KATHMANDU, Dec 20: Mental illness is a biological phenomenon that affects a person’s thinking, behavior, mood, eating habit and sleeping habit, among others. Examples of mental illness include anxiety, depression and psychosis. Many of us feel anxious at different situations like during exams, gatherings and job interviews, but if this anxiousness starts bothering us or affecting our daily habits, then we need to consult a doctor because it could be an anxiety disorder. 

Physical symptoms of anxiety disorder include dizziness, dryness of mouth, thirst, anger, sweating, trembling of legs and even headache. If you have these symptoms, you are not alone because around 20 percent of the total population in the world suffers from different kinds of anxiety, according to Neuro Psychiatrist at Annapurna Neuro Hospital, Dr Srijana Maharjan. 

There are five major types of anxiety disorders -- Generalized Anxiety Disorder (GAD), Obsessive Compulsive Disorder (OCD), Post Traumatic Disorder (PTD), Phobia and Social Anxiety Disorder. International celebrities like Zayn Malik, Howie Mandel and Selena Gomez also suffered from different kinds of anxiety. Zain Malik was said to be suffering from anxiety and eating disorder as sometimes he would not eat anything for two or three days. Similarly, Selena Gomez has said that she’d have an anxiety attack right before going to the stage. 

Psychological stressors like childhood trauma, sexual/emotional abuse, and poor family support can contribute to anxiety disorder. Likewise, a patient’s ability to cope with those stressors also determines the course of the disorder. Parenting style is a critical environmental factor in the development of anxiety. Children can learn anxious and fearful responding from the environment by direct negative experience or by observing their parents modeling fearful responses to a stimulus.

Prominent comedian Haribansa Acharya doesn’t have any idea about what anxiety is, but he says he was depressed after the death of his wife as it ended his 27 years’ love life. He said, “I was disturbed at that time, so I consulted a doctor and got into speech therapy. It helped me to recover. At times, I’d feel low and pessimistic, but I tried to control myself and started focusing on my work to get rid of such feelings.” 

He added, “Family support is vital for people who are suffering from mental illness. We should not be highly ambitious, but be happy with what we have in order to stay away from such illnesses. Nonetheless, we should never take mental illness lightly.”

Anxiety can affect any person, but it is mostly found among teenagers. Anxiety is also hereditary, so you could be at high risk of inheriting the disease if your parents suffer from the disorder. Milan Aryal, BSC students at Tri-Chandra Multiple Campus, said he feels anxious before exam and gets overwhelmed if he makes any mistakes during exams. He said, “To get rid of the anxiety attacks, I try to stay cool after exam and learn from my mistakes.” 

He added, “May be our weak socioeconomic condition is the reason why people take mental illness so lightly. So people suffering from anxiety disorder should be treated with positive thinking and counseling.”

According to Dr Richa Amatya, Neuro Psychiatrist at Annapurna Neuro Hospital, the number of patients suffering from anxiety is comparatively higher than those suffering from other mental illnesses. “Anxiety disorder is a normal mental disorder and the suicide rate due to anxiety is also much less than other mental illnesses like depression and psychosis. More than 30 percent of anxiety patients tend to fall victim to the disease again after they stop medical help, so it is important to continue professional help for better recovery.”

The most important thing is that people should not be forced to hide their mental illnesses as they can be cured with counseling as well as medication. 

My City talked to Dr Srijana Maharjan to know the causes, symptoms and prevention of anxiety as well as the condition of anxiety patients in Nepal. Following are the edited excerpt of the interview. 

What is anxiety disorder and how is it different from other mental illnesses?

Anxiety disorder is a common treatable mental disorder which is characterized by fear, worry and restlessness. It is considered to be a type of neurosis, which is a less severe form of mental disorder, as opposed to psychotic disorders. However it is one of the most prevalent mental disorders as compared to others.

What are the causes and symptoms of anxiety disorder?

Causes of anxiety disorder are genetic, neurobiological, psychological, environmental and social factors. It can also occur secondary to other diseases like anemia, heart diseases, thyroid abnormalities, alcohol and other substance abuse and so on. There are two types of symptoms in anxiety, physical and mental symptoms. 

Physical symptoms include heaviness of head, dizziness, awareness of fast heartbeats, chest discomfort, choking sensation, sweating, nausea, tingling sensation or numbness of limbs, feeling of weakness and sleep disturbances.

Similarly mental symptoms include restlessness, fearfulness, feeling like one is going to die, like one is going crazy, like the surrounding is unreal or like one’s body is unreal. 

How can we prevent anxiety disorder?

We can prevent anxiety disorder by following simple habits like adopting a healthy lifestyle (regular exercise/ yoga), avoiding stimulant containing food and drinks (coffee, energy drinks, alcohol), learning adaptive coping styles to deal with stress, trying to sleep well and so on. 

How can we treat anxiety disorder?

Treatment of anxiety disorder depends upon the severity and type of anxiety. If the symptoms of anxiety are severe enough to limit daily life activities, anti anxiety medications are preferred. However if the symptoms are mild, psychotherapy can be helpful.

What is the difference between anxiety and anxiety disorder?

Anxiety is a vague uneasy feeling that can occur even in normal people. Normal anxiety doesn’t create disturbances in social, educational and occupational functioning. Anxiety in optimal level is not necessarily a bad thing because it helps to bring greater alertness, quicker preparation for action and overall better performances.

However, a person with anxiety disorder feels inappropriate amount of anxiety in greater frequency than is reasonable. And the symptoms of anxiety may be so disabling that a person cannot perform his/her day to day activities. It might bring difficulties in an individual’s personal, social and professional aspects. 

Anxiety disorder is increasing globally and in Nepal, but people rarely speak about it, what might be the reason?

Despite being highly prevalent, there is less awareness of anxiety disorder in our country. People usually think that it’s their usual anxious nature and won’t know that it is a type of mental disorder. Another group of people think that the symptoms indicate some physical disease like heart disease or thyroid and hence don’t get appropriate treatment. Finally, the stigma surrounding mental illness and psychiatric medications might prevent them from visiting a psychiatrist. So basically, education and awareness programs regarding mental illness and its treatment is lacking in our county.