Anxiety and Diabetes
Anxiety disorders make up one of the most common groups of psychiatric conditions in the world. It has been reported in the National Comorbidity Study that one out of four persons will meet the diagnostic criteria for at least one anxiety disorder. Women have a 30.5 percent lifetime prevalence as compared to men who have a 19.2 percent lifetime prevalence.
Everyone experiences normal anxiety which is described as a “diffuse, unpleasant, vague sense of apprehension often accompanied by autonomic symptoms.” To distinguish anxiety and fear, anxiety is said to be an alerting signal which warns of impending danger and enables a person to take measures to deal with a threat. Fear may have a similar alerting signal but is said to be a response to a known, external, definite or non-conflictual threat. Hence, normal anxiety is adaptive and has lifesaving qualities. Symptoms of anxiety usually have two components: awareness of physiological sensations and awareness of being nervous or frightened.
Types of Anxiety Disorders
So when does anxiety become pathological? To date, our DSM-IV-TR lists twelve anxiety disorders: (1) panic disorder with agoraphobia, (2) panic disorder without agoraphobia, (3) agoraphobia without history of panic disorder, (4) specific phobia, (5) social phobia, (6) obsessive-compulsive disorder, (7) post-traumatic stress disorder, (8) acute stress disorder,
(9) generalized anxiety disorder, (10) anxiety disorder secondary to a general medical condition, (11) substance induced anxiety disorder, (12) anxiety disorder not otherwise specified. Each kind presents with particular symptoms.
For panic disorder with and without agoraphobia, we begin by defining what a panic attack is. A panic attack is a discrete period of intense fear or discomfort which may present with the following symptoms: palpitations, sweating, tremors, shortness of breath, choking sensation, chest pain, nausea, lightheadedness, feeling of unreality, fear of losing control, fear of dying, tingling sensations and chills or hot flushes that develops abruptly and peaks within 10 minutes. For it to be a panic disorder you present with recurrent panic attacks, persistent concern about having additional attacks, worry about the implications of the attack and a significant change in behavior related to the attacks. Agoraphobia is anxiety about being in places or situations from which escape may be difficult or embarrassing leading to avoidance of such places or situations.
Phobia refers to an excessive fear of a specific object, circumstance or situation. A specific phobia is a strong, persistent fear of an object or situation, whereas, a social phobia is a strong, persisting fear of situations in which embarrassment can occur. Either phobia interferes significantly with a person’s normal routine, occupational functioning or social activities.
The essential feature of an obsessive-compulsive disorder is the symptom of recurrent obsessions or compulsions sufficiently severe to cause marked distress to the person. These are time consuming and cause significant impairment in a person’s functioning. An obsession is a recurrent and intrusive thought, feeling, idea or sensation. In contrast to an obsession, which is a mental event, a compulsion is a behavior. A compulsion is a conscious, standardized recurrent behavior, such as counting, checking or avoiding.
Posttraumatic stress disorder (PTSD) is a syndrome that develops after a person sees, is involved in, or hears an extreme traumatic stressor. The person reacts to this experience with fear and helplessness, persistently relives the event and tries to avoid being reminded of it. Symptoms must last more than a month after the event and must significantly affect important areas of life such as family and work. Acute stress disorder occurs earlier than PTSD and remits within two days to four weeks.
People who seem to be anxious about almost everything are likely to be classified as having generalized anxiety disorder. It is defined as excessive anxiety and worry about several events or activities for most days during at least a six-month period. The worrying is difficult to control and is associated with somatic symptoms.
Treatment of Anxiety
Currently, treatments available for anxiety disorders are among the most effective in psychiatric medicine. Pharmacological, cognitive-behavioral and psychodynamic approaches have all proved useful. For many conditions most patients should expect substantial relief from their symptoms in a relatively brief period.
Whether an event is perceived as stressful depends on the nature of the event and the person’s resources, psychological defenses and coping mechanism. Diabetes is an example of an event that may be stressful. Often times, medical conditions may trigger anxiety which, if persistent, may lead to a disorder.
Once a person is diagnosed with diabetes, fears of the illness and not being in control of the situation may lead to frustration. It is the management of stress which may prove helpful to avoiding such conditions. A number of relaxation techniques like breathing exercises, progressive relaxation, meditation, visualization and self-hypnosis may prove effective. Coping skills training and time management tools have been useful in alleviating stress and anxiety.
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