Everyone experiences anxiety and worry sometimes and some people describe themselves as born worriers. Anxiety is almost synonymous with our modern world because of our civilization. As we move from our primitive agrarian society to the modern sophisticated society where we are bombarded with numerous signals whether on the road, work, office or the supermarket; anxiety has become a way of life. In motivational circles, we are told that anxiety sustains our quest for self- improvement. Our doors are automated and we no longer walk in staircases as we go to the topmost floor of a 30 storey building in automated lifts as we unconsciously experience the anxiety of a possible malfunctioning. As we receive the news of an air crash, we are on our way boarding another plane with feelings of tension, apprehension, uncertainty and worry dominating our minds. As we get more civilized, the social distance between us get wider and we are left alone with our fears. The mobile phones have helped us to elicit and sustain useful business contacts but we have had to experience undue apprehension and tension because of enormous uncensored traffic of information that gets to us which leaves us no space to sieve and compartmentalize information getting to us thereby overwhelming our coping mechanisms. The cable television system brings to our homes unsolicited news of calamities such as tsunamis, earthquake, famine, floods, wars and other disasters, which bombard our minds and overstretch our capacities to cope with life as anxiety is unconsciously generated. Medical science has made enormous progress in diagnostic endeavours with fantastic types of equipment that can proactively locate varying kinds of the pathological functioning of our systems than it promises to cure which sets up an unconscious feeling of anxieties in our mind. Violent crimes, sexual assaults, kidnapping, robbery attacks and suicide bomb attacks have increased the average person’s level of anxiety as they develop a post-traumatic stress disorder. Uncertainties in the economy and perennial failure of the government to fulfil electoral promises have been responsible for this high level of anxiety in an average modern man. A few years back, we experienced the global economic meltdown in one of the most sophisticated economies of the world and at home, the capital market crisis in our country has generated potent feelings of anxiety, as an investment is undertaken. The fundamental psychopathological mechanism intervening between all these situations and anxiety as a mental disorder is a THREAT. Paradoxically, it is not the magnitude of the situation that ultimately makes the feeling of anxiety in an individual a manifestation of mental disorder but the constitutional makeup of that individual. This group of individuals by design and otherwise have their coping mechanisms overwhelmed such that they come down with motor tensions, hyperactivity of their autonomic nervous system, apprehensive expectations and undue vigilance. They experience persistent anxiety and worry that is out of proportion to actual event or circumstance. Typically, in the pathological state, the anxiety and worry involve minor or everyday matters such as work, finances, relationships, health or safety of loved ones. Consequently, the worry often interferes with concentration and performance. There is associated variety of cognitive and bodily manifestations such as undue trembling, aches in the back and shoulders, vague but persistent headaches, chest tightness, restlessness, exaggerated responses to familiar stimuli, irritability and disturbed sleep pattern with horrible dreams. There is associated fatigue, erectile problems, frequent urination and frequent stooling. Most of the folks that have anxiety disorder usually have a running battle with the generalist doctor because they are quick to come up with the diagnosis of what they think is their problem and can argue endlessly with their doctors having done extensive research of their complaints on the internet. Other peculiar presentations in our environment include crawling sensations in the head to the sole of the feet, a feeling that worms move under the skin with a pulsating effect and complains of peppery and tingly sensations on the legs associated with internal heat but normal body temperature. They like to be investigated along with their lines of suspicions and could come up with a fatal erroneous diagnosis of fatal heart conditions, HIV- AIDS and are ready victims of quack native doctors. Appropriate medical investigations to exclude the physical basis of these complaints may be necessary just as mere symptomatic amelioration of these symptoms using drugs especially sedatives may not be helpful. Detailed personal history of such patient especially marital, occupational and social history may be crucial as they are referred to the mental health experts for further management. Relaxation techniques, supportive psychotherapy and practical thought control strategies can be taught. Learning to identify and deal with causes of anxiety early rather than denial may just be preventive before overwhelming their coping mechanisms.
Dr Adeoye Oyewole
adeoyewole2000@yahoo.com
+234 803 490 5808 (WhatsApp Only)
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