The Psychiatrist : Clinical and Therapeutic Journal
Open Access

Based on symptomatology, we will concentrate on medical conditions with high associations for anxiety and panic, such as neurological disorders (such as fibromyalgia, epilepsy, and cerebral palsy), diabetes, gastrointestinal conditions (such as irritable bowel syndrome, gastroesophageal reflux disease), and cardiovascular and respiratory conditions (such as asthma). Anxiety is a normal part of life on occasion. Many people experience anxiety as a result of health, financial, or family issues [1]. Anxiety disorders, on the other hand, include more than just sporadic anxiety or fear. For people suffering from an anxiety disorder, anxiety does not go away and can worsen over time. The symptoms can make it difficult to do things like work, school, and maintain relationships on a daily basis. Social anxiety disorder, generalised anxiety disorder, panic disorder, and a variety of phobia-related disorders are examples of anxiety disorders [2].

Generalized anxiety disorder

Signs and Symptoms GAD is typically characterised by a pervasive sense of fear or anxiety that can make daily life difficult. It is not the same as feeling anxious from time to time as a result of stressful life events or worrying about certain things. People with GAD experience frequent anxiety for months, if not years. Feeling restless, agitated, or on edge; being easily exhausted; having difficulty concentrating; being irritable; experiencing headaches, muscle aches, stomachaches, or other pains that are not explained; having difficulty controlling feelings of worry; and experiencing sleep issues such as difficulty falling or staying asleep. Panic disorder: When there is no obvious danger or trigger, panic attacks are brief periods of intense fear, discomfort, or a sense of losing control. Panic disorder is not always the result of a panic attack [3].

The following symptoms may occur during a panic attack

A pounding or racing heart; sweating; tingling or tingling in the chest; chest pain; a sense of impending doom; a sense of being out of control. People suffering from panic disorder are frequently concerned about when their next attack will occur. In order to avoid further panic attacks, they actively try to avoid places, situations, or behaviours that they associate with panic attacks [4]. Panic attacks can occur several times per year or several times per day. Social anxiety disorder is defined as an intense, persistent fear of being observed and judged by others. People suffering from social anxiety disorder may believe that their fear of social situations is beyond their control. Some people's anxiety may prevent them from going to work, school, or performing daily activities.

Sufferers of social anxiety disorder may experience the following symptoms

Disorders associated with phobias shivering, blushing, or sweating A phobia is a strong aversion or fear of a specific object or situation. Stomachaches A rigid body posture or speaking in an overly soft voice They have difficulty making eye contact or being around strangers. Selfconsciousness or fear that others will judge them negatively Although it is possible to feel anxious in certain situations, people who have phobias experience fear that is out of proportion to the actual danger posed by the situation or object.

There are several types of phobias and phobia-related disorders: The fear of coming into contact with the feared object or situation may be excessive or irrational. Avoid the feared object or situation as much as possible. Immediately experience intense anxiety when confronted with the feared object or situation. Survive unavoidable objects and situations with extreme anxiety [5]. Specific phobias, also known as simple phobias: People who suffer from a specific phobia, as the name implies, have a strong fear of or anxiety about a specific set of things or situations. One example of a phobia is the fear of certain things:

Flying Specific animals, such as dogs, snakes, or spiders Receiving injections Blood Social phobia, also known as social anxiety disorder: People with social anxiety disorder typically experience intense fear or anxiety in social or performance situations. They are concerned that others will criticise their anxiety-related actions or behaviours, making them feel embarrassed. People who suffer from social anxiety frequently avoid social situations as a result of their anxiety. Social anxiety disorder can appear in a variety of settings, including the workplace and school.

Agoraphobia: People with agoraphobia are terrified of at least two of the following scenarios:

Using public transportation, being in open spaces, being in enclosed spaces, waiting in line or in a crowd, and being alone outside of the house. People suffering from agoraphobia frequently avoid these situations, partly because they are afraid they will be unable to leave if they exhibit other embarrassing symptoms or panic-like reactions [6]. A person suffering from the most severe form of agoraphobia may become bedridden.

Disorder of separation anxiety

Most people think that only children deal with separation anxiety; However, separation anxiety disorder can also be diagnosed in adults. People who suffer from separation anxiety disorder are afraid of being apart from the people they care about. While they are apart, they frequently worry that their attachment figures will suffer some kind of harm or experience something unfavorable. They avoid being alone and being separated from their attachment figures as a result of this fear. People who suffer from separation anxiety may experience physical symptoms when they are about to be separated from an attachment figure or have nightmares about it [7-9].

Mutism selective : Selective mutism is a relatively uncommon anxiety-related disorder. Selective mutism describes people who have normal language skills but fail to speak in certain social situations. Selective mutism is frequently associated with extreme shyness, fear of social embarrassment, compulsive traits, withdrawal, clinging behaviour, and temper tantrums, which typically manifest before the age of 5. Other anxiety disorders are common in people who have selective mutism.

Anxiety disorders can be caused by both genetic and environmental factors, according to scientists.

• Each type of anxiety disorder has a distinct set of risk factors. However, some general risk factors are as follows:

• A history of anxiety or other mental disorders in biological relatives Anxiety symptoms can be caused or exacerbated.

• Shyness or feeling distressed or nervous in new situations in childhood Exposure to stressful and negative life or environmental events.

• Some physical conditions, like problems with the thyroid or heart arrhythmia Caffeine or other substances or medications If you think you might have an anxiety disorder, getting a physical exam from a doctor may help them find the right treatment for your symptoms.

• Anxiety disorders can be caused by both genetic and environmental factors, according to scientists.

Each type of anxiety disorder has a distinct set of risk factors. However, some general risk factors are as follows:

• Anxiety or other mental illnesses in biological relatives Anxiety symptoms can be caused or exacerbated by the following factors: Childhood shyness, distress, or nervousness in new situations Stressful and negative life events or environmental events.

• Some physical conditions, such as thyroid issues or heart arrhythmia Caffeine, as well as other substances or medications If you suspect you have an anxiety disorder, a physical examination by a doctor may help them find the best treatment for your symptoms.

• Treatments and Therapies Anxiety disorders are typically treated with psychotherapy, medication, or both. Anxiety can be treated in a variety of ways, and you should consult with your doctor to determine which one is best for you.

• Psychotherapy ,also known as "talk therapy," can help people with anxiety disorders. To be effective, psychotherapy must address your specific anxieties and be tailored to your needs.

• Cognitive behavioural therapy is one type of psychotherapy that can help people with anxiety disorders (CBT). It teaches people new ways to think, act, and handle situations in order to reduce fear and anxiety. CBT is the gold standard in psychotherapy and has been extensively researched.

• Exposure therapy, a CBT technique, is used to treat anxiety disorders. Exposure therapy focuses on confronting the fears that underpin the disorder in order to encourage people with anxiety disorders to participate in activities that they have previously avoided. Relaxation exercises are sometimes used in conjunction with exposure therapy.

Acceptance and Commitment Therapy (ACT)

It is a additional treatment option for some anxiety disorders. ACT and CBT approach negative thoughts in a different way. It uses techniques like goal setting and mindfulness to lower anxiety and discomfort. Because ACT is a more recent form of psychotherapy treatment than CBT, there are fewer data on its efficacy. Medication Despite its ability to alleviate symptoms, medication does not cure anxiety disorders [10-12]. Anxiety medication can be prescribed by a doctor, such as a psychiatrist or a primary care doctor. Psychologists with specialized training are also permitted to prescribe psychiatric medications in some states. Antidepressants, anti-anxiety medications (like benzodiazepines), and beta-blockers are the most frequently used classes of medications to treat anxiety disorders.

Anxiety disorders can benefit from the use of antidepressants, which are also used to treat depression. They might make it easier for your brain to use certain chemicals that control stress or mood. Before you find the antidepressant that works for you and doesn't cause too many side effects, you may need to try several different ones. Because it can take several weeks for antidepressants to start working, it's important to give them a chance before deciding if they work. If you start taking antidepressants, you shouldn't stop taking them without consulting a doctor first. Your doctor or nurse can guide you through a gradual and secure dose reduction. If you stop them suddenly, you may experience withdrawal symptoms. When taking antidepressants, children, adolescents, and adults younger than 25 may experience an increase in suicidal thoughts or actions, particularly in the first few weeks after starting or when the dose is changed. As a result, antidepressant users of all ages should be closely monitored, particularly during the first few weeks of treatment.

Medications for Anxiety can help alleviate the signs and symptoms of anxiety, panic attacks, and extreme fear and worry. Benzodiazepines are the most prescribed medications for anxiety. There are advantages and disadvantages to using benzodiazepines as a first-line treatment for generalized anxiety disorder. Benzodiazepines are better at reducing anxiety than antidepressants and have quicker effects. However, some individuals develop a drug tolerance, necessitating ever-increasing dosages to achieve the same effect. Some people even develop a need for them. Benzodiazepines are typically prescribed by doctors for brief periods of time to avoid these issues. People who suddenly stop taking benzodiazepines may experience withdrawal symptoms or experience a return of their anxiety. As a result, benzodiazepine withdrawal should be gradual. Your doctor or nurse can guide you through a gradual and secure dose reduction . Beta-blockers Although they are most used to treat high blood pressure, beta-blockers can also help alleviate the physical symptoms of anxiety, such as a rapid heartbeat and blushing. When taken for short periods of time, these medications can assist patients in controlling their physical symptoms. Additionally, they can be used "as needed" to alleviate acute anxiety, including the prevention of certain predictable performance anxieties.

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