MindSG
Explore our suite of self-care tools and resources to help you better understand and manage your mental health.
- Understanding anxiety disorder
- What is anxiety disorder?
- The basics of anxiety
- Types of anxiety disorders
- What causes anxiety disorders?
- How do we identify anxiety disorders?
- How are anxiety disorders diagnosed?
- How are anxiety disorders being treated?
- Self-assessment tools for anxiety disorders
- How can we manage anxiety disorders?
- Mental health services
Understanding anxiety disorder
We are in the
golden years of our lives, where the days may take on a more relaxed pace.
For some of us, our children would have grown, and we now have the time and
luxury to devote to new hobbies and interests. We also get to spend more
time with the people we care for. This can be quite an exciting time for us.
However, during this stage of life, we will inevitably encounter
experiences that can be overwhelming. We might have to face the loss of a
spouse, declining health, or a reduced sense of independence.
These changes might cause us to feel anxious. If the anxiety becomes
excessive and affects our daily lives, it can affect our physical and mental
health. If the anxiety persists, it might be a sign of anxiety disorder.
What is anxiety disorder?
Anxiety disorder occurs when a person’s anxiety is persistent, excessive, and irrational. This is different from anxiety, a common, normal, and appropriate feeling of worry, nervousness or unease when dealing with day-to-day stresses or problems.
How does it
affect us?
When we have anxiety disorders, we frequently have worries and fears that interfere with daily activities. These feelings are difficult to control, out of proportion, and can last a long time, affecting us in the following ways:
- The way we lead our lives, e.g. avoiding the fear and anxiety-provoking situations
- Our ability to cope with demands of work and our responsibilities
- Our ability to cope with the demands of life or relationships
Common misconceptions:
What people may think:
Anxiety disorders only happen to those who are often stressed and worry a lot.
What are the different
types of anxiety
disorders?
There are different types of anxiety disorders. Generalised
Anxiety Disorder (GAD) is a common anxiety disorder
that affects about 1 in every 167 Singaporeans aged
65 and above in their lifetime.
Other common anxiety disorders include panic disorder and specific
phobias.
People with GAD face excessive anxiety and worry over various situations. GAD is diagnosed when a person finds it difficult to control his/her worry over a prolonged period of at least 6 months.
Panic attacks are sudden episodes of intense
anxiety. They may occur out of the blue without
any real danger.
With panic disorder, an individual
experiences recurrent and unexpected panic
attacks over a period of a month.
They develop a constant fear of future
panic attacks and begin to change their behaviours
(e.g. avoiding certain places) to prevent
experiencing it again.
People with specific phobias experience
excessive and unreasonable fears over a period
of 6 months.
The fears range from thunder to lizards,
or situations such as confined spaces, height,
or
flying.
Although these objects and situations are
not dangerous, they provoke immense anxiety and
avoidance from those with the phobia.
Some people may be affected by more than one anxiety disorder or have other mental health conditions, e.g. depression, at the same time. This is not uncommon and a healthcare professional will be able to determine which condition(s) an individual has.
Causes
Causes
There are generally three factors in understanding the possible causes of anxiety disorders:
Biological
This includes inherited genetic traits or
the amygdala (the part of our brain that processes fear)
being more reactive when facing threats.
The healthcare professional may conduct tests to
determine if the anxiety disorder is a result of an existing
medical issue. Existing health issues or side effects from
some medications may also cause anxiety symptoms.
Biological
Social
This refers to lived experiences such as traumatic events or the environment we grew up in. Other factors that increase our risk of anxiety disorders are loneliness and experiencing recent loss.
Biological
Biological
Chronic illnesses such as heart problems, and
joint and muscle issues, may also increase the risk of
developing anxiety disorders. Other biological causes
include inherited genetic traits or chemical imbalances
in the brain.
The healthcare professional may request for tests
to determine if the anxiety disorder is a result of an
underlying medical issue. Underlying health issues or
side effects from some medications may also cause
anxiety symptoms.
Side effects of certain medications
Medications that may cause symptoms of
anxiety disorder include:
- Cortisone
- Adderall
- Ventolin
- Thyroid medicine
Biological
Chronic illnesses such as heart problems, and
joint and muscle issues, may also increase the risk of
developing anxiety disorders. Other biological causes
include inherited genetic traits or chemical imbalances
in the brain.
The healthcare professional may request for tests
to determine if the anxiety disorder is a result of an
underlying medical issue. Underlying health issues or
side effects from some medications may also cause
anxiety symptoms.
Underlying health issues
Medications that may cause symptoms of
anxiety disorder include:
- Heart disease
- Diabetes
- Thyroid problems, such as hyperthyroidism
- Respiratory disorders, such as chronic obstructive pulmonary disease (COPD) and asthma
Biological
Psychological
This includes negative thinking patterns such as the perception of not having control over the environment and/or emotions. Another psychological cause is cognitive impairment where deterioration of our cognitive abilities (e.g.memory and thinking skills) is linked to increased risks of anxiety disorder.
Signs and symptoms
Some common signs and symptoms of anxiety disorders include:
Chest pain/discomfort
Cold, numb/tingly hands
and
feet
Difficulties remaining calm and staying still
Dizziness
Excessive fear, panic, and feelings
of
uneasiness
Heart palpitations
Shortness of breath
Sweating
Other additional symptoms distinct to GAD, panic disorder and specific phobias are:
Generalised Anxiety Disorder (GAD)
- Excessive worrying that is difficult to control
- Difficulty concentrating
- Fatigue
- Irritability
- Muscle tension
- Restlessness or feeling on edge
- Sleep disturbance
Panic disorder
- Recurrent panic attacks
- Persistent concern/worry about future panic attacks and their consequences
- Fear of losing control and/or dying
- Maladaptive behaviour (poor patterns of behaviour to cope with the situation) such as avoidance
- Physical symptoms such as chest discomfort, difficulty breathing, giddiness and nausea
Specific phobias
- Distinct fear or anxiety about a specific object or situation
- The specific object or situation almost always provokes immediate fear or anxiety
- Specific objects or situations are actively avoided or endured with intense anxiety
- The fear or anxiety is out of proportion to the actual threat of the object and the social and cultural setting
The signs and symptoms can be managed with early treatment.
Diagnosis
To diagnose an anxiety disorder, a healthcare professional would
conduct a detailed clinical interview in which he/she would ask about the
individual’s past medical and psychiatric history, family history, current
symptoms, and the impact on his/her
functioning.
With the patient’s consent, there may also be requests to speak with a
family member to gather more information. A physical examination and some blood
tests may also be done.
Treatment
Medication and psychotherapy are effective treatments
to help reduce the signs and symptoms of anxiety
disorders.
Anxiety disorders respond well to treatment if they are identified and treated early. Antidepressants are effective in treating anxiety disorders. When combined with psychotherapy, medication results in a lower risk of relapse and better control of symptoms. The advice of a healthcare professional is required for the continuation or stopping of medication.
Psychological
therapies are treatments used to improve a
person’s mental health. Cognitive Behaviour
Therapy (CBT) is commonly used for anxiety
disorder and it is a psychological treatment
focused on improving mood by recognising and
changing unhelpful thought patterns.
A subtype of CBT that may be deployed is
Exposure Therapy (EP) where patients are
incrementally and gradually exposed to things or
situations that make them anxious. This therapy
seeks to help them reduce the distress
experienced.
Reaching out for support
The people we love and trust can be our
pillars of support in times of need. Such social
support can help us reduce any sense of
loneliness (which is a risk factor for anxiety),
and improve our mental well-being. Find out more
about how to reach out for
support.
Creating a routine
Establishing a routine can help eliminate
some of the surprises that we face in our
day-to-day activities by adding some
predictability to our lives.
Adopting self-care practices
Other simple strategies such as being
aware of what makes us anxious, learning
relaxation techniques and having regular
exercise help to reduce anxiety, and can
contribute to our mental well-being. Here are
some tips that can help us
cope with our anxiety.
Anxiety self-assessment
tool
Anxiety disorder is when our anxiety
(feelings of worry, nervousness, or unease) is persistent, excessive,
and irrational.
The General Anxiety Disorder-7 (GAD-7) is a set of 7 questions
that those aged 12 and above can use to assess if they
might be suffering from anxiety disorder and to take steps to feel
better.
Please note this is a self-assessment and not a medical
diagnosis.
Useful self-help tools
What people may think:
Feeling anxious is the same as having an anxiety disorder.
But did you know:
People with anxiety disorders often have constant
fears or anxious thoughts that get in the way of their daily lives.
This is different from feeling worried about situations such as
organising an important family event, etc.
What people may think:
Anxiety disorders only happen to those who are often stressed and worry a lot.
But did you know:
Anxiety disorders can happen to anyone, not just those who tend to get stressed and worried. Find out what are the possible causes of anxiety disorders.
What people may think:
Anxiety disorders will go away on their own.
But did you know:
Anxiety disorder requires care and support from healthcare
professionals.
To prevent it from worsening over time, seeking treatment should
not be delayed.
Anxiety
self-assessment tool
Anxiety disorder is when our anxiety
(feelings of worry, nervousness, or unease) is persistent,
excessive, and irrational.
The General Anxiety Disorder-7 (GAD-7) is a set of questions that those aged
12 and above can use to assess if they might be
suffering from anxiety disorder and to take steps to feel better.
Please note this is a self-assessment and not a
medical diagnosis. If you are under 18 years old and concerned
about your results, please seek advice from a
trusted adult.
Instructions
For each question, please SELECT the option that
comes closest to how you have felt IN THE
PAST 2 WEEKS — not just how you feel today.
Complete all
questions.
Your score will be automatically calculated and shown to
you after you submit your responses.
Select
the option that comes
closest to how you have felt IN THE PAST 2 WEEKS –
not just how you feel today.
Question of
Feeling nervous, anxious, or on edge
Not being able to stop or control worrying
Worrying too much about different things
Trouble relaxing
Being so restless that it is hard to sit still
Becoming easily annoyed or irritable
Feeling afraid, as if something awful might happen
Finally, please select your age group.
This will help us provide you with resources better suited to your needs.
Your score:
Your answers indicate that you are unlikely to be experiencing anxiety disorder at the moment.
You are doing a great job of looking after your feelings. Continue the great work!
Click “Next” for tips to help you maintain your self-care.
Your answers indicate that you are unlikely to be experiencing anxiety disorder at the moment.
You have been taking great care of your feelings. Continue the great work!
Click “Next” for tips to help you stay motivated in caring for yourself.
Your answers indicate that you are unlikely to be experiencing anxiety disorder at the moment.
You have shown consistent commitment to taking care of your feelings. Continue the great work!
Click “Next” for tips to help you keep up with your self-care routine.
Your score:
Your answers indicate that you could be experiencing mild anxiety.
As a youth, you may face a variety of daily demands and the pressures of balancing school, life, and relationships.
Click “Next” for tips to help you manage your emotions and overcome your challenges.
Your answers indicate that you could be experiencing mild anxiety.
Life often comes with its share of responsibilities, from work to relationships and even financial uncertainties.
Click “Next” for tips to help you cope better and care for your well-being.
Your answers indicate that you could be experiencing mild anxiety.
As you enter your senior years, you may experience big life transitions, such as retirement or health and financial challenges.
Click “Next” for tips to help you manage your emotions and better cope with your challenges.
Your score:
Your answers indicate that you could be experiencing moderate anxiety.
As you begin to transition into adulthood, life's ups and downs like navigating relationships, or academic and work matters can sometimes trigger emotions like stress and anxiety.
Click “Next” to find out how you can manage your emotions and better care for yourself.
Your answers indicate that you could be experiencing moderate anxiety.
Juggling daily work responsibilities and managing relationships can sometimes trigger emotions like stress and anxiety.
Click “Next” to find out how you can seek support to better cope with your emotions in tough times.
Your answers indicate that you could be experiencing moderate anxiety.
Adjusting to major life changes is never easy, no matter what phase of life you are in. Coping with changes like retirement or health and financial concerns can sometimes trigger emotions like stress and anxiety.
Click “Next” to find out how you can reach out for support to manage your emotions and overcome difficult times.
Your score:
Your answers indicate that you could be experiencing severe anxiety.
Life can sometimes throw us into situations that can be stressful and anxiety-inducing.
Click “Next” to find out how you can seek support to help manage your emotions and well-being.
Your answers indicate that you could be experiencing severe anxiety.
When day-to-day struggles become too overwhelming, life can sometimes feel almost unbearable and anxiety-inducing.
Click “Next” to find out how you can reach out for support to better cope in difficult times.
Your answers indicate that you could be experiencing severe anxiety.
Sometimes, our struggles may feel too overwhelming to bear, and can cause intense feelings of anxiety.
Click “Next” to find out how you can seek support to manage your emotions and care for your well-being.
