Anxiety, Panic Attacks and
OCD
Anxiety is a normal reaction to stress, but when it becomes excessive and persistent, it can develop into an anxiety disorder, such as generalised anxiety disorder and panic attack disorder, affecting daily functioning.
Symptoms
- Emotional: Excessive restlessness, nervousness, irritability.
- Physical: Increased heart rate, sweating, tremor, dizziness, gastrointestinal disturbances, etc.
- Mental: Difficulty concentrating, feeling of impending doom, thoughts over-analyzing and recycling in the mind.
- Behavioral: Avoiding situations that cause anxiety, worrying about daily activities.
Treatment Options
- Medication: Antidepressants (SSRIs, SNRIs), anxiolytics (benzodiazepines), beta-blockers.
- Psychotherapy: Cognitive-behavioral therapy (CBT), exposure and response prevention (ERP).
- Combination Therapy: A combination of medication and psychotherapy.
- Alternative therapies: Relaxation techniques, yoga, meditation.
- Supportive Therapy: Counselling therapy.
The primary anxiety disorders
Generalised Anxiety Disorder (GAD)
- Characteristics: Constant and excessive stress over various daily activities and events, lasting for at least 6 months.
- Symptoms: Difficulty concentrating, inability to control thoughts that may be racing, irritability, muscle tension, fatigue, sleep problems
Panic Attack Disorder
- Characteristics: Repeated, unexpected panic attacks and ongoing concern about their recurrence. These attacks are intense episodes of anxiety that occur suddenly and are accompanied by intense physical and psychological reactions.
- Symptoms: Panic attacks include various physical symptoms such as tachycardia, sweating, trembling, shortness of breath, choking, nausea, dizziness, hallucinations and feelings of impending death or madness. People suffering from this disorder often develop avoidance behaviours, avoiding situations or places associated with previous seizures.
Agoraphobia
- Characteristics: fear or stress about situations where escape may be difficult or impossible, fear of panic attack.
- Symptoms: Avoiding crowded places, public transport, and open or closed spaces, especially if they are unfamiliar.
Special Phobias
- Characteristics: Intense and irrational fear of certain objects or situations.
- Symptoms: Immediate stress reaction when exposed to the fearful object, avoidance of the object or situation.
Obsessive Compulsive Disorder (OCD)
- Characteristics: Presence of obsessions (repetitive, unwanted thoughts) and/or compulsions (repetitive behaviours or mental actions).
- Symptoms: Excessive hand washing, checking, counting, need for symmetry, perpetual seeking of assurances and confirmations from others, repetitive prayers.
Prognosis
The prognosis for anxiety disorders varies depending on the type of disorder, severity of symptoms and response to treatment. Below are the main factors affecting prognosis.
Positive Predictive Factors
- Early Diagnosis and Treatment: Early recognition and initiation of treatment usually improves outcomes.
- Compliance with Treatment: Regular monitoring and adherence to medication and treatment recommendations improve prognosis.
- Support Network: The presence of supportive friends and family can facilitate recovery.
- Absence of serious comorbidities: Better prognosis when there are no other mental or physical conditions.
Negative Predictive Factors
- Chronic Anxiety: Chronic anxiety symptoms can be more difficult to treat.
- Comorbidity: The presence of other mental disorders such as depression or substance abuse may worsen the prognosis.
- Inadequate Treatment: Lack of access to specialized treatment or discontinuation of treatment can make the condition worse.
Long-term Prognosis
- Relapse: Anxiety disorders can be chronic and recurrent. Many patients may experience relapses during their lifetime.
- Recovery: Many patients can make a full recovery with appropriate treatment, although some may need long-term or lifelong treatment.
- Functionality: With proper treatment, most patients can maintain normal functionality and quality of life.
Continuous monitoring and adjustment of treatment according to the patient’s needs are essential for achieving the best possible prognosis.
