Undertanding The Patient With Anxiety Issues

Panic attack (Photo credit: Wikipedia)

English: This chart shows the lifetime prevalence of anxiety disorders found in the Epidemiological Catchment Area Study. Data from: L. N. Robins and D. A. Regier, Eds. Psychiatric Disorders in America: The Epidemiologic Catchment Area Study. New York, NY: The Free Press. (Photo credit: Wikipedia)

English: Signs & Symptoms of Anxiety (Photo credit: Wikipedia)

English: An anxious person (Photo credit: Wikipedia)

Millions of Americans need help to deal with anxiety related health problems. If your patient reports anxiety to you when you take a medical history then you should report it to the doctor. Screenings for anxiety and depression are now part of routine check ups. What really is anxiety? Many people are anxious when they come to see the doctor for any reason. If a patient’s blood pressure is high and it is not part of their medical history to have hypertension there is a good chance anxiety is the cause. Taking the blood pressure again after the patient has settled in the exam room sometimes solves this issue.  Having a base understanding of anxiety is good for any Medical Assistant to help them understand this common patient issue.

Anxiety is a natural emotion that all humans experience. It is both a physiological state and a psychological state. It is a state of reaction to a perceived threat real or imaginary  causes people stress on all levels of experiences: cognitive, physical, and emotional. It determines that way we act in situations that generally trigger fear. Many people suffer from a generalized state of anxiety unable to understand what triggered it. It can manifest itself in panic attacks or just a state of constant worry and depression.

Anxiety is not always a non rational response to one's environment. It can be a normal reaction to everyday stress and the uneasiness can push us to complete tasks that it would be our natural inclination to avoid. A student feeling mild anxiety over an upcoming test might be inclined to study.

A student feeling severe anxiety about a test may be so paralyzed by fear that they cannot take a test at all. The measure or good motivational anxiety and pathological anxiety are a very personal thing. No one suffering panic attacks is experiencing motivational anxiety , but a child anxious to pass a test may be motivated to put up the videogame and study by a little anxiety.

There are different types of anxiety disorders. One type is a spiritual anxiety called existential anxiety. This tends to be the type of disorder freshman in college experience when they learn to think critically and realize that life is more complicated than it appears. They are no longer sure of the safe guards’ of meaning and purpose in life that they grew up with. This can be seen as a positive anxiety as it motivates people to define their own purpose in life and pick their own spiritual path.

Older people may again question the meaning of their lives in middle age. Again, a little anxiety is a good motivation to reevaluate the purpose of your life. This type of anxiety is best addressed by spiritual advisors and life coaches. It is part of the growth of spiritual and emotional maturity to realize that the decision you make in life determine your purpose and meaning

There are situational events that will trigger anxiety to some degree in almost all people. Most people will experience anxiety before a test. Still, for most people this is motivation that causes them to adopt positive actions to pass the test. It becomes pathological anxiety when it causes a person to be so consumed by fear they cannot take the test. This is also true; when it comes  to stranger anxiety and social anxiety. If a person is wary of strangers and avoids walking in dark streets for fear of getting mugged, then most would agree that is rational anxiety. If a person refuses to leave their house for fear of meeting any stranger on the street, it becomes a mental health issue

Most people do not suffer from an anxiety disorder to the point they will not leave the house. More likely people seek treatment for anxiety disorders when they suffer from panic attacks. They become flushed, sweat, and shake. Some people experience chest pain and think they are having some sort of coronary attack. Many people report feeling they are 'dying" during a panic attack. Many people will head to the emergency room when they have their first panic attack.

Many people do not know what triggers a panic attack. They will generally develop a fear of the environment that triggered the first panic attack. If you had a panic attack driving to the mall you would then probably not want to drive to the mall. Still the underlying cause of the panic attack; most likely had nothing to do with driving to the mall. Behavioral therapy helps people find the true triggers for their anxiety and helps them see their fears in a rational light. The goal of behavioral therapy is to give practical ways to behaving that stave off a panic attack.

There are other mental health disorders associated with anxiety. Post traumatic stress syndrome is one where the experience of a traumatic event keeps promoting a reaction of depression, anger, and anxiety long after the traumatic event has passed. It is usually a combination of medication and therapy that help people with this type of anxiety.

Obsessive compulsive disorder can also be seen as an anxiety disorder. People channel their anxiety into obsessive behaviors in order to feel in control of their environment. Unfortunately ,the obsessive and compulsive behaviors of these individuals become as source of increased anxiety of which the individual has no control. Again, medication with therapy is the approach most medical professional use to deal with OCD.

In the general category of anxiety there are a number of disorders that can affect the individual. The following are all considered anxiety disorders; Generalized Anxiety Disorder, Panic Disorder, Agoraphobia, Social Phobia, Obsessive Compulsive Disorder, Specific Phobia, Post-Traumatic Stress Disorder, and Acute Stress Disorder.

Many anxiety disorders are more common in women than men. Conditions like Post Traumatic stress however, will affect a significant amount of males who have served in the military, as opposed to a male just in the general population.

There appears to be biochemical and genetic factors that lead to anxiety disorders. Most people can find some relief from symptoms in cognitive / behavioral therapy and medication. Some people suffering from a generalized state of anxiety unable to identify a true trigger will opt to control symptoms with just medication.

The fast paced nature of life in the world today probably means we will be seeing an increase in individuals with some sort of anxiety disorder. Relaxation techniques and stress relieving exercises and family time can help most people deal with the anxiety of everyday life. People should avoid using recreational drugs and alcohol to self treat anxiety symptoms as an issue with substance abuse could develop.

If your patient is anxious to the point it affects their every day work and family relations they seek out professional help. 

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