Why am I always worried? Know anxiety disorder in a noisy world

Have you ever felt your heart racing before a meeting? Or found yourself over thinking the smallest of issues late at night? What if we told you that these aren't just 'nerves' or 'stress', but could be signs of something —anxiety disorder, one of the most common yet misunderstood mental health conditions of our time? In today's fast-paced and hyper-connected world, we are constantly inundated with information, expectations, and pressure to keep up.

It's no wonder that anxiety has become a silent epidemic affecting millions of people around the globe. The good news is that anxiety is manageable, treatable, and, most importantly, you are not alone. Anxiety is a normal human emotion—a survival response to perceived threats. But when it becomes excessive, persistent, and interferes with daily life, it may indicate an anxiety disorder, a medical condition that requires attention and care.

What are anxiety disorders?

Anxiety disorders are a group of mental health conditions characterised by intense, disproportionate, and uncontrollable worry or fear. These are not just occasional nervous moments; they are chronic and can affect a person's thoughts, behaviour, and physical health.

From a clinical standpoint, anxiety disorders are among the most common psychiatric conditions, yet they are often misunderstood, minimised, or overlooked.

According to the World Health Organisation (WHO), anxiety disorders are the most common mental disorders globally, affecting more than 300 million people.

Types of anxiety disorders

• Generalised anxiety disorder (GAD): Excessive, uncontrollable worry about everyday things—health, finances, work—even when there's little or no reason to worry.
• Panic disorder: Recurrent, unexpected panic attacks—sudden episodes of intense fear accompanied by palpitations, shortness of breath, chest pain, or a feeling of losing control.
• Social anxiety disorder (social phobia): Intense fear of social or performance situations due to fear of embarrassment, judgment, or rejection.
• Specific phobias: Extreme fear of a particular object or situation (e.g., heights, flying, animals) that leads to avoidance and distress.
• Agoraphobia: Fear of being in situations where escape might be difficult or help unavailable during a panic attack, often leading to avoidance of public spaces.
• Separation anxiety disorder: Common in children but also present in adults—marked by excessive fear of being apart from those to whom one is emotionally attached.

When this nerve becomes compressed or irritated, it misfires, sending erratic pain signals to the brain, even in response to mild stimulation.

Causes and triggers

The most common cause of TN is compression of the trigeminal nerve root by a blood vessel near the brainstem. This constant pressure damages the protective covering of the nerve (myelin sheath), causing abnormal nerve signals.

Clinical perspective: What we observe

As a psychiatrist, I often see patients who’ve been living with anxiety for years before seeking help. Symptoms can be subtle or masked, including chronic headaches, sleep disturbances, irritability, fatigue, gastrointestinal issues, or a general sense of unease. Many patients are high-functioning, making it harder for others (and sometimes themselves) to recognise the problem.

Some common signs include

• Persistent worrying or intrusive thoughts
• Avoidance of anxiety-provoking situations
• Physical symptoms like muscle tension, sweating, or a racing heart
• Difficulty concentrating or sleeping
• Panic attacks are often mistaken for medical emergencies

What causes anxiety disorders?

There is no single cause. Anxiety disorders arise from a complex interplay of,

• Biological factors: genetic vulnerability, neurochemical imbalances (like serotonin, norepinephrine, GABA)
• Psychological factors: childhood trauma, perfectionistic personality, negative thought patterns
• Environmental factors: chronic stress, life transitions, or medical illnesses
• Diagnosis: More than just feeling anxious
• A thorough psychiatric assessment is essential to differentiate an anxiety disorder from normal stress reactions, medical conditions (like thyroid dysfunction), or other psychiatric illnesses (like depression or OCD). Clinical judgment remains the cornerstone of diagnosis.

Treatment

The good news? Anxiety disorders are treatable. Early intervention can significantly improve outcomes.

1. Psychotherapy

• Cognitive behavioural therapy (CBT): The gold standard. It helps patients identify, challenge, and re-frame distorted thought patterns.
• Exposure therapy: Especially effective for phobias and panic disorder. Mindfulness-based therapies: Aid in emotional regulation and present-moment awareness.

2. Medications

• SSRIs and SNRIs: First-line pharmacological treatments.
• Benzodiazepines: Reserved for short-term, acute episodes due to the risk of dependence.
• Beta-blockers or Buspirone: Used in specific cases. Every medication is prescribed considering the patient's symptom profile, medical history, and preferences.

3. Lifestyle modifications

• Regular exercise
• Adequate sleep
• Balanced nutrition
• Limiting caffeine and alcohol
• Structured routines

4. Psychoeducation & support

Helping patients and families understand the illness reduces stigma, improves compliance, and promotes recovery.

Anxiety in children and teenagers

Yes, even kids can suffer from anxiety, and it is underdiagnosed.

Common signs include

• School refusal
• Nightmares
• Clinginess
• Stomach aches with no medical cause

Early intervention with psychiatrists, child psychologists, school counsellors, and family support is vital.

Myths vs. facts about anxiety

Myth: Anxiety is just over thinking.

Fact: Anxiety disorder is a clinical condition involving brain chemistry, not just thoughts.

Myth: Take a deep breath; everything will be okay.

Fact: People with anxiety can't just snap out of it—they need support, therapy, and in some cases, medication.

Myth: It's only for weak people.

Fact: Anxiety affects the strongest of people—from CEOs to soldiers—and it has nothing to do with willpower.

When to seek help

If anxiety is persistent, impacts your functioning, or causes distress, don't ignore it. Seeking help from a mental health professional early on can have a profound impact on your life.

In a nutshell

Anxiety can feel overwhelming and even debilitating, but it does not define who you are. With the right support, many individuals can go on to lead fulfilling and successful lives. Anxiety disorders are real, common, and treatable.

As a psychiatrist at KD Hospital, I emphasise a biopsychosocial approach, addressing not only the biological aspects but also the psychological and social dimensions of the disorder. Recovery is not just about reducing symptoms; it is about regaining control, clarity, and confidence in life.