Anxiety
What Is Anxiety?
Anxiety is the body’s natural “fight-or-flight” response to perceived danger. An anxiety disorder occurs when worry and fear persist beyond normal triggers, interfere with daily life, and last for six months or more. For an official overview, see the WHO’s Anxiety Disorders Fact Sheet.
Signs and Symptoms
Anxiety manifests across emotional, cognitive, physical, and behavioral domains:
| Domain | Examples |
|---|---|
| Emotional | Feeling nervous, restless, or tense; constant worry |
| Cognitive | Racing thoughts, difficulty concentrating, catastrophic thinking |
| Physical | Heart palpitations, sweating, trembling, gastrointestinal discomfort |
| Behavioral | Avoidance of feared situations, compulsive checking or rituals |
Types of Anxiety Disorders
Anxiety disorders vary in presentation and triggers. Common subtypes include:
Generalized Anxiety Disorder (GAD): Excessive, uncontrollable worry about everyday events for six months or longer.
Panic Disorder: Recurrent panic attacks—sudden surges of fear with physical symptoms (chest pain, shortness of breath)—and fear of future attacks.
Social Anxiety Disorder: Intense fear of social or performance situations due to potential scrutiny or embarrassment.
Specific Phobias: Irrational fear of specific objects or situations (e.g., heights, flying) leading to avoidance.
Agoraphobia: Fear of environments perceived as unsafe or inescapable, such as crowded places or public transportation.
What Causes Anxiety?
The origins of anxiety disorders are multifactorial:
Biological Factors: Genetics, brain chemistry (overactive amygdala), hormonal changes.
Psychological Factors: Personality traits (high neuroticism), cognitive distortions (catastrophizing).
Environmental Factors: Trauma, chronic stress, significant life changes (bereavement, job loss).
Medical & Substance-Related: Certain health conditions, medications, caffeine or alcohol use.
How Is Anxiety Diagnosed?
Dr. Sandeep Budhwar will conduct a thorough evaluation:
Clinical Interview: Detailed discussion of symptoms, duration, and triggers.
Questionnaires: Standardized tools such as GAD-7 for severity assessment.
Diagnostic Criteria: Based on DSM-5 guidelines to determine specific disorder subtype.
Treatment Options
Treatment is personalized according to severity:
1. Psychoeducation & Lifestyle Changes
Learn about anxiety’s mechanisms and normalize occasional worry.
Practice stress-reduction techniques: sleep hygiene, balanced diet, limit caffeine.
Engage in regular physical activity and relaxation exercises (deep breathing, progressive muscle relaxation).
2. Psychotherapy
Cognitive Behavioral Therapy (CBT): Gold-standard intervention focusing on restructuring negative thoughts and gradual exposure to fears.
Other Modalities: Mindfulness-based stress reduction, acceptance and commitment therapy, supportive counseling.
3. Medication
First-Line: SSRIs (e.g., sertraline, escitalopram) and SNRIs (e.g., venlafaxine) for long-term management.
Short-Term Relief: Benzodiazepines (e.g., clonazepam) for acute panic, used cautiously due to dependence risk.
Adjunctive Agents: Beta-blockers for performance anxiety, buspirone for generalized anxiety.
4. Combined Approach
Combining CBT with medication often provides the fastest and most sustainable relief, especially for moderate to severe cases.
For detailed clinical guidelines, refer to the RANZCP’s Anxiety Disorders Treatment Guidelines PDF.
Self-Help Strategies
In conjunction with professional care, patients can:
Keep a worry journal to identify triggers and track progress.
Practice daily relaxation (guided imagery, yoga, meditation).
Use graded exposure to face feared situations incrementally.
Seek support from trusted friends or support groups.
When and How to Seek Help
If anxiety symptoms persist and impair your daily functioning, reach out to Dr. Budhwar:
Visit our home page for more resources.
Anxiety disorders are treatable. With early intervention, tailored treatment, and active self-management, you can reduce distress, improve coping, and enhance your quality of life.