Anxiety disorders are among the most prevalent psychiatric disorders in the general population, and anxiety is the most frequent psychiatric symptom in clinical practice.
Fear is frequently distinguished from anxiety because fear is an apprehension in response to an external threat, whereas in anxiety the threat is largely unknown or internal. Anxiety is a normal phenomenon that is characterized by a state of apprehension or unease arising out of anticipation of danger.
When it significantly impairs a person’s functioning and/or causes subjective distress, normal anxiety turns into pathological anxiety.
Two types of anxiety are distinguished by some authors.
Trait anxiety:The statement “I often feel anxious” serves as an example of this habitual tendency to be anxious generally (a trait).
State anxiety:“I feel anxious now” is an example of the cross-sectional anxiety felt at the present moment.
State anxiety episodes are frequent in people with trait anxiety.
Symptoms
In general, physical and psychological symptoms of anxiety can be divided into two categories.
Physical symptoms
Motor symptoms
· Tremors
· Restlessness
· Muscle twitches
· Fearful facial expression
Autonomic and visual symptoms
· Palpitations
· Tachycardia
· Sweating
· Flushes
· Dyspnea
· Hyperventilation
· Constriction in the chest
· Dry mouth
The timing and frequency of micturation
· Dizziness
· Diarrhea
· Mydriasis
Psychological symptoms
Cognitive symptoms
· Poor concentration
· Distractibility
· Hyperarousal
· Vigilance or scanning
· Negative automatic thoughts
Perceptual symptoms
· Derealisation
· Depersonalisation
Affective symptoms
A generalized, unsettling, and nebulous feeling of unease
· Fearfulness
· Inability to relax
· Irritability
when it is severe, a sense of impending doom
Other symptoms
· Insomnia ( Initial)
· Increased sensitivity to noise
· Exaggerated startle response
GENERALIZED ANXIETY DISORDER
A diagnosis of generalized anxiety disorder must be made after at least 6 months of persistent anxiety symptoms, which are characterized by an insidious onset in the third decade and a stable, typically chronic course that may or may not be punctuated by recurrent panic attacks (episodes of acute anxiety).
The most prevalent psychiatric disorder in the general population, generalized disorder has a one-year prevalence of between 2.5 and 8%.
PANIC DISORDER
There may or may not be an underlying generalized anxiety disorder, and this is characterized by discrete episodes of acute anxiety. Panic attacks usually occur recurrently every few days, and the onset is typically in the early third decade with a frequently chronic course.
Typically, there is no obvious precipitating factor, though some patients report exposure to phobic stimuli as a precipitant, and the symptoms start suddenly or “out of the blue.” The episode typically lasts for a few minutes and is characterized by very severe anxiety.
The lifetime prevalence of panic disorder is 1.5-2%, with 3-4% reporting subsyndromal symptoms (i.e., symptoms that are not severe enough to qualify for panic disorder). Panic disorder is typically seen about 2-3 times more frequently in females. It can present either alone or in conjunction with agoraphobia.
Causes
Nevertheless, there are a number of theories that may all be applicable to a given patient, as the exact cause of anxiety disorders is not well understood.
Psychodynamic Theory
This theory holds that anxiety, also known as signal anxiety, is a sign that something is upsetting the internal psychological balance.
Developmentally, primitive anxiety is manifested as somatic symptomatology while developmentally advanced anxiety is signal anxiety. According to this theory, panic anxiety is closely related to the separation anxiety of childhood. In anxiety, repression fails to function adequately but the secondary defense mechanisms are not activated. As a result, anxiety comes to the fore-front unopposed.
Behavioral Theory
In accordance with this theory, phobias and anxiety are viewed as conditioned responses to relatively neutral stimuli that arise from the organism’s unconditioned inherent response to painful or dangerous stimuli.
Cognitive Behavioral Theory
According to cognitive theory, anxiety disorders are characterized by evidence of selective information processing (with more attention paid to information related to threats), cognitive distortions, unfavorable automatic thoughts, and a perception of diminished control over both internal and external stimuli.
Biological Theory
Genetic evidence:The concordance rate in monozygotic twins of patients with panic disorders is as high as 80% (4 times more than in dizygotic twins), and it is approximately 15-20% of first degree relatives of patients with anxiety disorders who also have anxiety disorders.
Chemically induced anxiety states:Oral administration of MAOIs before the lactate infusion protects the individual(s) from panic attack, thus providing a likely clue to the biological model of anxiety. Infusion of chemicals, such as sodium lactate, isoproterenol and caffeine, ingestion of yohimbine, and inhalation of 5% CO2, can produce panic episodes in predisposed individuals.
GABA-benzodiazepine receptors:The central nervous system contains many benzodiazepine receptors, and since GABA (gamma amino butyric acid) is the most common inhibitory neurotransmitter there, it has been proposed that changes in GABA levels may produce clinical anxiety. This is one of the most recent developments in the search for the aetiology of anxiety disorders.
Other neurotransmitters:Additionally linked to the development of anxiety disorders are norepinephrine, 5-HT, dopamine, opioid receptors, and neuroendocrine dysfunction.
Neuroanatomical basis:Regional cerebral blood flow is increased in anxiety, although vasoconstriction occurs in severe anxiety. Areas implicated in the aetiology of anxiety disorders include the locus coeruleus, limbic system, and prefrontal cortex.
Organic anxiety disorder:If anxiety symptoms can occur as a result of other medical conditions, such as coronary artery disease, hyperthyroidism, or phaeochromocytoma, it seems likely that anxiety has a biological basis.
Management
· Psychotherapy
· Relaxation Technique
Other behavioral therapies include hyperventilation management and biofeedback, for example.
· Drug Treatment
HOMOEOPATHIC REMEDIES
When it comes to ANXIETY DISORDER, there are many effective medicines available in homoeopathy, but the choice depends on the individuality of the patient, taking mental and physical health into consideration. Homoeopathy is currently a rapidly growing system that is practiced all over the world. Its strength lies in its evident effectiveness as it takes a holistic approach towards the sick individual through promotion of inner balance at mental, emotional, spiritual, and physical levels.
ARGENTUM NITRICUM:This is one of the most significant medications for anxiety-related disorders. The patient is very anxious and impulsive by nature; he moves very quickly in everything he does. He fears situations that might make him anxious and tries to avoid them.
ARSENICUM ABLB:He is extremely tense and restless, and his anxiety is worse at night. He is also very cold, exact, and troubleshooting, and he keeps everything meticulously clean.
CALCAREA CARB 200:The patient believes he has done something wrong, feels uneasy and anxious with palpitations, fears losing his sense of reason, is desperate for life, and fears going insane. He also tires people out by describing his ailments over and over again.
GELSEMIUM:Anxiety related to stage fright, stage fright, emotions, exciting news, upcoming exams and interviews, or stage fright is another important treatment for this condition.
LYCOPODIUM CLAVATUM:Extreme apprehension about being in public and performing in front of others. The patient dreads public appearances despite the fact that they are required by his profession. Extreme apprehension about performing poorly and fear of others’ negative evaluations. Total loss of confidence. Constant worry and worry about losing control under stress. The patient is unable to fall asleep because of the events of the day. Anxiety about upcoming events.
PHOSPHORUS:Patients who are extremely sensitive, restless, and anxious due to fears of the dark, thunder, being alone, or dying need security and constant reassurance.
PULSATILLA NIGRICANS:After receiving bad news or experiencing an emotional upheaval, the patient experiences anxiety and becomes touchy, weepy, and lonely.
SEPIA:Very sad. Cries when describing symptoms. Worries about the evening. Hates being by themselves. Ignores those they love the most.
SILICEA:It is frequently prescribed for people with generalized anxiety disorders, social phobias, and specific phobias. Patients taking this medication tend to be extremely jittery and timid, afraid of stressful situations like public performances and exams, etc. They startle at the slightest sound out of nervousness.
THUJA OCCIDENTALIS:Thuja is a very effective treatment for generalized anxiety disorders and obsessive compulsive neurosis. These patients frequently experience social phobia, which causes them to become anxious and twitch when approached by strangers.
SYPHILINUM:Marked fear of the night, the patient dreads the approach of night, there is intense anxiety and a constant feeling that he may go insane, and one important feature of Syphilinum patients is that they feel compelled to wash their hands repeatedly in order to relieve their anxiety.
NATRUM MURIATICUM:The patient, in such cases, repeatedly re-experiences the traumatic event in their minds and constantly dwells on it; sleep disturbances are a common occurrence; anxious dreams; startling at the slightest noise; spells of intense anxiety; and trembling of the extremities are other common occurrences. It’s a good drug for acute stress disorder and post-traumatic stress disorder that has been triggered by the sudden death of someone close.
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