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| WHEN
FEAR TAKES OVER |
| By
Dr Sanjay Chugh, consultant psychiatrist
Anxiety disorders are possibly the most common and frequently occurring mental disorders. They include a group of conditions that share extreme anxiety as the principal disturbance of mood or emotional tone. Anxiety, which may be understood as the pathological counterpart of normal fear, is manifest by disturbances of mood, as well as of thinking, behavior and physiological activity. Included in this category are panic disorder (with or without a history of agoraphobia), agoraphobia (with or without a history of panic disorder), generalized anxiety disorder, specific phobia, social phobia, obsessive-compulsive disorders, acute stress disorder and post-traumatic stress disorder. Anxiety
disorders are ubiquitous across human cultures. The longitudinal course of these
disorders is characterized by relatively early ages of onset, chronicity, relapsing
or recurrent illness and periods of disability. Panic disorder and agoraphobia
are particularly associated with suicidal tendencies. |
Anxiety
is manifest by disturbances of mood, thinking and behavior. It is debilitating
and should not be taken lightlyThe
attack typically has an abrupt onset, building to maximum intensity within
10 to 15 minutes. Most people report a fear of dying or a loss of control
over emotions and
behavior. This generally evokes a strong urge to flee the place where
the attack begins and, when associated with chest pain or shortness of
breath, frequently leads to seeking urgent assistance from a hospital
emergency room. Yet an attack rarely lasts for more than 30 minutes. According
to current diagnostic practice, a panic attack must be characterized by
at least four of the associated physical and psychological symptoms described
above. The panic attack is distinguished from other forms of anxiety by
its intensity and its sudden, episodic nature.
Panic attacks are not always indicative of a mental disorder, and up to 10 per cent of otherwise healthy people experience an isolated panic attack per year. PANIC
DISORDER COMPLICATIONS
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Panic
disorder is about twice as common among women as men. Age of onset is mostly between
late adolescence and mid-adulthood, with the onset relatively uncommon past the
age of 50. Typically, an early onset of panic disorder carries greater risks of
chronicity and impairment. Panic disorder also occurs as a familial condition. AGORAPHOBIA The ancient term 'agoraphobia' is translated from Greek as 'fear of an open marketplace'. Agoraphobia today describes severe and pervasive anxiety about being in situations from which escape might be difficult or avoidance of situations such as being alone outside one's home, traveling in a car, bus, or airplane, or being in a crowded area. ANXIETY
DISORDERS It is not clear why more women than men suffer from anxiety disorders, although some theories have suggested the possible role of steroids. Research on women's responses to stress suggests that women experience a wider range of life events that are stressful as compared to men. |
TREATMENT
• Counseling and Psychotherapy Anxiety disorders are responsive to counseling and to a wide variety of psychotherapies. During the past several decades, there has been an increasing enthusiasm for focused, time-limited therapies that address ways of coping with anxiety symptoms directly, rather than exploring unconscious conflict or other personal vulnerabilities. •
Pharmacotherapy •
Combination Treatment Panic disorders are extremely debilitating and common, yet respond well to treatment if started early enough in the course of the disease. It is not a condition to be taken lightly in view of its effect on the quality of the sufferer's life. Contact:
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Life Positive, April 2001 |
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