A psychiatrist and mindfulness-based therapist expands on the topic of anxiety, a crippling yet common mental health issue. He also explains how acceptance and commitment therapy (ACT) can work as a treatment option for those with anxiety disorder.
WORDS HANNAH MAY-LEE WONG
FEATURED EXPERT DR PHANG CHENG KARConsultant Psychiatrist Sunway Medical Centre |
HOW WOULD YOU DEFINE ANXIETY DISORDER?
Dr Phang:
Anxiety symptoms are part and parcel of life.
For example, it’s normal to feel anxious when you have a deadline for an assignment approaching.
Having anxiety disorder on the other hand, means:
- To have anxiety symptoms (fears, worries, and psychosomatic symptoms) that are more intense and frequent
- These intense and frequent symptoms interfere with a person’s daily activities such as job performance, schoolwork, and relationships.
WHAT ARE THE MORE COMMON CAUSES OF ANXIETY DISORDER?
Dr Phang:
The common mental conditions under the anxiety category that I encounter in my adult psychiatric clinic are:
- Panic disorder.
- Agoraphobia — intense fear in situations or places where escape might be hard or help wouldn’t be available if something went wrong. This can include crowded places, public transport, or even leaving home.
- Generalized anxiety disorder — feeling worried or anxious about lots of everyday things such as work, health, money, or family almost all the time, and often without a clear reason.
- Social anxiety disorder — fear or anxiety specifically about social situations such as meeting new people, speaking in public, or being judged or embarrassed in front of others.
It’s also common for anxiety to occur with depression.
The causes of these disorders are multifactorial. They could be:
- Biological, caused by hormonal disorders, such as thyroid problems, or stress from a physical illness like cancer.
- Psychological, such as traumatic childhood experiences, stressful life events like unemployment, etc.
- Environmental, such as natural disasters and haze.
- Social, such as political and economic instability.
CAN ANXIETY DISORDER RUN IN THE FAMILY?
Dr Phang:
Yes, that’s one of the biological causes of anxiety disorder.
I have a strong family history of anxiety disorders. I know the condition inside out.
The genetic risk factor partly contributes to my particular interest in anxiety education and treatment!
WHEN SHOULD SOMEONE WITH A POSSIBLE ANXIETY DISORDER SEE A MENTAL HEALTH PROFESSIONAL?
Dr Phang:
Someone with a possible anxiety disorder should see a health professional when:
- It interferes with their daily activity at school, work, or home.
- They may visit doctors often for physical symptoms that stem from mental health issues, or miss work frequently due to poor physical health.
- The anxiety leads to depression symptoms such as
- Loss of interest in daily activities
- Feeling hopeless or helpless
- Experiencing changes in sleep, appetite, or weight patterns
- Having irrational guilt, anger or irritability; or having suicidal thoughts
- Their loved ones find it challenging to cope with the emotional strain caused by their anxiety, which can sometimes lead to difficulties in relationships, including marriage and parenting.
- They cope with anxiety using unhealthy or harmful methods such as excessive alcohol consumption, illicit drug abuse, self-harm, or binge eating.
WHAT IS ACCEPTANCE AND COMMITMENT THERAPY(ACT)?
Dr Phang:
Acceptance and commitment therapy or ACT is a practical, science-backed therapy that helps people deal with anxiety, depression, and addiction.
In therapy sessions, ACT helps people learn simple skills such as:
- Staying focused on the present moment
- Noticing their thoughts without getting caught up in them
- Accepting their emotions instead of fighting them
- Observing how their mind works
These methods help people acknowledge their anxiety symptoms and respond to them in a healthier way, rather than fighting or feeling bad about them.
ACT also uses a set of exercises that help patients identify and commit to their meaningful goals and values in life.
ASIDE FROM ACT, WHAT OTHER COMMON THERAPIES ARE RECOMMENDED FOR ANXIETY DISORDERS?
Dr Phang:
- Cognitive behavioural therapy (CBT)
- Antidepressant and anti-anxiety medications may be prescribed by a psychiatrist
- Relaxation training such as progressive muscle relaxation, pleasant imagery, and deep breathing
- Emotional freedom technique (EFT) — sometimes called ‘tapping’, a self-help method that involves gently tapping on specific points on your body while focusing on a problem or feeling
- Eye movement desensitization and reprocessing (EMDR)
- Exercise, meditation, hypnosis, and prayer
| Click here to find out mote about eye movement desensitization and reprocessing with registered EMDR practitioner Faith Foo. |
CAN ONE’S ANXIETY DISORDER TRULY GO AWAY?
Dr Phang:
Anxiety disorder often does not completely go away.
So, instead of trying to eliminate anxiety, ACT focuses on helping people manage it and keep living a meaningful life.
WHAT IS YOUR ADVICE TO PEOPLE WHO PREFER TO SELF-DIAGNOSE AND SELF-TREAT?
Dr Phang:
If it works well for you, good.
If not, get guidance from a mental health professional who is familiar with ACT.
Most importantly, do not give up! Explore with a therapist on methods or combinations of treatments that suit you best.
| This article is part of our series on mental wellness. |
