Mental Health - Anxiety Disorders

It's Your Health

This article was produced in collaboration with the Public Health Agency of Canada.

The Issue

Anxiety disorders are the most common of all mental health problems. It is estimated that one in 10 Canadians is affected by them. These disorders can be successfully treated so it is important to recognize the difference between being anxious in response to a real event, and an anxiety disorder which produces fear or distress that is out of proportion to the situation.

Background

Everyone feels anxious at certain times. Workplace pressure, planning a big event or writing an exam can cause feelings of wariness, or even fear. While these situations are uncomfortable, they may be more severe for those who suffer from an anxiety disorder.

People who suffer from anxiety disorders have long periods of intense feelings of fear or distress out of proportion to real events. Their brains interpret real or imagined events to be much more risky or dangerous than they really are. Their lives are full of unease and fear, which interferes with their personal and professional relationships.

Anxiety disorders affect children as well as adults. All too often, people mistake these disorders for mental weakness or instability. The social stigma attached to mental illness often prevents those with anxiety disorders from asking for help.

Anxiety disorders affect behavior, thoughts, emotions and physical health. It is believed that a combination of biological factors, brain functions, personal circumstances, combined with social and economic factors, cause anxiety disorders, the same way that heart disease or diabetes are caused by a combination of factors.

People often suffer from more than one anxiety disorder, and those with anxiety disorders often suffer from depression, eating disorders or substance abuse as well. The good news is that anxiety disorders can be successfully treated once they are recognized.

Types and Symptoms of Anxiety Disorders

Panic Disorder

People with this disorder have panic attacks in which they are suddenly terrified, without warning. They may also have:

chest pain
heart palpitations
shortness of breath
dizziness
stomach discomfort
feelings of unreality
fear of dying.

If you avoid situations that may cause a panic attack, the condition is known as panic disorder with agoraphobia.

Phobias

Phobias are only considered disorders if they keep the affected person from leading a normal life. For example, people who have a phobia (or fear) of being in places or situations from which escape might be difficult (or embarrassing) may be too fearful to even leave the house. This type of phobia is called agoraphobia.

There are two categories of phobias:

social phobia, fear of social situations
specific phobias, such as fear of flying, spiders, blood or heights

Social Phobia

People with a social phobia are intensely fearful of a social situations. Being with people can paralyze them and make them feel unnaturally self-conscious. They're worried about being judged, and are terrified of doing something wrong in front of other people. Because their feelings are so intense, they tend to avoid situations that might trigger their fear. This dramatically limits their ability to lead a normal life or to interact with others.

Specific Phobia

People with a specific phobia have an overwhelming, irrational fear of a specific environment or object. Examples include fears of flying, bugs, snakes, heights or open spaces. They are unable to control their terror, even though they may recognize that their fears are ungrounded. Exposure to the feared situation causes them extreme anxiety and panic

Post-Traumatic Stress Disorder

This is a disorder that is triggered by a victim reliving a terrifying experience in which they were threatened with, or suffered, physical, mental or emotional harm. Survivors of rape, natural disasters, child abuse or war may all develop post-traumatic stress disorder. The most common symptoms are:

flashbacks, in which you re-live the terrifying experience
nightmares
depression
feelings of anger or irritability.

Obsessive-Compulsive Disorder

People with this disorder suffer from persistent unwanted thoughts (obsessions) and/or behavioral habits (compulsions), which they cannot control. Typical obsessions are:

contamination (there are germs all over you)
doubt (Did I turn off the stove or the iron?)
disturbing sexual thoughts
disturbing religious thoughts.

Compulsions include constant:

washing
organizing
checking
counting.

Generalized Anxiety Disorder

With this disorder, people worry excessively about ordinary, everyday situations and events. The condition usually lasts for at least six months. During this time the affected person expects the worst to happen, even when there is no evidence that it will. The physical symptoms may include:

nausea
trembling
fatigue
muscle tension
headache.

Treatment of Anxiety Disorders

Anxiety disorders can be successfully treated. The most common form of treatment is a combination of drug therapy and cognitive-behavioral therapy (CBT).

Because most anxiety disorders have some biological basis, the most common drugs prescribed are anti-depressants and anti-anxiety drugs.

CBT involves helping people to turn their anxious thoughts and feelings into more rational ones. Sometimes people will benefit from being exposed in a controlled way to the object and situation they fear. Some CBT techniques have been developed to deal with specific disorders. For example, people with panic disorder can benefit from learning new breathing and meditation techniques, which can help them deal with their anxiety.

Support groups and learning more about the disorder can also help a great many people deal with anxiety disorders. Involving family and friends who are also affected by the disorder, can help people recover or learn how to cope with their condition.

The most important first step in treatment is to get a proper diagnosis from a specialist in anxiety disorders. Many people suffer for 10 years or more before getting the right treatment.

Minimizing Your Risk

If you suspect that you or someone you know suffers from an anxiety disorder, talk to your health care provider. They can recommend you to a specialist in anxiety disorders or direct you to a specialized anxiety disorder clinic. These points may also help you cope.

Pick a time and place to do your worrying and make it the same time and place every day. Spend 30 minutes thinking about your fears and what you can do about them. Don't dwell on what 'might' happen, focus on what is actually happening.
Learn to relax. Yoga, muscle relaxation, biofeedback and deep breathing can all help you deal with your anxieties. See the link in the Need More Info? section for more information. For muscle relaxation, simply lie down and focus on one muscle group at a time, starting with your feet or your head. Tense the muscle for a few seconds then let it go. Move on to the next muscle.
Get plenty of sleep; it will help you put things in perspective.
Confront the things that have made you anxious in the past. You might start by making a list. Then picture yourself confronting these situations. This way you can develop techniques to deal with them before you are actually anxious. You might also try examining the level of your anxiety, on a scale of one to 10.
Exercise regularly; it can give you a sense of well-being and help lessen the anxiety.
Avoid alcohol and recreational drugs. Although they may seem to relax you while you are taking them, afterwards they can lead to even more anxiety and depression.
Avoid the caffeine found in coffee, tea, soft drinks and chocolate. They can increase your level of anxiety. Also avoid over-the-counter diet pills, and cough and cold medications.
For more information and help, contact the mental health organizations listed in the Need More Info? section.

Government of Canada's Role

The Government of Canada is working to help Canadians improve and maintain their mental health, including coping with anxiety disorders. Within its jurisdiction, the Government of Canada works to:

Support Canada's researchers in finding ways to prevent and treat mental illnesses and disorders.
Strengthen the capacity of the primary health care, home care and acute care sectors to effectively deliver mental health programs and services.
Work in collaboration with other governments and non-governmental organizations to improve the mental health of Canadians.
Provide high quality, reliable information to the public.
Report on health trends in the population.

In 2007, the federal government provided funding to establish and support the Mental Health Commission of Canada. Among other goals, the Commission leads in the development of a national mental health strategy and works to reduce the stigma about mental illness.

Need More Info?

For more information on anxiety disorders, contact the following:

Health Canada's Mental Health section

The Canadian Mental Health Association
Or contact the local Canadian Mental Health Association in your community, listed in the phone book.

Canadian Psychiatric Association

The National Network for Mental Health

The Canadian Psychological Association

Anxiety Disorders Association of Canada

A report on mental illness entitled The Human Face of Mental Health and Illness in Canada was published by the Government of Canada in 2006

For more on deep breathing and muscle relaxation techniques

For additional articles on health and safety issues go to the It's Your Health Web section.
You can also call toll free at 1-866-225-0709 or TTY at 1-800-465-7735*

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