ANXIETY DISORDERS

Anxiety is an emotion that many, if not all, people have experienced at one point or another. Anxiety is our body’s natural way of preparing us to confront a threat or danger and heightens our level of physiological arousal. For some people, anxiety seems to be present even when there is no immediate threat. Threats can be real or perceived/imagined and can come from the inside of you (such as feeling a burning sensation in your stomach; or thinking “what did I do wrong?” in response to hearing someone who you don’t know shout “what were you thinking?” in your general direction at a grocery store) or be external to you (a vehicle almost hitting your vehicle). Whenever we sense a threat, it activates the “fight/flight” arousal system in your physical body.

Persistent Anxiety can be exhausting, and can even lead to negative health outcomes in the long-term.[1] When Anxiety becomes unbearable and feels as though it is restricting your ability to live your life fully and happily, you may have an Anxiety Disorder.  Anxiety Disorders are serious and can lead to suicidal thoughts and behaviours if left untreated.[2] “Anxiety Disorder” is an umbrella term for a variety of Anxiety Disorders:

  • Generalized Anxiety Disorder: Excessive, unrealistic worry and tension, even if there is little or nothing to provoke the anxiety.
  • Obsessive Compulsive Disorder: Characterized by having obsessive thoughts and/or exhibiting compulsive behaviours.
  • Panic Disorder: Characterized by sudden feelings of terror such as sweating, chest pain, irregular heartbeats, and irregular breathing. It may feel as though you are having a heart attack.
  • Post Traumatic Stress Disorder: Characterized by re-experiencing the negative event(s), having heightened arousal, engaging in avoidance/numbing, and experiencing negative thoughts/moods/feelings.
  • Social Anxiety Disorder: Overwhelming worry and self-consciousness about everyday social situations. Fear of judgment and/or embarrassment.
  • Specific Phobias: Intense and inappropriate fear of a specific object or situation (fear of spiders, flying, etc.).

Canadian Statistics

  • Nearly 3% of Canadians ages 15 and older met the criteria for GAD over a 12-month period.[3]
  • People with partners were less likely to have GAD than people who were single, widowed, separated, or divorced.3
  • Adult women are more likely than men to be diagnosed with GAD.[4]
  • Anxiety Disorders caused mild to severe impairment for 5% of the household population.[5]
  • Nearly half of the people who feel they have suffered from Depression or Anxiety have not consulted a doctor about their mental health.5
  • Three million Canadians (11.6%) ages 18 and older reported that they had a mood and/or Anxiety Disorder.[6]
  • In 2014, 93% of people with mood and/or Anxiety Disorders were currently taking, or had taken, prescription medications. Only 20% of that same population received psychological counselling for their disorder(s).6
  • Fifty percent of people who reported having a mood or Anxiety Disorder required a job modification in order to continue working (hours worked, type of work, etc.).6
  • Ninety-Five percent of people who reported having a mood or Anxiety Disorder revealed that a doctor or other health professional had suggested prescription medications. Sixty-Two percent reported that a doctor or health professional had suggested psychological counseling.6
  • Women are twice as likely to develop Panic Disorder as men.[7]
  • Approximately 50% of people with PTSD recover fully within 3 to 6 months of the symptoms onset.7
  • SAD, also known as social phobia, typically develops in childhood or early adolescence.7

Behaviours associated with Anxiety:

  • Biting your nails
  • Bouncing your legs rapidly
  • Picking at your skin
  • Apologizing profusely for making minor mistakes
  • Using unhealthy distractions like alcohol, drugs, eating, or excessive television watching
  • Avoiding phone calls or other situations that might be potentially stressful

Feelings associated with Anxiety:

  • Insecurity
  • Fear
  • Worry
  • Restless
  • Irritable
  • Burnt Out

Thoughts associated with Anxiety:

  • “He was supposed to be home an hour ago. What if he was in a car accident?!”
  • “She was supposed to show up to the meeting 10 minutes ago. I bet she’s late because she thinks I can’t do this.”
  • “I’m too overwhelmed to begin this project right now; I’ll start it later.”
  • “I can’t go to that grocery store because the parking lot is so crowded! I just can’t stand it.”

Anxiety and the Body:

The symptoms of anxiety are physically felt because when you are feeling threatened, the body feels it. Anxiety symptoms can physically manifest in a variety of ways, some of which include:

  • Heart Palpitations
  • Muscle Tension such as a clenched jaw
  • Shortness of Breath
  • Dizziness or Nausea
  • Cold or Sweaty Hands/Feet
  • Heavy chest or unsettled stomach

Anxiety and the Brain:

According to research, the limbic system, which is comprised of several parts of the brain, is highly involved in Anxiety Disorders. Symptoms of mood and Anxiety Disorders do not result from the cognitive centers of the brain, but from the emotional centers.[8] One of the relevant parts of the brain within the limbic system is the hippocampus. The hippocampus is involved in moderating stress responses, and its size has been linked to stress sensitivity and resiliency for mood and Anxiety Disorders.8 The amygdala is another part of the limbic system that is involved with Anxiety Disorders. The amygdala is involved in the formation and retrieval of fear-related memories, and also plays a role in displays of fear and aggression.8

Does Psychology Work?

Depending on the type of Anxiety Disorder you are experiencing, there will be some treatment options that are more effective than others. Some of the treatment options that have been proven effective for various types of Anxiety Disorders include:

  • Cognitive Behavioural Therapy (CBT): CBT is a type of therapy where a trained Psychologist works with you to help you change your thoughts, beliefs, and strategies for interpreting information. By changing your cognition, productive behaviour and emotional changes are likely to follow. For Anxiety Disorders, CBT has been shown to be an effective treatment for Panic Disorder, Specific Phobias, and Generalized Anxiety Disorder. According to research, CBT is especially effective at treating generalized anxiety disorder.[9]
  • Mindfulness Therapy: Mindfulness is a process of being focused on the present moment without judging it or blocking out emerging sensations and feelings. Mindfulness Therapy aims to help you by increasing your awareness of your thoughts, feelings, and body sensations. Additionally, it aims to help you realize that your thoughts, feelings, and body sensations are fleeting, which can ease your worries that you will feel uncomfortable forever.[10] When it comes to treating Anxiety Disorders, Mindfulness Therapy can help you learn to face and tolerate anxiety more skilfully. You may come to realize that once you know that it will not last forever, anxiety becomes much easier to tolerate.
  • Somatic Therapy: This type of therapy teaches you how to use awareness of your body to release negative emotional states and overwhelming body sensations. Somatic Therapy also referred to as Body-Oriented Psychotherapy, includes practices such as breath-work, muscle relaxation, somatic experiencing, body awareness, and others.[11] There are many studies about how Somatic Therapies can reduce anxiety. For instance, Somatic Therapy has been shown to reduce anxiety in people who are experiencing Generalized Anxiety Disorder[12] because it helps them get in touch with their bodies, which over time gives rise to a feeling of being in control. People learn to listen to their anxiety as signalling something important to them and are no longer caught in the “fear of anxiety trap.” Somatic Therapy has also been shown to reduce feelings of anxiety in people suffering from Depression. Certain types of breath-work have also proven effective in reducing levels of anxiety.[13]

Tips to Manage Anxiety!

  • Education: One effective self-help treatment for anxiety is educating yourself about your Anxiety Disorder via books, manuals, audiotapes, DVDs, videos, etc. Although this tactic is much less effective than professional treatment, it can be more helpful than not seeking out any resources.[14]
  • Exercise: Multiple studies have shown that exercise can help reduce symptoms of anxiety. Even if the exercise is not regular, just one episode of aerobic exercise (for example: walking or running) can help reduce anxiety.[15] Exercise does not have to happen at a gym; you can walk, bike, or mow the lawn. When exercising, remember these two guidelines for the best results:[16]
  • Get Support from the People you Trust: Studies have shown that social support can help reduce anxiety. Studies of the brain reveal that the parts of your brain responsible for anxiety are affected positively by social support and that it can improve your emotional responses to anxiety.[17] You can receive support from family, friends, or even a support group offered in your community.

When anxiety becomes unbearable and feels as though it is restricting your ability to live your life fully and happily, it is often considered a problem and treatment may be necessary. People can have a variety of different combinations of the above symptoms and still have an Anxiety Disorder diagnosing. Oftentimes, your own personal experience of anxiety will therefore likely be unique. Additionally, you may experience multiple problems at the same time. For example, we often work with people who are experiencing grief and anxiety concurrently. Effective treatment is personalized to ensure that your needs and goals are taken into consideration. This may mean that the Psychologist may use different types of interventions and treatment methods in order to provide you with the best treatment results (for example, the Psychologist may suggest the use of CBT and Somatic Therapy to help you work on your goals). At Hopewell Psychological, we provide a range of services and treatment modalities, so that we can offer you options to suit your needs. We provide evidence-based treatments and also work with couples, families, and groups.

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*Psychologists are covered under Insurance Companies in Canada. You will need to check with your insurance company about the specific details regarding your coverage.

References

[1] “Anxiety and Physical Illness.” Harvard Health Publications. Harvard Health Publications, July 2008. Web. 19 Apr. 2017.

[2] Bentley, Kate H., et al. “Anxiety and its Disorders as risk factors for suicidal thoughts and behaviours: a meta-analytic review.” Clinical Psychology Review 43 (2016): 30-46.

[3] Gilmour, Heather. “Threshold and subthreshold Generalized Anxiety Disorder and suicide ideation.” Statistics Canada. Minister of Industry, 2016. Web. 19 Apr. 2017.

[4] Bushnik, Tracey. “The Health of girls and women in Canada.” Statistics Canada. Statistics Canada, 2013. Web. 19 Apr. 2017.

[5] “Fast Facts about Mental Illness.” Canadian Mental Health Association. (2016). Web. 19 Apr. 2017.

[6] “Mood and anxiety disorders in Canada.” Government of Canada. (2013). Web. 19 Apr. 2017.

[7] “Section B-Anxiety Disorders.” Statistics Canada. 27 Nov. 2015. Web. 19 Apr. 2017.

[8] Martin, E. I., et al. “The Neurobiology of Anxiety Disorders: Brain Imaging, Genetics, and Psychoneuroendocrinology.” Psychiatric Clinics of North America 32.3 (2009): 549-575.

[9] Norton, Peter J., & Price, Esther C. “A Meta-analytic Review of Adult Cognitive-Behavioral Treatment Outcomes Across the Anxiety Disorders.” The Journal of Nervous and Mental Disease 195.6 (2007): 521-531.

[10] Treanor, Michael. “The potential impact of mindfulness on exposure and extinction learning in anxiety disorders.” Clinical Psychology Review 31 (2011): 617-625.

[11] Bloch-Atefi, A. and Smith, J. “The effectiveness of body-oriented psychotherapy: A review of the literature.” Psychotherapy and Counselling Federation of Australia (2014).

[12] Stirman, Shannon W., et al. “New Psychotherapies for Mood and Anxiety Disorders.” Canadian Journal of Psychiatry 55.4 (2010): 193-201.

[13] Bloch-Atefi, A. and Smith, J. “The effectiveness of body-oriented psychotherapy: A review of the literature.” Psychotherapy and Counselling Federation of Australia (2014).

[14] Menchola, Marisa, & Arkowitz, Hal S. “Efficacy of Self-Administered Treatments for Depression and Anxiety.” Professional Psychology: Research and Practice 38.4 (2007): 421-429.

[15] Carek, Peter J., et al. “Exercise for the Treatment of Depression and Anxiety.” International Journal of Psychiatry in Medicine 41.1 (2011): 15-28.

[16] Carek, Peter J., et al. “Exercise for the Treatment of Depression and Anxiety.” International Journal of Psychiatry in Medicine 41.1 (2011): 15-28.

[17] Hyde, Luke W., et al. “Perceived social support moderates the link between threat-related amygdala reactivity and trait anxiety.” Neuropsychologia 49.4 (2011): 651-656.

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