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Frequently Asked Questions - Anxiety and Mood Disorders

What is anxiety?
Anxiety is a natural response to a stressful or dangerous situation. The body reacts to a situation with a racing heart, sweaty palms and shortness of breath. For those with an anxiety disorder, this reaction is more intense, occurs frequently and can last hours, even days.

Individuals with anxiety disorders tend to avoid anxiety-provoking situations, and often have difficulty with relationships, school and work performance, social activities and recreation.

How prevalent are anxiety disorders?
Anxiety disorders affect 12% of the population, making it the most common mental illness in Canada. For a variety of reasons, some individuals may not seek treatment for their anxiety, even though it can be effectively treated through many different options.
Who is at risk?

If you have a family member with an anxiety disorder, you have a higher chance of developing one.

What are the risk factors/triggers for anxiety disorders?
Anxiety disorders can be the result of a number of factors, including genetics (children of adults with an anxiety disorder have a higher risk of developing one), psychological (individual has a tendency to overestimate danger) and experiences (e.g. an embarrassing moment or a traumatic event).
 
Anxiety may coexist with depression or bipolar disorder and make coping more difficult. It is important that symptoms of anxiety and a mood disorder be treated.
What are the symptoms?

Generalized Anxiety Disorder

GAD is characterized by excessive and uncontrollable anxiety and worry about events or activities, experienced most days for a period of at least six months, with associated physical symptoms such as irritability and sleep disturbance. 

Post Traumatic Stress Disorder (PTSD)

This is characterized by flashbacks, re-experiencing, persistent avoidance of people and places that remind one of the event, and increased arousal, such as difficulty concentrating, anger and jumpiness in response to the terrifying experience in which physical harm occurred or was threatened in.

Social Phobia

Individuals experience excessive fear in social situations where they believe they are going to be judged negatively or make a fool of themselves, and which interferes with relationships, work and school performance.

Panic Disorder

Individuals have repeated panic attacks (with physical symptoms such as palpitations, sweating and trembling) along with avoidance of places and situations that caused the anxiety. 

Specific Phobia

Individuals may experience only a specific phobia, such as a fear of flying, a fear of spiders, a fear of escalators, and so on, without the anxiety translating into other facets of their lives.

Obsessive Compulsive Disorder

Obsessions are uninvited, intrusive thoughts, such as concerns or doubting, that are time-consuming and cause distress. Compulsions are behaviours or rituals that are followed to try to reduce obsessive thoughts, e.g. handwashing or checking.

What do i need to tell my doctor?

  • Write down symptoms you’ve had and in which situations
  • Write down key personal information
  • Make a list of all medications you are taking
  • Write down questions to ask your doctor
  • Take a family member or friend along

Discuss all of your symptoms with your doctor and describe how they are affecting your life (e.g. racing thoughts that cause you to lose focus and not get things done). Your doctor can suggest or provide appropriate therapy. Based on your symptoms, discuss all of the available treatments and medications and their benefits and side effects before making any decisions. 

What are the treatment options for anxiety disorders?

The most common forms of treatment for anxiety disorders include medication, Cognitive Behavioural Therapy (CBT) or a combination of the two, along with exposure therapy. Individuals can almost always be treated without being admitted to a hospital. 

CBT is a problem-focused treatment that allows the individual to change unproductive thought patterns and gain control over unwanted behaviours. It may also be worth exploring relaxation techniques to reduce stress. Additional treatments, such as massage, mindfulness meditation, shiatsu, therapeutic touch, aromatherapy, tai chi, Pilates and yoga, can also help to improve wellness.

Exposure therapy, also known as desensitization treatment, is a systematic process wherein an individual with a fear or phobia is taught relaxation techniques and is then gradually exposed to the object of fear until it can be tolerated. Over time, the fear response is extinguished.

Medications may also be given, and typically include antidepressants such as SSRIs (selective serotonin-reuptake inhibitors) and benzodiazepines. Don’t give up if one drug treatment fails; another may prove to be effective, even a drug of a similar type. Drug combinations may be tried if a single drug does not provide relief. Because some anxiety disorders are chronic, drug therapy may be needed for prolonged periods, even years.

Complementary therapy, such as peer support groups and other support programs may also be helpful.

What are the things I need to do to get well?
  • Stick to your treatment plan. Don’t skip psychotherapy sessions. Even if you’re feeling well, continue to take medication as prescribed.
  • Learn about anxiety disorders. Empower yourself by learning about your condition.
  • Pay attention to the warning signs. Find out what triggers your anxiety. Make a plan so that you know what to do if your symptoms get worse. Contact your doctor or therapist if you notice any changes. Ask friends or family to watch out for warning signs.
  • Get exercise. Physical activity may help reduce anxiety. Consider walking, jogging, swimming, gardening, or any other physical activity.
  • Maintain an adequate diet. The Canada Food Guide is a useful reference in helping you choose how to eat well. Choose more protein and Omega 3, and fewer simple carbohydrates.
  • Avoid alcohol and illicit drugs. It may seem like they lessen your worries, but in the long run, they generally make it worse and make your condition harder to treat.
  • Get plenty of sleep. This is especially important. If you’re having trouble sleeping, talk to your doctor about what you can do.
What else can I read?

10 Simple Solutions to Panic, M. Antony & R. McCabe. (2004)

An End to Panic: Breakthrough Techniques for Overcoming Panic Disorder (2nd edition), E. Znercher-White (1998)

The Anxiety and Phobia Workbook (4th Edition). E.J. Bourne (2005)

Getting Control: Overcoming your Obsessions and Compulsions. L. Baer (2001)

The OCD Workbook: Your Guide to Breaking Free from Obsessive Compulsive Disorder, B.M. Hyman and C. Pedrick (1999)

Mind over Mood, D. Greenberger and C. Pedesky (1995)

Reclaiming your Life from a Traumatic Experience (workbook), B.O. Rothbaum, E.B. Foa and E.A. Hembree (2007)

The Shyness & Social Anxiety Workbook (2nd edition) Antony & Swinson (2008)

The Worry Control Workbook, E. Copeland (2003)

The Feeling Good Handbook, David D. Burns (1999)

Where else can I go to learn more about anxiety and mood disorders?

Anxiety B.C. www.anxietyBC.com

Anxiety Disorders Association of Canada www.anxietycanada.ca

Anxiety Disorders Association of Ontario www.anxietydisordersontario.ca

MAC Anxiety Research Centre (McMaster University) www.macanxiety.com

Social Phobia/Social Anxiety Association  www.socialphobia.org

The Ontario Obsessive Compulsive Disorder Network www.ocdontario.org

The Panic Center  www.paniccenter.net