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In January, actor Anushka Sharma opened up about seeking treatment for anxiety. In an interview with Vogue magazine, she described it as a biological problem that required acceptance and, more importantly, needed to be talked about openly. “What’s the need to hide it?" she said, adding that there have been cases of depression in her family. Around the same time, her colleague Deepika Padukone too talked about battling anxiety and depression, saying she had sought professional help. She also said she intended to work towards increasing mental health awareness in the country.

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Anushka Sharma. Photo: Vijayanand Gupta/HT

In fact Padukone accepted that for a long time she blamed her unease on stress and overwork. Eventually, she sought help when her mother insisted that she meet a psychiatrist. She was put on medication, which helped.

Anxiety versus depression

“Not all anxious people have depression and not all depressed people suffer from anxiety, but quite often they are companions. Plus, there is a high possibility that one can lead to the other, particularly if ignored and not handled properly," says Bhatia. According to a 2013 study, published in the journal Nature Reviews Neuroscience, more than half of those suffering from depression and anxiety show symptoms of both disorders.

“Anxiety is characterized by a sense of fear and doubt about what is going to happen in the future, whereas in depression there is a feeling of extreme sadness coupled with listless, extreme negative emotions, suicidal thoughts and maybe myriad other physical symptoms like chronic fatigue," says Bhatia.

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Deepika Padukone. Photo; Prodip Guha/HT

Bullying is another reason, according to a study published in the April 2013 issue of the journal JAMA Psychiatry. Once considered a childhood rite of passage, bullying lingers well into adulthood. “Bullies and victims alike are at risk of psychiatric problems such as anxiety, depression, substance abuse and suicide when they become adults," says the study.

Watch out

“Even if you leave anxiety alone for too long, it won’t leave you alone," says Sameer Malhotra, head, mental health and behavioural sciences, Max Healthcare, New Delhi. “Anxiety sufferers often display symptoms like restlessness, fast heart rate, excessive sweating, shakiness/tremors, a choking feeling, breathlessness, twitches, feeling as if one is about to lose control or faint," he says. They may end up taking fast shallow breaths—this would lead to, he adds, a fall in the blood levels of carbon dioxide, in turn triggering a fall in blood calcium levels, leading to tetany (odd contracture of hands, and twitches). Anxiety can also manifest as increased frequency of passing urine, irritable bowel, lowered appetite, frequent unexplained vomiting, significant weight loss, lowered immunity and frequent infections. “And more often than not, (it) surfaces as inefficiency at work, problems with energy, and lack of focus," he adds.

Deal with it

Take help—anxiety-related disorders are treatable. Mind and body are interlinked through neurochemicals, hormones and the immune system, so all three need to be treated in tandem, says Malhotra. “Proper comprehensive assessment and psychiatric treatment is the first step. Psychiatric medication can help boost the brain serotonin level and help rectify negative thinking patterns and correct anticipatory anxiety—the ‘what if’ phenomenon. Balancing norepinephrine levels can help ease the physical symptoms of anxiety, namely, correction of tremors, fast heart rate, rise in systolic blood pressure," he says. “Psychiatric medications are time-tested and used as per standard international guidelines and timely management can effectively improve quality of life and ease distress and associated dysfunction," he adds.

Exercise may help too. In fact, it is increasingly being noted that exercise is an effective but often underused treatment for anxiety and depression. According to a 2011 study, exercise may be useful in preventing the development of panic and related disorders among people with high anxiety sensitivity. Benefits apparently go beyond just producing feel-good endorphins. “We’re not suggesting exercise instead of pharmacotherapy or psychotherapy but, rather, using exercise as a useful alternative which works," say the authors of the study, which was published in the journal Psychosomatic Medicine.

“It is important to avoid using alcohol as an aid to ease anxiety, as it worsens the situation and the risk of dependence is high, which adds to the troubles. Not only does it aggravate depression, it also increases suicidal risk," warns Malhotra. He recalls the case of a 33-year-old working with a multinational in Noida, near New Delhi. He had an irrational fear of flying and would panic just at the thought of boarding a plane. It got so bad that it started affecting his work—he lost out on assignments and promotions. He started drinking daily; this worsened matters. His appetite suffered and his sleep became disturbed. Finally, he sought help.

He took medication and started going for regular walks. “It is also important to avoid negative comparisons, and don’t let your work-life balance, sleep-wake cycle go awry. These add negatively to the situation," says Bhatia.


How to deal with anxiety:

® Don’t over-read or try to self-diagnose; most mental health problems have overlapping symptoms but might need different treatments

® Don’t try to treat it yourself

® Open up and share your doubts with people you love and trust, and keep them updated

® Seek therapy; for all you know you might come back from the appointment with a clean chit and a work-life balance lecture. Or, if need be, get started on the right treatment.

—Sakshi Bhatia, clinical psychologist, Columbia Asia Hospital, Pune.

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