Anxiety

Written by Anne McNelis, L.C.S.W., Director of Clinical Services at Transitions Mental Health Services

Nervousness, apprehension, worry…it’s normal to feel these sensations, particularly when associated with an event in life that creates some stress. Indeed, everyday worries can be common to all of us. Anxiety as a condition or disorder, on the other hand, is persistent and debilitating to those suffering with the symptoms. It can affect people from all walks of life and impact greatly on their ability to function successfully and happily.

Nearly twenty-five million Americans suffer with some form of Anxiety Disorder. *It is one of the leading mental health conditions diagnosed, next to depression. It’s not uncommon, either, to see individuals who suffer concurrently with these two disorders. Anxiety sufferers describe feeling terror, fear, panic, physical sensations that compare to experiencing a “heart attack,” mental distress from ruminating thoughts, and the desire to avoid whatever triggered this bodily response. Feeling “keyed up,” excessive fatigue, restlessness, and irritability are also associated symptoms. When left untreated, anxiety can worsen, and for some, lead to severe isolation and suicidal thoughts.

Anxiety disorders are a wide umbrella for many types of anxiety conditions. Post Traumatic Stress Disorder, Obsessive Compulsive Disorder, Generalized Anxiety Disorder, and phobias are a few of the commonly known or diagnosed anxiety disorders. They all have physical arousal/discomfort and mental anguish in common but differ in their specific triggers. There may be underlying psychological causes for anxiety, such as a traumatic experience. Someone may be genetically predisposed to suffering with anxiety, or it may be a combination of both triggers. One woman describes her experience of nightly discomfort with anxiety: “I lay in bed at night, fixating on things I did or didn’t do right, or didn’t get done during my day. It’s like a critical tape recording I play over and over in my head. I also think about all the ‘what if’s’ and ‘what will the future bring?’ I can feel how shallow my breathing is, and the tightness in my chest, and tension in my muscles, but I can’t seem to stop the flow of negative, critical, ‘beat-myself-up’ thoughts and the constant worrying that steals sleep from me.” This young woman describes the experience of persistent ruminations, which can take on a life of their own. Often these types of ruminations are associated with depression and anxiety. Ruminations can be symptom of a type of anxiety condition, called Generalized Anxiety Disorder, or GAD. These people, who are often referred to as “worry warts”, are in perpetual state of worry and experience high levels of tension and chronic physical discomfort as a result. To be diagnosed with GAD, this worry has to be persistent and pervasive in the individual’s daily life and impact on their ability to function. GAD is prevalent in 3-5% of the general population. For anxiety disorders in general, clinics are seeing that the number of Americans suffering and seeking help for anxiety appears to be on the rise.

OCD, or Obsessive Compulsive Disorder, is more widely known of the Anxiety Disorders. Jack Nicholson’s character in “As good as it Gets” educated audience members across America about the quirky, odd, eccentric rituals he engaged in to assuage his tension and obsessions. Nicholson astutely portrayed the inner tension of OCD sufferers and the often painful repetitive behaviors they get caught up in, day in and day out. The OCD sufferer experiences obsessional thoughts or ruminations that are worry-ridden and the compulsion refers to the behavior intended to “rid” oneself of the obsessional thought. The classic example is the germ-phobic who excessively cleanses their hands till they’re dry, cracked and raw. The tragic element of this disorder is that as the compulsions tend to grow more complicated or extensive in steps, they never have the ability to alleviate the sufferer.

Those who have experienced panic attacks, know all too well how terrifyingly similar this anxiety is to experiencing a heart attack. In fact, many sufferers end up getting diagnosed in an emergency room, believing the heart palpitations, muscle tension and shallow breathing are the onset of a heart attack. Many are equally disbelieving that this condition is not a sign that they are dying. One woman who began to recognize the onset of her panic attacks describes her experience and how she copes: “…it starts way down in the pit of my stomach and it escalates throughout my body, rendering my feet jumpy, my hands shaking and my mind racing. To cope I call a friend, pet my cat, journal, or hope I’m seeing my therapist very soon! I also imagine a waterfall with all its sights and sounds lulling me to a calm and peaceful being.” This woman uses behavioral techniques intended to distract her and relax her physiologically. Her imagery exercise is a progressive muscle relaxation technique proven to provide relief to bodily tension and discomfort associated with anxiety.

Phobias are probably the most common of the anxiety disorder in the general population, with lifetime prevalence rates from community samples tending to range from 7-12%. The diagnosis of Specific Phobia refers to a marked, persistent fear of a clearly identifiable object or situation. Phobias tend to fall into these categories: animal type, natural environment type, blood-injection-injury type, or situational type. Many people with phobias do not seek treatment until it results in great impairment occupationally or socially. Psychological treatment of phobias focuses on desensitizing the individual to the phobic object or situation in a graduated manner. Medications, such as anti-anxiety meds or sedatives, have a short-term, immediate effect on the physiological response one experiences with a phobia. However, they tend to be addictive and will not alleviate the sufferer of the symptoms in the long run.

Successful treatment for any anxiety disorder should involve therapy. For some individuals, the anxiety may be so great, an anti-anxiety medication may be helpful in reducing heightened symptoms that would otherwise impair the individual to carry out the behavioral skills therapy teaches. Psychotherapy often offers the greatest long-term benefits to treat anxiety. This treatment focuses on teaching an individual the cognitive-behavioral skills and relaxation techniques to cope with exposure to a feared event/object, worry-thoughts/ruminations, and the physical arousal associated with anxiety.

If you or a loved one is suffering with symptoms of an anxiety disorder, seek an evaluation with a mental health professional or doctor for diagnosis and treatment. If you would like more information about Anxiety Disorders or treatment for these illnesses, contact Transitions Mental Health Services to speak with a therapist. (Contact information can be found in the "About Us" section of this blog.)

*National Institute for Mental Health statistics