Anxiety disorders are common mental health conditions characterized by excessive worry, fear, and uncontrolled negative thoughts. They can significantly impact an individual's quality of life and daily functioning. This article aims to provide insights into the assessment, diagnosis, and management of anxiety disorders.

Anxiety disorders manifest through various symptoms. These include tension, apprehension, fear, persistent worrying, unexplained physical symptoms like chest pain, abdominal pain, muscular tension, headache, and nausea. Individuals may also experience episodes of palpitations, difficulty in breathing, feelings of choking, dizziness, fainting, and trembling. Additionally, repetitive unwanted thoughts and behaviors may be present, indicating obsessive-compulsive disorder (OCD).

When assessing anxiety disorders, healthcare professionals consider several factors. These include the duration of anxiety, the degree of distress, impairment of day-to-day functioning, symptoms of depression, substance and alcohol misuse, physical disorders (such as thyrotoxicosis, pheochromocytoma, and hypoglycemia), and psychosocial factors like ongoing stress and familial issues.

At the primary care level, psychoeducation plays a crucial role. Healthcare providers should provide reassurance and explain that the symptoms experienced are related to anxiety and may mimic physical illnesses. Excessive investigations should be discouraged, and trigger avoidance should be addressed. For mild cases, spending time, reassurance, and psychoeducation may be sufficient. In cases of severe and unbearable anxiety, short-term use of medications like diazepam may be considered. Escitalopram is recommended for cases that do not improve with initial interventions.

If there is no improvement with the initial treatment, a review of the diagnosis and treatment history should be conducted. If the patient has adhered to the prescribed medication, a second selective serotonin reuptake inhibitor (SSRI) may be considered. If there is no response to the second SSRI, cognitive-behavioral therapy (CBT) should be explored if trained therapists are available. Referral to a tertiary center may be necessary if the response remains unsatisfactory.

At the tertiary level, the reasons for treatment resistance should be evaluated. This includes assessing for comorbid conditions, reviewing the adequacy of drug treatment and CBT, and considering other pharmacological options such as non-SSRIs and tricyclic antidepressants. CBT, alone or in combination with medications, is the preferred mode of treatment. Comorbid psychiatric disorders should be addressed, and pharmacological augmenting strategies may be considered if initial treatments do not provide relief.

Anxiety disorders can significantly impact an individual's well-being and daily functioning. By understanding the symptoms, conducting thorough assessments, and implementing appropriate management strategies, healthcare professionals can effectively support individuals with anxiety disorders. It is important to provide personalized care, considering the specific needs of each individual. If you or someone you know is struggling with anxiety, it is crucial to seek professional help and follow the guidance of healthcare providers.

Disclaimer: This article provides general information and does not substitute personalized medical advice. The management of anxiety disorders may vary based on individual circumstances, and treatment should be undertaken in consultation with healthcare professionals.