Anxiety disorders are conditions in which a person experiences excessive fear, worry, or nervousness that interferes with daily life. While occasional anxiety is normal, persistent and uncontrollable anxiety may indicate a disorder. Anxiety disorders are among the most common mental health problems seen in clinical practice.
1. Types of Anxiety Disorders
A. Generalized Anxiety Disorder (GAD)
Characterized by excessive worry about everyday activities for at least six months.
B. Panic Disorder
Sudden episodes of intense fear accompanied by physical symptoms like palpitations, sweating, and breathlessness.
C. Social Anxiety Disorder
Fear of social situations or being judged by others.
D. Specific Phobias
Extreme fear of a particular object or situation (e.g., heights, insects).
E. Obsessive-Compulsive Disorder (OCD)
Previously grouped under anxiety disorders; involves repetitive thoughts and compulsive actions.
F. Post-Traumatic Stress Disorder (PTSD)
Anxiety following a traumatic event such as accidents, abuse, or natural disasters.
2. Causes and Risk Factors
Anxiety disorders result from an interaction of psychological and biological factors.
Biological Causes
- Imbalance of neurotransmitters (serotonin, norepinephrine, GABA)
- Overactivity of the amygdala (fear center)
- Genetic predisposition
Environmental and Lifestyle Factors
- Chronic stress
- Traumatic events
- Substance abuse
- Poor sleep
3. Symptoms of Anxiety Disorders
Psychological Symptoms
- Excessive worry
- Fear or sense of danger
- Difficulty concentrating
- Irritability
Physical Symptoms
- Palpitations
- Sweating
- Trembling
- Chest discomfort
- Shortness of breath
- Nausea
4. Diagnosis
- Clinical interview by a mental health professional
- Assessment tools such as GAD-7 or HAM-A
- Rule out medical conditions (thyroid disorders, arrhythmias)
- Review of medication and substance use
5. Treatment of Anxiety Disorders
Most patients improve with a combination of medication and psychotherapy.
A. Pharmacological Treatment
1. SSRIs (First-line)
- Sertraline
- Escitalopram
- Paroxetine
2. SNRIs
- Venlafaxine
- Duloxetine
3. Benzodiazepines (Short-term use only)
- Alprazolam
- Clonazepam
- Diazepam
Caution: Risk of dependence, sedation, withdrawal symptoms.
4. Buspirone
Useful for generalized anxiety; non-sedating and non-habit forming.
5. Beta-blockers
Propranolol may be used to control physical symptoms like tremors.
B. Non-Pharmacological Treatment
- Cognitive Behavioral Therapy (CBT)
- Relaxation techniques and breathing exercises
- Meditation and yoga
- Adequate sleep and balanced diet
- Avoiding caffeine and alcohol
6. Complications
- Depression
- Substance abuse
- Social isolation
- Poor productivity
- Increased risk of chronic illnesses due to prolonged stress
7. Prevention and Early Management
- Practice regular exercise
- Maintain healthy sleep patterns
- Stress reduction techniques
- Avoid smoking, caffeine, and alcohol
- Seek early help when symptoms begin
8. Role of the Pharmacist
- Educate patients about correct medication use
- Monitor for side effects of SSRIs and benzodiazepines
- Support medication adherence
- Identify drug–drug interactions
- Encourage lifestyle modifications
- Refer to mental health specialists when needed
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