In my practice, I see many patients who are quite anxious. There could be a number of different reasons why this happens such as work related stress, health issues or even personal problems.
The common anxiety many of us face is sometimes called ‘generalised anxiety disorder’ in the medical world.
Anxiety is often precipitated by some form of a trigger, as I have mentioned previously. However, that may not always be the case.
Some individuals may be anxious for the smallest of matters and slightest of reasons. These reasons are usually trivial to others.
In India, nearly 25% of the population suffers from anxiety, according to a report by Times of India. Of these, around 10% end up developing depression.
In order to understand anxiety a little better, I spoke with Dr Geetha Chandrashekhar, an independent physician consultant in psychiatry and former instructor at Johns Hopkins School Of Medicine, USA. I asked her some of the common questions patients ask me about anxiety and here is what she had to say.
Dr Vivek Baliga (VB) – Hello Dr Geetha, thank you for taking the time to do this interview and inform our readers about anxiety.
Dr Geetha Chandrashekar (GC) – Thank you Dr Vivek, pleasure to help.
VB: What is anxiety?
GC: Simply put, anxiety is excessive worries that are out of proportion to the situation at hand. These worries also affect your ability to carry out your day to day activities.
Disorders of anxiety are very common and are thought to affect at least 30% of the population at some point in their lifetime.
VB: Why do people get anxious? Does anxiety run in families? Can it be passed on to children?
GC: There is no single cause of anxiety. It is thought to be a combination of several factors including genetics and environment as well as psychological and developmental issues. As it is known to have a genetic component, it can run in families. Children can also develop anxiety though the symptoms can be different than those seen in adults.
VB: Patients sometime feel that there something wrong with them if they have anxiety? Can you please comment on that?
GC: Of course. If you have anxiety, there is nothing wrong with you. Anxiety is a medical illness like high blood pressure, diabetes or asthma. It can be effectively treated with medication and counselling.
VB: How does one know if they have an anxiety disorder?
GC: Symptoms of anxiety can include excessive worrying, irrational fears and nervousness. Physical symptoms like dizziness, shortness of breath, heart palpitations, stomach and other physical pains, numbness and tingling in the fingers and feeling “as if” you are going to die may occur.
These symptoms are excessive in nature and interfere with your daily life.
VB: Some patients worry that if they have anxiety, they may be depressed as well. Family members seem to think this as well. Is this possible?
GC: Anxiety and depression are two separate illnesses. While a person can suffer from both depression and anxiety, having anxiety does not mean that you also must have depression. A doctor can help diagnose what you are suffering from depending on your specific symptoms.
VB: What are the treatments available that can help patients with anxiety?
GC: Anxiety disorders are completely treatable and may people can obtain very good relief of symptoms. Different types of treatments are available for the treatment of anxiety disorders like talk therapy, learning coping skills and relaxation techniques and anti anxiety medications. The best treatment tends to be a combination of the above.
VB: Is the anxiety that we see in our patients the same as generalised anxiety disorder?
GC: Generalized anxiety disorder is one of the most common types of anxiety disorders and generally consists of the same symptoms one describes when one has an anxiety disorder, such as constant and excessive worrying that affects daily routines that can be accompanied by physical symptoms. It can include constant worrying about issues such as work, home or relatively minor issues like chores or appointments.
Other more common forms of anxiety disorders among adults include panic disorders, specific fears or phobias and social anxiety disorder (where a person feels uncomfortable when amongst a group of people).
VB: How can one cope if they have been diagnosed with having anxiety?
GC: Coping skills can be used at home when you have signs of anxiety. These can be taught by a therapist and include relaxation techniques, breathing exercises and even yoga and meditation.
VB: Do patients have to take medications or can they manage without them?
GC: While medications can be very helpful for anxiety, people with milder forms of anxiety can often learn to use coping skills alone to treat their anxiety. In other words, medication is not a necessity.
VB: If started, do medicines need to be taken for life?
GC: If patients do start medications, they do not have to use them for life. Many people focus on learning relaxation techniques and coping skills while on medications so that eventually they can utilize these skills instead of medications.
However, many people find that taking medications provides such good relief of symptoms that they prefer to take medications.
VB: What about the side effects of medicines?
GC: Like all medications, medications for anxiety do have side effects. Depending on what kind of medication you are prescribed, your doctor will be able to describe the most common side effects.
VB: How long do medications take to work?
GC: Depending on the type of medications your doctor prescribes, some medication provide almost immediate relief but only last a short period of time; Others may take a few weeks to provide good relief of symptoms, but those medications often lead to more long term relief of symptoms
VB: Can the individual work if they suffer from anxiety?
GC: While anxiety can often interfere with work and daily life routines, it does not have to prevent you from working. Prompt identification and treatment of anxiety will help you to lead a normal, anxiety free life.
VB: Do the medications affect driving and work?
GC: Certain medications for anxiety may cause drowsiness. If this is a concern, especially if you drive, let your doctor know so that another medication without this side effect can be prescribed. Otherwise, these medications should not affect your work.
VB: ‘I have anxiety and I am pregnant. Will the medicines affect me?’ is often asked. What are your thoughts on this?
GC: Taking any kind of medications during pregnancy must be discussed with your doctor. Your doctor will determine if the medications can be taken during pregnancy and what, if any, effects it may or may not have on you and your baby.
VB: Thank you so much for taking the time for this interview.
GC: My pleasure!
If you have any questions, please do post them in the comments section and we will have them answered by Dr Geetha.
Dr Geetha Chandrashekhar is a physician consultant in psychiatry. After completing her MBBS from Kempegowda Institute of Medical Sciences, Bangalore, she moved to the US where she trained in Childhood and Adolescent psychiatry at the prestigious Johns Hopkins School Of Medicine, Baltimore. She is the former director of the Infants and Pre-schoolers clinic at the Kennedy Kreiger Institute and is a peer reviewer for the Asian Journal of Psychiatry.
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