What are anxiety disorders?

We all experience occasional feelings of anxiety, worry and fear. These can be normal responses to certain situations. For example, you might worry about an upcoming interview for a job, or that you are able to pay a bill on time. If you are in a difficult or dangerous situation, these feelings can give you an awareness of the risks and what you need to do.
If you have an anxiety disorder, these feelings are more noticeable and difficult to live with. They can make you feel as though things are worse than they actually are. This can lead to you worrying all or most of the time and can affect your day to day life.
Symptoms of anxiety include:

• feelings of dread, panic or ‘impending doom’,
• feeling on edge or irritable,
• heightened alertness,
• difficulties sleeping,
• changes in appetite,
• difficulties concentrating,
• depersonalisation, and
• wanting to escape from the situation you are in.

You might also experience physical symptoms, which can include:

• sweating,
• heavy and fast breathing,
• hot flushes or blushing,
• dry mouth,
• shaking,
• hair loss,
• fast heartbeat,
• dizziness and fainting

What are the different types of anxiety disorder and how are they diagnosed?

There are different types of anxiety disorders. The following sections go into more detail for each condition.

• Agoraphobia
• Body dysmorphic disorder (BDD)
• Generalised anxiety disorder (GAD)
• Hair pulling (Trichotillomania)
• Obsessive compulsive disorder (OCD)
• Panic disorder (panic attacks)
• Post-traumatic stress disorder (PTSD)
• Skin picking
• Social anxiety disorder
• Toilet-related anxiety

Agoraphobia

Agoraphobia is an anxiety disorder where you have an intense fear of certain situations, including:

• leaving your home,
• being in public spaces,
• using public transport, and
• being in crowded spaces
• You might find that these situations make you feel distressed, panicked and anxious. You may avoid some situations altogether. This can affect your day-to-day life.

Agoraphobia can make it difficult to make an appointment with your GP to talk about your symptoms. You might not feel able to leave your house or go to the GP surgery. You can arrange a telephone appointment if you have symptoms of agoraphobia. A GP will make a diagnosis by asking you questions about your symptoms. You may need further assessment from a psychiatrist for to get a formal diagnosis.

Body dysmorphic disorder (BDD)

If you have body dysmorphic disorder (BDD), you will worry a lot about how you look or a particular part of your body. Although other people may not notice or see it the same way, it will make you feel distressed. You may think you have an odd body shape compared to other people or that a scar makes you look unattractive. BDD is not the same as being vain or self-obsessed.
BDD can make you do things that take up a lot of time.

• Staring at your face or body in the mirror
• Comparing your features with other people’s
• Covering yourself excessively with makeup
• Considering plastic surgery when you do not need it

BDD can lead to depression. Some people with BDD have suicidal thoughts or feelings.
If you think you have BDD, you should speak to your GP. If they feel you have BDD, then they should discuss treatment options with you. The GP may arrange for a mental health worker who is experienced in BDD to help you.

Generalised anxiety disorder (GAD)

If you have generalised anxiety disorder (GAD), you feel anxious a lot of the time. This may feel out of your control. You might feel ‘on edge’ and alert to your surroundings.
This can affect your day-to-day life. You might find that it affects your ability to work, travel places or even leave the house. You might also get tired easily or have trouble sleeping or concentrating. You might experience physical symptoms, including :

• muscle tension,
• headaches,
• sweating,
• nausea,
• ‘butterflies’ in your stomach, and
• a fear of fainting.

It is common to have other conditions such as depression or other anxiety disorders if you have GAD.
GAD can be difficult to diagnose because it does not have some of the obvious symptoms of other anxiety disorders. Your doctor is likely to say you have GAD if you have felt anxious for most days over six months.

Hair pulling (Trichotillomania)

Hair pulling is a condition where you feel the urge to pull out your hair. This can be from your scalp or other places such as your arms, eyelashes, legs or pubic area. You will find it difficult to stop yourself doing this. It is linked to obsessive compulsive disorder (OCD).
You might experience a build-up of tension, which you can relieve by pulling out the strand of hair. You might not even be aware that you’re doing it.
It can be difficult to stop, which can lead to hair loss. This in turn can make you feel guilty, embarrassed and affect how you feel about yourself or how your friends and family see you.
Your GP will look at the following to diagnose your condition:

• You repeatedly pull your hair out, causing noticeable hair loss
• You feel increasing tension before you pull your hair out
• You feel relief or pleasure when you have pulled your hair out
• There are no underlying illnesses, such as a skin condition, causing you to pull your hair out
• Pulling your hair out affects your everyday life or causes you distress
• If you are concerned about your appearance, you could arrange a wig from the NHS.

Obsessive-compulsive disorder (OCD)

An obsession is an unwelcome thought or image that repeatedly enters your mind and is largely out of your control. These can be difficult to ignore. You may not want these thoughts and they can be disturbing, which can make you feel distressed and anxious.
Compulsions are things you think about or do repeatedly to relieve the anxiety from your obsessive thoughts.
You might believe that you or someone close to you might come to harm if you do not do these things. You may realise that your thinking and behaviour is not logical but still find it very difficult to stop.
There are different types of OCD, which include:

• Contamination
• Checking
• Intrusive thoughts
• Hoarding

When you first see a healthcare professional like a GP about your symptoms, he or she will ask you about them. This helps them to find out if you have OCD, how severe your symptoms are and what treatment will be best for you.

Panic disorder (panic attacks)

A panic attack makes you feel anxious and frightened. It happens suddenly and feels intense. You also have physical symptoms. These can include the following.

• An overwhelming sense of dread or fear
• Chest pain and/or a sensation that your heart is beating irregularly
• Feeling that you might be dying or having a heart attack
• Sweating and hot flushes or chills and shivering
• A dry mouth, shortness of breath or choking sensation
• Nausea, dizziness and feeling faint
• Numbness, pins and needles or a tingling sensation in your fingers
• A need to go to the toilet
• A churning stomach
• Ringing in your ears

It can be common for people having panic attacks to experience a sense of detachment from who they are. This is known as depersonalisation. It is thought that this may be the mind’s way of dealing with the intense sensations associated with panic attacks.
For some people, certain situations cause panic attacks. For example, if someone has a fear of small spaces and has to board a plane, they may have a panic attack then.
Panic attacks can be linked to variety of different anxiety disorders. Panic disorder is where you have regular panic attacks and there is no particular trigger. This can make you worry about when you might have another attack. If this happens, you may get a diagnosis of panic disorder.

Post-traumatic stress disorder (PTSD)

You can develop post-traumatic stress disorder (PTSD) if you experience a traumatic or frightening event. It can develop shortly after the event, or sometimes months or years later. Types of situations that can cause PTSD include:

• being a victim of serious violent crime or sexual assault,
• being subjected to prolonged sexual abuse, violence or severe neglect,
• witnessing a death or a violent attack on someone else,
• being involved in military combat,
• situations working for the emergency services,
• surviving a severe accident, such as a road traffic accident,
• being held hostage, and
• experiencing natural disasters, such as an earthquake.

PTSD causes feelings of intense fear, helplessness and horror. You can have panic attacks, nightmares and flashbacks (seeing images or visions of the past event in your mind).
You may find it very difficult to relax. This can lead to problems with sleep, concentration and anger management.
People with PTSD often avoid places, people, conversations or experiences which remind them of the trauma. This can become very isolating and can lead to emotional numbing.
To get a diagnosis of PTSD, you will usually have to show symptoms for more than a month. You may feel less able to socialise, work or carry out everyday activities.

Skin-picking

Skin-picking is a condition where you will repetitively pick at your skin. This can cause damage to your skin, including bleeding, bruising and sometimes permanent marks. You will usually pick the skin on your face, but might also pick other areas of the body. You will find it difficult to stop yourself doing it.
It seems that skin-picking can relieve tension and stress. However, often the relief is short-lived, and you will feel the urge to continue picking. You may not be aware that you are doing it.
Because skin-picking leaves visible marks, you might go to lengths to hide these using makeup or clothing.
Your GP may arrange for you to see a specialist mental health doctor like a psychiatrist for diagnosis.

Social anxiety disorder

Social anxiety disorder (sometimes known as social phobia), means you will have an intense fear or dread of social or performance situations.
Some common situations where you may experience anxiety are:

• Speaking in public or in groups
• Meeting new people or strangers
• Dating
• Eating or drinking in public

You will be worried that you will do something or act in a way that is embarrassing or humiliating.
You might feel very aware of the physical signs of your anxiety. This can include sweating, a fast heartbeat, a shaky voice and blushing. You may worry that others will notice this or judge you. As a result you might find that you try to avoid such situations completely. You might realise that your fears are excessive, but will find it difficult to control them.
Your GP will ask you questions about your symptoms, and might ask you to fill out a questionnaire. This will help them find out what how anxious you feel in social situations.
If you feel that it would be difficult to visit your GP, you can ask for a telephone appointment.

Toilet anxiety

This is a fear of using toilets in either your own home, someone else’s home or in public spaces. This can lead to difficulty and embarrassment when needing to use the toilet.
You may:

• fear that other people can hear you using the toilet,
• worry about the cleanliness of the toilet, or
• worry about being able to use the toilet at all.

Anxiety UK runs a special project on toilet anxiety. You can find their contact details at the end of this section.

• Irritable bowel syndrome (IBS), stomach aches and sickness.

Source:  https://www.rethink.org/diagnosis-treatment/conditions/anxiety-disorders

Men shouldn’t suffer in silence with depression and anxiety

‘Things always change, as long as you give them the chance to.’ Photograph: Alamy

I was 24 when my dad, Peter Manderson, took his own life. We had a troubled relationship and hadn’t spoken to each other for about six years; for no real reason we just stopped. Then one day I got in touch to try and repair some of the damage. It was Boxing Day and we argued over the phone about where to meet. I got angry, and my dad, who was a gentle man, stammered and stuttered. The last words I said to him were: “If I ever see you again I’m going to knock you out.” It all seems so desperately trivial now.
The tragic last hours of Robin Williams’ life have been raked over in minute detail over the past week. Susan Schneider, his wife, has said he was battling depression and anxiety, as well as the early stages of Parkinson’s.
I still don’t know what was going through my dad’s mind when he killed himself in a park not far from where he lived in Brentwood, Essex, in April 2008. I’ll never know. The last time I saw him alive was my 18th birthday. He had been in and out of my life for years. I was brought up by my gran in Hackney, east London, because neither of my parents were capable of looking after me. I just wish that he could have reached out to someone, anyone.
The moment I found out my dad had killed himself is as clear today as it was when it happened. That morning I woke up with a sense of dread knowing that something was very wrong. My gran came into my room with tears in her eyes and said: “Stephen, your dad’s dead. He’s hanged himself.”
His death was a complete shock and it’s still a struggle to articulate how I felt. I went through so many emotions that day. At first I was angry with him for doing what he did. I kept thinking, how could he take himself away from me? Williams’ daughter Zelda said something similar about her dad: “I’ll never understand how he could be so loved and not find it in his heart to stay.”
I thought my dad was selfish for taking the easy way out. But then I quickly realised that I was the one who was being selfish for thinking he was selfish. For someone to be able to do that, I don’t think it is cowardice; it’s the only solution they think they have. The last thing I said to him kept replaying in my head – you have no idea how much I regret that the final words he heard from me were anger and hate. I would give anything to change that. I never got a chance to say a proper goodbye or tell him that I loved him.
Last year in Britain, almost 6,000 people killed themselves, leaving behind families struggling for answers. Men aged between 30 and 44 are most at risk. My dad was 43. I later found out that one of his brothers had killed himself two years before and that another brother, whom I am named after, is believed to have died after allowing himself to fall into a diabetic coma.
Communication is a big problem with us men. We don’t like to talk about our problems; we think it makes us look weak. There have been times when I’ve suffered from anxiety and depression. I even had cognitive behavioural therapy and although that didn’t work for me, I did find that talking about things to someone helped the problem seem smaller than it was in my head. It’s important to let things out and not bottle them up.
Society likes to tell you that you have to be happy all the time, and it’s easy to think that if you’re not happy then there’s something wrong with you. But happiness isn’t permanent, it’s not something you can feel all the time – and neither is sadness.
What happened to my dad and uncles makes me want to deal with things. As much as I love my dad, I don’t want to be the father to my child that he was to me. I wrote the song Lullaby about my experience of depression and how it has affected my life. The most important lyrics are the final two lines: “Things always change, as long as you give them the chance to.”
Know that is true. I just wish my dad did.

Source:-  http://www.theguardian.com/commentisfree/2014/aug/20/men-suffer-depression-anxiety

Smoking cannabis DOES increase the risk of anxiety and depression

Smoking cannabis does increase the risk of depression and anxiety, a new study has concluded.

U.S. researchers found the brains of users were less able to react to dopamine - the feel-good chemical that inspires a spirit of get-up-and-go.

The study adds to previous research suggesting marijuana can lead to people becoming withdrawn, lethargic and apathetic.

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Danger: The brains of cannabis users were less able to react to the feel-good chemical dopamine 

What are the physical effects of smoking Cannabis/Marijuana

Psychiatrist Dr Nora Volkow, of the National Institute on Drug Abuse in the U.S., used the stimulant Ritalin to see the effect cannabis had on the brain.

Like cocaine, Ritalin raises levels of dopamine in the brain.This made it ideal for the study, published in the journal Proceedings of the National Academy of Sciences.

Of the 48 people in the study, half received the drug - while the other half acted as a control group.

Personality and brain scans showed the cannabis users had significantly blunted dopamine responses compared with the controls who had never taken the drug.

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Previous research has suggested a lack of dopamine makes people lazy

This could contribute to drug-craving and negative emotions, a tendency towards depression and anxiety which are hallmarks of cannabis addiction.

Dr Volkow said the phenomenon cannot be unequivocally attributed to reductions in dopamine release.

They believe there is a downstream effect later in the process in an area of the brain called the striatum - the reward and motivation region.

Indeed, last year a study from Imperial College London found that long-term use of cannabis destroys dopamine.

Levels in the striatum - found towards the side of the brain - were lower in regular cannabis users.
Dr Michael Bloomfield, of Imperial College London, said: 'Dopamine is involved in telling the brain when something exciting is about to happen - be it sex, drugs or rock ‘n roll.
'Our findings explain why cannabis has a tendency to make people sit around doing nothing'

Commenting on the new study, the U.S. researchers said: 'Moves to legalise marijuana highlight the urgency to investigate effects of chronic marijuana in the human brain.'

Source: http://www.dailymail.co.uk/health/article-2691837/Smoking-cannabis-DOES-increase-risk-anxiety-depression.html

The kindest way to banish anxiety

melia Adams has suffered from anxiety since she was a teenager – a constant worry that can leave her light-headed, shaky and exhausted.
Now aged 22, she had her first panic attack at 17 and has spent years trying to overcome her overwhelming feelings.
Today, after two courses of cognitive behavioural therapy – the standard NHS treatment for anxiety – proved ineffective, Amelia is finally being helped by a new type of psychological intervention: compassion focused therapy (CFT).
Inspired by Buddhism, CFT was  conceived 30 years ago by Professor Paul Gilbert, a clinical psychologist for Derbyshire Health Care Foundation Trust. It is now being offered as a therapy option at a number of NHS hospitals.
Sessions can be either for individuals and last about 50 minutes, or be 90-minute group discussions.
‘It’s similar to CBT, which works by helping patients to consider their negative thoughts and come to more realistic alternative views,’ says Prof Gilbert.
‘But while CBT focuses on changing behaviour in a neutral, practical way – such as using timesheets to plan the day more productively –  in CFT the focus is more on being kind to yourself.’
Sessions have three elements: encouraging patients to do activities or make changes that are kind to themselves, such as writing to a friend; helping them focus on seeing the good in other people and their own lives rather than the negative aspects; and getting the patient  to speak out loud to themselves in a kind, warm tone.
‘Our brains naturally focus on the negative,’ says Prof Gilbert. ‘For example, if we go shopping and in nine shops the assistants are extremely helpful but in one shop the assistant is very rude, we focus on the latter and lose sight of the positive experiences.

‘Deliberately training our attention to notice kindness in others can be very helpful, which CFT does.’
Through tackling the self-criticism and replacing it with kindness, patients then judge themselves and their lives less harshly and therefore feel happier.
‘By helping people feel compassion, we believe you can create  a positive physiological change in your body – just like imagining a delicious dinner will stimulate saliva and appetite,’ continues Prof Gilbert. ‘CBT is primarily focused on thinking and behaviour change but CFT looks at the emotion behind people’s thoughts.’

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Kind words: In compassion focused therapy (CFT) the focus is on being kind to yourself and encouraging positivity

CFT therapist Chris Irons adds: ‘It is a relatively new therapy but we are working hard to show that this approach has something important to offer.
‘So far there has been one successful randomised control trial of CFT which found a reduction in symptoms in patients with depression.’ Up to 30 per cent of the population suffers anxiety at any one time.  Last month a report from the  Office for National Statistics said young women are more anxious than young men, while growing numbers of middle-aged women  are suffering chronic anxiety – females aged over 60 are the most likely group to need hospital treatment for the condition.
‘My anxiety started on a night  out with friends when we were on holiday in Greece,’ says Amelia, a personal assistant from Surrey.
‘I felt suddenly overwhelmed by panic and I ended up walking back to our apartment alone and then  was up all night in absolute bits trying to calm myself down.
‘I ended up getting in the shower every hour to cool down and I had no one to speak to, which made it ten times worse.
‘It was so terrifying I flew home early from the holiday, and afterwards I was always really nervous that I’d have another panic attack somewhere far from home with nobody there to comfort me.’
Following that trip, Amelia’s attacks became regular, happening once or twice a month. They lasted about ten minutes each time and left her upset and exhausted. Her GP referred her for two courses of CBT, but the anxiety persisted.
‘It sounds silly, but I couldn’t stop worrying about my cat during the day – thoughts about her getting run over. Whatever the trigger, I feel light-headed and shaky, my stomach churns and for a moment it’s a bit like I’m having a panic attack. It’s really upsetting.’
Amelia heard about CFT through her volunteer work at a mental health charity and, hoping to eliminate her anxiety, she booked a course of six sessions with a private therapist.
Amelia says: ‘CBT had helped with my generalised anxiety but I preferred CFT because it involved more talking and delving into things like my childhood. I’m usually quite hard on myself so it’s taught me to be kinder, which has really helped.
‘Now when I’m on my own and start to feel panic, I am more gentle on myself, so instead of panicking  I sort of talk myself round with comfort. I now know that the anxiety I feel is not my fault. For the first time in years I have found a way to calm down rather than wind myself up still further.’

Source: http://www.dailymail.co.uk/health/article-2619470/The-kindest-way-banish-anxiety-Compassion-Focused-Therapy-help-conquer-crippling-worries-teaching-sufferers-nice-themselves.html

Dealing with panic attacks

A panic attack is an experience of sudden and intense anxiety. Panic attacks can have physical symptoms, including shaking, feeling confused or disorientated, rapid heartbeats, dry mouth, sweating, dizziness and chest pain.
The symptoms of a panic attack normally peak within 10 minutes. Most episodes (attacks) will last for between five minutes and half an hour.
Phobia sufferers will try to avoid whatever is causing their fear, but in some cases, such as agoraphobia, this can seriously restrict their movements.
Professor Paul Salkovskis, a psychologist at King's College London, says it's important not to let your fear of panic attacks control you.
"Panic attacks always pass and the symptoms are not a sign of anything harmful happening," he says. "It's important not to restrict your movements and daily activities."

Confront your fear

During an attack you experience a whole range of frightening symptoms, and worrying thoughts may go through your mind.
"Many people have a sense of impending disaster, and think they're going to faint, lose control or even die," says Salkovskis.
"You need to tell yourself that this is not going to happen and the symptoms you're experiencing are caused by anxiety."
He says don't look for distractions. "Ride out the attack. Try to keep doing things. If possible, don't leave the situation until the anxiety has subsided."
"Confront your fear. If you don't run away from it you're giving yourself a chance to discover that nothing's going to happen."
As the anxiety begins to pass, start to focus on your surroundings and continue to do what you were doing before.
"If you’re having a short, sudden panic attack it can be helpful to have someone with you, reassuring you that it will pass and the symptoms are nothing to worry about," says Salkovskis.
"Then you need to try to work out what particular stress you might be under that could make your symptoms worse.
"There's no quick fix but if your attacks are happening time after time, seek medical help."

Relaxation techniques

If you have panic disorder, you may feel constantly stressed and anxious, particularly about when your next panic attack may be.
Learning to relax, which isn't as easy as it sounds, can help to relieve some of this stress and tension, and may also help you to deal more effectively with your panic attacks when they occur.
Regular exercise, especially aerobic exercise, will help you to manage stress levels, release tension, improve your mood and boost confidence.
Phobia support groups provide useful advice about how you can effectively manage your attacks. Knowing that other people are experiencing the same feelings can be reassuring.
Antidepressants and cognitive behavioural therapy (CBT) are the two recommended treatments for panic disorder.
Cognitive behavioural therapy aims to identify and change the negative thought patterns and misinterpretations that are feeding your panic attacks.
"CBT is particularly effective. Most people will be completely free of panic disorder at the end of therapy and will remain that way," says Salkovskis.
Source: http://www.nhs.uk/Conditions/stress-anxiety-depression/Pages/coping-with-panic-attacks.aspx