Anxiety

Anxiety Related Issues

Anxiety is a normal human feeling which we all experience when faced with situations we find threatening or difficult. In fact, fear and anxiety can be useful as they make us more alert, helping us to avoid dangerous situations, and give us the motivation to deal with problems. Sometimes, however, an anxiety or phobia can take over a person’s life.

•Anxiety disorder: some people have feelings of fear and dread which are too strong, go on for too long, or are experienced in the absence of any apparent threat.

•Panic: sudden unexpected surges of anxiety which usually lead to the person having to quickly get out of whatever situation they are in.

•Phobia: some people have very strong anxiety when faced by a particular situation (e.g. meeting new people) or objects (e.g. spiders) which are not dangerous and which most people do not find troublesome.

•Obsessive-compulsive disorder: extreme anxiety which ends up dominating the person’s life through obsessions, unreasonable fears/thoughts and compulsions (rituals carried out in response to the obsession).

•Post-Traumatic Stress Disorder (PTSD): occurs to people who have been exposed to life-threatening situations such as car or train crashes, fires, or violent attacks. They can feel nervous and anxious for months and years after the event.

Early changes in the person’s behaviour

You may notice that your friend or relative is behaving out of character and is no longer able to live life normally. They may:
•appear unusually worried or fearful much of the time
•be easily startled by normal sounds
•try to avoid certain situations, sometimes taking drastic actions to do so (eg. never leaving the house)
•be irritable and tired
•appear pale and tense
•lose confidence in themselves
•have trouble falling and staying asleep at night
•change in appetite
•not be able to keep up with shaving, washing, doing the laundry
•in the case of PTSD, have nightmares and flashbacks.

They complain of physical symptoms such as:
•sweating
•palpitations
•dizziness and faintness.

Making a diagnosis

A Psychiatrist can make the diagnosis by talking to the person and/or a close relative or friend. The professional needs to understand:
•the person’s past – what may have laid the foundations for the anxiety
•recent events which may have triggered the anxiety
•how they live their life now – what may be keeping the anxiety going
•any other possible causes – commonly alcohol and street drugs.

A number of treatments are available for anxiety and panic such as:
•relaxation techniques
•self help – books and computer courses.
•lifestyle changes – exercise, occupation etc.
•talking therapies (psychotherapy and counselling)
•Cognitive Behavioural Therapy (CBT) which helps the person think about themselves and others in a different way
•medication, such as tranquillisers and antidepressants.

As the carer, you may feel worried about:
•admitting there is a problem
•losing the person you knew
•what will happen in the future
•how you can cope
•how to get help
•the effect on the rest of the family
•the impact on your finances
•how other people react to the person’s illness - the stigma associated with it
•how to talk to the person about what they are feeling.

You may also find yourself impatient with the person’s behaviour – and exhausted by caring for them.

For carers:

Partnership with your doctor and members of the health team. It's important that there is clear, regular communication between the doctor, other professionals, the person with anxiety and their carer. It doesn't happen automatically and will take time and effort. For instance, if you really feel that you need more time than usual to talk about what is happening with your GP, you can book a double appointment, which will give you more time.

Most people with anxiety disorders are seen by their family doctor and will not need to go into hospital. Your family doctor may be able to refer a person directly to a counsellor, psychotherapist or cognitive therapist.

However, some people do need to see a psychiatrist and/or other members of the Mental Health Team/Service. You may meet:
•psychiatrists
•psychologists
•psychotherapists
•counsellors

Regular and well prepared visits to the doctor or other members of the mental health team will make sure that you both get the best care and support.

Planning for a follow up visit
•Discuss any new worries or changes in anxiety, thoughts and behaviour.
•Keep a note of these changes as they happen, with the dates.
•Keep a note of any reactions to medication, again with the dates if possible.
•Just before the next visit, look at your notes and decide, with your friend or relative, the most important points.
•Write down your top three concerns to make sure that you discuss these, and take the other notes with you. These could include:
•changes in symptoms and behaviour
•side-effects of medication
•general physical health, eg putting on or losing weight
•your own health as a carer
•any extra help you need
•when the person will be fit to return to normal activities, including work and driving.

During the visit
•If either of you do not understand something, ask questions until you do.
•Encourage your friend or relative to tell the professional about how they feel.
•Take notes of what you are told. At the end, tell the doctor what you and the person have understood, so that any misunderstandings or omissions can be cleared up.

Don’t forget to take care of yourself
•Share your worries with trusted friends and family members – but do respect the patient's right to privacy and confidentiality.
•Don’t struggle on alone, do ask for help when you feel you need it.
•Make time for yourself and leisure activities.
•Make sue you eat well and get enough exercise.
•Go and see your own doctor if you find it hard to sleep, or are anxious or depressed.