Anxiety Disorders - Clinical Experience and Observations as well as well-known knowledge on Anxiety. There are many causes for anxiety in someone's life. Genetic predispositions and stressors increase one's vulnerability to having an Anxiety Disorder. Other medical illnesses can present with symptoms of either anxiety or depressive disorders. Diabetes and Thyroid Disorder are just a few with symptoms of anxiety. Once the underlying medical illness is diagnosed and treated, the anxiety symptoms generally resolve. We know that substances such as Amphetamine, Caffeine and Cocaine can elicit anxiety symptoms. Once the substances are out of one's system, the anxiety symptoms dissipate.
The symptoms of an Anxiety Disorder are generally varied depending on the person. Some of the anxiety symptoms people usually have are accelerated heart rate, sweating, trembling, a feeling of choking or shortness of breath, a feeling of dizziness or a feeling of faintness, chest pain or pressure, nausea, diarrhea, a fear of losing control or a fear of dying, numbness or tingling in one's extremities, chills or hot flushes. If these symptoms just come out of blue, are intense and last for about 10 minutes, we call it a panic attack. It these symptoms are more mild but longer lasting for hours of the day for about six months, we call it Generalized Anxiety Disorder, especially when accompanied by excessive or unrealistic multiple worries.
Other symptoms of Anxiety, tend to be associated with Phobias triggered by different objects or situations (e.g. animals, natural environment, blood-injection-injury, situational or in social performance situations). People can also become anxious from obsessional thoughts that make them perform certain behaviors, such as, the fear of germs and illness causing a person to wash his or her hands excessively each day. Those who witness or are involved in traumatic incidents can also have triggers of conversations or places where the event occurred causing them to relive and experience severe anxiety symptoms.
These symptoms of anxiety can be debilitating. We know that anxiety disorders and depression account for much lost time from work as well as disability. These symptoms interrupt someone's ability to concentrate and remember things due to the constellation of physical symptoms (i.e. upset stomach, dizziness, chest pressure). Sometimes, in the case of panic attacks, it can be very unnerving to the point one needs to get to the Emergency room for fear that one is having a heart attack or will die. If it is a true anxiety disorder, the person will be checked to make sure that the person has not had a heart attack or has other medical illnesses. If the person has not, an antianxiety medication, such as, Xanax or Ativan, is given. This usually is given in intramuscular form, so that, it takes effect more quickly. This usually takes the symptoms of anxiety away quickly.
The usual treatment of these Anxiety Disorders is with an Antidepressant medication and Psychotherapy. We know that the cause of these illnesses is similar to Depression. As far as we know at the present, there is a chemical imbalance in the neurotransmitters Serotonin, Norepinephrine, and Dopamine. There seems to be a deficiency of these neurotransmitters. This deficiency is corrected while one is taking the Antidepressant medication. It can take up to approximately four to six weeks for the Antidepressant medication to reveal it's true efficacy; but within even the first few weeks, many people see improvement in their amount of worry decreasing along with their physical anxiety symptoms. Sometimes, it is necessary to give an anti-anxiety medication, such as, Klonopin, Ativan, or Xanax for the first four weeks if the anxiety symptoms are very intense. This is prescribed for a short amount of time usually, because these medications, unlike antidepressant medications are addictive. We give them along with the antidepressant for the first four weeks to give the antidepressant time to kick in. After this time, a taper off is usually tried.
Side effects that may occur with the antidepressants include: upset stomach, headache, diarrhea or constipation, decreased libido, weight gain or weight loss. The side effects are a little different depending on the one you are started on to initiate treatment. Many side effects get better and go away after the first week of treatment.
Some of the side effects of the benzodiazepines (i.e. Klonopin, Ativan, Xanax), are psychomotor slowing and sedation. Therefore, you have to know how you are functioning after you take this especially before you get behind the wheel of a car.
The success rate of being treated with these agents is pretty high. It is 75% effective even with the first antidepressant tried. Sometimes, though people have untoward side effects initially that would be too bothersome to continue on the particular antidepressant. At that time, the medication is switched.
It may be necessary for one to be treated with the antidepressants long-term. Although, this is not a negative thing. These illnesses are usually chronic in nature lasting many years and the research is showing us that these illnesses left untreated can be very detrimental to the brain. Those who aren't treated for depression actually have lower brain volumes than those who are due to their high number of circulating stress hormones(glucocorticoids). These substances cause cell damage and death, whereas, the antidepressant medications have a neuroprotectant effect preventing this cell death and damage. Since depression and anxiety are so closely linked, one can extrapolate the findings that there would be cell damage also with anxiety disorders that are left untreated. In my opinion treatment for anxiety should be no less than a full 12 months to avoid and prevent anxiety relapse.
The good news is that we have many very effective medications to treat the Anxiety Disorders. Many times, peoples' symptoms resolve and they get back to their usual state of functioning. I have been very fortunate to see many of my patients return to healthy functioning, and productive lives through medication management.
The other treatment of Anxiety Disorders is with Psychotherapy. The research has proven that the combination of medication and psychotherapy is the most effective way to treat both anxiety and depression. For this reason, I usually work in close association to therapists that are simultaneously treating patients. So with holistic approach we can often treat the symptoms and defeat anxiety. Genetics is showing promise for identifying the genes responsible for mental illness; then doing some "genetic repairs" and "possibly curing anxiety someday in the future. This is a ways off but does show some empirical validity and hope. Symptoms of Anxiety
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This article is for informational purposes only and not to be used in diagnosing or treating any potential illness