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Frazzled, Fried, and Frenzied: The Ins and Outs of Anxiety

Anxiety Disorders: The Numbers

Research from the National Institute of Mental Health (NIMH) indicates that anxiety disorders –  persistent and overwhelming worry and fear about many areas of life – have become increasingly prevalent, and are now the most common form of mental illness in the United States. Affecting 40 million adults (age 18 and older) and representing 18% of the population, nearly 6% of adults experienced one or more of these disorders during the past year. Approximately 23% of cases are classified as “severe”. Women are 60% more likely than men to experience an anxiety disorder during their lifetime. These numbers are expected to rise, with about 4 in 10 adults in the U.S. reporting symptoms of anxiety or depression during the global pandemic.

Collectively, anxiety disorders are estimated to cost the U.S. more than $42 billion per year – about a third of the nation’s total health bill. Of that, $4 billion is attributable to (indirect) workplace costs, of which 88% is due to lost productivity while at work (not absenteeism). Other than simple phobias, all anxiety disorders are associated with impairment in workplace performance. Despite being highly treatable, nearly 65% of sufferers never receive any treatment. Of those who do, 34% receive only minimally adequate treatment. People with anxiety disorders often seek relief for symptoms that mimic physical illnesses – nearly $23 billion in costs are associated with the repeated use of health care services.

The distinction between anxiety disorders and “normal” anxiety is not always clear. While anxiety is a normal reaction to stress and can be beneficial in certain situations, for some individuals, it becomes excessive, debilitating, and disabling with substantial effects on both physical and mental health. For example, a recent study presented at the annual European College of Neuropsychopharmacology Congress in Vienna found that men who suffer from anxiety are more than twice as likely to die from cancer as men who don’t.

The Stress-Anxiety Connection

Stress – a broad and often vague term – doesn’t affect everyone the same way. What one person finds stressful, another may see as stimulating or exciting. That said, chronic stress is a well-known risk factor for the development of anxiety. Others include a complex mix of genetics, brain chemistry (neurotransmitters, hormones), environment, and life events.

The Many Faces of Anxiety

Anxiety comes in many forms. To rise to the level of a clinical anxiety disorder, symptoms have to cause significant distress or impairment in social, work or occupational performance, interpersonal relationships or some other important area of functioning. Disorders include:

  • Generalized anxiety disorder (GAD) – excessive anxiety and worry occurring more days than not for at least six months about a number of events/activities, with symptoms that include persistent problems with sleep or concentration, feelings of restlessness, edginess or irritability.
  • Panic disorderrecurrent unexplained panic attacks; a panic attack is an abrupt surge of intense fear or discomfort that peaks within minutes, accompanied by physical sensations such as sweating, chills, trembling, shaking, numbness or tingling, dizziness or light-headedness, shortness of breath, choking, racing/pounding heart, chest pain or discomfort, fear of losing control or dying, fears of subsequent attacks, or fear/avoidance of places where past attacks have occurred; attacks are typically disproportionate to the situation.
  • Social anxiety disorder – marked fear or anxiety about situations in which one is exposed to possible scrutiny, i.e. eating or performing in front of others (giving a speech), meeting/conversing with unfamiliar people.
  • Separation anxiety disorderexcessive and inappropriate fear or anxiety concerning separation from those to whom the individual is attached.
  • Agoraphobia – marked fear or anxiety about being outside the home alone, in enclosed or open venues (theaters, bridges), standing in line, being in a crowd.
  • Specific phobia – marked fear or anxiety about a specific object or situation.

Anxiety can co-occur with many other conditions – depression, eating disorders, body dysmorphic disorder, adult ADHD, sleep disorders, headaches, chronic pain, fibromyalgia, irritable bowel disease – which can make symptoms worse and recovery more difficult.

More often, anxiety is mild, intermittent or temporary, and treatable with early modest interventions, including lifestyle changes, dietary modifications, or nutritional approaches (nutraceuticals, botanicals, adaptogens). Other things people may find helpful are exercise, meditation, relaxation/breathing techniques, positive self-talk, maintaining a regular sleep pattern, long, warm baths, reducing or eliminating caffeine, avoiding substances such as alcohol and cannabis, or talking with a supportive person. There are even online apps that may be helpful for some individuals, such as Tao Connect.

For more severe cases, prescription medications can be very helpful, as can formal counseling. Cognitive behavioral therapy aims to help individuals recognize and change maladaptive patterns of thinking; psychotherapy helps people explore causes of anxiety and develop coping strategies.

Anxiety manifests in many ways and no single approach is right for everyone. Because anxiety can be caused by so many things and mediated by many different imbalances (hormonal, neurotransmitters), at Integrative Psychiatry, we recommend specialized laboratory testing that provides us with a comprehensive view of your unique status, which in turn, allows us to personalize your treatment, whether that be with medications, nutraceuticals, herbal adaptogens, hormones, diet, lifestyle changes or some combination of these.

Contact us today to get started.

 

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Sources:

Anxiety and Depression Association of America:

https://www.adaa.org/about-adaa/press-room/facts-statistics

Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health (HHS Publication No. SMA 16-4984, NSDUH Series H-51). Retrieved from http://www.samhsa.gov/data/

Diagnostic and statistical manual of mental disorders, 5th edition. Washington, D.C.: American Psychiatric Association; 2013.

Greenberg, P.E. et al. The Economic Burden of Anxiety Disorders in the 1990s. Journal of Clinical Psychiatry, 1999 July; 60(7):427-35.

The National Institute of Mental Health: http://www.nimh.nih.gov/health/statistics/prevalence/any-anxiety-disorder-among-adults.shtml

Wang, P.S., Lane, M., Olfson, M., Pincus, H.A., Wells, K.B., Kessler, R.C. Twelve month use of mental health services in the United States. Archives of General Psychiatry. 2005 Jun;62(6):629-640.

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