Anxiety disorders: worries that seem too much

All of us worry about things from time to time, especially if we have a lot of problems, but for some people the worry can become excessive. Anxiety disorders occur when a person worries without sufficient reason (Figure 16.2). Some examples of normal worry could be a student worrying on the night before an exam, a woman worrying about her child who is ill, or a man worrying about how he can provide for the family after the crops have failed. Some examples of abnormal worry (an anxiety disorder) could be a student who worries all the time, even when their exam results are good, a woman who worries constantly about her child even though the child is healthy and happy, and a man who worries about the harvest even when the crops are growing well.

Anxiety can be distressing and disabling, for example, preventing people doing things that they used to such as going out of the house and meeting up with other people. As well as causing a person to worry too much, anxiety can lead to physical symptoms (as you have already discovered in Table 16.1). Anxiety often goes hand-in-hand with depression. Also, people who are worrying too much may use alcohol and khat as a way of trying to cope with their symptoms. Although this might help them to feel better in the short term, alcohol and khat usually make anxiety worse in the longer term (see Study Session 14).

Here are some ways that you can help a person if they are suffering from an anxiety disorder (worrying too much):

• Show the person that you take their problem seriously.
• Screen for depression and refer for treatment if needed (see Study Session 12).
• If they are using alcohol and/or khat then advise them to stop (see Study Session 14).
• Suggest cutting back on coffee as this can make anxiety worse.
• If they have sudden attacks of severe anxiety, tell them to breathe into a paper bag. This will help to calm them down.
• Depending on the person, regular exercise could help.
• For the person who worries about lots of different things at the same time, problem solving (a simple, structured way to approach problems; see Box 16.2) can also be a useful approach.

If none of these approaches helps or the anxiety is severe, refer to the next level health centre for further assessment.

Next we would like you to complete Activity 16.1.