Understand Anxiety – Symptoms, Causes & Treatment

Are anxiety disorders common?

Yes they are. A large 2016 mental health study in Singapore found that 1.6% of the population suffer from Generalised Anxiety Disorder (GAD). This may not sound like much, but it translates to almost 100,000 Singapore residents. The other commonly encountered anxiety disorders are:

• Panic disorder
• Agoraphobia
• Social phobia

In anxiety disorders and phobias, you will notice that the fear is out of proportion to the actual danger (e.g. fear of cockroaches but they don’t bite us). The fear is often irrational and experienced by the person as being out of their control. There is avoidance behaviour too (e.g. running away from our fears).

What is GAD?

GAD is a condition in which the person worries excessively and finds it hard to stop. There are other associated symptoms such as

• Poor sleep
• Feeling tired
• Getting upset easily
• Feeling restless
• Muscle pain, stiffness or tension (e.g. in the neck and shoulders)
• Not able to focus

For a doctor to diagnose GAD, the anxiety has to be persistent for at least several months.

What is the difference between Social Anxiety Disorder and Agoraphobia?

Social anxiety disorder is a condition where one feels anxious during social situations (e.g. gatherings, parties, meetings and presentations). The person is worried about getting bad feedback from others. An example is excessive fear during school or company presentations which then results in poor performance.

On the other hand, agoraphobia is fear of situations like taking the bus or MRT; going out of the house; crowded places; tight spaces (like lifts) or open spaces. The commonality in all these situations is that the person is worried that if they are not feeling their usual self, they cannot escape. They avoid going to these places or they need to get others to accompany them.

(Interesting fact: Do you know that in Ancient Greek, “Agora” means the city centre or marketplace?)

What causes Anxiety Disorders?

A stressful situation can trigger anxiety disorders but there are often other factors that can increase our risk of developing anxiety disorders Some of these are:

• Genes : If our parents or siblings have anxiety problems
• Challenging childhood eg. parents divorce when the child is at a young age; bullying in school
• Having an anxious personality
• Challenging financial situation

How can you tell when someone suffers from anxiety?

It is hard to tell because many people have learnt to manage their anxiety as they go about their daily lives. This is a positive thing. Anxiety can manifest in many ways – they may talk in a hurried way; ask a lot of questions and repeatedly seek reassurance. They may also have difficulties making decisions.

Is there an online test for anxiety?

Try searching for the GAD-7 screening form online. In general, higher scores reflect more anxiety. However it is not a conclusive test and if you suspect you are suffering from an anxiety disorder, you should speak to a trained mental health professional for assessment.

Is there a blood test to diagnose anxiety?

There are no blood tests to diagnose anxiety. But doctors often order tests to make sure the anxiety is not due to other medical conditions. Abnormalities in thyroid hormone levels and mineral salts such as sodium and calcium can result in anxiety symptoms. Blood tests can help doctors to exclude these conditions. Some medications can also cause anxiety as a side effect.

Which medications are good for anxiety?

A group of medicines called SSRI (Selective Serotonin Reuptake Inhibitors) is a safe and effective first choice. Unlike alcohol or cigarettes, they do not cause addiction. Most patients will benefit from taking medication for 6 to 12 months. Only a minority will require medication for a longer period. One of the common SSRI that you may have heard of is Prozac (or fluoxetine). SSRI are also commonly used to treat depression.

What are the common side effects of SSRI?

All medications, even painkillers like paracetamol, may have some side effects. Some patients complain of nausea and bloatedness – an uneasy feeling which usually goes away after the first few days. Some people may find it hard to sleep if they take it at night.

I have heard of Xanax? Is it helpful?

Xanax is the trade name for a medicine called alprazolam. It belongs to a family of sleep medication and it can be used for sleep, to stop anxious feelings and to stop seizures. It works on the same parts of the brain as alcohol, and just like alcohol, there is a chance of getting addicted to it if it is used daily. Therefore it should not be taken every day.

Is therapy helpful for anxiety?

Yes, very much so and there are various types of therapies which are helpful, such as Acceptance and Commitment Therapy (ACT) and Cognitive Behavioural Therapy (CBT). These may be delivered by a psychologist or psychiatrist. During the sessions, patients will learn a combination of the following:

• Gaining awareness of their anxiety
• Learning to cope with anxiety (e.g. relaxation skills, acceptance)
• Learning to slowly venture again into situations that make them anxious.

In fact, therapy combined with medication is more effective than either medicine or therapy alone.

How do I make an appointment for help?

Click here to make an appointment. Contact us through email, WhatsApp, phone call or online booking. If you have further questions about depression, you can also reach us through the same channels.