When anxiety gets the better of you

Does your heart pound wildly when the stock market fluctuates? Do you worry constantly about your performance at work? Are you plagued with stress about your family’s welfare and safety? Do you experience severe trepidation during an emergency? If your answer to any of these questions is ‘yes’, you are probably in the grip of an anxiety attack.

Anxiety disorders are of different kinds — panic disorders, obsessive compulsive disorders (OCDs), post-traumatic stress disorders. It may even result out of different kinds of phobias. Though doctors aren’t able to pin down the exact cause for these disorders, theories contend that they are related to psychological and biological problems that occur in an individual.

According to the National Comorbidity Survey (NCS) — a study carried out in the US over the last decade to learn more about the patterns of mental disorders — the lifetime prevalence of panic disorder was 3-4 per cent. Doctors in Mumbai say that four out of every 100 Indians are likely to suffer from anxiety disorders.

“Generalised anxiety disorders and panic disorders are most common,” says Mumbai-based psychologist Samindara Sawant. “But with the rise in overall stress levels, OCDs are also becoming quite common.” Though a lot of people suffer from anxiety disorders, because of the nature of the disorder and the symptoms it manifests itself in, getting professional help is usually the last thing on people’s minds.

For instance, a panic attack is usually mistaken for a heart attack because of its symptoms — increased heart rate, breathlessness, pain in the chest and trembling, says city psychiatrist Dr Harish Shetty. “There’s a good chance that the patient will approach a cardiologist and get an ECG, angiogram and a whole set of tests, only to find that his heart is in perfect working condition.”

Bangalore-based Sameera Shah was 14 years old when she had her first panic attack. “It was sudden and painful. Though it lasted just a few minutes, I dreaded it,” she says.
She consulted her family physician, who despite examining her and taking an X-ray, found nothing wrong. When the attacks continued, she went to a cardiologist, mistaking the chest pains for a possible heart problem. “The doctor ruled out cardio problems and told me that I was normal, though I never felt so,” she says. Even today, at the age of 23, the attacks recur. “The pain made me collapse at times and I disliked it because every time it happened, I was drawing a lot of public attention. I didn’t like the feeling of helplessness.”

Cases like Sameera’s are just the tip of the iceberg. Dr YC Janardhan Reddy, additional professor of psychiatry at the National Institute of Mental Health & Neuro Sciences (NIMHANS), Bangalore, says that once a person has had an attack, they develop a phobia called agoraphobia, which means an ‘intense dread of attacks’. In such cases, the patient develops an inevitable fear about his next attack.

Some people fear travelling alone and also hesitate to attend meetings, parties or other social gatherings. “They feel helpless during such panic attacks and reiterate the thought of ‘what if I have an attack?’ Depression can also be an aftermath,” he adds.

“Every age group is vulnerable,” says Dr Chhabria, who has patients as young as 13. “A class-VII student refused to go to school or attend tuitions because he feared an attack,” she says.

Dr Reddy feels there is lack of sensitivity among doctors, who sometimes fail to diagnose a panic attack at the very first level. “Many a time, the patient comes to the psychiatrist in the end, after seeing other consultants. It is possible to miss the symptoms during a busy practice as they mimic ordinary physical problems,” says Dr Reddy.

In such a situation, the problem that usually arises, explains psychiatrist Anjali Chhabria, is telling the patient that he needs help. “He knows there’s something wrong, but has no medical evidence to back his ‘heart attack-like’ symptoms. It’s up to the doctor to explain that the possible panic attack is also a medical problem and he needs to seek help for it,” says Dr Chhabria.

The stigma attached to needing a psychiatrist is also a major obstruction, which needs to be nipped in the bud. People must realise that like any other illness, anxiety disorders and panic attacks are also an illness which requires medical treatment. Just willpower and hope of curing it with yoga and meditation is not enough; timely intervention by a doctor is critical.

Samindara Sawant explains that while anxiety is adaptive in human nature, it makes people more careful and alert to dangers. “All of us feel anxious at some point. But when the anxiety is chronic or triggered by a situation, it is time to get help. It is a common psychiatric problem, right next to depression,” she says.

Anxiety disorders may not be curable, but can certainly be treated. Today, there are medicines to help fight the problem along with counselling and therapy. So the next time you feel anxiety creeping into you, don’t wait. Seek help.