Anxiety Health Article

Social and environmental stressors

Because humans are social creatures, anxiety often has a social dimension. People frequently report feelings of high anxiety when they anticipate or fear the loss of social approval or love. Social phobia is a specific anxiety disorder that is marked by high levels of anxiety or fear of embarrassment in social situations.

Another social stressor is prejudice. People who belong to groups that are targets of bias have a higher risk of developing anxiety disorders. Some experts think, for example, that the higher rates of phobias and panic disorder among women reflects their greater social and economic vulnerability.

Several controversial studies indicate that the increase in violent or upsetting pictures and stories in news reports and entertainment may raise people's anxiety levels. Stress and anxiety management programs often recommend that patients cut down their exposure to upsetting stimuli.

Environmental or occupational factors can also cause anxiety. People who must live or work around sudden or loud noises, bright or flashing lights, chemical vapors, or similar nuisances that they cannot avoid or control may develop heightened anxiety levels.

Diagnosis

Diagnosing anxiety is difficult and complex because of the variety of possible causes and because each person's symptoms arise from highly personalized and individualized experiences. When a doctor examines an anxious patient, he or she will first rule out physical conditions and diseases that have anxiety as a symptom. The doctor will then take the patient's history to see if prescription drugs, alcohol or drug abuse, caffeine, work environment, or other external stressors could be triggering the anxiety. In most cases, the most important source of diagnostic information is the patient's psychological and social history. The doctor may administer several brief psychological tests, including the Hamilton Anxiety Scale and the Anxiety Disorders Interview Schedule (ADIS).

Treatment

Meditation and mindfulness training can benefit patients with phobias and panic disorder. Hydrotherapy, massage therapy, and aromatherapy are useful to some anxious patients because they can promote general relaxation of the nervous system. Essential oils of lavender, chamomile, neroli, sweet marjoram, and ylang-ylang are commonly recommended by aromatherapists for stress relief and anxiety reduction.

Relaxation training, which is sometimes called anxiety management training, includes breathing exercises and similar techniques intended to help the patient prevent hyperventilation and relieve the muscle tension associated with the fight-or-flight reaction. Yoga, aikido, tai chi, and dance therapy help patients work with the physical, as well as the emotional, tensions that either promote anxiety or are created by the anxiety.

Homeopathy and traditional Chinese medicine (TCM) approach anxiety as a symptom of a holistic imbalance. Homeopathic practitioners select a remedy based on other associated symptoms and the patient's general constitution. Homeopathic remedies for anxiety include ignatia, gelsemium, aconite, pulsatilla, arsenicum album, and coffea cruda. These remedies should be prescribed by a homeopathic healthcare professional.

Chinese medicine regards anxiety as a disruption of qi, or energy flow, inside the patient's body. Acupuncture and/or herbal therapy are standard remedies for rebalancing the entire system. Reishi (Ganoderma lucidum or Ling-Zhi) is a medicinal mushroom prescribed in TCM to reduce anxiety and insomnia. However, because reishi can interact with other prescription drugs and is not recommended for patients with certain medical conditions, individuals should consult their healthcare practitioner before taking the remedy. Other TCM herbal remedies for anxiety include the cordyceps mushroom (also known as catepillar fungus) and Chinese green tea. In addition, there are numerous TCM formulas that combine multiple herbs for use as an anxiety treatment, depending on the individual problem.

Herbs known as adaptogens may also be prescribed by herbalists or holistic healthcare providers to treat anxiety. These herbs are thought to promote adaptability to stress, and include Siberian ginseng (Eleutherococcus senticosus), ginseng (Panax ginseng), wild yam (Dioscorea villosa), borage (Borago officinalis), licorice (Glycyrrhiza glabra), chamomile (Chamaemelum nobile), milk thistle (Silybum marianum), and nettles (Urtica dioica). Tonics of skullcap (Scutellaria lateriafolia), and oats (Avena sativa), may also be recommended to ease anxiety.

A 2002 preliminary study found that St. John's wort could be an effective treatment for generalized anxiety. Patients taking 900 mg a day and higher doses responded well in early trials. However, further research was needed, particularly at doses higher than 900 mg per day. The Ayurvedic herb gotu kola, long used by practitioners of India's holistic medical system to enhance memory and relieve varicose veins, may also help patients with anxiety by working against the startle response.