incurable, you can manage the symptoms. Our dedicated professionals will help you face your fears and live a fulfilling life. Talk to our anxiety specialists, and find out the different treatment methods available for you.

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