Anxiety Disorders Treatment in Gurgaon

By Dr. Gianender Rao, M.D. (Psychiatry)

Anxiety Treatment in Gurgaon, Treatment for anxiety in Gurgaon

What is Anxiety Disorders ?

Anxiety Disorders treatment in Gurgaon is most common psychiatric condition. It is a vague, unpleasant sense of apprehension associated with autonomic symptoms, like headache, sweating, palpitations, stomach discomfort, restlessness and chest pain.

FEAR : Response to threat that is known external, definite or non conflictual

ANXIETY : Response to threat that is unknown, internal, vague or conflictual

Symptoms of Anxiety :

  • Restlessness, generalized weakness, fearful, fatigue, lack of concentration
  • Increase in heart rate (palpitations), shortness of breath, sweating, tremors or shivering, stomach upset, increase urinary frequency, loose motions, tingling and increase in BP
  • Stress, tension, lack of concentration in work

PHOBIA :


AGORAPHOBIA :

  • Fear or avoidance of crowds, public places or travelling alone
  • Palpitations, sweating, trembling or dry mouth
  • Difficulty breathing, feeling of choking, chest pain, nausea or abdominal distress
  • Feeling dizzy, faint or unsteady
  • Feeling that objects are unreal or self is not really here
  • Fear of losing control, fear of dying.
  • Hot flushes or cold chills, numbness or tingling
  • Significant emotional distress
agoraphobia

AGORAPHOBIA

agoraphobia-avoidance-of-crowds

Agoraphobia-Avoidance of Crowds

agoraphobia-avoidance-of-public-places

Agoraphobia-Avoidance of Public Places

social-phobia-gurgaon-treatment

Social Phobia

Associate with fear of behaving in a way that will be embarrassing or humiliating

social-phobia-gurgaon-treatment-dr-gianender-rao

Social Phobia-Avoidance Meetings

Marked avoidance of being the focus of attention in social situations.

treatment-social-phobia-avoidance-speaking-in-public

Social Phobia-Avoid Speaking in Public

Avoidance of speaking in public places, entering small groups of parties.


SOCIAL PHOBIA :

  • Associate with fear of behaving in a way that will be embarrassing or humiliating
  • Marked avoidance of being the focus of attention in social situations e.g. speaking in public or entering small groups of parties, classrooms meetings, associated with fear of vomiting or micturition, blushing or shaking

PANIC DISORDER :

  • A. Recurrent panic attacks not associated with specific situation or object and often occur spontaneously
  • B. A panic attack is characterized by –
    • 1. Abrupt intense fear of discomfort
    • 2. Lasts at least some minutes
    • Includes: palpitation, sweating, shaking, dry mouth, choking, chest pain, breathlessness, nausea, dizziness, fear of dying, hot flushes, numbness, cold limbs

GENERALISED ANXIETY DISORDER :

There must be a period of at least 6 months with tension, worry, apprehension about everyday events and problems with associated autonomic symptoms.

OBSESSIVE COMPULSIVE DISORDER – :

  • A. Either obsessions or compulsions present for at least 2 weeks
  • B. OBSESSIONS (thoughts, ideas or images) and compulsions (acts) must be unpleasant, excessive, repetitive, none resisting, distressing and originating in own mind

ACUTE STRESS REACTIONS - :

Exposure to an exceptional mental or physical stress or immediate onset of symptoms of anxiety.

PTSD (Post Traumatic Stress Disorder) :

Exposure to a stressful event or situation of threatening or catastrophic nature with persistent remembering or reliving of the stress in flash back or memories, dreams. There is inability to recall events. There are symptoms of difficulty in sleep, anger, lack of concentration, hypervigilance.

TREATMENT OF ANXIETY DISORDERS :
  • A. PANIC DISORDER AND AGORAPHOBIA:
    • 1. Pharmacotherapy
      • a. SSRIs : Paroxetine, Fluvoxamine & Sertraline are best tolerated.
      • b. BZDs : Alprazolam, Lorazepam, Clonazepam for rapid onset.
    • 2. COGNITIVE BEHAVIOR THERAPY :
    • includes applied relaxation, respiratory training and In vivo exposure

    • 3. Insight Oriented Psychotherapy :
  • B. SPECIFIC AND SOCIAL PHOBIA :
    • 1. BEHAVIOR THERAPY (Most effective Treatment) includes systematic desensitization, Hypnosis, Flooding or implosion.
    • 2. Insight Oriented Psychotherapy (To understand origin of phobia, secondary gain and how to deal with stimuli.
    • 3. ERP (Exposure and Response prevention)
    • 4. Effective Drugs include SSRIs, BZD, Venlafaxine, Buspirone
  • C. OBSESSIVE COMPULSIVE DISORDER:
    • 1. Prevalence of OCD in general population – 2- 3 %
    • 2. Most common pattern – First obsession of contamination followed by washing of hands with associated anxiety. Second is obsession of doubt followed by compulsion of checking. Thirdly sexual or aggressive thoughts and fourthly need for symmetry or precision, religious thoughts.
    • 3. TREATMENT : SSRI (Fluoxetine, Fluvoxamine, Paroxetine, Sertraline, CLOMIPRAMINE
    • 4. BEHAVIOR THERAPY : ERP, FLOODING etc
  • D. GENERALISED ANXIETY DISORDERS:
    • 1. BENZODIAZEPINES
    • 2. BUSPIRONE
    • 3. SSRI ( SERTRALINE, PAROXETINE)
    • 4. CBT (Cognitive Behavior Therapy)
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