- Understanding anxiety disorder
- What is anxiety disorder?
- The basics of anxiety
- Types of anxiety disorders
- What causes anxiety disorders?
- How do we identify anxiety disorders?
- How are anxiety disorders diagnosed?
- How are anxiety disorders being treated?
- Self-assessment tools for anxiety disorders
- How can we manage anxiety disorders?
- Mental health services
Understanding anxiety disorder
We are in the golden years of our lives, where the days may take on a more relaxed pace. For some of us, our children would have grown, and we now have the time and luxury to devote to new hobbies and interests. We also get to spend more time with the people we care for. This can be quite an exciting time for us.
However, during this stage of life, we will inevitably encounter experiences that can be overwhelming. We might have to face the loss of a spouse, declining health, or a reduced sense of independence.
These changes might cause us to feel anxious. If the anxiety becomes excessive and affects our daily lives, it can affect our physical and mental health. If the anxiety persists, it might be a sign of anxiety disorder.
What is anxiety disorder?
Anxiety disorder occurs when a person’s anxiety is persistent, excessive, and irrational. This is different from anxiety, a common, normal, and appropriate feeling of worry, nervousness or unease when dealing with day-to-day stresses or problems.
How does it
affect us?
When we have anxiety disorders, we frequently have worries and fears that interfere with daily activities. These feelings are difficult to control, out of proportion, and can last a long time, affecting us in the following ways:
- The way we lead our lives, e.g. avoiding the fear and anxiety-provoking situations
- Our ability to cope with demands of work and our responsibilities
- Our ability to cope with the demands of life or relationships
Common misconceptions:
What people may think:
Anxiety disorders only happen to those who are often stressed and worry a lot.
What are the different
types of anxiety disorders?
There are different types of anxiety disorders. Generalised Anxiety Disorder (GAD) is a common anxiety disorder
that affects about 1 in every 167 Singaporeans aged 65 and above in
their lifetime.
Other common anxiety disorders include panic disorder and specific phobias.
People with GAD face excessive anxiety and worry over various situations. GAD is diagnosed when a person finds it difficult to control his/her worry over a prolonged period of at least 6 months.Learn more about GAD here:
Panic attacks are sudden episodes of intense anxiety. They may occur out of the blue without any real danger.
With panic disorder, an individual experiences recurrent and unexpected panic attacks over a period of a month.
They develop a constant fear of future panic attacks and begin to change their
behaviours (e.g. avoiding certain places) to prevent experiencing it again.
People with specific phobias experience excessive and unreasonable fears over a period of 6 months.
The fears range from thunder to lizards, or situations such as confined spaces, height,
or flying.
Although these objects and situations are not dangerous, they provoke immense anxiety and avoidance from those with the phobia.
Some people may be affected by more than one anxiety disorder or have other mental health conditions, e.g. depression, at the same time. This is not uncommon and a healthcare professional will be able to determine which condition(s) an individual has.
Causes
Causes
There are generally three factors in understanding the possible causes of anxiety disorders:
Biological
This includes inherited genetic traits or the amygdala (the part of our brain that processes fear) being more reactive when facing threats.
The healthcare professional may conduct tests to determine if the anxiety disorder is a result of an existing medical issue. Existing health issues or side effects from some medications may also cause anxiety symptoms.
Biological
Social
This refers to lived experiences such as traumatic events or the environment we grew up in. Other factors that increase our risk of anxiety disorders are loneliness and experiencing recent loss.
Biological
Biological
Chronic illnesses such as heart problems, and joint and muscle issues, may also increase the risk of developing anxiety disorders. Other biological causes include inherited genetic traits or chemical imbalances in the brain.
The healthcare professional may request for tests to determine if the anxiety disorder is a result of an underlying medical issue. Underlying health issues or side effects from some medications may also cause anxiety symptoms.
Side effects of certain medications
Medications that may cause symptoms of anxiety disorder include:
- Cortisone
- Adderall
- Ventolin
- Thyroid medicine
Biological
Chronic illnesses such as heart problems, and joint and muscle issues, may also increase the risk of developing anxiety disorders. Other biological causes include inherited genetic traits or chemical imbalances in the brain.
The healthcare professional may request for tests to determine if the anxiety disorder is a result of an underlying medical issue. Underlying health issues or side effects from some medications may also cause anxiety symptoms.
Underlying health issues
Medications that may cause symptoms of anxiety disorder include:
- Heart disease
- Diabetes
- Thyroid problems, such as hyperthyroidism
- Respiratory disorders, such as chronic obstructive pulmonary disease (COPD) and asthma
Biological
Psychological
This includes negative thinking patterns such as the perception of not having control over the environment and/or emotions. Another psychological cause is cognitive impairment where deterioration of our cognitive abilities (e.g.memory and thinking skills) is linked to increased risks of anxiety disorder.
Signs and symptoms
Some common signs and symptoms of anxiety disorders include:
Chest pain/discomfort
Cold, numb/tingly hands
and feet
Difficulties remaining calm and staying still
Dizziness
Excessive fear, panic, and feelings
of uneasiness
Heart palpitations
Shortness of breath
Sweating
Other additional symptoms distinct to GAD, panic disorder and specific phobias are:
Generalised Anxiety Disorder (GAD)
- Excessive worrying that is difficult to control
- Difficulty concentrating
- Fatigue
- Irritability
- Muscle tension
- Restlessness or feeling on edge
- Sleep disturbance
Panic disorder
- Recurrent panic attacks
- Persistent concern/worry about future panic attacks and their consequences
- Fear of losing control and/or dying
- Maladaptive behaviour (poor patterns of behaviour to cope with the situation) such as avoidance
- Physical symptoms such as chest discomfort, difficulty breathing, giddiness and nausea
Specific phobias
- Distinct fear or anxiety about a specific object or situation
- The specific object or situation almost always provokes immediate fear or anxiety
- Specific objects or situations are actively avoided or endured with intense anxiety
- The fear or anxiety is out of proportion to the actual threat of the object and the social and cultural setting
The signs and symptoms can be managed with early treatment.
Diagnosis
To diagnose an anxiety disorder, a healthcare professional would conduct a detailed clinical interview in which he/she would ask about the individual’s past medical and psychiatric history, family history, current symptoms, and the impact on
his/her functioning.
With the patient’s consent, there may also be requests to speak with a family member to gather more information. A physical examination and some blood tests may also be done.
Treatment
Medication and psychotherapy are effective treatments
to help reduce the signs and symptoms of anxiety disorders.
Anxiety disorders respond well to treatment if they are identified and treated early. Antidepressants are effective in treating anxiety disorders. When combined with psychotherapy, medication results in a lower risk of relapse and better control of symptoms. The advice of a healthcare professional is required for the continuation or stopping of medication.
Psychological therapies are treatments used to improve a person’s mental health. Cognitive Behaviour Therapy (CBT) is commonly used for anxiety disorder and it is a psychological treatment focused on improving mood by recognising and changing unhelpful thought patterns.
A subtype of CBT that may be deployed is Exposure Therapy (EP) where patients are incrementally and gradually exposed to things or situations that make them anxious. This therapy seeks to help them reduce the distress experienced.
Reaching out for support
The people we love and trust can be our pillars of support in times of need. Such social support can help us reduce any sense of loneliness (which is a risk factor for anxiety), and improve our mental well-being. Find out more about
how to reach out for support.
Creating a routine
Establishing a routine can help eliminate some of the surprises that we face in our day-to-day activities by adding some predictability to our lives.
Adopting self-care practices
Other simple strategies such as being aware of what makes us anxious, learning relaxation techniques and having regular exercise help to reduce anxiety, and can contribute to our mental well-being. Here are some
tips that can help us cope with our anxiety.
Anxiety
self-assessment
tool
Anxiety disorder is when our anxiety (feelings of worry, nervousness, or unease) is persistent, excessive, and irrational.
The General Anxiety Disorder-7 (GAD-7) is a set of 7 questions that those
aged 12 and above can use to assess if they might be suffering from anxiety disorder and to take steps to feel better.
Please note this is a self-assessment and not a medical diagnosis.
Useful self-help tools
What people may think:
Feeling anxious is the same as having an anxiety disorder.
But did you know:
People with anxiety disorders often have constant fears or anxious thoughts that get in the way of their
daily lives.
This is different from feeling worried about situations such as organising an important family event, etc.
What people may think:
Anxiety disorders only happen to those who are often stressed and worry a lot.
But did you know:
Anxiety disorders can happen to anyone, not just those who tend to get stressed and worried.Find out what are the possible causes of anxiety disorders.
What people may think:
Anxiety disorders will go away on their own.
But did you know:
Anxiety disorder requires care and support from
healthcare professionals.
To prevent it from worsening over time, seeking treatment should not be delayed.
Anxiety
self-assessment tool
Anxiety disorder is when our anxiety (feelings of worry, nervousness, or unease) is persistent, excessive, and irrational.
The General Anxiety Disorder-7 (GAD-7) is a set of
questions that those
aged 12 and above can use to assess if they might be suffering from anxiety disorder and to take steps to feel better.
Please note this is a self-assessment and not a medical diagnosis.
Instructions
For each question, please SELECT the option that comes closest to how you have felt
IN THE PAST 2 WEEKS — not just how you feel today.
Complete all
questions.
Your score will be automatically calculated and shown to you after you submit your responses.
Select the option that comes
closest to how you have felt
IN THE PAST 2 WEEKS –
not just how you feel today.
Question of
Feeling nervous, anxious, or on edge
Not being able to stop or control worrying
Worrying too much about different things
Trouble relaxing
Being so restless that it is hard to sit still
Becoming easily annoyed or irritable
Feeling afraid, as if something awful might happen
Your score:
Your answers indicate that you are
unlikely to be experiencing anxiety disorder at the moment.
Continue to care for yourself and monitor your emotions. Learn more about how to manage your
stress and
emotions in this portal.
Your score:
Your answers indicate that you could be
experiencing mild anxiety.
Daily needs and demands such as responsibilities and relationships can cause us to feel what we feel. And when we feel them, it’s okay to
reach out for support.
If you feel overwhelmed and in need of some support, these helplines and services are available:
24-hour
24-hour
Belle, Beyond the Label helpbot, is an interactive platform for users to find mental health resources and services in a private and convenient manner. If you or anyone you know is overwhelmed with stress or anxiety, find the help you need via Belle.
Your score:
Your answers indicate that you could be
experiencing moderate anxiety.
Daily needs and demands such as responsibilities and relationships can cause us to feel what we feel. And when we feel them, it’s okay to
reach out for support.
If you feel overwhelmed and in need of some support, these helplines and services are available:
24-hour
24-hour
Belle, Beyond the Label helpbot, is an interactive platform for users to find mental health resources and services in a private and convenient manner. If you or anyone you know is overwhelmed with stress or anxiety, find the help you need via Belle.
Your score:
Your answers indicate that you could be experiencing severe anxiety. It is okay to reach out and we strongly encourage you to consult a healthcare professional via the following helplines for further assessment and advice.
24-hour
24-hour
Belle, Beyond the Label helpbot, is an interactive platform for users to find mental health resources and services in a private and convenient manner. If you or anyone you know is overwhelmed with stress or anxiety, find the help you need via Belle.
Mental health services
Belle, Beyond the Label helpbot, is an interactive platform for users to find mental health resources and services in a private and convenient manner. If you or anyone you know is overwhelmed with stress or anxiety, you may find the help you need via Belle.
Get access to Belle
You may also visit here for more mental health resources or download the list of community mental health services including your nearest GP here.
