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Anxiety - Answers to all your questions

This is the transcript of an interveiw with Dr. Prakash C. Tholar. Dr. Prakash is a psychiatrist & Chief Medical Officer in Sri Matha Hospital, Kundapur, Former President of IMA Kundapur, and actively involved in social welfare and voluntary organisations. Furthermore he is also the medical director of Parivartana.


What exactly is an anxiety disorder?

Anxiety disorder is like fearfulness. Feeling fearful or becoming anxious that something terrible might happen. Whenever you become anxious, you feel terrified to face the situation. You may have physical symptoms of anxiety, like dryness of the mouth, shivering of hands, unable to concentrate. You will feel like the frequency of maturation will increase, you will try to avoid that situation, you will try to run away from that situation, you may feel like something bad or catastrophic will happen to me, I may die. Whenever these physical symptoms occur, such as palpitations, increased heart rates, pulse rate, and blood pressure, we may feel like we may die. So this type of physical and emotional symptoms points to anxiety. So there are different types of anxiety disorders; one is a generalised anxiety disorder. In generalised anxiety disorder, you experience stress for what would be normally considered "silly matters". For example, if someone leaves the house until they return, you are constantly anxious that something may have happened to them. If you have a sore throat or nasal discharge, you may think that you have COVID or some life-threatening disease. Another disorder is panic disorder. Panic disorder is a sudden bout of anxiety, followed by an increased heartbeat, feeling of death, or a feeling like you need to be rushed to the hospital. That comes down after some time. Another such anxiety disorder is an exam anxiety disorder; when you become more anxious, you avert that situation; it becomes a phobic disorder.

What is a panic attack?

A panic attack is a part of anxiety. When you become very anxious, you can get a panic attack. During a panic attack, you may experience increased heartbeat, palpitations, tremors, sweating, chest pain, and giddiness. You may feel like you are having a heart attack, experience paralysis, or may even fall. So this sudden bough of increased anxiety is called a panic attack. Usually, panic attacks last for about a few minutes and then come down. After which, you may start anticipating another panic attack. If it occurs again, how am I to deal with it. Thinking about this itself can cause anxiety.

So once a person learns that they have an anxiety disorder, should they seek professional help?

Mild anxiety is not a bad thing. For example, mild anxiety during our exams can improve performance. But when it crosses that line, when it becomes severe, then it becomes an illness, it bothers you; you can concentrate on anything, you can't perform your daily tasks, you'll always be thinking negatively, you feel as though there is no better way for you to do things so you'll inevitably end up in failure. Taking the exam example forward, you may feel as though you can't perform well; you'll get all the difficult questions, and questions will come from topics you haven't prepared well. So all these negative thoughts will be there, and sometimes these thoughts will be uncontrollable. Usually, in mild anxiety, you can control such thoughts, but here you won't be able to curb these thoughts or divert your mind. That's when you need to consult a professional.

So can anxiety disorder get cured by itself? Suppose I notice that I have it and talk to my parents etc. Will that work in a severe case, or do you NEED to speak to a professional?

See, in mild anxiety and moderate also, if you know exactly what is the cause of your anxiety, what led to it and precisely what thoughts led to it. Usually, anxiety occurs because of our thoughts; we call it cognitions. So, if you can find out what is that thought that is making you feel anxious and if you can counter it by suggesting yourself, by talking to yourself, by thinking about the positive aspects of your personality, life or achievements; if you can overcome all those things by thinking of positive things, sometimes people don't require professional help. But, if you cannot find out the root cause of it, then you may not be able to overcome the anxiety alone and hence can reach out for professional help.

So what exactly does a professional do when it comes to anxiety disorders? what does a professional do to help those diagnosed with anxiety disorders?

Anxiety also has certain medications, such as anti-anxiety medications that will help, and they do cognitive therapy and behavioural modifications. So, in cognitive therapy, whatever thoughts we get and symptoms, we get when we think about those thoughts and what we act on; like we leave that place, we try to avoid the situation etc., these things they analyse and teach us how to overcome that. How to rectify our acts, and how to modify our actions. So, therapy and medication help.

Say that someone has a panic attack; what can you do to help them or calm them down at that moment?

You can do some relaxation techniques, such as deep breathing exercises, yoga, and meditating; all these things will help calm you down. In specific situations, you should tell the person to "calm down, just relax and take a few deep breaths" Breathing deeply is very important; otherwise, when you get anxious, you will take short breaths that increase your heart rate and, in turn, your anxiety. So, 10 to 15 deep breaths, followed by lying down and whatever catastrophic thing they fear will occur, gently remind them that these are just anxious thoughts, they are not at all real; remind them that they are okay, their bodily symptoms are okay as well. Gently tell them that they've had prior feelings like these where none of those anxieties manifested into reality, and they were okay, and this is no different than that.

As a friend, if you know someone who has an anxiety disorder, and they are seeking professional help and going through that journey, how should you support them?

The thing is, they should modify their lifestyles. Sometimes particularly stress as the day-to-day stressors may lead to anxiety and depression, so in case they are facing such stress, you can suggest ways to overcome these stressors or deal with them better; sharing work with colleagues at work when you feel overburdened, or reaching out to a teacher when they are struggling with work. So these are problem-solving things you can suggest to them. Seeking help is vital and talking always helps solve the problem.

Transcript written by: Anjali Anandavally Varghese

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