Clinical presentations and management of Anxiety Disorders

Signs & Symptoms

Patients with generalised anxiety disorder may present with a variety of symptoms including  rapid heartbeat, shortness of breath, increased sweating, stomach cramping, a feeling of a lump in the throat or inability to swallow, frequent need to urinate, dry mouth, nausea, diarrhoea, clammy hands, head, neck or backaches or non-specific body aches. Patients may also complain of uncontrolled shaking or trembling or twitching, usually precipitated by anxiety inducing situations. 

Treatment

Patients with panic disorder frequently present with chest pain or dyspnoea (shortness of breath), fearing that they are dying of myocardial infarction. Anxiety symptoms often accompany or can exacerbate respiratory conditions such as asthma and chronic obstructive pulmonary disease.
Intravenous or oral acute sedation with benzodiazepines may be used if indicated.
Untreated panic attacks can subside spontaneously within 20-30 minutes, especially with reassurance and a calming environment.
Discontinue or replace any suspect medication if possible,
Discontinue or reduce caffeine and alcohol intake
Treatment options available include lifestyle changes; psychotherapy, especially cognitive behavioral therapy; and pharmaceutical therapy. Education, reassurance and some form of cognitive-behavioral therapy should be used, either alone, or in combination with medication.