Anxiety Disorders

Health Resources

Everyone experiences some level of anxiety. These feelings may include feeling embarrassed, frightened, insecure, panicky, nervous, scared, or humiliated. These are all normal emotions.

However, if you are experiencing these feelings on most days and they are affecting your life, you may be suffering from an Anxiety Disorder.

Sometimes, these Anxiety Disorders can cause physical symptoms of muscle tension, headaches, heart palpitations, sweating, trembling, trouble breathing, choking sensations, chest pain, stomach problems, dizziness, numbness, tingling sensations, blushing, sleep problems, concentration problems, memory problems, or fatigue.

If your anxiety is so severe that you have trouble working or socializing with your friends and family, you may be suffering from a medical condition in which help is available. There is good scientific research available on the following medical conditions.


Panic Disorder

Do you suffer from sudden and unexpected bouts of panic symptoms like:

  1. Pounding heart.
  2. Sweating.
  3. Trembling or shaking.
  4. Sensations of trouble breathing.
  5. Feeling of choking.
  6. Chest pain or discomfort.
  7. Nausea.
  8. Dizziness or lightheaded.
  9. Feeling unreal or detached from your self.
  10. Fear of losing control or going crazy.
  11. Fear of dying.
  12. Numbness or tingling sensations.
  13. Chills or hot flashes.

If you have 4 or more of these symptoms that suddenly appear all at once, you may be having Panic Attacks. Panic attacks are quite common and can occur in many situations (for example: if someone were to throw a snake in your lap, you may get a Panic Attack).

Many people get Panic Attacks and are not bothered by them. Panic Attacks on their own are not considered to be a medical condition.

However, if these Panic Attacks begin to influence your life or bother you significantly, you may be suffering Panic Disorder.

If you are constantly worried about getting another attack, worrying about losing control, worrying about having a heart attack, worrying about going crazy, or stopped doing some things to prevent another attack, you may be suffering from a medical condition called Panic Disorder. If you become afraid of going into certain situations because you think you won’t be able to get out if you get a panic attack, you may be suffering from Agoraphobia.

These places include subways, buses, malls, grocery stores, bridges, driving, grocery stores, movie theatres, restaurants, elevators, crowds, line-ups, being alone, or going out of town. Approximately 2%-5% of the population will suffer from Panic Disorder. It usually develops in young adulthood, but can develop at any age. However, it is unusual to suddenly develop panic attacks after the age of 45.

You should see your family doctor right away if just developed panic attacks after 45 years old. It could be a serious medical condition.


Specific Phobia

A phobia is an excessive fear of an object or situation. These include certain animals, insects, heights, seeing blood, injections, storms, water, flying, elevators, enclosed spaces, choking fears or fears of vomit.

Many people will experience fear in the above situations. However, if the fear is severe enough that it affects your ability to work or socialize with your friends and family, you may have a Phobia.

Specific phobias are very common. Approximately 5%-10% of the population has a Specific Phobia.


Social Phobia

Do you feel scared or anxious when you have to do things in front of people or when you are just around people? Are you scared that you may embarrass or humiliate yourself? Would you avoid these social situations if you had the chance? If you answered yes to all these questions, you may be suffering from Social Phobia.

Social Phobia is more than just shyness. Shyness is a normal human trait and does not interfere significantly with one’s life. Social Phobia is a medical condition, which significantly interferes with people’s work functioning or social life.

It is a common condition that affects approximately 10%-15% of the population at least once in their lives. It usually begins in the teenage years.


Obsessive-Compulsive Disorder

Do you suffer from obsessions? Obsessions are recurrent and intrusive thoughts, images or impulses.

Examples of obsessions include recurrent concerns about being contaminated with germs or dirt, recurrent thoughts that you may not have locked your door or shut off the stove, excessive concerns that you may have hurt someone accidentally, intrusive religious/sexual/horrific images or impulses to hurt someone you don’t want to hurt.

Do you suffer from compulsions? Compulsions are behaviours you have to do a certain way or over and over again, in order to relieve a sense of tension or anxiety.

Examples of compulsions include excessive hand washing, repeated checking of things (for example: lights, doors, appliances, faucets), counting things for no reason, hoarding useless items (like bills, papers, or magazines), doing things in a specific ritual that other people do not do, and making sure things are lined up perfectly or placed in a certain way.

If you have an obsession or compulsion and it bothers you or it significantly interferes with your life you may be suffering from a disease called Obsessive-Compulsive Disorder.

Approximately 2%-3% of the population suffers from this disease.


Post-Traumatic Stress Disorder (PTSD)

  1. Have you ever experienced an event that was overwhelming and traumatic? Examples of traumatic events include being in a war, being tortured, being in a natural disaster (earthquake, flood etc.), assault, rape, or a serious accident.
  2. Did you feel extremely scared, helpless or horrified when the event was happening?
  3. Do you have difficulties forgetting about the traumatic event? For example, you have constant thoughts about the situation, nightmares about the event, sometimes feel as if it is happening again, or get very nervous when something happens that reminds you of the event.
  4. Do you avoid things that might trigger the fear you experienced during the traumatic event? Do you feel emotionally numb?
  5. Do you have difficulty with your sleep, get angry easily, have difficulty with your concentration, constantly on edge watching everything around you, or are you easily scared?

If you answered yes to all of the above questions and you find that you have difficulties coping with your life because of these symptoms, you may be suffering from a disease called Posttraumatic Stress Disorder. You should talk to your family doctor about this disease if you think that you may have it. There is treatment available. This is a disease that can affect up to 3% of the population.


Generalized Anxiety Disorder

Do you find yourself worrying excessively about ordinary things almost every day? For example, do you worry about your finances when they are fine? Do you worry about your health when you are physically ok? Do you worry about the health and safety of your loved ones when they are fine? Do you find these worries very difficult to control? Do you suffer from physical symptoms because of these worries? These physical symptoms can include fatigue, difficulties concentrating, irritability, muscle tension, sleep problems or restlessness/feeling on edge. If this sounds like you, you may be suffering from Generalized Anxiety Disorder. Generalized Anxiety Disorder is a common disease that can occur in proximately 5% of the population. It usually exists with other conditions such as Major Depression.


What causes Anxiety Disorders?

Some research suggests that anxiety disorders develop when people learn to associate certain situations with fear.

They learn to overestimate the degree of danger and the probability of harm in certain situations. Some people with anxiety disorders also underestimate their own abilities to cope in certain situations.

A number of brain chemicals have been found to be associated with anxiety disorders. These brain chemicals include norepinephrine, serotonin, and GABA. Brain scan research has revealed that certain areas of the brain may be different in those people who suffer from an anxiety disorder.

There may also be a genetic component. Close relatives of people with an anxiety disorder tend to have a slightly higher chance of also suffering from an anxiety disorder.


Treatment for Anxiety Disorders: Cognitive-Behaviour Therapy

Cognitive-Behaviour Therapy is a form of treatment that involves two types of therapy.

It involves Cognitive Therapy and Behaviour Therapy. Cognitive Therapy helps you to look at your feared thoughts.

Usually, your fears are exaggerated or irrational. Cognitive Therapy helps you to examine and challenge your fears.

Sometimes people with anxiety disorders will avoid or escape fearful situations. These behaviours usually lead to more anxiety in the future. Behaviour Therapy teaches you how to gradually face your fears and not avoid or escape these situations.


Treatment for Anxiety Disorders: Medications

Antidepressants can be helpful for some anxiety disorders. Even though they were initially developed for depression, they have been scientifically proven to be helpful for most of the anxiety disorders.

It is believed that they help in balancing the brain chemicals that cause anxiety disorders.

Because one of the side effects of antidepressants can be a short-term increase in anxiety, your doctor may tell you to start the antidepressant at a much lower dosage to prevent this.

The initial increase in anxiety will usually go away after 1-2 weeks. Your doctor may also gradually increase your antidepressant over a period of 1-2 months, to dosages that are higher than that used for depression.

Scientific research has shown that you may need higher dosages of antidepressants to treat some of the anxiety disorders. It may also take longer for the medication to work.

It can take 8-12 weeks of being on the medication before you see any significant improvement. See section on medications for Major Depression for more information.

Benzodiazepines are a class of medications that are sometimes used in treating anxiety disorders. The common medications in this class are Valium/diazepam, Ativan/lorazepam, Rivotril/clonazepam, and Xanax/alprazolam.

These medications are quite effective in relieving anxiety temporarily. However, they can be quite addictive and difficult to stop. As a result, they are usually used for short periods of time, for example, 3-6 months only.


Suggestions For Families

  1. Learn as much as you can about the symptoms and treatments for anxiety disorders.
  2. Support your relative’s medication and treatment program.
  3. View your relative’s anxiety behaviours, as symptoms, not character flaws. Remember that your relative is a person with a disorder, but who is healthy and capable in many other ways.
  4. Do not participate in your relative’s anxiety behaviours (for example, avoidance of certain situations or unusual compulsions), and explain to your relative that you are doing this to help support their treatment program. If you have fallen into the habit of participating in the anxiety behaviours, it will take some practice to change back to more normal behaviours.
  5. Maintain a normal family life as much as possible, do not allow the anxiety disorder to take over.
  6. Keep communications positive, direct and clear. State what you want to happen rather than criticizing your relative for past behaviours.
  7. Keep calm. Avoiding losing your temper will contribute to a positive atmosphere.
  8. Combine humour with caring. Support doesn’t always have to be serious. Respectful humour can help your relative detach from his or her symptoms.
  9. If there are children in the home, explain that their family member behaves this way because he or she is sick with an illness, and reassure them that they did not cause it.
  10. Depression can accompany an anxiety disorder. Learn the warning signs of suicide and make an emergency plan that includes these phone numbers: your relative’s psychiatrist or family doctor, emergency services and the police. If possible, make the plan with the assistance of your relative.
  11. Take good care of yourself. Creating a low-stress environment for you by seeking and accepting support, cultivating interests that are just yours, and taking a little time out each day to recharge your batteries will give you the energy to support your relative.
  12. The most important thing to remember is that life is a marathon, not a sprint. While you are doing the best you can to provide support to your relative, you will sometimes find yourself accommodating to anxiety behaviours before you realize it. Try not to be judgmental toward yourself when you fall into old routines, in the same way that you try not to judge your relative. Just start again.


Where Can You Get Help In Toronto?

Your Family Doctor

If you think that may be suffering from an anxiety disorder, make an appointment with your family doctor. At the beginning of your visit, ask your family doctor if you might be suffering from an anxiety disorder. If your family doctor thinks that you are suffering from an anxiety disorder, he/she will give you advice about what to do. If your family doctor needs a second opinion about your illness, he or she may send you to a psychiatrist, a specialist in this area of medicine.


Community Health Programs

Hong Fook Mental Health Association
Tel: 416- 493-4242
This is the main agency for Asians with mental health issues.

Toronto Western Hospital – Asian Initiatives in Mental Health
Tel: 416-603-5800 ext.5349

South Riverdale Community Health Centre
Tel: 416-461-1925
This program is only for South Riverdale residents.

Wellness Centre
Tel: 416-291-3883


Local Hospital Emergency Room

If you are seriously thinking about ending your own life, you must see a doctor right away. You may go to your local hospital emergency room if you can’t see your family doctor right away. If your relative is talking about killing himself or herself, you can call their family doctor or the hospital emergency room. They will give you advice about what to do.


Links to other websites on Depression and Anxiety 

(These Websites are in English Only)