Panic and anxiety: Are you just stressed or suffering from a disorder?

“Waking up each morning is painful and hard. The thought of just going through the day and preempting the worse makes me feel like throwing up all the time. I have a continuous sense of dread and doom, like something bad is going to happen. I get that sickening feeling in the pit of my stomach all the time and it doesn't just go away. I can feel my heart pounding in my chest most of the time and sometimes when I get the attack, I feel like I'm going to collapse or die of a heart attack. I start sweating, my vision starts blurring, I feel cold and clammy and like I'm going to collapse. I feel shaky and uneasy at work. Can't concentrate, focus or make decisions, so I have stopped going to the office for a week. I don't feel like getting out of the house or meeting my friends as I've lost all confidence. I feel weak and embarrassed. My appetite has reduced and I can't shut down my mind to keep it from racing through negative thoughts. I can't sleep at night. I wake up each morning unable to face yet another day. I keep thinking— what if these attacks happen when I'm out or alone? What if it happens in front of my boss or colleagues at work or whilst I'm driving or in a crowded lift or travelling?

The preemptive anxiety is the worst. I have gone through a blood test, several ECGs and a stress test. Everything is normal. But I feel so helpless because I just don't understand what is happening to me. I have never been like this before...”

When stress becomes a panic attack 

Occasional anxiety is a normal part of one’s life. You might feel anxious when faced with a problem or stress at work, before taking an exam in school, or making an important decision like choosing a new job or making a financial decision.

Anxiety disorders involve more than just temporary worry or fear. For a person with an anxiety disorder, the anxiety does not go away and can get worse over time. These feelings can interfere with daily activities such as job performance, academics or social functioning.

Anxiety disorders are one of the most prevalent of mental illnesses, affecting almost 18% of the world’s population. Yet very few cases are detected or diagnosed and only a third receive treatment for the condition.

Recent research suggests that as many as one in six young people will experience an anxiety condition at some point in their lives. This means that up to five people around you may be living with anxiety, whether that be OCD (obsessive compulsive disorder), social anxiety and shyness, exam stress, worry or panic attacks.

Anxiety disorders affect one in eight children. Research shows that untreated children with anxiety disorders are at higher risk of performing poorly in school, missing out on important social experiences, and engaging in substance abuse. Anxiety disorders develop from a complex set of risk factors, including personality, genetics, brain chemistry, neuro-biological factors, or life changing events.

It's not uncommon for someone with an anxiety disorder to also suffer from depression or vice versa. Nearly one-half of those diagnosed with depression are also diagnosed with an anxiety disorder.

What should one do and how can a caregiver help?

First, always rule out an underlying medical cause by doing a routine health check-up and a complete blood profile. Sometimes hormonal imbalances may also lead to these symptoms.

Read up on the disorder to understand anxiety and panic attacks and be aware that it is like being diagnosed with any other routine medical condition.

Reach out to a mental health professional or psychologist to rule out any underlying stressors and, perhaps, confirm the diagnosis for you. Only a psychiatrist should initiate treatment and medication for the same.

Science, research and new age medications have been created and are now freely available. They are effective, side effect-free and do not cause drowsiness or dependency in any way. They have to be taken for a duration of time as prescribed, to complete the course. One does not get 'addicted' to these medications, neither do they 'make the brain numb or dull' and they definitely do not have to be taken for life.

These are various reasons why individuals, families or caregivers procrastinate on seeking professional health. There are many myths regarding psychiatric medications. However, when we need to take a pill or a treatment course for pain or an infection, for the flu or malaria, we don't question, doubt, worry or think twice about it. The same attitude and approach needs to be taken for treating mental health conditions.

Counselling, psychotherapy or cognitive behaviour therapy is also very important for individuals going through anxiety so that they feel understood, reassured, secure and confident that it's a highly treatable condition with very positive outcomes. 

There should be no guilt, embarrassment, shame or stigma when approaching or sharing these highly prevalent mental health concerns. Everyone deserves to live a stress and anxiety free life!.

Make a pledge to seek help for someone you love or know, or seek guidance for yourself if you feel you possibly are going through the same. Stamp out stigma and be part of the movement towards a mentally healthier life.

Dr. Zirak Marker is a child and adolescent​ psychiatrist and Medical Director, Mpower.