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Anxiety: Is it Normal and When Should I Seek Help?

  • 30 Nov 2020
  • 4 mins

Remember that anxiety before going for a job interview or when you are about to meet your date for the first time? It is completely normal, says psychiatrist Dr. Tan Hong Yee at Mind Care Clinic.

Anxiety is a normal response to threat. As humans, whenever we encounter a situation or see something we perceive as threat – perhaps, a scary or dangerous scenario – our bodies would react in predictable ways.

For instance, our heart rate would go up. We would also start breathing more shallowly and even experience our body tensing up.

“This all starts from the very primitive fight or flight reflexes our body is built for in the face of danger,” shared Dr. Tan. “Anxiety usually goes away. It is very specific to a situation. When the problem or difficult situation is overcome, anxiety would go away too. It only becomes a problem when the anxiety persists or when symptoms start affecting our lives and relationships.”
 

Anxiety Can Improve or Affect Performance

Ever wondered why some people work well under pressure and some do not? This could be understood with the Yerkes-Dodson law, where there are clear indicators to see how the levels of anxiety affect one’s performance.

Touching on the effect anxiety can have on performance, Dr. Tan said: “If we are lying in bed with no worries, there probably won’t be much to stimulate us. When anxiety or stress is built up in the face of deadlines, some people actually get better in their performance.”

“However, there comes a time after the peak performance where one would get anxious. That’s when we start having problems and face difficulties in getting our work done or struggle through our day to day life,” Dr. Tan added.


Common Types of Anxiety Syndromes

Anxiety can manifest in different ways. According to Dr. Tan, some common types of anxiety often present in Singapore includes:

  • Generalized Anxiety

    As the name implies, this type of anxiety is usually generalized and it is hard to pin point a specific cause for it. People experiencing this may feel uptight, edgy and even breathless at times. If this is experienced every day, one would get tired and fatigued at the end of the day. Some may even get quite irritable and face difficulty concentrating. Very often, this group of people with generalized anxiety can experience sleep problems as well.
  • Panic Disorder

    Panic episodes are common for people with a panic disorder. People with anxiety may generally experience short-lived panic attacks that include symptoms such as a racing heart, difficulty breathing, tremors, shortness of breath or even chest pain, chest tightness, giddiness etc. However, a small subset of this group of people may go on to develop long-term panic disorder; a condition where one has a persistent fear of having future panic episodes.
  • Social Anxiety Disorder

    This disorder is not just about the anxiety one feels before attending a big party filled with strangers. There will always be the element of anxiety or consciousness for everyone but the magnitude of anxiety is much higher for those who suffer from social anxiety disorder. It can happen even if there are not many people (strangers) around. This group of people are often very self-conscious. They could also experience a lot of negative self-appraisal and are particularly concerned about how others see them.


Seeking Help for Anxiety

Given that anxiety can be normal in day to day life, Dr. Tan advises that it is good to wait it out and see if there are things we could do to get rid of anxiety and its source.

However, when symptoms get persistent and start to affect one’s daily life resulting in fear to go outdoors, meeting friends; fear of going out, meeting friends – these are signs to see a doctor early.

The other good thing about seeing a doctor early is that sometimes, there may be other issues that could lead to or contribute to anxiety. For instance, a hyperactive thyroid.

“Screening tools such as GAD-7 are available online, where one can assess their health and anxiety levels,” Dr. Tan added. However, there are limitations for sure and the public are encouraged to seek a professional’s help and opinion for an accurate diagnosis.
 

Treating Anxiety

Contrary to popular beliefs, not every psychiatrist will treat your anxiety with medication. In fact, there are many who believe in non-medication approaches.

Touching on the type of treatments available, Dr. Tan explained:

“For psychiatrists at Mind Care Clinic, we believe strongly in non-medication approaches and that they should always be used first. This includes the gold standard of therapy that is Cognitive Behavioral Therapy (CBT), which could be used to treat the cognitive or behavioral condition. Some other techniques that work very well for patients also include mindfulness techniques. Sometimes, therapists could also teach patients other methods like breathing or relaxation techniques.”

The element of medication is needed in certain situations when a patient’s condition ranges from moderate to severe cases. Antidepressants or adjuncts such as beta blockers could be prescribed to help control heart palpitations. Of course, there are also tranquilizers but they are only for short-term use as they come with its own set of problems which include dependence.

Dr. Tan advised that it is important to be aware of our emotions and behavior, and seek help when red flags show up.

Contributed by

Dr. Tan Hong Yee
Psychiatrist
Mind Care Clinic
Farrer Park Hospital