We have all felt anxious at some point in our lives. Be it when writing an examination, going in for a medical checkup, giving an interview for a job, or speaking in public. While anxiety can strike anyone on occasion, it can be a problem when it is lasting and uncontrollable.
Anxiety is an emotional state that is associated with being uneasy or distressed and can vary from mild to severe. A person is said to suffer from an anxiety disorder when he or she experiences a fear or worry that does not go away and that only gets worse over time.
Anxiety can also be a major symptom of other medical conditions such as panic disorders, phobias, post-traumatic stress disorder (PTSD) and generalised anxiety disorder (GAD).
Prominent anxiety attack symptoms include – but are not limited to – an increased heart rate, trembling, irritation, sweating, hot flashes, dry mouth and dizziness. In severe cases, the symptoms of anxiety can worsen, causing disturbed sleep, headaches, weight and appetite changes, trouble in concentrating, fatigue, muscle tension and aches.
What causes anxiety?
Research still needs to fully identify and establish the factors and patterns that trigger anxiety. Since we do not fully understand yet what causes anxiety, researchers say there is a combination of several factors that can lead to an anxiety attack.
According to the US National Institute of Mental Health triggers of anxiety include chemical imbalances in the brain that regulate mood and behaviour, a history of stressful or traumatic experiences, certain medical conditions such as asthma, changes in blood pressure, thyroid disorders, long-term medical conditions such as COPD (chronic obstructive pulmonary disease), mental illness, and substance abuse or chronic alcoholism.
If you are experiencing these symptoms, and if they are affecting your daily routines either cognitively or behaviourally including causing you regular distress, it could be time to seek help either through a family member or a trusted physician/psychiatrist.
In mild to moderate cases of anxiety, one can find some relief by practising yoga and meditation; maintaining a balanced and nutritious diet; and limiting the consumption of coffee, tea and alcoholic drinks. Experts also suggest that such persons will benefit from engaging themselves in activities such as simple sports, music and hobbies in their free time.
In severe cases of anxiety, apart from therapy, a psychiatrist may also prescribe medication as a last resort. In fact, it is preferred if one can find relief through lifestyle modifications, changes in eating habits, closely analysing and avoiding triggers of anxiety.
Increasingly experts are also suggesting individuals consider integrative therapies to overcome anxiety.
The Integrative approach
Dr Kishore Kumar R, a professor of Ayurveda in the Department of Integrative Medicine at NIMHANS in Bengaluru, says that the motive is to work collaboratively with allied mental healthcare professionals to bring out a more holistic anxiety treatment approach for individuals suffering from common mental health disorders like anxiety.
At NIMHANS, an individual opting for integrative therapies will be screened by a panel of an Ayurveda physician, psychiatrist, and psychologist to determine the best therapy approach. For instance, if an individual isn’t responding well to counselling, their anxiety treatment may be modified to include herbal medications.
Understanding how Ayurveda and yoga work is key to addressing anxiety, Dr Kumar adds. While Ayurveda looks at anxiety as an imbalance in the mind’s physiology (rational/irrational thoughts and perceptions), yoga considers it an imbalance of an individual’s air element (Vayu).
“The integrative approach is all about corrective measures to address this imbalance,” says Dr Kumar. “This imbalance leads to irrational thoughts and fear.”
This can be done by reassurance, reforming the objectives of life, giving hope, and solving the accumulated thoughts from the past. Along with this, depending on the individual’s condition, herbal medicines like Withania Somnifera (Ashwagandha) and Convolvulus Pluricaulis (Shankhpushpi) can also be prescribed, along with psychoeducation to help alleviate anxiety.
When it comes to yoga’s role in managing anxiety, Dr Kumar explains that a combination of asanas helps balance an individual’s thought process. “Yoga and Pranayama have much more effect on the body, mind, and soul and help in better and faster outcomes,” he stresses.
There’s a lot of research to back this. A meta-analysis published in British Journal of Sports Medicine, led by author Graham Kirkwood at Newcastle University, England found that yoga has a positive results in individuals who have anxiety.
Other effective therapies
Cognitive Behavioural Therapy (CBT) is another effective approach to understanding anxiety-causing triggers, based on which a mental health practitioner helps setting goals for an individual. But before initiating this process an individual needs to be in a relaxed state of mind.
Vandana S, a counsellor and psychologist at mental health startup Psychoflakes says this is done through grounding techniques (getting an anxious individual to think about the present moment) by asking questions like:
- What are the things you are seeing around?
- How are you feeling?
- What are you smelling, hearing?
- Is there any taste in your mouth?
Psychoeducation is the next key step. This helps an individual understand and differentiate between their thoughts, feelings, and emotions. This step is critical to moving ahead with the CBT intervention.
Once an individual can differentiate between these, evidence-based intervention is adopted in CBT. “We try to understand the thought process. After assessing their core beliefs ingrained from childhood, we try to rewire them to help them challenge and overcome their anxiety,” Vandana added.
However, if the person is not able to challenge those thoughts which are making them anxious, an alternative route such as Acceptance and Commitment Therapy (ACT) is introduced. This is almost akin to changing medications if someone is showing allergic reactions to it.
“In this, we prepare the individual to accept their emotions rather than challenge them. In severe cases, we work collaboratively with a psychiatrist along with psychological intervention for a better outcome,” Vandana sums up.
However, she adds that Acceptance and Commitment Therapy (ACT) is not yet a common concept in India but has been extensively adopted in Western countries.