- Understanding anxiety disorder
- What is anxiety disorder?
- The basics of anxiety
- Types of anxiety disorders
- What causes anxiety disorders?
- How do we identify anxiety disorders?
- How are anxiety disorders diagnosed?
- How are anxiety disorders being treated?
- Self-assessment tools for anxiety disorders
- How can we manage anxiety disorders?
- Mental health services
Understanding
anxiety disorder
In our teenage years, we experience many changes and new events in our lives, for example, change in schools, family dynamics, friend groups, and more. We also start to experience physical changes to our body and some of us may feel uncomfortable about it.
These changes can cause us to feel anxious or fearful, with many thoughts swirling in our minds such as how should I feel about my body? Do my friends accept me? Why can’t I be given more independence? Who am I and who do I want to be?
When faced with these thoughts and feelings, it’s important not to dismiss them, but instead to ask ourselves honestly how we are coping with them. It is natural for everyone to feel overwhelmed at times, and reaching out for support is a good way to manage our distress.
It helps prevent fear and anxiety from being left unmanaged over long periods of time, so that it doesn’t affect our physical and mental health.
What is anxiety disorder?
Anxiety disorder occurs when a person’s anxiety is constant, overwhelming, and illogical. This is different from anxiety, a common, normal, and appropriate feeling of worry, nervousness or unease when dealing with day-to-day stresses or problems.
How does it affect us?
When we have anxiety disorders, we frequently have worries and fears that interfere with daily activities. These feelings are difficult to control, out of proportion, and can last a long time, affecting us in the following ways:
- The way we lead our lives, e.g. avoiding situations that cause fear and anxiousness
- Our ability to cope with the challenges of school
- Our ability to cope with the demands of life or relationships
Common misconceptions:
What people may think:
Anxiety disorders only happen to those who are often stressed and worry a lot.
What are the different
types of anxiety disorders?
There are different types of anxiety disorders. Generalised Anxiety Disorder (GAD) is a common anxiety disorder
that affects about 1 in every 45 Singaporeans aged 18 to 24 years old in their lifetime.
Other common anxiety disorders include panic disorder, social anxiety disorder, and specific phobias.
People with GAD face excessive anxiety and worry over various situations. GAD is diagnosed when a person finds it difficult to control his/her worry over a prolonged period of at least 6 months. Learn more about GAD here:
Panic attacks are sudden episodes of intense anxiety. They may occur out of the blue without any real danger.
With panic disorder, an individual experiences repeated and unexpected panic attacks over a period of a month.
They develop a constant fear of future panic attacks and begin to change their behaviours (e.g. avoiding certain places) to prevent experiencing it again.
People with specific phobias experience excessive and unreasonable fears over a period of 6 months.
The fears range from thunder to lizards, or situations such as confined spaces, height, or flying.
Although these objects and situations are not dangerous, they trigger strong feelings of anxiety and avoidance of the things they fear.
Some people may be affected by more than one anxiety disorder or have other mental health conditions, e.g. depression at the same time. This is not uncommon and a healthcare professional will be able to determine which condition(s) an individual has.
Causes
Causes
There are generally three factors in understanding the possible causes of anxiety disorders:
Biological
This includes inherited genetic traits or the amygdala (the part of our brain that processes fear) being more reactive when facing threats.
The healthcare professional may conduct tests to determine if the anxiety disorder is a result of an existing medical issue. Existing health issues or side effects from some medications may also cause anxiety symptoms.
Biological
This includes inherited genetic traits or the amygdala (the part of our brain that processes fear) being more reactive when facing threats.
The healthcare professional may conduct tests to determine if the anxiety disorder is a result of an existing medical issue. Existing health issues or side effects from some medications may also cause anxiety symptoms.
Side effects of certain medications
Medications that may cause symptoms of anxiety disorder include:
- Cortisone
- Adderall
- Ventolin
- Thyroid medicine
Biological
This includes inherited genetic traits or the amygdala (the part of our brain that processes fear) being more reactive when facing threats.
The healthcare professional may conduct tests to determine if the anxiety disorder is a result of an existing medical issue. Existing health issues or side effects from some medications may also cause anxiety symptoms.
Underlying health issues
Medical problems that may cause symptoms of anxiety disorder include:
- Heart disease
- Diabetes
- Thyroid problems, such as hyperthyroidism
- Respiratory disorders, such as chronic obstructive pulmonary disease (COPD) and asthma
Biological
Psychological
This includes excessive negative thoughts when facing unfamiliar or uncertain situations and negative thoughts about ourselves, such as about our bodies.
Biological
Social
This refers to lived experiences such as traumatic events or the environment we grew up in. Traumatic events can include experiencing the death of a loved one, getting into or witnessing a car accident, or experiencing any form of abuse.
Some examples of the social environment include over-controlling, overprotective or neglectful parenting, stress from the demands of school, social media, acceptance by our peers, and being unable to establish our independence.
Signs and symptoms
Some common signs and symptoms of anxiety disorders include:
Chest pain/discomfort
Cold, numb/tingly hands
and feet
Difficulties remaining calm and staying still
Dizziness
Excessive fear, panic, and feelings
of uneasiness
Heart palpitations, where the heart is pounding or racing
Shortness of breath
Sweating
Other additional symptoms distinct to GAD, panic disorder and specific phobias are:
Generalised Anxiety Disorder (GAD)
- Excessive worrying that is difficult to control
- Difficulty concentrating
- Fatigue
- Irritability
- Muscle tension
- Restlessness or feeling on edge
- Sleep disturbance
Panic disorder
- Repeatedly having panic attacks
- Continuous and ongoing concern/ worry about future panic attacks and their consequences
- Fear of losing control and/or dying
- Maladaptive behaviour (poor patterns of behaviour to cope with the situation) such as avoidance.
- Physical symptoms such as chest discomfort, difficulty breathing, giddiness and nausea
Specific phobias
- Distinct fear or anxiety about a specific object or situation
- The specific object or situation almost always provokes immediate fear or anxiety
- Specific objects or situations are actively avoided or endured with intense anxiety
- The fear or anxiety is out of proportion to the actual threat of the object and the social and cultural setting
The signs and symptoms can be managed with early treatment.
Diagnosis
To diagnose an anxiety disorder, a healthcare professional would conduct a detailed clinical interview in which he/she would ask about the individual’s past medical and psychiatric history, family history, current symptoms, and the impact on his/her functioning.
With the patient’s consent, there may also be requests to speak with a family member to gather more information. A physical examination and some blood tests may also be done.
Treatment
Medication and psychotherapy, also known as talk therapy, are effective treatments
to help reduce the signs and symptoms of anxiety disorders.
Anxiety disorders respond well to treatment if they are identified and treated early. Antidepressants are effective in treating anxiety disorders. A short course of benzodiazepines may also be prescribed for short term relief of anxiety symptoms.
When combined with psychotherapy, medication results in a lower risk of relapse and better control of symptoms. The advice of a healthcare professional is required for the continuation or stopping of medication.
Psychological therapies are treatments used to improve a person’s mental health. Cognitive Behaviour Therapy (CBT) is commonly used for anxiety disorder and it is a psychological treatment focused on improving mood by recognising and changing unhelpful thought patterns.
A subtype of CBT that may be deployed is Exposure Therapy (EP) where patients are incrementally and gradually exposed to things or situations that make them anxious. This therapy seeks to help them reduce the distress experienced.
Positive coping skills are crucial for treatment. Simple strategies such as being aware of what makes us anxious, learning relaxation techniques and having regular exercise help to reduce anxiety, and can contribute to our mental well-being. Here are some tips that can help us cope with our anxiety.
Grounding ourselves
Grounding is a technique to help us bring ourselves to the present moment when anxious thoughts or feelings get too overwhelming. A simple grounding exercise is to describe, in specific details, the things we are feeling, hearing and seeing. We can practise this with a trusted adult.
Spending time with friends or family
Spending time with people we love and trust can help tide us through difficult periods. Sharing about how we feel can help us explore new ways of seeing things and understand why we are experiencing certain anxious feelings. Learn how we can reach out to others tips.
Anxiety self-assessment
tool
Anxiety disorder is when our anxiety (feelings of worry, nervousness, or unease) is persistent, excessive, and irrational.
The General Anxiety Disorder-7 (GAD-7) is a set of 7 questions that those aged 12 and above can use to assess if they might be suffering from anxiety disorder and to take steps to feel better.
Please note this is a self-assessment and not a medical diagnosis.
Useful self-help tools
What people may think:
Feeling anxious is the same as having an anxiety disorder.
But did you know:
People with anxiety disorders often have constant fears or anxious thoughts that get in the way of their daily lives. This is different from feeling worried over situations such as preparing for examinations and presentations, etc.
What people may think:
Anxiety disorders only happen to those who are often stressed and worry a lot.
But did you know:
Anxiety disorders can happen to anyone, not just those who tend to get stressed and worried. Find out what are the possible causes of anxiety disorders.
What people may think:
Anxiety disorders will go away on their own.
But did you know:
Anxiety disorder requires the care and support from healthcare professionals. To prevent it from worsening over time, seeking treatment should not be delayed.
Anxiety
self-assessment tool
Anxiety disorder is when our anxiety (feelings of worry, nervousness, or unease) is persistent, excessive, and irrational.
The General Anxiety Disorder-7 (GAD-7) is a set of questions that those aged 12 and above can use to assess if they might be suffering from anxiety disorder and to take steps to feel better.
Please note this is a self-assessment and not a medical diagnosis. If you are under 18 years old and concerned about your results, please seek advice from a trusted adult.
Instructions
For each question, please SELECT the option that comes closest to how you have felt IN THE PAST 2 WEEKS — not just how you feel today.
Complete all questions.
Your score will be automatically calculated and shown to you after you submit your responses.
Select the option that comes
closest to how you have felt IN THE PAST 2 WEEKS –
not just how you feel today.
Question of
Feeling nervous, anxious, or on edge
Not being able to stop or control worrying
Worrying too much about different things
Trouble relaxing
Being so restless that it is hard to sit still
Becoming easily annoyed or irritable
Feeling afraid, as if something awful might happen
Finally, please select your age group.
This will help us provide you with resources better suited to your needs.
Your score:
Your answers indicate that you are unlikely to be experiencing anxiety disorder at the moment.
You are doing a great job of looking after your feelings. Continue the great work!
Click “Next” for tips to help you maintain your self-care.
Your answers indicate that you are unlikely to be experiencing anxiety disorder at the moment.
You have been taking great care of your feelings. Continue the great work!
Click “Next” for tips to help you stay motivated in caring for yourself.
Your answers indicate that you are unlikely to be experiencing anxiety disorder at the moment.
You have shown consistent commitment to taking care of your feelings. Continue the great work!
Click “Next” for tips to help you keep up with your self-care routine.
Your score:
Your answers indicate that you could be experiencing mild anxiety.
As a youth, you may face a variety of daily demands and the pressures of balancing school, life, and relationships.
Click “Next” for tips to help you manage your emotions and overcome your challenges.
Your answers indicate that you could be experiencing mild anxiety.
Life often comes with its share of responsibilities, from work to relationships and even financial uncertainties.
Click “Next” for tips to help you cope better and care for your well-being.
Your answers indicate that you could be experiencing mild anxiety.
As you enter your senior years, you may experience big life transitions, such as retirement or health and financial challenges.
Click “Next” for tips to help you manage your emotions and better cope with your challenges.
Your score:
Your answers indicate that you could be experiencing moderate anxiety.
As you begin to transition into adulthood, life's ups and downs like navigating relationships, or academic and work matters can sometimes trigger emotions like stress and anxiety.
Click “Next” to find out how you can manage your emotions and better care for yourself.
Your answers indicate that you could be experiencing moderate anxiety.
Juggling daily work responsibilities and managing relationships can sometimes trigger emotions like stress and anxiety.
Click “Next” to find out how you can seek support to better cope with your emotions in tough times.
Your answers indicate that you could be experiencing moderate anxiety.
Adjusting to major life changes is never easy, no matter what phase of life you are in. Coping with changes like retirement or health and financial concerns can sometimes trigger emotions like stress and anxiety.
Click “Next” to find out how you can reach out for support to manage your emotions and overcome difficult times.
Your score:
Your answers indicate that you could be experiencing severe anxiety.
Life can sometimes throw us into situations that can be stressful and anxiety-inducing.
Click “Next” to find out how you can seek support to help manage your emotions and well-being.
Your answers indicate that you could be experiencing severe anxiety.
When day-to-day struggles become too overwhelming, life can sometimes feel almost unbearable and anxiety-inducing.
Click “Next” to find out how you can reach out for support to better cope in difficult times.
Your answers indicate that you could be experiencing severe anxiety.
Sometimes, our struggles may feel too overwhelming to bear, and can cause intense feelings of anxiety.
Click “Next” to find out how you can seek support to manage your emotions and care for your well-being.
Social anxiety disorder is experienced when one feels anxiety or fear in social situations where there is interaction with people.
This comes from the fear of being judged negatively by others, e.g. doing something in front of others that is humiliating or embarrassing.
It can include situations such as meeting new people, dating, answering a question in class, or having to talk to a cashier in a store.