In the first chapter and discourse of the Bhagavad Gita we find a classic example of anxiety when Arjun flinches on seeing his kinsmen arrayed for the epic battle. Arjun said: “Seeing these, my kinsmen, O Krishna, arrayed, eager to fight, my limbs fail and my mouth is parched, my body quivers and my hairs stand on end! The Gandiva (bow) slips from my hand, and my skin burns all over; I am unable even to stand, and my mind is reeling.” Having spoken with such despondency in the midst of the battlefield, Arjun cast aside his bow and arrow, and sat down on the seat of the chariot, his mind overwhelmed with sorrow.
What are Anxiety Disorders?
The term ‘anxiety disorders’ describe a number of common mental health conditions. Anxiety disorders differ from what is regarded as developmentally normal fear or anxiety, by being excessive or persistent beyond developmentally appropriate ages. The symptoms are often persistent across various situations impacting on all aspects of an individual’s life. Many of these disorders start in early childhood and tend to persist if not treated.
What is Anxiety?
Anxiety as a word is derived from the Greek word, meaning ‘to press tight’ or ‘to strangle’. The word anxiety may be described as a continual and often irrational feeling of arousal, discomfort and tension, usually without any justifiable cause. Anxiety is a response to a threat that is generally unknown, internal, vague, or conflicted; whereas fear is defined as a response to a known, external, definite, or non-conflictual threat.
Mark Twain said, “I’m an old man and have known a great many troubles, but most of them never happened.”
The feeling of anxiety is a normal human emotion that everyone experiences. Many people feel anxious or nervous when faced with a work problem or before an exam. In some situations, anxiety can even be essential to your survival. For example, if you were standing on a footpath and a car swerved towards you, you would immediately sense danger, feel alarmed and jump back to avoid the car. This normal anxiety response, called the “fight or flight” response, is what prompts you to either fight or flee from danger. In most cases of normal anxiety we can identify a cause of stress and the reaction is reasonable and appropriate.
Anxiety disorders are different, however. They can cause such distress that they interfere with a person’s ability to lead a normal life.
Classification of Anxiety Disorders
About one in four people have an anxiety disorder that needs treatment at some time in their life.
Anxiety disorders take a variety of forms. Recent American psychiatric classification of anxiety disorders have listed the following clinical disorders:
Separation Anxiety Disorder: Where the individual is fearful of separation from an attached person to the degree that is developmentally inappropriate. He or she has constant fear that harm or separation from the significant attachment figure would occur. For example, a child persistently refusing to separate from his/her mother to go to school.
Selective Mutism: Consistent failure to speak in social settings in which there is an expectation to speak (e.g. at school), even though the individual speaks in other situations. This behaviour tends to affect various aspects of the individual’s life.
Specific Phobia: Individuals are fearful, anxious or avoidant of an object or situation. This includes fear of animals, heights, seeing blood and injections, confined spaces and many others. The word phobia is derived from the Greek word ‘phobos’, the name of the Greek god who provoked panic and flight in his enemies.
Social Anxiety Disorder: Individuals are fearful, anxious or avoidant of social interactions and situations that will involve possibility of scrutiny or humiliation. Examples include having a conversation, meeting unfamiliar people, eating and public speaking.
Panic Disorder: Individuals experience recurrent panic attacks and are persistently concerned of having another panic attack or develop maladaptive behaviour to prevent further panic attacks. A panic attack is a sudden feeling of intense terror which may occur in certain situations or for no apparent reason. Symptoms include shortness of breath, dizziness, rapid heartbeat, choking and nausea. The person may feel they are going crazy, about to have a heart attack or die. The word panic is derived from the Greek word ‘Pan’. Pan is the Greek god who is the originator of sudden and unexplainable terror.
Agoraphobia: Individuals develop fear or anxiety of certain environmental situations for fear of not being able to escape or help not being available in the event of having a panic attack. They may avoid using public transport, being in crowds, malls, or even leaving home.
Generalized Anxiety Disorder: This is excessive anxiety and worry about almost everything including work, finances and school. An individual finds it difficult to control the worry and it is often accompanied with physical symptoms such as headaches, neck spasms, mind going blank and insomnia.
Thus, there are a range of anxiety disorders, characterized by persistent, unreasonable fears about general or specific events. Anxiety disorders which are untreated can lead to depression and other long term physical and psychological problems.
It is also important to note that many medical diseases, alcohol and other substances can cause anxiety-like symptoms. These underlying causes need to be treated first to relieve the individual of anxiety. If the anxiety does not subside, then the anxiety needs to be treated as well.
Conditions such as obsessive compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) were previously also incorporated into the anxiety disorder classification. Since 2013, they are considered in different categories.
What causes Anxiety?
Some reasons include:
A learnt response over time – such as learning to fear something after having seen others being fearful of it
Personality types – some people are naturally more anxious than others
Stressful or traumatic life events
A family history of anxiety disorders
Childhood development issues
Alcohol, medications or illicit substances
And other medical or psychiatric problems.
Equally important may be the person’s general level of anxiety, beliefs and attitudes the individual may hold about herself / himself and how the world should be. Such problems often begin as a young adult and may be triggered by one or more major events in a person’s life.