Anxiety

Treatment in a Safe, Welcoming, and Confidential Environment.

What causes anxiety?

If you are one of the millions of Americans suffering from an anxiety disorder, you know how debilitating it can be. Thankfully, there are proven strategies you can use to manage your anxiety and improve your quality of life.

What is Anxiety?

Anxiety Disorders encompass multiple characteristics of excessive fear, nervousness, and associated changes in behavior.

Fear is defined as the response to an immediate threat. Thoughts about the immediate threat and escape behaviors are typical of fear.

Anxiety is defined as the response to an upcoming threat. Vigilance for the upcoming threat and avoidant behavior are typical of anxiety.

 

Common physical symptoms of anxiety disorders and changes in a person’s physical condition due to anxiety disorders include rapid heart rate (typically more than 100 beats per minute), heart palpitations (sensations that the heart is pounding or fluttering), and muscle tension.

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It’s normal to experience occasional mild anxiety, such as during a job interview or completing a work assignment by the deadline. This occasional mild anxiety helps drive us to accomplish things in our life. If we didn’t experience any anxiety at all, then, we would be too apathetic to accomplish things in our life.

Anxiety becomes a problem when it becomes persistent and excessive, to the point that it prevents you from completing important things in your day-to-day life.

People who struggle with an anxiety disorder often have excessive and repetitive dwelling on certain thoughts (also known as rumination) as well as an intense fear when attempting to perform activities in our daily life (such as attending scheduled work meetings or going to the bank).

The overwhelming worry and fear may become so extreme that a person would dread leaving their homes. Such people often fear that the worst case scenario will occur (also known as catastrophizing) if they leave their homes, despite the necessity to do so.

For example, people who have a specific fear of certain objects or things (also known as specific phobia) will go to extreme lengths to avoid any type of interaction with that certain object or thing. Common fears include dogs, insects, and needles.

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Risk Factors for Developing an Anxiety Disorder

Hyperthyroidism (overactive thyroid)

Cushing syndrome (too much cortisol in your blood)

Alcohol withdrawal

Opioid withdrawal

Sudden withdrawal from benzodiazepines

Use of corticosteroids

Chronic Obstructive Pulmonary Disease (COPD)

Chronic pain

Certain personality traits have been associated with developing an anxiety disorder. These include:

Negative or traumatic events in childhood have been associated with developing an anxiety disorder. Experiencing negative and/or traumatic events in childhood may increase a person’s sensitivity to anxiety, which would increase the chances that a person develops an anxiety disorder.

Such negative or traumatic events can include death of a parent, separation, physical abuse, and sexual abuse.

 

Certain genetic factors increase the risk of developing an anxiety disorder. These genetic factors are shared with other mood disorders, including depressive disorders.

Tendency to experience nervousness

Tendency to experience fear

Excessive worrying

Shyness

Being fearful

Being doubtful

Negative or traumatic events in childhood have been associated with developing an anxiety disorder. Experiencing negative and/or traumatic events in childhood may increase a person’s sensitivity to anxiety, which would increase the chances that a person develops an anxiety disorder.

Such negative or traumatic events can include death of a parent, separation, physical abuse, and sexual abuse.

Certain genetic factors increase the risk of developing an anxiety disorder. These genetic factors are shared with other mood disorders, including depressive disorders.

Types of Anxiety Disorders

Generalized Anxiety Disorder

Generalized Anxiety Disorder involves having excessive anxiety and worrying about multiple things for at least 6 months. Common symptoms of Generalized Anxiety Disorder include:

Feeling “on edge” or restless

Trouble concentrating

Excessive worrying

Being irritable

Getting physically tired easily

Muscle tension 

Trouble falling asleep (taking more than 1 hour to fall asleep)

Trouble staying asleep (waking up multiple times per night and having difficulty falling back to sleep)

Generalized Anxiety Disorder vs Post-Traumatic Stress Disorder

Anxiety is a symptom of both Generalized Anxiety Disorder and Post-Traumatic Stress Disorder, the anxiety that is characteristic of Generalized Anxiety Disorder is focused on upcoming problems or events. Whereas the anxiety that is characteristic of PTSD is focused on a traumatic event that has occurred. 

Generalized Anxiety Disorder vs Obsessive Compulsive Disorder

In Generalized Anxiety Disorder, anxiety and excessive worries are usually about upcoming problems or events involving daily activities. With OCD, the obsessional thoughts causing anxiety are intrusive, unwanted, and frequently irrational. 

Anxiety in children can present as tantrums, excessive crying, or clinging behavior.

Social Anxiety Disorder

Social Anxiety Disorder, also known as Social Phobia, involves having intense fear or anxiety about being in a social situation in which one can be criticized by other people. These social situations can include:

People with Social Anxiety Disorder worry that they will behave in a manner or exhibit anxiety symptoms that will be embarrassing. They try to avoid these social situations. If these social situations cannot be avoided, then these social situations are experienced with intense fear or anxiety. 

Meeting and talking to new people or strangers

Eating in front of others

Giving a speech in front of a group of people

Separation Anxiety Disorder

Bipolar Disorder

Separation Anxiety Disorder involves having excessive fear or anxiety about being separated from people they are attached to. They worry that they may never see them again or a serious illness will befall on those people if they are separated from them.

This can result in a person with Separation Anxiety Disorder refusing to leave the home to go to school or work. Physical symptoms, such as upset stomach, headache, and nausea, can occur when the separation happens. 

Panic Disorder

Panic Disorder involves having repeated and unanticipated panic attacks. A panic attack, also known as an anxiety attack, is a sudden surge of intense fear that reaches it maximal intensity within minutes and can include the following symptoms: 

Heart palpitations (sensations that the heart is pounding or fluttering)

Shakiness

Excessive sweating

Shortness of breath

Chest pain (may result in feeling like you are having a heart attack)

Nausea

Upset stomach

Feeling dizzy

Treatment Options for Anxiety

There are multiple treatment options that are available for anxiety. Dr. Wu uses treatment options that have been proven by scientific studies to be effective for treating anxiety. He believes that treatment should always start with the safest and most conservative option first to protect the physical and mental health of each person. 

Diaphragmatic Breathing

A person who has severe anxiety or is having anxiety or panic attacks tends to hyperventilate (take rapid and shallow breaths). When a person hyperventilates, their anxiety increases, and they utilize less of their diaphragm to breathe.

The diaphragm is a thin sheet of muscle located below your lungs and above your stomach. When a person inhales deeply, the diaphragm pulls downwards to expand the lungs. When a person exhales deeply, the diaphragm returns upwards to push the air out of the lungs.

Dr. Wu recommends using diaphragmatic breathing to treat anxiety. To perform diaphragmatic breathing, a person would:

Sit comfortably in a chair

Place one hand on the upper chest. Place the other hand below the rib cage (where your stomach is located).

Inhale slowly for several seconds through your nostrils. This draws your breath down towards your stomach and you will be able to feel your hand below your rib cage move outwards. The hand on your upper chest should remain relatively still

Squeeze your abdominal muscles and exhale slowly over several seconds through pursed lips. You will be able to feel your hand below your rib cage move inwards. The hand on your upper chest should remain relatively still. 

A person would practice this breathing technique for 5 minutes each time around 3 times per day.

Anti-Anxiety Medications

The gold standard or first-line medication for treatment for anxiety are selective serotonin reuptake inhibitors (SSRIs). This class of medications increase the amount of serotonin between neurons. If a person does not improve adequately enough from SSRIs, then, serotonin-norepinephrine reuptake inhibitors (SNRIs) are used instead. SNRIs increase the amount of serotonin and norepinephrine between neurons. There are other classes of medications that are used if a person does not improve adequately enough from SNRIs.

Anxiety is not just "In Your Head" - Contact Meadows Psychiatry 

With proper psychiatric care and treatment, you can become better at managing your symptoms and start living life to the fullest, without struggling with prolonged and excessive anxiety levels. Dr. Richard Wu is a mental health professional trained in all aspects of the treatment of anxiety disorders, including Cognitive Behavioral Therapy and anti-anxiety medications. 

Anxiety treatment options - Rockville, MD

He has been practicing since 2015 and has vast experience in treating people with anxiety disorders in outpatient settings. Contact Dr. Wu today to learn how you can face the common symptoms and causes of anxiety. With his expertise and guidance, you can learn to implement diaphragmatic breathing and other Cognitive Behavioral Techniques into your life to manage your anxiety and improve your quality of life.