Anxiety is an emotion characterized by an unpleasant state including feeling of uneasiness, worry which can manifest both physically and mentally. Anxiety differs from fear in that fear is an emotional response to an actual stressful event whereas anxiety is an anticipation of a potential threat.
The feeling of anxiety can persist way beyond the explainable period in a response to life events and therefore becoming one of the many anxiety disorders such as generalized anxiety disorder or panic disorder. Anxiety disorder can be differentiated from anxiety based on a time frame. Most individuals suffering from anxiety disorder experience anxiety on most days for a period of 6 months. Anxiety disorders are one of the most common mental problems which unfortunately tend to last for decades. Recognizing the symptoms of anxiety is crucial for early intervention and effective management.
Physical symptoms of anxiety
Anxiety commonly produces a variety of physical symptoms that can mimic other medical conditions. These symptoms include:
Rapid Heartbeat (Palpitations): Individuals with anxiety can experience an accelerated heart rate, even in non-stressful situations.
Shortness of Breath: A feeling of breathlessness or suffocation is a common manifestation of anxiety.
Muscle Tension: Muscle stiffness and tension, especially in the neck, shoulders, and back, can present as a physical response to anxiety.
Sweating: Profuse sweating, even when not due to physical exertion or heat, is a frequent symptom of anxiety.
Trembling/Shaking: Uncontrollable trembling or shivering, often in the hands or limbs, can present during anxiety episodes.
Gastrointestinal Symptoms: Nausea, stomach upset, and diarrhoea are common gastrointestinal manifestations of anxiety.
Different types of anxiety disorders
Generalized Anxiety Disorder (GAD): Persistent and excessive worry about a wide range of everyday concerns.
Panic disorder: Recurrent, unexpected panic attacks characterized by intense fear and physical symptoms.
Social anxiety disorder: Intense fear of social situations and a strong desire to avoid them.
Specific phobias: Intense fear and avoidance of specific objects or situations (e.g., fear of flying, fear of spiders).
Obsessive-Compulsive Disorder (OCD): Characterized by intrusive, unwanted thoughts (obsessions) and repetitive behaviours (compulsions) to reduce anxiety.
Post-Traumatic Stress Disorder (PTSD): Occurs after exposure to a traumatic event and involves symptoms such as flashbacks, nightmares, and severe anxiety.
Separation anxiety disorder: Most seen in children, it involves excessive fear or anxiety about being separated from caregivers.
Diagnosis
Diagnosing anxiety typically includes a comprehensive assessment by a qualified healthcare professional, such as a psychiatrist, psychologist, or general practitioner. There are no specific laboratory tests or imaging studies that can definitively diagnose anxiety disorders. The diagnosis relies on a combination of clinical evaluation, medical history, as well as presentation of symptoms.
The healthcare professional shall conduct a thorough clinical assessment, which involves obtaining information about symptoms, duration, and their impact on daily life.
Further assessment should involve asking about other medical conditions, medications, substance misuse, as well as family history of mental health issues.
Standardized diagnostic criteria are usually used, such as those outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), to determine if the individual's symptoms meet the criteria for a specific anxiety disorder (for instance Generalized Anxiety Disorder, Panic Disorder, Social Anxiety Disorder). A physical examination should be performed to exclude any underlying medical conditions that could be causing the symptoms.
Treatment
The treatment of anxiety disorders typically involves a combination of therapeutic approaches, lifestyle changes, and sometimes medication, depending on the severity of the condition and individual needs.
Cognitive-Behavioural Therapy (CBT): CBT is a highly effective therapeutic approach for various anxiety disorders. It helps individuals identify and change negative thought patterns and behaviours contributing to anxiety. Exposure therapy, a subtype of CBT, is particularly useful for treating specific phobias and OCD.
Acceptance and Commitment Therapy (ACT): ACT focuses on accepting anxious thoughts and feelings and committing to positive behavioural changes aligned with personal values.
Dialectical-Behaviour Therapy (DBT): DBT combines elements of cognitive-behavioural techniques with mindfulness strategies, helping individuals regulate emotions and cope with distress.
Medications
Antidepressants: Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) are commonly prescribed for anxiety disorders.
Benzodiazepines such as diazepam/alprazolam can be taken for short-term relief but are generally avoided for long-term use due to the high risk of dependence.
Lifestyle Changes
Stress management: Learning stress-reduction techniques, such as mindfulness meditation, deep breathing exercises, or progressive muscle relaxation, can help in anxiety management.
Regular exercise: Physical activity has been shown to reduce symptoms of anxiety and improve overall mental well-being.
Healthy diet: A balanced diet can positively influence mood and anxiety. Limiting caffeine and alcohol intake also proved to be beneficial.
Adequate sleep: Ensuring a regular sleep schedule and obtaining enough sleep is crucial for managing anxiety.
Avoiding substance abuse: Alcohol as well as recreational drugs exacerbate anxiety symptoms, therefore it is essential to avoid their use.
Support Groups
Group therapy or support groups can provide a sense of community and understanding for individuals with anxiety disorders. Sharing experiences and coping strategies can be valuable.
Medical evaluation
Ensuring that there are no underlying medical conditions contributing to anxiety such as thyroid disorders.
Supplements
Several supplements have been studied for their potential to help manage anxiety symptoms.
Omega-3 fatty acids: Omega-3 fatty acids, found in fish oil supplements, have anti-inflammatory properties, and help with anxiety. Moreover, they are important for overall brain health.
Magnesium: Magnesium is a mineral that plays a role in various bodily functions, including nerve function as well as muscle relaxation.
L-Theanine: L-theanine is an amino acid found in tea leaves, particularly in green tea. It has calming effects and promotes relaxation.
Valerian Root: Valerian is an herb commonly used to promote relaxation and improve sleep.
Ashwagandha: Ashwagandha is an adaptogenic herb which aids the body react better. During stressful situations.
Kava: Kava is a plant native to the South Pacific, and its root extract has been used traditionally as a natural remedy for anxiety and stress.
Concluding, recognition of the anxiety symptoms of is the first step toward effective management and treatment. Anxiety is a treatable condition, and individuals experiencing symptoms should not be hesitant with regards to seeking help. Early intervention together with appropriate treatment significantly improve the quality of life and well-being.
Prof. Renald Blundell is a biochemist and biotechnologist with a special interest in Natural and Alternative Medicine. He is a professor at the Faculty of Medicine and Surgery, University of Malta.
Andrea Weronika Gieleta is a registered nurse and is currently a medical student at the University of Malta.