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What are anxiety disorders?

Occasional anxiety is normal, but extreme fear or worry, panic attacks and phobias may signal something more serious

Anxiety disorders are a common mental illness, affecting one in every five South Africans.

Characterised by overwhelming worry and fear, anxiety disorders can keep you from functioning in your normal life.

They include panic disorder, social anxiety disorder, specific phobias and generalised anxiety disorder (GAD).

Obsessive compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) are also closely related to anxiety disorders.

‘GAD includes symptoms interfering with daily life and lasts for more than six months,’ says Felicity Pienaar, occupational therapist at Akeso Clinic in Nelspruit.

People with OCD suffer from obsessive behaviour and may have anxiety about making mistakes or falling short of standards.

They develop compulsive behaviour that may be cognitive (for example needing to repeatedly tell yourself ‘it will be ok’) or physical (for example, repeated hand washing or straightening objects). This becomes a disorder when these ‘rituals’ drive their lives.

PTSD is a debilitating condition that follows a traumatic event.

People struggling with PTSD may experience flashbacks, nightmares, numbing of emotions, depression and feeling angry, irritability or feeling distracted and being easily startled.

A panic disorder is characterised by sudden attacks of panic and fear, and attacks are usually triggered by fear-producing events or thoughts.

Panic disorder results in physical symptoms such as rapid heartbeat, strange chest sensations, shortness of breath, dizziness, tingling and anxiousness.

Overcoming avoidance behaviours

Trying to avoid certain situations, thoughts or feelings often results in experiencing more of the thing you are trying to avoid, as the patient ends up constantly focusing on that one thing.

Instead, Pienaar advises the following:

1. Recognise the cost of avoidance. Take note of the time and mental energy spent trying to avoid something.

2. Learn to tolerate uncomfortable thoughts and feelings about situations.

3. Use distraction techniques (cognitive distraction such as counting backwards in threes or sevens, singing your favourite song or reciting your favourite poem) or progressive muscle relaxation.

4. Aerobic exercise releases happy hormones called endorphins. They act as natural pain killers and improve our ability to sleep, which is very important to reduce stress.

5. Avoid stimulants such caffeine and nicotine. We believe that it will calm our nerves, but the physical effect on our body is the opposite.

6. Eat a balanced diet. Avoid processed and high-sugar foods, as these foods cause fluctuations in blood sugar, which affects mood. This is followed by a ‘crash’, which can cause shaking and tension that worsen anxiety.

7. Get enough sleep. After a good night’s sleep, coping with our problems becomes more manageable.

How friends and family can help

Educate yourself on the type of anxiety with which your loved one is struggling.

Encourage them to seek professional help, be open to listening to them, but do not try to be their therapist.

Accept their anxiety by assuring them that you do not see it as a weakness or a flaw.

Don’t fall into the reassurance-seeking trap. If a loved one repeatedly asks for reassurance about what it is they fear (‘Are you sure it’s not cancer? ‘Are you sure you aren’t cross with me?), they probably need help from a psychotherapist.

Help them to face some of the things they are avoiding or putting off altogether owing to anxiety.

Encourage exercise, meditation/mindfulness and breathing exercises. Avoid activities that involve alcohol.

Don’t give up hope – anxiety is treatable if your loved one is willing to put in the work.


Seek professional help

A combination of medication, prescribed by a psychiatrist, and ‘talk’ therapy with a psychologist, is often the most successful treatment, according to Pienaar.

Join a support group.

Contact www.akeso.co.za or the South African Depression and Anxiety Group (SADAG) to find a group in your area on 011 262 6396, or visit www.sadag.org.

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