Articles on anxiety

In the Grasp of Anxiety - When Worrying Has Become a Disorder

Ms. Pallavi Tomar, Psychologist
Everyone is familiar with anxiety.It may pop up as a feeling of unexplained apprehension, or a flood of constant worrying thoughts, a sudden burst of panic, or even an intense dread or fear. These feelings are all to situations, things and people perceived as overwhelming, unsafe or threatening. In all its manifestations, it is unpleasant and it is quite natural to want to avoid or eliminate these feelings.But before we move on to discussing anxiety as a disorder, lets understand the evolutionary function of this seemingly out of control beast.The essential evolutionary function of an anxiety response is to prepare an individual to deal effectively with danger and threat. That is why it exists at all.Take a look at a few symptoms and the function they may serve:The feeling of restlessness and increased heart rate may keep us physically prepared for action.Our interpretation of ambiguous information as threatening may actually be aimed at reducing the probability of missing any threats around us.Our mind racing with multiple thoughts of all that which can happen may actually keep us prepared for all possibilities and scenarios.The lack of sleep will allow us to be constantly alert.It propels us, makes us strive, challenges us and pushes our limits. Toss away anxiety and you may lose out a great deal of your motivation, persistence, excitement and caution.So ideally if anxiety is experienced in the right manner, for the right reasons and for the right duration – it is only natural!But how do we recognize the transformation of this natural experience of anxiety into a disorder?There are a few things to consider. Anxiety reactions manifest in three basic forms:As an emotion: The fear, the apprehension, the worry, and the despair.As a thought: Of an impending doom, of things going wrong, of death, of injury.As a physical response: To avoid, to evade, to check, to run, to become immobile, increased heart rate, difficulty breathing etc.In an anxiety disorder, these three basic forms of anxiety may be experienced as difficulties in any of the four below mentioned domains.Intensity – Is the experience of anxiety exaggerated and far too intense than what may be warranted in a situation? Does the individual find it difficult to contain and manage the anxiety? Is the individual finding it difficult to cope with the intensity of the signs and symptoms?Frequency – Are the signs of anxiety experienced too frequently by the individual? Is the individual repeatedly reacting to the same stressor/threat without developing newer ways to cope or deal with it?Pervasiveness – Are the signs or symptoms of anxiety experienced at most times across all situations? Does it seem to be pervading across all aspects of an individual's life?Dysfunction – Is the experience of anxiety impacting the individual's functioning in their personal, professional or social life? Does the individual have to make too many changes to accommodate and cope with the experience of anxiety? Is it affecting others around the individual?If your answer is affirmative to any of these questions, your experience of anxiety may not be serving the evolutionary purpose it is essentially meant for. But before you go ahead and diagnose yourself, I encourage you to talk to a mental health professional about your concern.

Beware! Dr Google Can Cause Health Anxiety

Dr. Naveen Jayaram, Psychiatrist
Health anxiety is a constant fear that there may be a threat to your health. This fear triggers anxiety response, which in turn makes people catastrophically misinterpret health related information. e.g If I am having headache  I might be having a brain tumor. Any sensation in the body will be interpreted as a sign of serious medical condition. Health anxiety becomes a concern when1. Health concerns are excessive2. Out of proportion to the realistic likelihood of having a serious medical problem3. Concerns persist in spite of negative test results and assurances from health professionals4. Normal functioning and quality of life gets affectedHow googling can worsen health anxiety?Internet is an amazing technology and we use it regularly to search for things we want to know. Off late it has become the only source of information to people, any doubt about anything, just google it. Also recently there are discussions that Dr Google can help with accurate medical diagnosis. Searching for medical terms in internet causes significant health related anxiety. This has become a significant problem among IT professionals.People generally search for a symptom or diagnosis, often they end up reading many nonspecific things and have a tendency to concentrate on more negative aspects about the condition. Few people start to experience the symptoms which they read and start believing  that they have developed a serious illness. To overcome this anxiety they try to research about their condition more  and it complicates things further. This anxiety leads to multiple consultations and too many unnecessary investigations and it hampers the quality of life of the individual and family.Tips to overcome this anxiety?1. Identify if you have a tendency to worry about your health2. Understand that it is normal to have  many sensations in the body3. Stop searching for medical terms in internet4. Do not do repeated consultations to look for medical problems5. Practice relaxation and breathing exercises6. Cognitive behavioural therapy can help you to minimize health anxiety

8 Ways to Manage Your Anxiety Better, Now!

Ms. Pallavi Tomar, Psychologist
Anxiety can be a helpful, healthy emotion, but when it spurs out of control it can be especially difficult to deal with. Following are a few techniques to help you manage your anxiety better:1. Understand false alarmsIntense anxiety or a panic attack may feel like you are dying. It’s important to understand how such an instance may mimic a panic attack but that’s only because the brain has made you believe it’s a heart attack or an uncontrollable symptom. When you experience such symptoms, understand that a panic attack is only a momentary experience of intense anxiety but it does fade away and is definitely not life threatening. 2. Learn to challenge your thoughtsIn a state of anxiety, one’s thoughts are generally highly unrealistic and unlikely to occur in reality. There is a tendency to think of the worst possible outcome when anxious. In fact, one’s experience of anxiety comes from these flawed perceptions and thoughts about a situation. In such a situation, make it a habit to question the possibility of your thought actually occurring in reality and even if it does what would be so bad about it. Make a list of all possible outcomes, positive and negative for a situation. Challenge your present negative thought and question the probability of its occurrence. For example: one may think that asking a question in a group meeting may bring them ridicule. Ask yourself what are the other possibilities in such a situation? That people may appreciate their question, be indifferent to the question, or many other questions may be brought forth because of his point or if nothing else you at least participated in the meeting. Now even if people feel it’s a ridiculous question, how many times in the past has someone been ridiculed for asking a question? Does that really happen? Or is it just perceived by you because you are overly sensitive to rejection due to anxiety?3. Avoid AvoidanceThe biggest mistakes people with anxiety make is avoiding the triggers in their environment which makes them anxious. The way out of anxiety is only through it. Do not avoid such situations. In fact, try to gradually expose yourself to that which makes you anxious starting from a lower intensity trigger moving up to a more anxiety producing trigger. For example: If you get anxious talking on the phone to a friend in front of others, try having a conversation on WhatsApp first in front of other people. Then initiate a call for 2 minutes in front of one another person, then a 2 minutes call in front of 3-4 people gradually increasing the time and number of people till you can habituate yourself to such a situation. 4. Equip yourself with relaxation techniquesThis differs from person to person. Indulge in activities on a daily basis (with or without the experience of anxiety) that lower your stress and help you relax such as exercising, listening to music, reading, practising a hobby, spend time with loved ones. Learn relaxation techniques, visualization techniques and take a regular time out to de-stress.5. Learn to identify unsolvable problemsVery often, anxious individuals are unable to distinguish between a real / solvable problem versus an imagined /unsolvable problem. Learn to ask yourself; “Is this a problem I am currently facing or something I fear may happen (what if)?”“Even if it’s a problem I am currently facing, can I do something about it or is it unsolvable?”A concern that is solvable and you can take action on right away are the ones to work with.If the concern is presently there and solvable, make a list all possible ways to deal with it (even if some seem ridiculous). Focus on those things you can try and change rather than trying for perfection or fretting over what cannot be solved for. 6. Accept uncertaintyThe inability to tolerate uncertainty is one of the main underlying causes of anxiety problems. People suffering from anxiety always want to be 100% assured about a certain outcome or decision. Worrying then is seen as a way to predict what may happen in the future or how things may go wrong and to control the problem. Thinking of all the ways in which things can go wrong does not make life decisions any more predictable. Focusing on worst case scenarios does not prevent them from occurring. 7. Stay in the presentThe biggest issue with people suffering from anxiety is their inability to stay in the moment, they are constantly worrying about things that may go wrong in the future. Make it a habit to remind yourself to be in the present moment and really be involved. If your attention again drifts to thoughts of the future, gently bring it back to whatever you are doing at the moment and make the most of it.8. Don't hesitate to ask for professional helpIf despite your best efforts you are unable to manage your anxiety, do seek professional advice from a Clinical Psychologist or a Psychiatrist.

Tips to Manage Work Place Anxiety

Dr. Naveen Jayaram, Psychiatrist
Working is a special part of our lives. We spend almost 8-12 hrs per day in the work place. Work not only provides income, but also fulfills a variety of other needs - mental and physical exercise, social contact, a feeling of self-worth and competence.According to reports 50% employees in India are under stress. 71% people under stress feel they are not productive. Anxiety occurs when we start feeling that we cant cope up with work pattern or with the people working with you.Factors influencing work place anxiety:• The drive for success• Changing work patterns• Working conditions• Overwork/Under-work• Uncertainty/Conflict• Responsibility• Relationships at workNot all the anxiety we experience is generated at work!!! Most of the time our personal behavior and thinking might influence work directly or indirectly.How to manage work anxiety:1. Identify whether you are comfortable and content with your current work pattern 2. Recognizing the problem doesn’t mean you are a weak or incapable person, it will help you to plan and overcome it.3. Do not allow your past work experiences and emotional memories to affect your current work. 4. Change your thinking: A. Re-frame the situation to change the way you look at things. It will help you view things in a different light and in a less stressful      way. B. Positive thinking - Forget powerlessness, dejection, despair, failure. Focus on your strengths and seek out the positive. 5.Change your behavior: A. Be assertive (Learn how to say “no” to certain things) B. Get organized - Prioritize objectives, duties and activities makes them manageable and achievable. Don’t overload your mind. C. Time management - set achievable goals, make a list, know what must be done, and learn to drop unimportant activities.     D. Develop a support network through friends or colleagues to talk with, sometimes sharing the feelings helps. E. Humor relieves stress. F. Diversion and distraction - If situation is extreme, take time out, get away from things which bother you, think logically to handle the situation.  G. Change your lifestyle - regular exercise, relaxation- deep breathing exercises, pranayam, good diet etc.We need to feel good and be content with whatever work we do. Be aware that we cannot change the people or the organization rules, but if we are committed and motivated we can change ourselves to adapt to work environment.“Always work hard, be honest and be proud of who you are”

5 Signs That Can Help You Identify Anxiety Disorder

Dr. Vasavi Samyukta Sunki, Psychologist
Anxiety is a very normal emotion, which gives rise to feelings of nervousness every now and then. An anxiety disorder is a serious medical condition in which people experience a high degree of distress and mental trauma, which causes difficulties in leading a normal life. People suffering from this medical condition experience high levels of anxiety and nervousness almost all the time. Here are the symptoms that indicate you're suffering from anxiety disorder.1. Excessive worry - This condition persists if you worry about the day to day activities a bit too much on a regular basis. It is identified when you start taking too much stress about very petty things, which tends to affect you in an adverse manner. A noticeable sign of excessive worry can be too much fatigue.2. Sleep problems - Problems falling asleep at the right time and problems in maintaining sound sleep are two signs that indicate you have an anxiety disorder.3. Irrational fears - This symptom is not generalized; instead, it is specific and subjective in relation to a particular thing or situation. The fears that are experienced under this category are sudden and unexpected in nature and there is no fixed rationale behind these fears.4. Muscle tension - Muscle discomfort and pain is one of the leading physiological causes of an anxiety disorder. The pain felt is chronic and pervasive, and is very common among people facing situations of anxiety. If you are exposed to constant periods of anxiety, you will experience fatigue, muscle pains and unwillingness to work.5. Chronic indigestion - Problems related to the digestive system are also a sign of anxiety disorder. In this case, you may face constant digestive problems accompanied by a common disorder called IBS (Irritable Bowel Syndrome). IBS refers to an anxiety situation in the digestive tract, which is characterized by stomach aches, cramping, bloating, gas, constipation, and/or diarrhea.Apart from the above-mentioned symptoms, other symptoms of an anxiety disorder include stage fright, self- consciousness, panic attacks, memory flashbacks, perfectionism, compulsive behaviors, self- doubt, and such others.

Signs of Severe Anxiety and Coping Mechanism

Dr. Priyanka Srivastava, Psychologist
Do you have a habit of getting too anxious about minor matters? Is your severe anxiety hampering the smooth functioning of your daily life? Is anxiety giving you headaches, causing insomnia and making you paranoid? All these conditions imply that you are suffering from anxiety disorder. There are several types of anxiety disorders with various symptoms, and there are effective treatment procedures for curing them as well.Signs and symptoms of severe anxiety/ anxiety disorder: The signs of anxiety disorder vary from person to person, but one common major symptom is severe fear, tension, and worries even in petty situations.Emotional symptoms:The common emotional symptoms except fear and tension include the following:Feelings of great apprehension or a dread feelingProblem with concentrationFeeling overly tensedAlways anticipating the worst in any situationFeeling restless and irritableWatching out for danger signs in everythingFeeling mentally blankPhysical symptoms:Anxiety is much more than being just a feeling and several physical symptoms are observed as a result of the body's response to severe anxiety. The most common physical symptoms are as follows:A pounding heartExcessive sweatingAn upset or dizzy stomachEnhanced urge for urination and diarrheaBreathing problemsMuscle tensionFeeling twitches and tremorsA severe headache and excess fatigueSleeplessness or insomniaCoping with severe anxiety:In order to cope with anxiety disorder, you should follow these tips:You should connect with other people as being lonely or isolated may trigger your anxiety. Meet friends or join support groups. You should share your feelings with a loved one to ease the anxiety.You must start undertaking relaxation techniques such as mindfulness meditation, progressive muscle relaxation or deep breathing. These help in reducing your anxiety and make you feel relaxed.Regular exercise and work out is a natural stress buster and relieves anxiety. Practice different types of exercises strictly every day.You must get sufficient sleep as lack of sleep boosts your feelings of anxiety and tension. You should get nine hours of undisturbed sleep every night.You should reduce your intake of alcohol and caffeine products, which worsen your anxiety.You must train your mind to stay calm. The habit of needless worrying must be brought under control. You can undertake strategies such as creating a worry period, challenging the thoughts of anxiety and accepting uncertainty in life.The self-help strategies for coping with severe anxiety can be quite effective. In some cases, fear and anxiety attacks become very severe and cause great distress in a person's life. In such cases, professional help is required. Certain behavior therapies can be undertaken for eliminating severe anxiety.

Is Your Anxiety Making You Anxious?

Ms. Damini Grover, Psychologist
I'm pretty sure that every now and then, all of us experience this inexplicable restlessness, breathlessness and worry.Maybe, we find ourselves hyperventilating and going crazy with the thought 'What will happen if...', 'Will it happen...', 'What if it doesn't happen..?' and before we know it, we are consumed by this feeling called 'anxiety'.So what is this 'anxiety'?Simply put, it's a state of heightened worry, nervousness or apprehension about a situation. It comes up especially when, the outcome is uncertain.We humans, aren't so well programmed to deal with uncertainty. If given a choice,subconsciously, we would like to know the how and why of everything! It's essential for our sense of security and stability.When we know what's going to happen, we can comfortably sit back and enjoy the ride. However, when we don't know, it creates a havoc in our internal life because not knowing, comes as a package of many possibilities. And that's what scares us. What if we get stuck with an outcome we don't want? What if we don't like what we'll get? What if we don't know what to do when faced with an outcome?So many 'what ifs' and no answer...and that's enough to send the mind into a tizzy!But the fact of the matter is, we will never know everything about anything! It's this uncertainty which pushes us to take things a bit seriously; take ourselves seriously and learn how to deal with uncertainty. However, problems arise when we take ourselves a little too seriously and lose the plot of the situation!The only opposite of 'not knowing' is 'knowing'. But we end up focusing all our energies on the probable outcomes which leaves us nowhere.On the contrary, what would be of great help would be to know how to deal with this looming uncertainty. That can only happen by preparing ourselves to deal with all possible outcomes.Ironically, the question 'what if' is sort of rhetorical. It forces us to think of ways to deal with the situations we are obviously not prepared for! But instead of breaking the situation down into its 'known elements', we only focus on the question.By repeating this 'what if' a dozen times in our minds, it only creates more and more anxiety!And then we get even more anxious about the fact that we are anxious!Therefore, here are some things we can do to keep anxiety at bay-BREAK DOWN THE SITUATION: into what you know and what you don't know about a particular situation.FIND OUT MORE INFORMATION: about those aspects of the situation that you are currently unaware of.IDENTIFY VARIABLES: every situation has some constant and some variable factors. Constant factors stay the same throughout. It's the variable that creates anxiety.Variable factors are those which are not under our control. e.g. you can control the time and effort you put into your studies or work. But you can't control the marks that you get or the feedback you get from your boss. Those are the variables.FOCUS: on what you can do and do it well. You may end up with a crappy examiner who decides not to read your paper carefully. But the fact that you gave it your 100%, would play a pivotal role in helping you keep up your self-esteem.PREPARE, NOT CONTROL: Why must everything be about control? Shift your focus to preparing for various outcomes rather than obsessing over the possibilities. e.g. instead of torturing yourself with 'What if I don't get this job..', shift your focus to 'If /I don't get this job,I will...." and then prepare for such a possibility. Keep back ups ready.The feeling of anxiety usually comes up when we are not prepared to deal with an outcome we don't like and don't want. More often than not, we know about the possible outcomes that exist. But instead of bracing ourselves for them, we cover it up with a thick layer of 'What if.'Until and unless we give ourselves an answer to that question; anxiety will be our best friend.Think. Prepare. Relax. Stay healthy!

Do You Have Exam Phobia?

Dr. Kavita Sagarkar, Psychiatrist
So, what is Exam Phobia! Well, everyone of us has experienced it. Admit it.I know people who are so stressed out before exams  that they have physical symptoms like a headache, loose motion, stomach ache( even a stomach migraine)  and body ache. Exam stress may cause one to go blank during the actual exam like Ghajini. There may be sweating, palpitations that disturb so much that one cannot think straight and end up messing up  the paper. Also, in subsequent exams it becomes worse and the fear intensifies. The person may end up feeling a failure, feeling guilty  and may even be suicidal!Why does this happen ? Exams are an integral part of our growing up. The competition today is very intense. We are tested, judged by a single exam. They may be important in deciding our career. In our perception, exams become like an insurmountable mountain that seems difficult to climb. Sometimes, the failure in previous exams worsens the situation. Sometimes, the person may have a critical parent who makes one feel like a good for nothing with the message that he/ she can never succeed. Let us understand what can be done or rather, undone! After identifying the problem, it is important to de-anchor  from the negative effects of the previous bad exam experiences. This can be done by simple visual/auditory exercises. Close your eyes and relax. Think of your previous exam where you had the fear. Notice if you are visualizing it or having negative thoughts about it.Put the negative images in a helium balloon and let go of these. Take the  thoughts that make you feel fearful and hear them in a sing -song fashion in your head, with the tune of your favorite song!  Notice now that you are able to rid yourself of the stress and feeling calm. Now add  visual exercises to instill confidence. Visualize the time you did well in some exam or sport, something that makes you feel confident and proud of yourself. Associate with these images ie. imagine being  there in that moment or time. Hear the thoughts  that give you confidence. Now, see yourself studying and doing well in your future exams. .  In this way you can  train  the brain to focus on doing well, through different techniques using N.L.P. (Neuro Linguistic Programming). In rare cases, anti anxiety medicines may be added. Yes, you can definitely succeed. All the Best! 

Anxiety and Addiction - Is There a Link?

Ms. Rajeshwari Luther
Substance abuse and mood disorders are closely linked for a variety of reasons. Many people believe that using substances is an effective way of feeling happier and calmer. People with severe anxiety may discover that alcohol or drugs give them short term relief and may resort to using them regularly. Often, people with anxiety are prescribed drugs like Xanax. They may like the calmness they feel when on this medication and may begin to take dosages higher than those recommended by their psychiatrist.What is Anxiety?There are many different kinds of anxiety disorders - obsessive compulsive disorder, generalized anxiety disorder, post-traumatic stress disorder, social anxiety and panic disorder. Many of these are caused by severe chemical imbalances in the brain, something that alcohol and drugs alter further. Alcohol and drugs make anxiety disorders worse, rather than better, in the long run. In addition to feeling anxiety, a substance abuser with a dual diagnosis of addiction and anxiety, is likely to feel symptoms such as:- Irritability- Restlessness- Paranoia- Psychosis- Physical complications like highly elevated heart rate and shortness of breathWhat does it have to do with addiction?While people with anxiety may use alcohol or drugs to calm themselves, and not ‘get high’, they may find excitement in a calm euphoria. Their addiction begins to develop as they find that they are unable to feel calm and happy without drugs, not realizing that the continued abuse of drugs and alcohol would render them unable to feel happy or calm at all. These positive emotions can only return once addicts enter recovery, where not only their addiction is addressed, but also its underlying issues.  Another common form of anxiety is phobia - a disorder which is characterized by an extreme, irrational fear of an object or situation. Common examples of these are claustrophobia and agoraphobia. As alcohol is known to release inhibitions, people with phobias may find that they are more relaxed and less on-edge when they drink. Somebody with agoraphobia may actually have the courage to leave their house, when they know that they can consume drugs that consume their fear.What hope does?One of the risks in addiction treatment is the process of detox. Detoxification comes with many withdrawal symptoms, a very common one being panic attacks. When a person with anxiety goes through withdrawal, they are likely to have severe panic attacks with acute physical symptoms. This is why rehabilitation centres like Hope Trust monitor clients throughout the process of detoxification.With anxiety, as with all dual disorders, patients are trapped in a vicious cycle. Their anxiety will lead them to consume drugs or alcohol; and their consumption of drugs and alcohol will cause them more anxiety. This is why patients must be treated in a highly specialized way with individual attention placed on them.Hope Trust places emphasis on keeping our in-patient group small so we can ensure that patients with dual disorders, such as addiction and anxiety, receive specific treatments targeting their personal issues, with reference to their bio-psycho-social background. At Hope Trust, we aim to enable addicts to break free from their problems - whatever they may be - so they can live a happier, fuller and more content lives.