ANXIETY

Anxiety is a common human experience. It is a natural response to stress, uncertainty, or perceived danger. In many situations, anxiety is helpful. It prepares the body and mind to respond to challenges.

Problems arise when anxiety becomes excessive, persistent, or difficult to control, and begins to interfere with daily functioning, relationships, work, or physical health. At that point, anxiety may be considered a mental health condition that deserves attention and care.

As mental health professionals, our goal is to help the public understand anxiety clearly, reduce stigma, and encourage timely support.

What Anxiety Is

Anxiety is a state of heightened alertness involving emotional, cognitive, physical, and behavioural responses. It often includes feelings of fear, tension, or unease, accompanied by bodily reactions such as increased heart rate or muscle tightness.

Anxiety Versus Normal Worry

Normal worry is temporary and linked to specific situations, such as preparing for an examination or facing an important decision. Anxiety disorders differ in that the fear or worry is excessive, lasts longer than expected, and may occur even when no immediate threat is present.

1. Generalized Anxiety Disorder
   Characterized by persistent and excessive worry about everyday matters such as health, finances, work, or family. The worry is difficult to control and often present most days.
2. Panic Disorder
   Involves sudden episodes of intense fear known as panic attacks. These episodes may include chest discomfort, shortness of breath, dizziness, and fear of losing control.
3. Social Anxiety Disorder
   Marked by intense fear of social situations where one may be judged, embarrassed, or rejected. This often leads to avoidance of social interactions.
4. Specific Phobias
   Strong fear of particular objects or situations such as heights, animals, injections, or flying. The fear is disproportionate to the actual risk.
5. Separation Anxiety Disorder
   Excessive fear related to separation from attachment figures. Though common in children, it can also affect adolescents and adults.
6. Health Anxiety
   Persistent worry about having or developing a serious medical illness despite medical reassurance.

Anxiety does not have a single cause. It usually results from a combination of factors.

Biological Factors

• Genetic vulnerability
• Brain chemistry involving neurotransmitters such as serotonin and norepinephrine
• Medical conditions including thyroid disorders or chronic illness

Psychological Factors

• Personality traits such as perfectionism or high sensitivity
• Poor coping skills
• Previous traumatic or stressful experiences

Social and Environmental Factors

• Chronic stress from work, school, or finances
• Family conflict or unstable relationships
• Exposure to violence, abuse, or neglect
• Substance use including caffeine, alcohol, or illicit drugs

Emotional and Cognitive Symptoms

• Persistent worry or fear
• Feeling on edge or restless
• Difficulty concentrating
• Fear of negative outcomes
• Irritability

Physical Symptoms

• Rapid heartbeat
• Sweating
• Muscle tension
• Stomach discomfort or nausea
• Headaches
• Fatigue
• Sleep disturbance

Behavioural Symptoms

• Avoidance of feared situations
• Reassurance seeking
• Over preparation
• Withdrawal from activities

When untreated, anxiety can affect academic performance, job productivity, family life, and social relationships. It may contribute to sleep problems, reduced confidence, and physical health complaints.

Over time, individuals may begin to structure their lives around avoiding anxiety, which can significantly limit personal growth and wellbeing.

From a psychiatric standpoint, diagnosis involves:

• A detailed clinical interview
• Assessment of symptoms, duration, and severity
• Evaluation of medical history and medications
• Use of standardized screening tools when appropriate

From a counselling perspective, attention is also given to:

• Life stressors
• Emotional patterns
• Coping strategies
• Personal meaning attached to fear and worry

Psychological Interventions

Counselling and psychotherapy are central to anxiety treatment.

• Cognitive Behavioral Therapy — Helps individuals identify and challenge unhelpful thought patterns and gradually face feared situations.
• Supportive Counselling — Provides emotional support, validation, and problem solving in a safe environment.
• Stress Management and Relaxation Training — Includes breathing techniques, muscle relaxation, and mindfulness practices.
• Trauma Focused Therapy — Used when anxiety is linked to past traumatic experiences.

Medical Treatment

From a psychiatric perspective, medication may be recommended when symptoms are moderate to severe, persistent, or significantly impairing.

Common categories include:

• Antidepressant medications used for anxiety regulation
• Short term anxiolytic agents in selected cases

Medication decisions are individualized and require professional monitoring.

Lifestyle and Self Care Strategies

• Regular physical activity
• Consistent sleep routines
• Balanced nutrition
• Limiting caffeine and alcohol
• Structured daily schedules
• Healthy social connections

Learning to recognize early signs of anxiety and responding with coping skills can prevent symptom escalation.

Professional support should be sought when:

• Anxiety interferes with work, school, or relationships
• Symptoms persist for several weeks or months
• Physical symptoms cause distress
• Avoidance behaviors increase
• Self help strategies are no longer effective

Early intervention leads to better outcomes.

Anxiety in young people may present as school refusal, irritability, physical complaints, or clinginess. Supportive parenting, school involvement, and professional care are important.

Anxiety in youth is treatable and does not define a child’s future.

Anxiety is not a personal weakness or lack of faith or willpower. It is a health condition that can affect anyone.

Open conversations, accurate information, and compassionate responses reduce stigma and promote recovery.