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ANXIETY DISORDERS

UNDERSTANDING ANXIETY

UNDERSTANDING ANXIETY: Files

THE PURPOSE OF ANXIETY

  • Anxiety is a natural protective mechanism.

  • It purposely designed to manifest as an uncomfortable sensation.

  • We would naturally do whatever it takes to avoid this feeling or that which is necessary to relieve ourselves of this feeling.

  • In the concrete jungle, for most of us, it is a matter of making sure we meet our obligations, for example, our deadlines or targets or prepare adequately for our examinations.

  • Once we have met our responsibilities, we then find relief.

  • There will be those amongst us who don’t worry much regardless of the situation and there will be those who worry too much for even the smallest of things. 

  • For the survival of a species there had to be those that were more cautious and those that were more adventurous. 

  • The more cautious individuals would rather play it safe (minimize risk) and in doing so ensure their survival but potentially lose out on opportunities.

  • The more adventurous individuals would take risks which could compromise them but on the other hand provide them with potentially great reward.

ANXIETY AND THE BRAIN

  • The brain is a complex organ and when it comes to psychiatric disorders there are multiple parts of our brain that are involved i.e. Frontal, Temporal and “Limbic” lobes of structures.

  • The Prefrontal Cortex (PFC) can be considered to be the Central Processing Unit just like a computer. 

  • It plays a very intricate role in mood, anxiety, thinking, planning and organization.

  • The PFC regulates our thoughts and if one is vulnerable (genetic susceptibility or traumatic exposure or poor coping skills) can result in overactivity.

  • Thus, the PFC plays a very crucial role in anxiety disorder.

  • When we find ourselves in a bind (not much options) or we cannot control ourselves from overthinking, or we are overwhelmed by our responsibilities, or don’t have the coping skills, or we have been exposed to a severe traumatic event then there will be overactivity in our PFC.

  • There is also a primitive part in our brain that automatically reacts to potentially serious situations which could endanger life (amgydala and hypothalamus). This system is responsible for the ‘fight or flight response’. Essentially this means to defend oneself against danger or to flee. 

THE FLIGHT OR FIGHT RESPONSE

Increased brain activity and increased state of arousal (level or alertness) in order to process more information about the situation so that we can make an appropriate decision – to flee or defend and how to go about it. Naturally at this point in time a person would be the opposite of a relaxed, unconcerned or somnolent state for if this were the case then we would be in mortal danger. It just wouldn’t make sense for our biological system not to take a grave matter seriously and respond accordingly. 


The brain stimulates the release of adrenaline which is intended to increase the heart rate so that more blood can be pumped into the lungs to pick up more oxygen and deliver it to the muscles. Our muscles automatically tense up. Ultimately, we will need our muscles to help us defend ourselves or run away. Adrenaline also causes blood vessels in our peripheries (extremities of our bodies) to constrict (narrow) which may save blood in the event of an injury sustained whilst defending or fleeing i.e. reduced blood flow to the small blood vessels which especially affect the nerves in our hands and feet which typically manifests as tingling sensation. Adrenaline also causes tremors and sweating. Blood is also deviated away from the digestive tract (which expends energy) and diverts this energy rather to those organs that will make the difference between life and death i.e. brain, heart and muscles. 


We can all relate to this phenomenon as we all have been scared or afraid at some stage or the other.


This is the stress system at its peak. 

PANIC ATTACKS

If we are constantly worried for whatever reason, then the stress system becomes sensitive.

This sensitivity may manifest in a ‘flight or fight response’ despite not actually facing a physically dangerous situation. 


When this happens the overactivity within the various structure of the brain may result in feeling as if one is losing control, or a sense of impending doom, or going crazy.

the adrenaline released causes the heart to beat past, which may be perceived as palpitations (pounding heart), chest pain and may feel like one is having a heart attack with pain extended to the left arm. Yes, indeed, it may feel “like your heart skipped a beat “or ‘as if somebody broke your heart”. We don’t actually feel in out hearts! It is because of this primitive physiological link between this very basic survival emotion and our heart that we perceive emotions in this way. 


Additionally, the pins and needles in the hands and tremors 

The physical system requests more oxygen and thus breathing becomes more and the person has a sensation of not getting enough oxygen when in actual fact there isn’t any need for any more oxygen. This is a very uncomfortable sensation of difficulty breathing or choking. 

The sinking feeling/ butterflies in the stomach is from blood being deviated away from the gastro intestinal tract. 

Although not commonly described but people can even faint! 


Our bodies where not designed to operate at this level for prolonged periods of time. 


A panic attack is the body reacting to stress or anxiety. Panic attacks can occur in any if not all of the anxiety disorders. 


Panic attacks reinforce the stress system by lowering its threshold, and by reducing our belief that we do not have control. As long as feel this way thee more vicious this cycle will become. It is however a modifiable process with the right kind of treatment which is just not chemical but also psychological. However, there is a very crucial need for patience and practice because it will not settle in a matter of days. And the more we beat ourselves over it the worse it will become. So, if I was not able to control it this time it doesn’t mean that I will not be abel to control it the next time. Who was ableto learn to ride a bicycle or anything else for that matter in minutes or days? Indeed this is more challenging but the process is fundatmentally the same. The process of learning and the duration will defer. . this is not a comparison or a race. You have to crawl before you can walk before you can run we have to keep on convincing ourselves that we can and eventually we can gain control. 


Panic attacks are further compounded by the fear of experiencing a panic attack in public. Which in turn further compounds the anxiety and the chances of experiencing another panic attack. 


There are degrees at which the stress system  function from none to all. None when are calm, mild to moderate, for example when he pressed to complete a task over a certain duration of time,  and exteme when we are subjected to severe trauma. Some people with anxiety will manifest some of the panic attacks i.e not necessarily all of the symptoms.

Some people may just have the experience of difficulty breathing, or just tremors, or few of the symptoms. 


As mentioned earlier anxiety is an unpleasant experience and often leads to depression. It is thus often associated with depression and perhaps one of he major cuases of depression. 

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