Q Quite often, we are under tremendous stress and anxiety. Some people can handle it and take it as a part of life. But for others, it is agony. What are the triggering factors and treatments for anxiety? Can the patients themselves do something to overcome it?

A Having some anxiety symptoms occasionally is a natural response to the stressors we commonly face in life and serves as a function to warn and protect us from danger.

For example, it could help us to be more careful when crossing a narrow bridge or improve our performance when we take examinations.

It is only when the anxiety symptoms are severe, longstanding and interferes with our usual daily functioning that it becomes a "disorder" which requires treatment.

The most common example of such a disorder is generalised anxiety disorder (GAD), in which one becomes easily worried about many things throughout the day for a period of more than six months.

As a result, one cannot function at work or school due to the constant high levels of anxiety.

Another example is panic disorder, in which there are frequent recurrent "panic attacks" (short episodes of severe anxiety symptoms), as well as anticipatory fears of subsequent "attacks", which may cause the person to avoid going out and thus affect his daily activities.

Having physical symptoms of anxiety such as palpitations or shortness of breath is not life- threatening by itself.

But if someone suddenly has these symptoms, he should see a doctor to exclude other medical problems first, such as heart or lung conditions, before he can be diagnosed with an anxiety disorder.

A person with anxiety disorder can be helped with medications and psychological therapies, which include cognitive methods - where patients are taught about physical responses related to anxiety. They are also exposed to possible triggers and taught the use of relaxation techniques.

Lifestyle changes, such as getting sufficient sleep and adequate exercise, and stress management would also help, as excessive stress can trigger or worsen anxiety.

Avoid or moderate intake of certain foods and beverages like caffeinated beverages which can cause anxiety-like symptoms such as tremors and palpitations.

The condition warrants a visit to the doctor when it hinders the person from performing daily tasks.

Dr Wei Ker-Chiah

Consultant and chief in the department of community psychiatry at the Institute of Mental Health

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