Understanding anxiety attack symptoms and causes can help heal agoraphobia. Psychology experts at Meri Sehat have explained how to deal with anxiety.

Anxiety

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Saad Ullah Siddiqui

Overview

While occasional anxiety is a normal part of life, it becomes a cause for concern when everyday worries such as health, family, or financial problems do not settle with time or get worse to the point where it affects a person&rsquo;s daily routine. Anxiety disorders are defined as worry or fear that interferes with daily activities, for example, relationships, schoolwork, and job performance.

Anxiety is the body&rsquo;s natural response to a <a href="https://merisehat.pk/disease/depression">stressful</a> situation, for example, fear or apprehension of what is to come. It is normal to feel anxious during a job interview, the first day of school, or before taking a test. This feeling of nervousness is normal, and it comes and goes. However, if your anxiety lasts for more than 6 months, and is interfering with your life, you may have an anxiety disorder. Often, feelings of anxiety may be intense and even debilitating. If left untreated, the condition worsens to the point where it can make it difficult for the sufferer to do something as simple as entering an elevator, crossing the road, or even leaving one&rsquo;s home.&nbsp;

&nbsp;

According to the World Health Organization, anxiety disorders are common across the globe and affect 264 million people or 3.6% of the world&rsquo;s population. In the United States, 19.1% of the adult population suffers from anxiety disorders. The incidence of anxiety disorders varies by age and is seen in 22.3% of people between the ages of 18 and 29, whereas 22.7% of people between the ages of 30 and 44 years. However, the prevalence drops to 20.6% in people aged between 45 and 59 years. Contrastingly, anxiety in older adults (60+) is less common, and only affects 9% of the people<a href="#accordion">[1]</a>.&nbsp;

&nbsp;

Pakistan is also burdened with anxiety disorders, however, the exact prevalence of anxiety disorders is not known. Also, there are no policy developments to tackle anxiety and depressive disorders in Pakistan. The mean overall prevalence of anxiety and depression in Pakistan is 33.62%<a href="#accordion">[2]</a>. The American Psychiatric Association states that anxiety disorder is the most common form of emotional disorder that can affect any gender at any age, but women are more likely to be diagnosed with an anxiety disorder. Anxiety disorders can be divided into several types, including generalized anxiety disorder, social anxiety disorder, and other phobia-related disorders.&nbsp; 
&nbsp;

<h5>Generalized Anxiety Disorders (GAD)</h5>

Generalized anxiety disorder is an umbrella term used for persistent and excessive worrying that often interferes with daily activities. GAD may also be accompanied by physical symptoms, such as:&nbsp;

&nbsp;

<ul>
	<li>Restlessness&nbsp;</li>
	<li>Feeling on the edge&nbsp;</li>
	<li>Fatigue&nbsp;</li>
	<li>Difficulty concentrating&nbsp;</li>
	<li>Muscle tension&nbsp;</li>
	<li><a href="http://merisehat.pk/disease/sleep-apnea-91">Problems sleeping</a>&nbsp; 
	&nbsp;</li>
</ul>

The worries generally revolve around everyday things, for example, work, family health, chores, appointments, car repairs, etc.&nbsp; 
&nbsp;

<h5>Panic Disorder&nbsp;</h5>

A distinguishing symptom of panic disorder is recurrent panic attacks. Panic attacks can be described as an overwhelming feeling of physical and psychological stress. Interestingly, because the symptoms are so severe, people experiencing panic attacks may often think they are having a heart attack or are suffering from another life-threatening illness. Panic attacks are generally triggered as a response to a feared object. Studies have shown that panic disorders may occur with other mental health disorders, for example, depression or PTSD. During the attack, people may experience the following symptoms: 
&nbsp;

<ul>
	<li>Palpitations&nbsp;</li>
	<li>Increased or rapid heart rate&nbsp;</li>
	<li>Sweating&nbsp;</li>
	<li>Trembling&nbsp;</li>
	<li>Shortness of breath&nbsp;</li>
	<li><a href="https://merisehat.pk/disease/breast-cancer">Chest</a> pain&nbsp;</li>
	<li>Dizziness or light-headedness&nbsp;</li>
	<li>Feeling of choking&nbsp;</li>
	<li>Numbing or tingling sensation&nbsp;</li>
	<li>Hot flashes or chills&nbsp;</li>
	<li>Nausea&nbsp;</li>
	<li>Abdominal flashes&nbsp;</li>
	<li>Feeling detached&nbsp;</li>
	<li>Fear of losing control and dying&nbsp; 
	&nbsp;</li>
</ul>

<h5>Phobias&nbsp;</h5>

A phobia is described as a persistent fear of a specific object or situation that is otherwise not harmful. Despite knowing that the fear is unreasonable, people cannot overcome it. People struggling with phobias will go to any length to avoid the fears, for example, fear of spiders, fear of flying, public speaking, etc. 
&nbsp;

<h5>Agoraphobia&nbsp;</h5>

Agoraphobia is described as a fear of situations, where it may be difficult or embarrassing to escape. While the fear is out of proportion to the actual situation, it lasts for six months and sometimes even longer, and consequently causes problems in functioning. A person with agoraphobia may experience fear in the following situations:&nbsp; 
&nbsp;

<ul>
	<li>Using public transportation&nbsp;</li>
	<li>Being in open or enclosed spaces&nbsp;</li>
	<li>Being in a crowd&nbsp;</li>
	<li>Being outside or home alone&nbsp; 
	&nbsp;</li>
</ul>

People with agoraphobia actively avoid situations that require a companion as it causes fear and anxiety. If left untreated, agoraphobia can make it difficult to do something as simple as leaving the house. The fear significantly interferes with normal daily activities which can make it intensely upsetting.&nbsp; 
&nbsp;

<h5>Social Anxiety Disorder&nbsp;</h5>

A person with social anxiety may suffer from significant anxiety and discomfort. They may also feel embarrassed, humiliated, and rejected. People who have this problem avoid social interactions and situations that may aggravate their anxiety. Common examples of extreme fear include meeting new people, public speaking, and eating in public. In addition, this fear also causes problems with doing normal tasks.&nbsp; 
&nbsp;

<h5>Separation Anxiety Disorder&nbsp;</h5>

Separation anxiety disorder can be described as a person being excessively anxious or fearful of being separated from those they are emotionally attached to. The feeling persists for at least 4 weeks in children and 6 months in adults. The person may be worried about losing someone close to them or may have difficulty sleeping away from home without that person, in addition to having nightmares about separation. The physical symptoms generally develop during childhood, but may also persist through adulthood. 
&nbsp;

Signs And Symptoms

The general symptoms of anxiety include:&nbsp; 
&nbsp;

<ul>
	<li>Feeling nervous&nbsp;</li>
	<li>Restlessness&nbsp;</li>
	<li>Feeling of panic, doom, or impending danger</li>
	<li>Hyperventilation&nbsp;</li>
	<li>Sweating&nbsp;</li>
	<li>Trembling&nbsp;</li>
	<li>Feeling tired and weak&nbsp;</li>
	<li>Difficulty concentrating&nbsp;</li>
	<li>Difficulty sleeping&nbsp;</li>
	<li>Stomach problems&nbsp;</li>
	<li>Constantly worrying&nbsp;</li>
	<li>Avoiding things that trigger anxiety 
	&nbsp;</li>
</ul>

Causes

While the causes of anxiety disorders are not fully understood, traumatic life experiences and events are known to trigger anxiety. In some cases, inherited traits can also be a cause.&nbsp; 
&nbsp;

<h5>Medical Causes&nbsp;</h5>

Anxiety is often linked with underlying health issues. Similarly, the signs and symptoms of anxiety in some cases are the first indicator of mental illness. If your doctor suspects your anxiety is a symptom of any other medical issue, they will order tests to diagnose the illness. Examples of medical problems include:&nbsp; 
&nbsp;

<ul>
	<li><a href="https://merisehat.pk/disease/heart-burn-58">Heart </a><a href="merisehat.pk/disease/heart-burn-58">disease&nbsp;</a></li>
	<li><a href="https://merisehat.pk/disease/diabetes-type-1-and-2">Diabetes</a>&nbsp;</li>
	<li><a href="https://merisehat.pk/disease/hyperthyroidism">Hyperthyroidism</a>&nbsp;</li>
	<li>Chronic obstructive pulmonary disease or <a href="http://merisehat.pk/disease/asthma">asthma</a>&nbsp;</li>
	<li>Drug misuse&nbsp;</li>
	<li>Alcohol, anti-anxiety medication, or other medications withdrawal&nbsp;</li>
	<li><a href="https://merisehat.pk/disease/irritable-bowel-syndrome-62">Irritable bowel syndrome</a>&nbsp;</li>
	<li>Chronic pain&nbsp;</li>
	<li>Tumors 
	&nbsp;</li>
</ul>

In some cases, anxiety may also be a side effect of certain medications. 
&nbsp;

There is a high possibility that your anxiety disorder may be because of a medical condition if:

<ul>
	<li>Your parents or siblings don&rsquo;t have an anxiety disorder&nbsp;</li>
	<li>You didn&rsquo;t have an anxiety disorder as a child&nbsp;</li>
	<li>You don&rsquo;t avoid situations because of your anxiety&nbsp;</li>
	<li>You don&rsquo;t have a previous history of anxiety and your anxiety has a sudden-onset 
	&nbsp;</li>
</ul>

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Diagnosis

If you have symptoms of anxiety, then your healthcare provider will start with a complete medical history and physical examination. However, there are no lab tests or scans to diagnose anxiety, but your doctor may run tests, such as blood and urine tests to rule out any physical conditions that may be causing the symptoms.&nbsp;

If your doctor finds no signs of physical illness, they will refer you to a psychiatrist or psychologist. Psychiatrists and psychologists are mental health professional who specialize in diagnosing and treating mental health conditions. The doctor will use tools and assessments especially designed to diagnose whether you have an anxiety disorder. They will also refer the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The diagnosis is typically based on:&nbsp; 
&nbsp;

<ul>
	<li>The reported symptoms, how intense they are, and how long they last.&nbsp;</li>
	<li>Discussion on whether the symptoms interfere with your daily life&nbsp;</li>
	<li>Your attitude and behavior&nbsp; 
	&nbsp;</li>
</ul>

Treatment

Anxiety has several treatment options including lifestyle changes and medical treatment. In many cases, lifestyle changes may be enough to cope with the symptoms. However, treatment can help with overcoming the symptoms and help you lead a more manageable day-to-day life. Treatment for anxiety can be divided into two categories: psychotherapy and medication. A psychiatrist or therapist can help you with strategies and tools to cope with anxiety.&nbsp;

Typically, medications used to treat anxiety include antidepressants and sedatives. The medications increase the production of the &ldquo;happy chemicals&rdquo; in your brain. They help control the symptoms of anxiety and allow you to carry out daily activities, such as school or work. In addition, lifestyle changes are an effective way to relieve stress and anxiety. Most of these lifestyle changes focus on natural remedies to care for your body and participate in healthy activities, for example:&nbsp; 
&nbsp;

<ul>
	<li>Getting a good night&rsquo;s sleep&nbsp;</li>
	<li>Meditating&nbsp;</li>
	<li>Staying active&nbsp;</li>
	<li>Eating healthy&nbsp;</li>
	<li>Avoiding alcohol and caffeine&nbsp;</li>
	<li>Quitting smoking 
	&nbsp;</li>
</ul>

Risk factors that may increase the risk of developing anxiety disorders include:&nbsp; 
&nbsp;

<ul>
	<li>History Of Trauma &ndash; Children who have been exposed to childhood traumas or witnessed traumatic events are at an increased risk of developing anxiety at some point in their lives. Even adults who have a history of traumatic events can also develop anxiety.&nbsp;</li>
	<li>Stress Because Of An Illness &ndash; If you are suffering from a serious illness or health condition it can cause significant stress due to the stress about your treatment.&nbsp;</li>
	<li>Buildup Of Stress &ndash; If you have any big event coming up or are experiencing a triggering situation, such as&nbsp;the death of a family member, financial worries, or a death in the family, this can increase the risk of developing an anxiety disorder.&nbsp;</li>
	<li>Personality &ndash; Some personalities are more prone to developing anxiety than others.&nbsp;</li>
	<li>Other Mental Health Illnesses &ndash; People with depression often also have an anxiety disorder.&nbsp;</li>
	<li>Genetics &ndash; Anxiety disorders can run in families, so, having a blood relative with an anxiety disorder increases your risk of developing anxiety.&nbsp;</li>
	<li>Drugs And Alcohol &ndash; Drug and alcohol abuse can worsen anxiety.&nbsp; 
	&nbsp;</li>
</ul>

Key Points

<ul>
	<li>Anxiety is the body&rsquo;s natural response to a stressful situation, for example, fear or apprehension of what is to come.</li>
	<li>The mean overall prevalence of anxiety and depression in Pakistan is 33.62%.</li>
	<li>While the causes of anxiety disorders are not fully understood, traumatic life experiences and events are known to trigger anxiety.</li>
	<li>Treatment for anxiety can be divided into two categories: psychotherapy and medication. A psychiatrist or therapist can help you with strategies and tools to cope with anxiety.&nbsp; 
	&nbsp;</li>
</ul>

[1] Remes, O., Brayne, C., Van Der Linde, R. and Lafortune, L., 2016. A systematic review of reviews on the prevalence of anxiety disorders in adult populations. Brain and behavior, 6(7), p.e00497.

[2] Khan, H., Kalia, S., Itrat, A., Khan, A., Kamal, M., Khan, M. A., ... & Naqvi, H. (2007). Prevalence and demographics of anxiety disorders: a snapshot from a community health centre in Pakistan. Annals of general psychiatry, 6(1), 1-6.