12 March 2004

Worried about being anxious?

Anxiety disorders are the most common psychiatric disorders in South Africa. We take a look at these disorders and their treatment.

Anxiety disorders are the most common psychiatric disorders in South Africa. We take a look at these disorders and their treatment.

Everybody feels anxious at times. Anxiety gears you up to face a threatening situation and rouses you to action. In general, it helps you cope.

But if you have an anxiety disorder, this normally helpful emotion can do just the opposite – it can keep you from coping and disrupt your daily life. Anxiety disorders aren’t just a case of “nerves”. They are illnesses, often related to the biological makeup and life experiences of the individual and they frequently run in families.

There are several types of anxiety disorders, each with its own distinct features. Many people have a single anxiety disorder. But it isn’t unusual for an anxiety disorder to be accompanied by another illness, such as depression, an eating disorder, substance abuse or another anxiety disorder.

What are the different types of anxiety disorders?
Phobias are the most common form of anxiety. They are characterised by an intense, irrational and almost paralysing fear of a specific situation or object. Adults with phobias realise their fears are irrational, but often facing, or even thinking about facing, the feared object or situation brings on a panic attack or severe anxiety.

Generalised anxiety disorder (GAD). People with GAD usually expect the worse and worry excessively about everyday life circumstances (such as their health, job, raising of children or finances), or minor matters (such as household chores or renovations - even just getting through the day becomes problematic). The person’s worries are much more than normal day-to-day anxiety. They are excessive, unrealistic, chronic and relentless.

Panic disorder. Panic attacks are characterised by a sudden rush of fear, usually accompanied by a pounding heart, shortness of breath, a choking or suffocating sensation or other physical symptoms. They often occur in response to a stressful situation or during a period of chronic emotional stress. Attacks can occur in the most familiar and seemingly non-threatening settings, at the grocery store, in church or while driving along a familiar road. Sufferers often describe a feeling of unreality during the attack. Someone experiencing a panic attack may feel on the verge of losing control or even dying.

Obsessive-Compulsive disorder (OCD). OCD is characterised by obsessions and compulsions. Obsessions are persistent, intrusive and unwanted thoughts; compulsions are repetitive behaviours or mental acts, often linked to obsessions. The obsessions and compulsions are distressing and time-consuming and often lead to impairment in functioning.

Post Traumatic Stress Disorder (PTSD). As a result of exposure to traumatic events, many people display symptoms such as intrusive memories of the event, nightmares, avoiding reminders of the event, feeling anxious or down, detachment from others, and a restricted range of emotions. A diagnosis of PTSD is made if these symptoms are present for more than three months and interfere with functioning.

Social Anxiety Disorder (SAD), also called Social Phobia, is an intense, persistent fear of being humiliated or embarrassed in social situations. Sufferers tend to think other people are very competent in public and that they are not. Small mistakes make appear much more serious than they really are. Blushing may seem painfully embarrassing, and they feel as though all eyes are focused on them. Exposure to the feared social situation or anticipation of the situation can produce an intense and immediate anxiety reaction, including physiological symptoms such as sweating and blushing.

How is it treated?
Treatment for anxiety disorders consists of psychotherapy (especially Cognitive Behavioural Therapy and Exposure therapy) and medication.

Medications, although not cures, can be very effective at relieving symptoms. The first line medication is certain kinds of antidepressants. The Selective Serotonin Reuptake Inhibitors are most commonly used. Any co-existing disorder should also be treated.

What is the National Anxiety Disorder Awareness Week (NADAW)?
The aim of this campaign is to create public awareness and understanding of the anxiety disorders, as well as to work towards combating the stigma that is still associated with these conditions.

The focus of this year’s NADAW will be on posttraumatic stress disorder (PTSD). This is in line with the theme for World Mental Health Day 10 October, i.e. ‘The effects of trauma and violence on children and adolescents’.

Various events to help educate the public and mental health professionals about the effects of trauma and violence on children will be hosted during NADAW.

The MHIC will host professional education talks in 3 provinces, the SA Society of Psychiatrists (SASOP) and the Depression & Anxiety Support Group will coordinate a nationwide anti-stigma campaign, and the SA Federation for Mental Health will distribute information leaflets and media releases. The Department of Health: Mental Health Programmes has designed a schools drama project, which will run for the following 18 months in the Western Cape.

For more information about any of these events, contact the MHIC at (021) 938 9229 or the Depression and Anxiety Group at (011) 783 1474.

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