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Yo to an a o o . co y t tc ut ur D Yo h ou ac u d f m h i r zz ha yo ur al br in na rb h in y i l g; ea s ou ur ea ne m us g o o go v d r i t ou r o s c t e er h. y. ’s at s ut he br a n e t is to an D Yo h yo ea ar po th s r i d a t fy h zz e d ur ur .Y e th ci ry a th n i s sa und ou ng .Y ne ou he bo a b r g u i m u e rw rc ;i ng ss on r m ou ar dy se ta at e t t he r he ’ e . e a a s so tt ou is he n D ni d a p st lm t im d he iz z ng re ry ra ou ha th a e .Y n r ci ,s yo t i a b t rd n s n h t ou h ng is us ut o am di es as w u re y n o rm ra ea ;i ea ou an at s at g ve e g c t a o e ’ t d s t i t rm yo ta co lm e, so at dr rt the resilience and recovery of people Yo u h ou is he t im ng re ne ea the mental health of all and supports s tc en it w e di th go charitable organization that promotes es t. ca es ’t ok er m un e s rh Association (CMHA) is a nation-wide, z in ch an br e www.cmha.ca lik ov sa po ar ha Yo u The Canadian Mental Health UNDERSTANDING ANXIETY DISORDERS What are Anxiety Disorders? An overview times when we are nervous or fearful about a particular situation, and we experience any or all of the symptoms Your heart is racing; it’s pounding so hard you feel like it is coming out of your chest. Your mouth has gone dry but at the same time, sweat has broken out all over your body. Dizziness and nausea are threatening to overwhelm you and you can’t catch your breath. Do you have an anxiety disorder? Let’s start by understanding the difference between the anxiety that everyone experiences occasionally, and an anxiety disorder. We all have described above. Your nervousness can even temporarily interfere with your ability to cope; this is normal. However, if these symptoms create ongoing, significant distress that causes disruption in daily living, you may have an anxiety disorder. Symptoms Remember that under different circumstances, the following symptoms can affect any individual for a short period of time. It is only when they are prolonged, severe and disruptive to your life, that you may need to consider if you have an anxiety disorder. In greater or lesser degrees, and depending on the disorder, symptoms include: ■ 1 Racing pulse, heart palpitations, possibly even chest pain 2 UNDERSTANDING ANXIETY DISORDERS ■ ■ ■ ■ ■ ■ ■ ■ Shortness of breath, panting, dry mouth Blushing Nausea and/or vomiting Trembling, shaking, muscle tension Dizziness Hot flashes and sweating, or chills Difficulties with sleep Inability to concentrate Types of Anxiety Disorders ere are actually five different kinds of anxiety disorders. You have probably run across the following terms, but let’s briefly go over them. For more detail, the Canadian Mental Health Association has pamphlets that delve more deeply into each of these topics. 1. Panic Disorders “Panic attacks” are associated with these disorders; they can strike without warning and are accompanied by feelings of terror that range from mild to extreme. e fear experienced by those with a panic disorder is powerful, unpredictable and overwhelming. After experiencing a panic attack, some people become so frightened of having another, they avoid any situation where they cannot escape or find help. As a result, they will not take public transit, go to shopping malls, or in some cases venture outside their homes. is is called a panic disorder with agoraphobia. 3 An overview 2. Phobias Phobias are usually divided into two categories: specific and social. People with a specific phobia have an uncontrolled, irrational fear of something in particular. It could be an object, situation, animal, activity or anything else that is significant to that person. Whatever it is, the individual experiences inexplicable levels of fear and will often go to extremes to avoid encountering it. Social phobias describe excessive anxiety over social situations. ese fears go beyond average apprehension over such things as mingling at a party or self-consciousness, but extend to extreme feelings of anxiety. People with social phobias would rather avoid a gathering of people than suffer the anxiety that accompanies the situation. 3. Post-Traumatic Stress Disorder (PTSD) Following a life-threatening experience or one that caused physical or emotional harm, a person can experience PTSD. Examples of incidents that can cause PTSD include rape, child abuse, war or natural disaster. With this disorder, people not only experience symptoms described previously, they can also have flashbacks of the incident, nightmares, depression, uncontrolled anger and irritability. 4 UNDERSTANDING ANXIETY DISORDERS 4. Obsessive-Compulsive Disorder (OCD) Causes People with OCD have unwanted, persistent thoughts (obsessions) and a need to perform repetitive activities (compulsions) that can overtake their lives. Anxiety disorders are not the “fault” of the person experiencing them, nor are they a weakness in character. In fact, research shows that these disorders are most likely a combination of complex biological and psychological factors, as well as exposure to challenging situations earlier in life. A person with obsessions often knows that their thoughts are irrational and excessive, but they cannot ignore them. Examples of obsessive thought include worrying about contamination, fears and worries over things done or not done, sexual or religious fixations. In an attempt to relieve their intrusive thoughts, people with OCD resort to compulsive habits, that have very specific “rules”. ese excessive habits provide temporary relief, however the obsessive thoughts soon return. Examples of compulsive behaviour include things like repetitive hand washing, constant organizing, and endless checking and counting. 5. Generalized Anxiety Disorder (GAD) Repeated, exaggerated worrying for more than six months characterizes GAD. People with GAD have disproportionate levels of worry over routine events and activities that others feel are of minor concern; they are always expecting the worst, and constantly “disasterizing”. 5 An overview Scientists have discovered that the biological factors of anxiety disorders include possible genetic causes (as these disorders often run in families), changes in brain chemicals called neurotransmitters, and alterations in certain areas of the brain. Psychological factors include the ways people learn to think about certain situations or cues, the fears they associate with things, and the amount of control they believe they have over events or situations. Termed the “cognitive behavioural” factors, they also form the basis of treatment. Some researchers also include “developmental” factors as a pre-cursor to an anxiety disorder. ese factors are the result of childhood experiences that shape the way an adult deals with anxiety. Treatment If you suspect that you or someone you care about has an anxiety disorder, the first thing you should do is talk to your family doctor. Have a complete physical examination to make sure there are no underlying ailments such as anemia or a thyroid problem mimicking the signs of an anxiety disorder. 6 UNDERSTANDING ANXIETY DISORDERS If your family doctor feels you have an anxiety disorder, s/he will discuss treatment options. Two main types of treatment are often prescribed: 1. Cognitive Behavioural Therapy (CBT) One-on-one CBT, or in small group is very effective in helping with anxiety disorders. During the cognitive portion of the sessions, a therapist assists individuals in identifying their anxiety-producing thoughts and then in evaluating their validity. When focusing on the behavioural portion of therapy, individuals are challenged in small, manageable steps, to face the situations that provoke their anxiety, and through gradual exposure, learn to control their fears. An overview Lifestyle Choices Let’s not forget about the things you can do on your own. You need to be an active member of your mental health team. Take a proactive role in your well-being and make lifestyle choices that are mindful and healthy. Do: ■ Join a support group if your community has one: It is important for you to network with others who are also asking questions about their illness and looking for coping strategies to help them with their disorder; ■ Eat a healthy diet: A well-balanced, nutritious diet is important for overall health; ■ Avoid alcohol, caffeinated beverages and illegal drugs: While it is tempting to seek emotional relief from substances, they often increase your anxiety and can trigger panic attacks; ■ Stop smoking: Try to cut down or even quit smoking. As you cultivate a healthy body, you will feel great about getting rid of this habit; ■ Exercise: Get active and stay active. Physical activity has been proven to improve mood and a sense of calm; Stress management: Find a course on stress management and seek ways to reduce your stressors and your perception of them; Depending on the disorder, CBT may be prescribed as the only treatment approach. 2. Medication Due to the biological factors contributing to anxiety, prescribed medications targeted at the brain’s chemical messengers can also be helpful. ese include classes of drugs known as selective serotonin reuptake inhibitors (SSRI), serotonin-norepinephrine reuptake inhibitors (SNRI) and benzodiazepines. ■ 7 8 UNDERSTANDING ANXIETY DISORDERS ■ ■ Try meditation and other activities that calm the mind: Sitting or moving meditations such as tai chi and yoga are beneficial to calming the mind; Get a good night’s sleep: You need sufficient sleep to help you feel good the next day, so be sure to get enough rest at night; An overview Don’t let anxiety overwhelm you. We can help you turn the tables and gain control of your life. Take the first step and reach out for help today. Share your feelings: Nurture your relationships just as they in turn nurture you. Empower your own capacity to heal by making lifestyle choices that work for your mental health. A healthy body helps a healthy mind. ■ Reach Out for Help Whether you or someone you care about, is experiencing an anxiety disorder, the future does not have to be bleak. Don’t let fear or embarrassment stop you – find out more about the help that is available in your community. e Canadian Mental Health Association and other community mental health organizations offer services, information and support to people affected by mental illness. e Canadian Mental Health Association (CMHA) is a nation-wide, charitable organization that promotes the mental health of all and supports the resilience and recovery of people experiencing mental illness. For more information about the CMHA and our services, please go to www.cmha.ca 9 10