Anxiety Disorders

Anxiety and worry are ubiquitous conditions, but when they are occur as mental illnesses they can become severely disabling. Anxiety may be constant and unremitting or occur in brief distressing bursts or take the form of nagging worry about health or safety of self or others. It needs to be correctly identified, investigated and treated effectively so that it does not consume your life. While reassurance is hardly ever sufficient, knowledge of the anxiety mechanism itself can help to master it. There are a range of physical and psychological treatments that are available. I will help to tease the problem out and help you choose the option most acceptable and effective for you.

Anxiety

Anxiety Illness is a commonly occurring condition. It is mildly uncomfortable or can be severely disabling.

symptoms of anxiety

There may be physical, emotional and behavioural symptoms.

Common physical symptoms of anxiety include a pounding heart, sweating, knots in the stomach, fatigue, insomnia, shaking, hot flushes, muscle tension, dry mouth, feeling sick and tension headaches.

Emotional symptoms are in the form of irrational and excessive fear and worry, trouble concentrating, irritability, anticipating the worst and thinking that you may lose control and/or go "mad". Sometimes individuals may experience episodes of severe anxiety referred to as panic attacks.

Behavioural symptoms especially in those who suffer panic attacks is avoidance. They can take the form of agitation, obsessive and compulsive behaviours

Treatments

Medications

A variety of medications, including benzodiazepines( diazepam, temazepam and lorazepam are the commonly used ones), beta blockers ( propranolol, atenolol) Pregabalinand antidepressants, can be used in the treatment of anxiety disorders.. Benzodiazepines work by affecting the way certain brain chemicals (neurotransmitters) transmit messages to certain brain cells. In effect, they decrease the excitability of many brain cells which has a calming effect on various functions of the brain. Beta blockers are usually used to treat high blood pressure but can be used, in low doses, to control tremors, palpitations which may be the physical symptoms of anxiety. Antidepressants are the mainstay of treatment and are equally effective anti anxiety agents. They may cause side-effects such as increasing agitation and anxiety initially but these side effects usually wear off in a week or two. The benefit may be apparent after 2-4 weeks. These medicines can be taken safely for longer periods, without risk of tolerance or addiction.

Counseling & Therapy.

Talking through your problems with a counsellor may help you to understand and control your anxiety. Cognitive behavioural therapy helps to challenge negative thoughts, feelings and behaviour and is particularly suitable if you have problems such as phobias or panic attacks. Exposure therapy which encourages you to confront your fears in a safe, controlled environment is also commonly used for anxiety disorders. Through repeated exposures to the feared object or situation, either in your imagination or in reality, you gain a greater sense of control. As you face your fear without being harmed, your anxiety gradually diminishes.

In Patient Care

This is only rarely necessary and only for more severe cases.
Sometimes anxiety can be so severe that patients benefit from regular, intense treatment in a caring environment. Here patients have access to daily treatment which can include both medications and talking therapies to help the individual achieve a less anxious and more functional mood state.


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