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The Week

Understanding anxiety

A lot of people in the valley suffer from anxiety but still don’t know what anxiety really is. When the physical symptoms manifest, they go from doctor to doctor, never being satisfied with any of their diagnosis because the symptoms persist. When they finally visit a psychiatrist, they have a big file of medical reports with them but not a single solution. The Week talked to Dr Arun Kunwar to know more about this disorder.
By The Week Bureau

A lot of people in the valley suffer from anxiety but still don’t know what anxiety really is. When the physical symptoms manifest, they go from doctor to doctor, never being satisfied with any of their diagnosis because the symptoms persist. When they finally visit a psychiatrist, they have a big file of medical reports with them but not a single solution. The Week talked to Dr Arun Kunwar to know more about this disorder.







Are you susceptible?

Anxiety disorder often runs in the family. If you have family members who are suffering form anxiety it is more than likely that you too will get anxiety. In general, your chance of suffering from this disorder is 30% but when someone in your family has it, your chances double up and leave you more prone to it. 



However, even if it isn’t in your genes, if you work or live in a stressful environment, you are likely to become anxious. “Imagine if your boss at work is constantly nagging you about things and scolds you all the time. You are likely to stress about going to work when you aren’t there and constantly become agitated when you are,” Kunwar said. Therefore the environment you are in makes a big difference on whether your genes are expressed or not.



Anxiety doesn’t only affect people of a certain age group. Young children too can be affected by it and it often manifests as separation anxiety. If a young child sees his mother being abused, he is likely to follow her everywhere, including the bathroom, because he thinks letting her out of sight will make the abuse worse. Some children are anxious about going to school and will fall sick at night or in the morning, some even running a fever. They are, however, fine during the day and the symptoms manifest again in the evening when they become anxious about having to go to school the next day.



Parents can generally notice this during long holidays where nothing happens to the child, but s/he gets sickly when the school reopens. 


Generalized anxiety disorder 

People who have generalized anxiety disorder often expect the worst0case scenario even when there is no obvious reason of concern. They are constantly anticipating a disaster, for example if their children are 15 minutes late they will immediately jump to conclusions that they have been kidnapped or something worse, said Kunwar. 



Imagine getting stage fear, being tongue-tied and shaking with nervousness, now imagine having that all the time, that’s how people with generalized anxiety disorder feel all the time. They mostly worry about family, finances, work, and the health of their loved ones. With mild generalized anxiety disorder, although people may avoid some situations, they can be employed and function in society.



90% of people with anxiety can get reintegrated into the society and live happily after being treated.   


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Social anxiety

Some people are fine with meeting a few friends but get very nervous when they have to attend a big event with many people attending. These people however find that alcohol makes them less anxious and that they can enjoy better when they are tipsy. “One of my patients is very socially anxious but loves going to parties so always drinks when she heads out. Instead of now treating her for just anxiety I’m now working on trying to get her to drink less when she goes out,” he revealed.  

Panic disorder



Falling under the spectrum of anxiety disorder, panic disorder is characterized by recurrent attacks in unexpected moments. It is a period of intense fear and feeling that something really bad is about to happen. Most people have triggers for these attacks and tend to avoid situations that have triggered it before. The physical symptoms for it include sweating, shaking, palpitation, numbness or shortness of breath. 


Treatment

Treatment for anxiety is a cross between cognitive behavioral therapy and medication. The medication is mild and has very less side effects. The FDA (Food and Drug administration) lists drowsiness, constipation, restlessness and dry mouth as some of the side effects of an anti psychosis drug. Most people in Nepal, however, have to take more drugs than strictly necessary because there aren’t many therapists available. The cognitive behavioral therapy is a short-term, goal oriented treatment that takes a practical approach in solving a problem, and has been proven to be the most effective treatment for anxiety. It takes five to ten months to solve most of the emotional problems. It gives you a new way to think about your issues and also gives you ways in which you can deal with them.   

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