Fear and anxiety in our life Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults. These disorders fill people's lives with overwhelming anxiety and fear. Unlike the relatively mild, brief anxiety caused by a stressful event such as a business presentation or a first date, anxiety disorders are chronic, relentless, and can grow progressively worse if not treated. Both fear and anxiety send signals through the body that prepare all systems for possible danger. Hormones, such as adrenaline and catecholamine, are released in what is known as the "fight or flight" response. The sudden increase in hormone levels speeds up the heart and increases the amount of blood being pumped. At the same time, the muscles tighten, increasing the individual's ability to fight or flee from danger. The intensity of these physiological responses varies according to the seriousness of the event or thought that sparked the emotion, the strength of the individual's fear or anxiety, and his or her previous experience and genetic makeup. While both fear and anxiety can provoke an arousal response, their other effects diverge. Very intense fear sometimes serves to "freeze" the body to protect it from harm, causing little or no change in heart rate and blocking the impulse to move. In anxiety, the physical changes caused by arousal lead to a second stage marked by thought patterns such as worry, dread, and mental replays of anxiety-arousing events. Thousands of scientific studies over the past several years show that high blood pressure, ulcers, migraine headaches, strokes, alcoholism, depression, anger, fatigue, drug addiction and many other medical conditions are often due to the long-term effects of stress.
Health care professional really may help Among the professionals who can help are psychiatrists, psychologists, social workers, and counselors. However, it's best to look for a professional who has specialized training in cognitive-behavioral therapy and/or behavioral therapy, as appropriate, and who is open to the use of medications, should they be needed. Remember, though, that when you find a health care professional that you're satisfied with, the two of you are working together as a team. Together you will be able to develop a plan to treat your anxiety disorder that may involve medications, cognitive-behavioral or other talk therapy, or both, as appropriate. You may be concerned about paying for treatment for an anxiety disorder. If you belong to a Health Maintenance Organization or have some other kind of health insurance, the costs of your treatment may be fully or partially covered. There are also public mental health centers that charge people according to how much they are able to pay. If you are on public assistance, you may be able to get care through your state Medicaid plan.
Treatment of disorders Effective treatments for each of the anxiety disorders have been developed through research. In general, two types of treatment are available for an anxiety disorder--medication and specific types of psychotherapy (sometimes called "talk therapy"). Both approaches can be effective for most disorders. The choice of one or the other, or both, depends on the patient's and the doctor's preference, and also on the particular anxiety disorder. For example, only psychotherapy has been found effective for specific phobias. When choosing a therapist, you should find out whether medications will be available if needed. If you have been treated previously for an anxiety disorder, be prepared to tell the doctor what treatment you tried. If it was a medication, what was the dosage, was it gradually increased, and how long did you take it? If you had psychotherapy, what kind was it, and how often did you attend sessions? It often happens that people believe they have "failed" at treatment, or that the treatment has failed them, when in fact it was never given an adequate trial.
The many causes of anxiety Experts have yet to agree on the root cause of anxiety disorders. In fact, most concede that several factors may be at work in each case. Stress, trauma, uncertainty. Most theorists agree that, other factors aside, stress, trauma, and uncertainties can play a role in the development of anxiety disorders. Studies show a relationship between anxiety and stress, which can be defined as a consequence of adapting to a change. Challenges such as the death of a loved one require a major adaptation that can contribute to the development of an anxiety disorder. Uncertainty during transitions, or about the future, can also produce anxiety. Some studies have found that a stressful event precedes the appearance of many anxiety disorders, though this result is not yet conclusive. The influence of these factors appears to vary with the disorder. In post-traumatic stress syndrome, such factors play a major role, whereas in obsessive- compulsive disorder, brain chemistry appears to be the primary culprit. An imbalance in these neurotransmitters can cause a corresponding shift in our thoughts. But is the reverse also true? Can a determined change in our thinking alter the chemistry in the brain? Many experts are convinced this is true; and behavioral therapy aimed at changing our reactions does, in fact, cure many problems. Indeed, for some disorders, such as phobias, this type of therapy remains the most effective alternative. 1. Remember that though your feelings and symptoms are very frightening, they are not dangerous or harmful.
2. Understand that what you are experiencing is an exaggeration of your normal bodily reactions to stress.
3. Do not fight your feelings or try to wish them away. The more you are willing to face them, the less intense they will become.
4. Do not add to your panic by thinking about what "might" happen.
5. Stay in the present. Notice what is really happening to you as opposed to what you think might happen.
6. Label your fear level from zero to 10 and watch it go up and down. Notice that it does not stay at a very high level for more than a few seconds.
7. When the fear begins to trigger "what if" thinking, focus on and carry out a simple and manageable task such as counting backwards from 100 by threes or snapping a rubber band on your wrist.
8. Notice that when you stop adding frightening thoughts to your fear, it begins to fade.
9. When the fear comes, expect and accept it. Wait and give it time to pass without running away from it.
10. Be proud of the progress you make, and think about how good you will feel when you succeed this time.
Drugs for psychiatric disorders It is not entirely clear why psychotropic medications work; yet, it appears that they reestablish balance within the chemistry of the brain. Behavior is determined through messages transmitted within the brain from one nerve cell to another through various chemicals. These chemicals are called neurotransmitters. Through the millions of nerve cells within the brain, chemicals trigger memories, sleep patterns, perceptions, feelings, moods and thoughts. The electric current that carries the messages are received by nerve ends, called synapses, which then release the neurotransmitter. These chemicals, in turn, propagate the message by stimulating the next nerves in line to send on the electrical message. Once used, the neurotransmitter chemical is returned and stored in the nerve end. This recycling process is called reuptake. When this signaling process goes askew, the effects are seen in a person's behavior and experienced in his emotions, perceptions, sensations, and ideas. Medication is most helpful when there is clear disorder or, sometimes, a specific target symptom for a particular drug. Usually, a pattern of symptoms point to a specific chemical imbalance. Whenever an imbalance appears evident through a person's disordered behavior and emotional state, medication centers on modifying the strength of the signal or readjusting the balance among them.
The anxiety associated with diets? Prescription drugs and those purchased over the counter also can cause anxiety symptoms. Cold medicines, diet pills, antispasmodic medications, stimulants, digitalis, thyroid supplements, and, paradoxically, antidepressants given to reduce panic all may cause anxiety. Discontinuing a variety of drugs, including tranquilizers, sleeping pills, and certain blood-pressure medicines can lead to withdrawal symptoms that often include anxiety. Diet also can be a culprit. The most common dietary offenders are caffeine and caffeine-like substances found in coffee, tea, and many soft drinks. In sensitive individuals, the jitteriness precipitated by caffeine can reach panic levels. In rare cases, extreme vitamin deficiencies may also lead to anxiety.
Steps to make treatment more effective Stress management techniques and meditation may help you to calm yourself and enhance the effects of therapy, although there is as yet no scientific evidence to support the value of these "wellness" approaches to recovery from anxiety disorders. There is preliminary evidence that aerobic exercise may be of value, and it is known that caffeine, illicit drugs, and even some over-the-counter cold medications can aggravate the symptoms of an anxiety disorder. Check with your physician or pharmacist before taking any additional medicines. Most people with depression can get help from treatment. For most people, spotting depression early and getting it treated might cut down on how long and how serious the depression is. The most common treatments are antidepressant medicines, "talk" therapy, or a combination of both. You and your doctor can work together to decide on the right depression treatment for you.
Understanding fears Anxiety disorders are surprisingly frequent, and affect more Americans than does any other emotional disorder. They are more common than depression, manic depression, or abuse of alcohol and other substances. According to the American Psychiatric Association, while depressive disorders affect one person in 20, one in 12 suffers an anxiety disorder. Because consumers and doctors alike are less attuned to anxiety disorders than other emotional problems, these disorders often go unrecognized. This is unfortunate, because most cases of anxiety can be treated successfully. In fact, anxiety disorders are considered the most treatable of all emotional problems. Faced by a threat, your body responds with a complex cascade of chemicals. The hypothalamus, alerted by the brain, pumps out a specialized hormone that ultimately prompts the two adrenal glands (perched atop the kidneys) to release the energizing hormone known as adrenaline. The result--faster pulse, higher blood pressure, sharpened awareness--is the "fight or flight" response to fear and anxiety.
Depression's research Many organizations today supports research into the causes, diagnosis, prevention, and treatment of anxiety disorders and other mental illnesses. Studies examine the genetic and environmental risks for major anxiety disorders, their course--both alone and when they occur along with other diseases such as depression--and their treatment. The ultimate goal is to be able to cure, and perhaps even to prevent, anxiety disorders. Like heart disease and diabetes, the brain disorders are complex and probably result from a combination of genetic, behavioral, developmental, and other factors. In addition, with new findings about neurogenesis (birth of new brain cells) throughout life, perhaps a method will be found to stimulate growth of new neurons in the hippocampus in people with post-traumatic stress disorder.
Learn symptoms of anxiety disorders Depressed people will seem sad, or "down," or may be unable to enjoy their normal activities. They may have no appetite and lose weight (although some people eat more and gain weight when depressed). They may sleep too much or too little, have difficulty going to sleep, sleep restlessly, or awaken very early in the morning. They may speak of feeling guilty, worthless, or hopeless; they may lack energy or be jumpy and agitated. They may think about killing themselves and may even make a suicide attempt. Some depressed people have delusions (false, fixed ideas) about poverty, sickness, or sinfulness that are related to their depression. Often feelings of depression are worse at a particular time of day, for instance, every morning or every evening. Feelings associated with anxiety include impatience, apprehensiveness, irritability, and decreased ability to concentrate. People suffering from anxiety may also worry, for no particular reason, that something bad is going to happen to themselves or their loved ones. Individuals with anxiety disorders may make such statements as:
- I always thought I was just a worrier, but I would worry about things for days, to the point where I couldn't even sleep.
- I had a very strong feeling of impending doom, like I was losing control in an extreme way.
- I was always worried that if I didn't do certain things, my parents were going to die.
- I felt as if my heart was going to explode, and I couldn't calm down. Physical symptoms of this disorder include: trembling, twitching, muscle tension, headaches, irritability, sweating, nausea, hot flashes, light-headedness, and difficulty breathing. GAD is diagnosed when psychological and physical symptoms of anxiety last more than a month and are not accompanied by the symptoms of other anxiety disorders. If you have been excessively worried about a number of everyday problems for at least six months and have at least six of the common symptoms of anxiety listed earlier, you may have generalized anxiety disorder. Check with your family physician or mental- health professional. Generalized anxiety disorder is highly treatable.
Definition interpretingAnxiety
- A state of uneasiness and apprehension, as about future uncertainties.
- Worry or tension in response to real or imagined stress, danger, or dreaded situations. Physical reactions such as fast pulse, sweating, trembling, fatigue, and weakness may accompany anxiety.
Anxiety disorder
- A psychiatric disorder involving the presence of anxiety that is so intense or so frequently present that it causes difficulty or distress for the individual.
Anxiety disorders
- Any of various disorders in which anxiety is either the primary disturbance or is the result of confronting a feared situation or object; they include obsessive-compulsive disorder and posttraumatic stress disorder.
Fear
- Fear is an unpleasant feeling of perceived risk or danger, whether it be real or imagined.
Depression
- In psychiatry, a symptom of mood disorder characterized by intense feelings of loss, sadness, hopelessness, failure, and rejection.
Mental health
- A state of emotional and psychological well-being in which an individual is able to use his or her cognitive and emotional capabilities, function in society, and meet the ordinary demands of everyday life.
- The psychological state of someone who is functioning at a satisfactory level of emotional and behavioral adjustment.
Stress
- A state of extreme difficulty, pressure, or strain.
- A physical and psychological response that results from being exposed to a demand or pressure.
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