Anxiety disorders are characterized by marked and persistent mental and physical symptoms of anxiety, that are not secondary to another disorder and that impact negatively upon an individual’s life. 
Occasional anxiety is a normal part of life. You might feel anxious when faced with a problem at work, before taking a test, or making an important decision. But anxiety disorders involve more than temporary worry or fear. For a person with an anxiety disorder, the anxiety does not go away and can get worse over time.
The feelings can interfere with daily activities such as job performance, school work, and relationships.
An anxiety disorder may make you feel anxious most of the time, without any apparent reason. Or the anxious feelings may be so uncomfortable that to avoid them you may stop some everyday activities.
Private profit-making businesses are different from government-owned bodies. In some countries, certain businesses are legally obliged to be organized in certain ways.
Classification of Anxiety disorders:
There are several different types of anxiety disorders.
- Gereralized Anxiety disorder
- Panic disorder
- Specific Phobias
- Social anxiety disorder
- Obsessive compulsive disorder
- Post traumatic stress disorder (PTSD)
- Acute stress disorder
- Sepretive Anxiety disorder
- Selective Mutism
1. Generalized Anxiety Disorder:
Generalized anxiety disorder (GAD) is much more than the normal anxiety people experience day to day. It’s chronic and exaggerated worry and tension, even though nothing seems to provoke it. Having this disorder means always anticipating disaster, often worrying excessively about health, money, family, or work. They tend to feel tired, have trouble concentrating, and sometimes suffer depression too. People with GAD also seem unable to relax. They often have trouble falling or staying asleep. It’s more common in women than in men and often occurs in relatives of affected persons. It’s diagnosed when someone spends at least 6 months worrying excessively about a number of everyday problems. 
- Restlessness or feeling wound-up or on edge
- Being easily fatigued
- Difficulty concentrating or having their minds go blank
- Muscle tension
- Difficulty controlling the worry
- Sleep problems (difficulty falling or staying asleep or restless, unsatisfying sleep) 
2. Panic Disorder:
This is characterised by discrete episodes of acute anxiety. The onset is usually in early third decade with often a chronic course. The panic attacks occur recurrently every few days. The episode is usually sudden in onset, lasts for a few minutes and is characterised by very severe anxiety. Panic disorder is usually seen about 2-3 times more often in females. Panic disorder can present either alone or with agoraphobia. People with panic disorder have feelings of terror that strike suddenly and repeatedly with no warning. You may genuinely believe you’re having a heart attack or stroke, losing your mind, or on the verge of death. Attacks can occur any time, even during non-dream sleep. While most attacks average a couple of minutes, occasionally they can go on for up to 10 minutes. In rare cases, they may last an hour or more. 
- Pounding heart or accelerated heart rate
- Trembling or shaking
- Sensations of shortness of breath
- Smothering, or choking
- Feeling of impending doom
- Feelings of being out of control during a panic attack
- Intense worries about when the next attack will happen. 
Phobias occur in several forms. A specific phobia is a fear of a particular object or situation. Social phobia is a fear of being painfully embarrassed in a social setting. And agoraphobia, which often accompanies panic disorder, is a fear of being in any situation that might provoke a panic attack, or from which escape might be difficult if one occurred. Phobias aren’t just extreme fear; they are irrational fear.
You may be able to ski the world’s tallest mountains with ease but feel panic going above the 10th floor of an office building. 
4. Social Anxiety Disorder:
“Social phobia is an intense fear of becoming humiliated in social situations, specifically of embarrassing yourself in front of other people. It often runs in families and may be accompanied by depression or alcoholism. Social phobia often begins around early adolescence or even younger.” Blushing it may seem painfully embarrassing, and you feel as though all eyes are focused on you. You may feeling anxious about giving a speech, talking to a boss or other authority figure, or dating. More rarely it may involve a “fear of using a public restroom, eating out, talking on the phone, or writing in the presence of other people, such as when signing a check. 
- Being very afraid that other people will judge them
- Worrying for days or weeks before an event where other people will be
- Staying away from places where there are other people
- Having a hard time making friends and keeping friends
- Blushing, sweating, or trembling around other people
- Feeling nauseous or sick to your stomach when other people are around 
5. Obsessive Compulsive Disorder:
The disturbing thoughts or images are called obsessions, and the rituals performed to try to prevent or dispel them are called compulsions. Obsessive-compulsive disorder is characterized by anxious thoughts or rituals you feel you can’t control. If you have OCD, you may have persistent, unwelcome thoughts or images. OCD strikes men and women in approximately equal numbers and afflicts roughly 1 in 50 people. It can appear in childhood, adolescence, or adulthood, but on the average it first shows up in the teens or early adulthood. 
- You may be obsessed with germs or dirt, so you wash your hands over and over.
- The person may be filled with doubt and feel the need to check things repeatedly.
- He might be preoccupied by thoughts of violence and fear that you will harm people close to you.
- People may spend long periods of time ‘touching things or counting.
- You may be troubled by thoughts that are against your religious beliefs.
- A lot of healthy people can identify with having some of the symptoms of OCD, such as checking the stove several times before leaving the house. 
6. Post-Traumatic Stress Disorder:
Ordinary events can serve as reminders of the trauma and trigger flashbacks or intrusive images. Anniversaries of the event are often very difficult. Post-Traumatic Stress Disorder (PTSD) is a debilitating condition that follows a terrifying event. Often, people with PTSD have persistent frightening thoughts and memories of their ordeal and feel emotionally numb, especially with people they were once close to. These include kidnapping, serious accidents such as car or train wrecks, natural disasters such as floods or earthquakes, violent attacks such as a mugging, rape, or torture, or being held captive. Or it could be something witnessed, such as mass destruction after a plane crash. PTSD can occur at any age, including childhood.
Patients may also experience sleep problems, depression, feeling detached or numb, or being easily startled. People may lose interest in things they used to enjoy and have trouble feeling affectionate. They may feel irritable, more aggressive than before, or even violent.
A person having a flashback, which can come in the form of images, sounds, smells, or feelings, usually believes that the traumatic event is happening all over again.
Causes of Anxiety Disorders:
Anxiety is a normal response to stress or a dangerous situation and it’s often referred to as the “fight or flight” response. It’s also the most prevalent mental health condition. Anxiety becomes problematic when it is constant or in reaction to inappropriate circumstances, which over time can negatively affect your day-to-day life.
Causes of anxiety include:
- traumatic life experiences
- thyroid problems
- dysfunctional serotonin
- excessive alcohol
- caffeine or sugar intake
- hormone imbalance
In addition, research shows that risk factors for anxiety disorders include being female, experiencing stressful life events in childhood and adulthood, having a family history of mental health disorders, having limited economic resources and being shy in childhood.
Common Symptoms of Anxiety disorder:
- muscle tension
- chest tightness
- heart palpitations
- high blood pressure
- digestive problems
- panic attacks
- difficulty concentrating
- inability to socialize
Natural Remedies for Anxiety Disorder:
1. Eat a Clean and Well-Balanced Diet
2. Avoid Sugary and Processed Foods
3. Limit Caffeine and Alcohol
5. Kava Root
6. Vitamin B Complex
7. Lavender Oil
8. Roman chamomile essential oil
9. Physical Activity and Excercise
10. Get Enough Rest
Anxiety disorders are generally treated with psychotherapy, medication, or both.
- Psychotherapy or “talk therapy” can help people with anxiety disorders.
- To be effective, psychotherapy must be directed at the person’s specific anxieties and tailored to his or her needs.
- A typical “side effect” of psychotherapy is temporary discomfort involved with thinking about confronting feared situations.
Cognitive Behavioral Therapy (CBT):
- CBT is a type of psychotherapy that can help people with anxiety disorders. It teaches a person different ways of thinking, behaving, and reacting to anxiety-producing and fearful situations.
- CBT can also help people learn and practice social skills, which is vital for treating social anxiety disorder.
- Two specific stand-alone components of CBT used to treat social anxiety disorder are cognitive therapy and exposure therapy.
- Cognitive therapy focuses on identifying, challenging, and then neutralizing unhelpful thoughts underlying anxiety disorders.
- This therapy focuses on confronting the fears underlying an anxiety disorder in order to help people engage in activities they have been avoiding.
- It is used along with relaxation exercises and/or imagery. One study, called a meta-analysis because it pulls together all of the previous studies and calculates the statistical magnitude of the combined effects, found that cognitive therapy was superior to exposure therapy for treating social anxiety disorder.
- CBT may be conducted individually or with a group of people who have similar problems. Group therapy is particularly effective for social anxiety disorder. Often “homework” is assigned for participants to complete between sessions.
Self-Help or Support Groups:
- Some people with anxiety disorders might benefit from joining a self-help or support group and sharing their problems and achievements with others.
- Internet chat rooms might also be useful, but any advice received over the Internet should be used with caution, as Internet acquaintances have usually never seen each other and false identities are common.
- Talking with a trusted friend or member of the clergy can also provide support, but it is not necessarily a sufficient alternative to care from an expert clinician.
- Stress management techniques and meditation can help people with anxiety disorders calm themselves and may enhance the effects of therapy.
- While there is evidence that aerobic exercise has a calming effect, the quality of the studies is not strong enough to support its use as treatment.
- Since caffeine, certain illicit drugs, and even some over-the-counter cold medications can aggravate the symptoms of anxiety disorders, please avoiding them should be considered.
The drugs of choice for generalised anxiety disorder have traditionally been benzodiazepines, and for panic disorder, antidepressants. It is useful to begin the treatment of panic disorders with small doses of antidepressants, usually SSRIs (e.g. ﬂuoxetine).
- Benzodiazepines (such as alprazolam and clonazepam): are useful in short-term treatment of both generalised anxiety and panic disorders.
- Several antidepressants (such as sertraline): are now licensed for treatment of anxiety and panic disorders.
- β-blockers such as propranolol and atenolol: are particularly useful in the management of anticipatory anxiety (e.g. anxiety occurring before going on stage or before examinations). However, due care must be exercised in the use of propranolol in the patients with history of asthma, bradycardia or heart block.
Atenolol does not cross the blood brain barrier and takes care of only the peripheral symptoms of anxiety. It also has less likelihood of causing bronchial constriction than propranolol.
- Buspirone: is an anti-anxiety drug which does not have any dependence potential, unlike It takes about 2-3 weeks before its action is apparent. It may be preferable to benzodiazepines for the long–term management of anxiety disorder. It, however, has not much role in the management of panic disorder. 
Homeopathic Medicine for Anxiety Disorders:
The following remedies may be useful to you in treating symptoms of anxiety.
A panic attack that comes on suddenly with very strong fear (even· fear of death) may indicate this remedy. Strong palpitations may accompany a state of immense anxiety, shortness of breath, and flushing of the face.
1. Sudden, intense ailments from fright.
2. Anxiety and restlessness with complaints.
3. Fears that do not subside.
4. Faintness or dizziness upon waking up.
5. Sudden fever with one cheek red, the other pale.
6. Intolerance of pain.
7. Painful urination with anxiety.
8. Pains· followed by numbness and tingling.
9. Eye pain and injuries.
10. Throbbing headache.
11. Unquenchable thirst.
This remedy is indicated when anxiety develops before a big event. (Examples: an interview for job, an exam, a public speech, social engagement, marriage, etc.)
1. Emotional upset.
4. Extended period of unusual or continued mental exertion.
7. Craving for sweets and salt. Craving for strong flavours.
8. Enthusiastic and suggestible, with a tendency towards peculiar thoughts and impulses.
This remedy is recommended for people who are deeply anxious about their health, and extremely concerned with order and security. Panic attacks often occur around midnight or the very early hours of the morning. The person may feel exhausted and still be restless fidgeting, pacing, and anxiously moving from place to place. These people may also have digestive problems or asthma attacks accompanied by anxiety. They are typically obsessive about small details and very neat. They may feel a desperate need to be in control of everything.
2. Anxiety associated with later stages of head cold, with sneezing.
3. Asthma worse after midnight, fears, suffocation while lying down.
7. Sleepiness but insomnia.
8. Thirsty for frequent small drinks.
9. Weak and exhausted.
10. Desiresair but is sensitive to cold.
11. Vomiting, with or without diarrhoea, after eating and drinking.
People who benefit most from this remedy have a chilly constitution. The slightest cold “goes right through them.” They have trouble keeping them- selves warm. They have a craving for sweets, and are easily fatigued. They are dependable, solid people who become overwhelmed from physical illness · or too much work and start to fear a breakdown. Their thoughts can be muddled and confused when tired, which adds to the anxiety. Worry and bad news may agitate them, and a nagging dread of disaster ( to themselves or others) may develop. Fear of heights and claustrophobia are also common.
1. Increased perspiration.
2. Night sweats.
3. Cold hands and feet.
6. Ravenous hunger.
7. Aversion to fats .
8. Craving for eggs.
9. Eyes sensitive to light.
10. Pale face.
11. Large appetite with slow digestion.
This remedy is indicated when you have feelings of weakness, trembling, and mental dullness (being “paralyzed by fear”). It is also useful when a person experiences anxiety about an upcoming event such as stage-fright about a public performance or interview, or anxiety before a test, impending visit to the dentist, or other stressful events. Chills, perspiration, diarrhea, and headaches will often occur with nervousness. Fear of crowds, a fear of falling, and even a fear that. the heart might stop are other indications for Gelsemium.
3. Anxiety prior to an examination or public performance.
4. Fatigue and aching of whole body.
5. Limbs, head, eyelids heavy.
7. Scalp sore to touch.
8. Sore throat.
9. Lack of thirst.
10. Dizziness, trembling, fatigue, dullness.
A sensitive person who is anxious because of grief, loss, disappointment, criticism, loneliness ( or any stressful emotional experience) may benefit from this remedy. The primary factor for this remedy is emotional stress, especially disappointment or grief. Other indications are a defensive attitude, frequent sighing, and mood swings. The person may burst unexpectedly into either tears or laughter.
2. Sensation of a lump in the throat.
3. Chills with fever.
4. Thirst during chills.
5. Chills relieved by warmth.
6. Cramping pains in the abdomen or back.
7. Headaches that feel like a nail driven into the side of the head.
8. Skin very sensitive to drafts.
13. Rejects company.
16. Insomnia from emotional distress.
17. Nausea relieved by eating.
18. Eating intensifies hunger.
Indicated when a person has been exhausted by overwork or illness. Feels a deep anxiety and inability to cope. Jumpy and oversensitive. May be startled by ordinary sounds. Hearing unpleasant news or thinking of world events can aggravate the problems. Insomnia and an inability to concentrate may develop, increasing the sense of nervous dread. Eating, warmth, and rest often bring relief.
2. Deep anxiety and inability to cope.
4. Jumpy and oversensitive.
5. Startled by ordinary sounds.
7. Nervous digestive upsets.
Lycopodium patients attempt to cover an inner sense of inadequacy by putting up fronts, by pretending to be something they are not. They feel anxiety from mental stress and suffer from a lack of confidence. He can be self-conscious and feel intimidated by people they perceive as powerful. Person can feel a deep anxiety and fear of failure, when they take on responsibility and usually do well, once started on a task.
1. Shakes head without any apparent cause.
2. Facial contortions.
3. Gassy, constipation or diarrhoea.
4. Sour belching.
7. Digestive upsets with gas and bloating.
8. Craves sweets, warm food and drink.
9. Night cough.
10. Wants to be alone.
11. Cranky on waking.
12. Bullying tendency.
13. Fear of failure.
14. Breaking down under stress.
The primary candidates for this remedy are personally aloof but have a social conscience and a desire to help others. Deep emotions and a self- protective shyness can make these people seem reserved, aloof, and private. Even when feeling lonely, they tend to stay away from social situations, not knowing what t? say or do. Easily hurt and offended, they can brood, bear grudges, dwell on unhappy feelings, and isolate themselves. They refuse consolation even when they want it. They are often sympathetic listeners to other people’s problems. Claustrophobia, anxiety at night (with fears of robbers or intruders), migraines, and insomnia are often seen when this remedy is needed.
1.Tongue feels dry.
2. Mucous membranes dry.
6. Migraine headache.
8. Pain around eyes.
9. Craves salt and dry food.
10. Weepy but won’t let others see it.
11. Consolation aggravates them.
12. Angry from isolation.
13. Fright, grief, anger.
14. Nervous, discouraged, broken down.
Indicated when the victims are openhearted, imaginative, excitable, easily startled, and full of intense and vivid fears. Just thinking of almost anything can easily trigger strung anxiety. Always nervous and sensitive to others. They can overextend themselves with sympathy to the point of feeling exhausted and “spaced out” or even getting ill. Also need a lot of company and reassurance. A person often feel better from conversation or a back-rub. Easy flushing of the face, palpitations, thirst, and a strong desire for cold, refreshing food are other indications for Phosphorus.
4. Associated with hoarseness.
5. Tight heavy chest.
6. Dry rasping cough.
7. Burning pains in stomach, abdomen, between shoulder blades.
8. Thirst for cold drinks that are vomited.
10. Night sweats.
People who need this remedy often express anxiety as insecurity and clinginess, with a need for constant support and comforting. They fear being alone. They are easily discouraged, moody, tearful, whiny, even emotionally childish. Getting too warm or being in a stuffy room often increases anxiety. Anxiety around the time of hormonal changes (puberty, menstrual periods, or menopause) often is helped with Pulsatilla.
3. Wants attention and sympathy.
4. Changeable symptoms and moods.
5. Craves open air.
6. Sensitive to heat.
7. Dry mouth with lack of thirst.
8. Rich food upsets stomach.
9. Insomnia from recurring thought.
10. Head colds.
11. Loose cough, worse at night.
12. Delayed menstrual period with scanty flow.
Indicated for those who are capable and serious, yet are also nervous, shy, and subject to bouts of temporary loss of confidence. Anxiety can be extreme when they are faced with a public appearance, interview, examination, or any new job or task. Worry and overwork can bring on headaches, difficulty concentrating, and states of exhaustion, over sensitivity, and dread.
4. Difficulty concentrating.
6. Over sensitivity.
7. Overreact and devote attention to tiny details.
8. Low stamina.
9. Frequently catch colds, sore throats, or other illnesses.
- Homeopathy in treatmet of Psychological Disorders by Shilpa Harwani / ch 7.
- A Short Textbook of PSYCHIATRY 7th edition by Niraj Ahuja / ch 8.
Psychiatry, Fourth Edition – Oxford Medical Publications -SRG-by John Geddes, Jonathan Price, Rebecca McKnight / ch 24.