Dr C.R. ChandrashekarVandana, 18 years old, studying B.Sc. Her complaint:My heart beats fast. I feel unpleasant sensations in the chest and stomach. I am unable to concentrate. I will be sitting in front of the book but will be unable to read. Whenever I see strangers, sick people, crowd, heavy traffic, dogs I become fearful.My hands tremble. I cannot hold the pen and write. I always think that something bad or terrible will happen. My life, my future may be in danger. But I do not know the reasons for this feeling.Whenever I want to ask a question or give my opinion, my mouth becomes dry and I cannot speak. When teachers ask a question, I know the answer but I cannot say it. My memory is very bad. I keep forgetting and have lost pens, books, chappals and money. I feel like a useless person, fit for nothing. I feel like running away from everybody. Everyday I feel miserable. Please help me.My parents are good and look after me well. But there is something wrong with me. Am I mentally weakVandana is suffering from ‘anxiety disorder’. Typical symptoms are fearfulness, apprehension, anticipation of bad and dangerous events or outcomes. Increased heart beats, sweating, muscle and joint paints, fatigue, weakness, numbness, headache are common.Anxiety disorder is more common in children and adolescents. Students who face severe competition, pressure and uncertainty suffer from anxiety disorder. Thus a sizeable number of students who face final and other competitive exams suffer from anxiety and their performance is affected.People who live in a hostile environment, face life threatening situations police, army, people who take part in high risk and very competitive games, people who migrate, those who are under strict supervision, people who feel or who are made to feel insecure, victims of disasters tend to suffer from anxiety disorders.There are certain professions which increase the anxiety levels. For example, drivers of heavy vehicles, surgeons, police and law enforcing authorities in disturbed areas, army personnel during war time, fire fighters. About 10 per cent people are found to be suffering from anxiety disorder. Genetic factors, unhappy and disturbed childhood, lack of parental love and support, exposure to repeated and severe criticism, punishment and negative life events failures, insults, losses etc, high expectations, lack of exposure to stress, lack of good social support system, poor or inadequate coping skills, poor or low self esteem, prolonged ill health lead to anxiety disorder.4 types of anxietydisorders1Phobia: Anxiety is seen in specific situations or objects like lifts, bridges, tunnels, heights, animals, insects, water, blood, operation theatres etc.2Panic: Anxiety starts suddenly, reaches its pe-ak in 10 to 15 minutes and subsides. Panic disorder co-mes in attacks with or without a precipitating factor.3Generalised anxiety disorder: Anxiety symptoms are present most of the time of the day and in all situations.4Performance anxiety is seen in situations where and when the individual has to perform an activity like an examination, interview, stage play, or do an activity in front of people.Treatment suggested:Minor tranquillisers or anti depressant drugs have to be used for short periods under the supervision of a doctor. Learn to relax. Yoga mediation, deep breathing exercises, music, arts can help. Counselling to improve self confidence and emotional support to the individual is very essential.The writer is a professor of psychiatry and deputy medical superintendent at Nimhans, Bengaluru