DR DAVID HARTMAN, PSYCHIATRIST
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Anxiety

The word 'anxiety' refers to a state of fear, worry and tension. A certain amount of anxiety is part of normal life, it is nature's way of warning us about danger and risk, and we would only call it a clinical disorder if it so severe that it interferes with your life in some way. Severe anxiety is often associated with physical symptoms such as feeling short of breath, heart palpitations, feeling shaky, tummy pains and nausea, headaches and disturbed sleep.

'Generalised anxiety' is when a person has a perpetual state of worry and fear which may include worry about the future, bad things happening to themselves or to others, worry about themselves, their health, making mistakes, or worrying about what other people think of them.

'Social anxiety' is when a person has a particular fear of social situations, feeling extremely self conscious when around other people, feeling that people are looking at you and judging you. 

"Agoraphobia' is a specific fear of busy and crowded places such as shops, restaurants, public transport or entertainment venues. There is a fear of being trapped, being in a place where you cannot escape. 

Anxiety often comes with 'panic attacks' which are short episodes of extreme anxiety, so bad that the person thinks that they are going to die or go mad, along with severe physical symptoms of shaking, heart palpitations and feeling unable to breathe. 

Obsessive compulsive disorder, or OCD, is a particular kind of anxiety state where the person has unwanted repetitive thoughts, and feels that they have to carry out certain repetitive behaviours. 

Anxiety can also be a symptom of another mental health problem, for example it can be part of depression, eating disorders, post-traumatic stress disorder or a personality disorder. 

Helping yourself

Thank you to the Canadian Government for this wonderful website - AnxietyBC - which has a huge amount of self help resources for anxiety. There are separate sections for adults, children and youth. 

Beyondblue has a lot of good general information about anxiety.

e-Couch is an online self-help CBT program run by Australian National University.

OCD self help
This page from the International OCD Foundation gives a good overview on how to do your own OCD therapy
There are a whole lot of self help tools for OCD on this AnxietyBC page

​Sleep
Anxiety can cause sleep disturbance, on the other hand if you are not getting enough sleep then you will be more vulnerable to stress worry. Getting a better night's sleep is one of the most important things you can do to improve your mood. You can go here for more on sleep.

Diet
Diet and nutrition can have a big effect on your state of mind. Go here for more on nutrition.

Exercise
Exercise can be a very effective intervention for anxiety and depression. Go here for more on exercise.

Mindfulness and meditation
Mindfulness based therapies are effective as a component of treatment for a range of mental illness. Go here for more on mindfulness and meditation.

Treatment

Treatment of anxiety should always include some kind of psychological treatment or psychotherapy. If this isn't effective on its own then treatment might also include medication.

Psychological treatment


Cognitive Behaviour Therapy (CBT) is the standard treatment of anxiety. This usually involves learning to recognise the triggers for your anxiety, learning to examine the beliefs and thoughts which keep your anxiety going, learning ways of coping with your anxiety and learning to change behaviour patterns which involve avoiding difficult situations. Here is a good description of CBT. 

Medication

The group of medications referred to as 'antidepressant' medications are also often very effective for anxiety. These include:
  • SSRIs (selective serotonin re-uptake inhibitors) such as fluoxetine (Lovan, Prozac), fluvoxamine (Luvox), escitalopram (Lexapro), sertraline (Zoloft) and paroxetine (Aropax)
  • SNRIs (serotonin and noradrenaline re-uptake inhibitors) such as venlafaxine (Effexor), desvenlafaxine (Pristiq) and duloxetine (Cymbalta)
  • Mirtazepine (Avanza) which is a noradrenaline and specific serotonin antidepressant (NaSSA)
  • Moclobemide (Aurorix) with is a Monoamine Oxidase Inhibitor (MAOI), increasing noradrenaline, serotonin and dopamine in the brain
  • Clomipramine (Anafranil) is a tricyclic antidepressant which is particularly effective for OCD

'Benzodiazepines' are tranquillisers such as diazepam (Valium) or alprazolam (Xanax). They are very effective for anxiety but can cause dependence so are best avoided, or only used for a short period of time of absolutely necessary. 

'Antipsychotic' medications (tranquillising medications) such as quetiapine (Seroquel) and aripiprazole (Abilify) at low doses can be very helpful for anxiety either on their own or in combination with other medications.

You can find medication information here at the Choice and Medication website



Books


​The Worried Child 
by Paul Foxman
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  • Home
  • Contact
  • What do I do?
  • Referral process and fees
  • My professional background
  • Resources
    • ADHD
    • Adolescence
    • Anxiety
    • Autism Spectrum Disorder
    • Borderline personality disorder
    • Depression
    • Eating disorders
    • In a crisis
    • Parenting
    • Mindfulness and meditation
    • Psychotherapy
    • Other resources