Anxiety is a feeling when someone feels under threat or stress. It is a natural response to threats that has helped with the survival of humans across the ages, but in today’s world, it becomes a problem if it stops us from living our everyday life to the full and we can’t get things done. We all get anxious from time to time – such as before a job interview or an important meeting - and this is normal but some people find that anxiety is constant and affects their normal daily life. Anxiety can cause symptoms of feeling worried, tense or panicky and physical symptoms can develop such as a feeling the heart is beating hard or fast, sweating, shaking, dry mouth, feeling sick, breathing fast and a heaviness in the chest. These occur in response to your body releasing adrenaline when it feels under threat. Everyone will experience this feeling at points in their life, but anxiety can also be problematic at times. If anxiety occurs without a reason, if it persists after the threat or stress is over, if the level of anxiety is out of proportion to the threat, or if it affects your day-to-day life, this might be reason to seek help. Anxiety disorder is an ‘umbrella’ term for many related conditions. People are affected with anxiety in many different ways but some of the more well-known or common anxiety disorder conditions include: generalised anxiety disorder, which is near-constant anxiety about lots of different things in life panic disorder, where regular panic attacks occur without a specific reason social anxiety disorder, which is severe anxiety around social situations or the thought of social situations post-traumatic stress disorder (PTSD), where severe anxiety occurs after a traumatic event obsessive compulsive disorder, known as OCD, where severe anxiety causes repetitive thoughts or actions phobias, which is severe anxiety around a specific thing or situation
Anorexia, or anorexia nervosa, is a mental health condition that manifests as an eating disorder. It can have a huge impact on people's day-to-day lives and it can become life-threatening. It's a complex disorder, which makes it difficult to treat if not addressed early on. Each person varies in their individual symptoms and severity, but the disease has common characteristics: the restriction of food or calories in order to lose weight, the fear of gaining fat or weight, and a distorted body image (seeing yourself as fat when you have a normal or low body weight). Some may feel compelled to control their weight by excessive exercise, skipping meals, lying about food intake, wearing baggy clothes to cover up their body size, and the use of laxatives or other drugs to control weight. With a lack of nutrition and consequent hormonal changes, physical appearance can change. Downy hair may appear on the body and they may suffer dry skin. Girls or women may lose female characteristics post-puberty, or fail to develop these if before or during puberty. Periods may stop or not have started. Constipation, dizziness and fainting are common. Other mental health conditions can run alongside, or develop as a consequence of anorexia, such as depression, social withdrawal or anxiety, and difficulty with sleep and concentration. Left untreated, children may experience stunted growth or bone development problems. It can lead to health problems such as osteoporosis, anaemia, a lowered immune system, and heart problems or dangerously low blood pressure. It is because of these health problems that anorexia can become life-threatening.
Postnatal depression - sometimes also called PND or postpartum depression - is a type of depression that happens after having a baby and can affect anyone around the baby. It is by far most common in the mother (PND occurs in 1 in 10 women) but can also occasionally occur in the fathers. Your doctor will ask you about these symptoms at your six-week check but if you want to speak to someone about it earlier, contact your doctor straight away. It's always important to seek advice from your doctor if you think you may be experiencing postnatal depression. Postnatal depression can get worse over time without any intervention and persist for months, so it’s really important to get the right support early for you and your family.
Parkinson's disease (PD) is a complex nerve disorder that affects movement and usually – but not always – starts over the age of 50. It becomes more common the older we get, so about 1 in 200 of the population develop it by their 60s, and this rises to 1 in 25 people over the age of 80. It affects both men and women but is very slightly more common in men. Symptoms start slowly and progress over time. The main symptoms are tremor, stiffness, and slowed movement and it can significantly affect their day-to-day activities. There is no cure for Parkinson's disease, but medication can be used to improve symptoms and the majority of people do respond to these.
Panic attacks are sudden extreme episodes of anxiety that can happen out of the blue with no clear trigger. They are common with around 1 in 10 people experiencing them during their life. During a panic attack, your body has gone into "fight or flight" mode where adrenaline is released into your bloodstream. This causes physical changes where your heart starts racing and you’re breathing fast (hyperventilating).
Depression is the most common condition affecting mental health with about 1 in 25 of adults experiencing it every year. It can be mild and last a relatively short time, but about a quarter of women and 1 in 10 men have an episode of depression at some point in their lives that’s severe enough to need treatment. The average length of an episode of clinical depression is 6-8 months. It is a medical condition that can be serious, but most cases improve over time, and treatments such as lifestyle changes and talking therapies can help this. It's very important to seek help early if you notice any persistent symptoms of depression. Although depression affects people in different ways, the core symptoms are of persistently low mood or sadness, and a significant lack of enjoyment or interest in anything, even in activities you normally enjoy. It’s a marked difference from how you were before and you may also find it difficult to concentrate and focus. You may feel excessively tired, sluggish and lack motivation, and you may find it hard to start tasks or complete them. Your sleep may also change, such as sleeping in the daytime, finding it hard to get to sleep or to sleep through the night, and waking early in the morning. You may lose your appetite or begin over-eating. People with depression often describe feeling worthless or hopeless, and they often avoid seeing other people. Depression can be categorised as mild, moderate or severe depending on the number of symptoms and how severely they are affecting you. Everyone can feel a bit sad from time to time, if you are going through difficult times such as losing a loved one or a divorce, but this doesn’t necessarily mean you have depression. This can be a normal and appropriate response, and your coping strategies will help you get back on your feet. This becomes more concerning if you’re feeling down for more than a few weeks and it’s getting worse, if it wasn’t in response to anything, or if you’re finding it hard to do your job or get everyday tasks done like washing or cooking. This is more like clinical depression. Depression can lead to persistent thoughts of suicide or self-harm. This can have a significant impact on people's lives or be life-threatening and is why it is important to seek help if you are suffering from depression. Even the most severe depression can get better with the right support and treatment.
Bulimia, also known by its longer medical name of bulimia nervosa, is a mental health condition and type of eating disorder. It can have a huge impact on people's day-to-day lives and can lead to further health problems which in severe cases can be life-threatening if not treated. Symptoms and the severity of symptoms can vary from person to person but bulimia is characterised by cycles of eating or binging on large amounts of food in a short space of time and then compensating for this by restricting food, inducing vomiting, using laxatives, or excessively exercising. The compensatory behaviours to try and avoid weight gain cause hunger and so can lead to binge eating and is why bulimia can be a vicious cycle of binging followed by purging or restricting. Along with this, poor body image specifically regarding weight is also a common factor.
Borderline personality disorder (BPD) is a lifelong mental health condition that is characterized by difficulties in regulating emotions and interacting with others. It is also known as emotionally unstable personality disorder, and is the most common and well-known type of personality disorder.
Bipolar disorder is a mental health condition that used to be called manic depression. It can lead to extreme changes in mood, energy, and ability to function. There are two distinct parts of the illness: periods of feeling depressed and low, and then huge emotional highs – called mania - where the person can be incredibly overactive. Unlike daily mood swings, people with bipolar may be in one state of either mania or depression for weeks or months at a time. In between these episodes, the person may feel normal and well. (Less commonly, some people with bipolar disorder can have what is known as a mixed bipolar episode, where they can alternate between depression and manic symptoms in a matter of hours). Bipolar symptoms can be severe and may affect your daily life, work, studies and relationships and are very different from the normal mood swings we can all have from time to time. If you have less severe mania symptoms, this is known as hypomania. There are two types of bipolar disorder – Type I and Type II. Type I usually starts with manic symptoms, often mixed with depression, whereas Type II only involves hypomania. Around 2% of people develop bipolar disorder at some time in their life, and it can occur at any age, although it usually presents between the ages of 18 and 30. Men and women are equally affected. The average length of a manic episode is four months, and six months for the depressive phase. It’s impossible to predict how long each manic-depressive cycle will last, and the average number of episodes you may experience in your life if you have bipolar disorder is ten. Three quarters of people who have an episode of bipolar disorder have another one within four years.
As a parent, it can be a tough job to work out whether your child has an anxiety disorder or they’re just dealing with the challenges of growing up. As a paediatrician, I face this dilemma daily in my clinic. I’ll try to help you decide the difference between a healthy state of anxiety and an unhealthy one, and where to go next.