SelfhelpMagazine Newsletter (TM) - Anxiety
Vol. 9 No. 4 March 7, 2003
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T A B L E O F C O N T E N T S
1. Feature Article # 1:
"Generalized Anxiety Disorders"
by National Institute of Mental Health
2. Feature Article # 2:
"Panic Disorder"
by National Institute of Mental Health
3. Feature Article # 3:
"Phobias"
by National Institute of Mental Health
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SHM FEATURE ARTICLE # 1:
"Generalized Anxiety Disorders"
by National Institute of Mental Health
-- "I always thought I was just a worrier. I'd feel keyed up and
unable to relax. At times it would come and go, and at times it
would be constant. It could go on for days. I'd worry about
what I was going to fix for a dinner party, or what would
be a great present for somebody. I just couldn't let something
go."
-- "I'd have terrible sleeping problems. There were times I'd
wake up wired in the morning or in the middle of the night.
I
had trouble concentrating, even reading the newspaper or a
novel. Sometimes I'd feel a little lightheaded. My heart would
race or pound. And that would make me worry more."
Generalized anxiety disorder (GAD) is much more than the normal
anxiety people experience day to day. It's chronic and exaggerated
worry and tension, even though nothing seems to provoke it.
Having this disorder means always anticipating disaster, often
worrying excessively about health, money, family, or work.
Sometimes, though, the source of the worry is hard to pinpoint.
Simply the thought of getting through the day provokes anxiety.
People with GAD can't seem to shake their concerns, even though
they usually realize that their anxiety is more intense than the
situation warrants. People with GAD also seem unable to relax. They
often have trouble falling or staying asleep. Their worries are
accompanied by physical symptoms, especially trembling,
twitching, muscle tension, headaches, irritability, sweating, or hot
flashes. They may feel lightheaded or out of breath. They may feel
nauseated or have to go to the bathroom frequently. Or they might
feel as though they have a lump in the throat.
Many individuals with GAD startle more easily than other people.
They tend to feel tired, have trouble concentrating, and sometimes
suffer depression, too.
Usually the impairment associated with GAD is mild and people with the
disorder don't feel too restricted in social settings or on the
job. Unlike many other anxiety disorders, people with GAD don't
characteristically avoid certain situations as a result of their
disorder. However, if severe, GAD can be very debilitating, making
it difficult to carry out even the most ordinary daily
activities.
GAD comes on gradually and most often hits people in childhood or
adolescence, but can begin in adulthood, too. It's more common in
women than in men and often occurs in relatives of affected persons.
It's diagnosed when someone spends at least 6 months worried
excessively about a number of everyday problems.
Having GAD means always anticipating disaster, often worrying
excessively about health, money, family, or work. Worries are
often accompanied by physical symptoms like trembling, muscle
tension, and nausea.
In general, the symptoms of GAD seem to diminish with age. Successful
treatment may include a medication called buspirone. Research into
the effectiveness of other medications, such as benzodiazepines and
antidepressants, is ongoing. Also useful are cognitive-behavioral
therapy, relaxation techniques, and biofeedback to control muscle
tension.
Where to get more information or help:
List of Organizations
Psychology Resource Links
Article on How to get Help for Anxiety
Anxiety Forum
More Articles on Anxiety
The National Institute of Mental Health (NIMH) conducts and
supports research nationwide on mental illness and mental health,
including studies of the brain, behavior, and mental health
services. NIMH is a part of the National Institutes of Health (NIH),
the principal biomedical and behavioral research agency of the
United States Government. NIMH is a component of the U.S. Department
of Health and Human Services.
What do you think?
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SHM FEATURE ARTICLE # 2:
"Panic Disorder"
by National Institute of Mental Health
-- It started 10 years ago. I was sitting in a seminar in a
hotel
and this thing came out of the clear blue. I felt like I was dying."
"For me, a panic attack is almost a violent experience. I feel
like I'm going insane. It makes me feel like I'm losing control in
a very extreme way. My heart pounds really hard, things seem
unreal, and there's this very strong feeling of impending doom."
"In between attacks there is this dread and anxiety that it's
going to happen again. It can be very debilitating, trying to escape those feelings of panic."
People with panic disorder have feelings of terror that strike
suddenly and repeatedly with no warning. They can't predict when an
attack will occur, and many develop intense anxiety between episodes,
worrying when and where the next one will strike. In between times
there is a persistent, lingering worry that another attack could come
any minute.
When a panic attack strikes, most likely your heart pounds and you may
feel sweaty, weak, faint, or dizzy. Your hands may tingle or feel
numb, and you might feel flushed or chilled. You may have chest pain
or smothering sensations, a sense of unreality, or fear of impending
doom or loss of control. You may genuinely believe you're having a
heart attack or stroke, losing your mind, or on the verge of death.
Attacks can occur any time, even during nondream sleep. While most
attacks average a couple of minutes, occasionally they can go on for
up to 10 minutes. In rare cases, they may last an hour or more.
You may genuinely believe you're having a heart attack, losing
your mind, or on the verge of death.
Attacks can occur any time, even during nondream sleep.
Panic disorder strikes between 3 and 6 million Americans, and is twice
as common in women as in men. It can appear at any age--in children or
in the elderly--but most often it begins in young adults. Not everyone
who experiences panic attacks will develop panic disorder-- for
example, many people have one attack but never have another. For those
who do have panic disorder, though, it's important to seek treatment.
Untreated, the disorder can become very disabling.
Panic disorder is often accompanied by other conditions such as
depression or alcoholism, and may spawn phobias, which can develop in
places or situations where panic attacks have occurred. For example,
if a panic attack strikes while you're riding an elevator, you may
develop a fear of elevators and perhaps start avoiding them.
Some people's lives become greatly restricted--they avoid normal,
everyday activities such as grocery shopping, driving, or in some
cases even leaving the house. Or, they may be able to confront a
feared situation only if accompanied by a spouse or other trusted
person. Basically, they avoid any situation they fear would make them
feel helpless if a panic attack occurs. When people's lives become so
restricted by the disorder, as happens in about one-third of all
people with panic disorder, the condition is called agoraphobia. A
tendency toward panic disorder and agoraphobia runs in families.
Nevertheless, early treatment of panic disorder can often stop the
progression to agoraphobia..
Studies have shown that proper treatment--a type of psychotherapy
called cognitive-behavioral therapy, medications, or possibly a
combination of the two--helps 70 to 90 percent of people with panic
disorder. Significant improvement is usually seen within 6 to 8 weeks.
Cognitive-behavioral approaches teach patients how to view the panic
situations differently and demonstrate ways to reduce anxiety, using
breathing exercises or techniques to refocus attention, for example.
Another technique used in cognitive-behavioral therapy, called
exposure therapy, can often help alleviate the phobias that may result
from panic disorder. In exposure therapy, people are very slowly
exposed to the fearful situation until they become desensitized to it.
Some people find the greatest relief from panic disorder symptoms when
they take certain prescription medications. Such medications, like
cognitive-behavioral therapy, can help to prevent panic attacks or
reduce their frequency and severity. Two types of medications that
have been shown to be safe and effective in the treatment of panic
disorder are antidepressants and benzodiazepines.
Where to get more information or help:
List of Organizations that May be Useful
Psychology Resource Links
More Articles on Anxiety
Panic Disorder Forum
The National Institute of Mental Health (NIMH) conducts and supports
research nationwide on mental illness and mental health, including
studies of the brain, behavior, and mental health services. NIMH is a
part of the National Institutes of Health (NIH), the principal
biomedical and behavioral research agency of the United States
Government. NIMH is a component of the U.S. Department of Health and
Human Services.
Want to comment on this article? Express Yourself!
To find more articles by this author, run a search on his
last name from this page:
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SHM FEATURE Article #3:
"Phobias"
by National Institute of Mental Health
Phobias occur in several forms. A specific phobia is a fear of a
particular object or situation. Social phobia is a fear of being
painfully embarrassed in a social setting. And agoraphobia, which
often accompanies panic disorder, is a fear of being in any situation
that might provoke a panic attack, or from which escape might be
difficult if one occurred.
Specific Phobias
-- "I'm scared to death of flying, and I never do it anymore.
It's an
awful feeling when that airplane door closes and I feel trapped. My
heart pounds and I sweat bullets. If somebody starts talking to me, I
get very stiff and preoccupied. When the airplane starts to ascend, it
just reinforces that feeling that I can't get out. I picture myself
losing control, freaking out, climbing the walls, but of course I
never do. I'm not afraid of crashing or hitting turbulence. It's just
that feeling of being trapped. Whenever I've thought about changing
jobs, I've had to think, "Would I be under pressure to
fly?" These
days I only go places where I can drive or take a train. My friends
always point out that I couldn't get off a train traveling at high
speeds either, so why don't trains bother me? I just tell them it
isn't a rational fear."
Phobias aren't just extreme fear;
they are irrational fear. You may be
able to ski the world's tallest
mountains with ease but feel panic
going above the 10th floor of an
office building
Many people experience specific phobias, intense, irrational fears of
certain things or situations--dogs, closed-in places, heights,
escalators, tunnels, highway driving, water, flying, and injuries
involving blood are a few of the more common ones. Phobias aren't just
extreme fear; they are irrational fear. You may be able to ski the
world's tallest mountains with ease but panic going above the 10th
floor of an office building. Adults with phobias realize their fears
are irrational, but often facing, or even thinking about facing, the
feared object or situation brings on a panic attack or severe anxiety.
Specific phobias strike more than 1 in 10 people. No one knows just
what causes them, though they seem to run in families and are a little
more prevalent in women. Phobias usually first appear in adolescence
or adulthood. They start suddenly and tend to be more persistent than
childhood phobias; only about 20 percent of adult phobias vanish on
their own. When children have specific phobias--for example, a fear of
animals--those fears usually disappear over time, though they may
continue into adulthood. No one knows why they hang on in some people
and disappear in others.
If the object of the fear is easy to avoid, people with phobias may
not feel the need to seek treatment. Sometimes, though, they may make
important career or personal decisions to avoid a phobic situation.
When phobias interfere with a person's life, treatment can help.
Successful treatment usually involves a kind of cognitive-behavioral
therapy called desensitization or exposure therapy, in which patients
are gradually exposed to what frightens them until the fear begins to
fade. Three-fourths of patients benefit significantly from this type
of treatment. Relaxation and breathing exercises also help reduce
anxiety symptoms.
There is currently no proven drug treatment for specific phobias, but
sometimes certain medications may be prescribed to help reduce anxiety
symptoms before someone faces a phobic situation.
Social Phobia
-- "I couldn't go on dates or to parties. For a while, I
couldn't
even go to class. My sophomore year of college I had to come home for
a semester."
"My fear would happen in any social situation. I would be
anxious
before I even left the house, and it would escalate as I got closer to
class, a party, or whatever. I would feel sick to my stomach--it
almost felt like I had the flu. My heart would pound, my palms would
get sweaty, and I would get this feeling of being removed from myself
and from everybody else."
"When I would walk into a room full of people, I'd turn red and
it
would feel like everybody's eyes were on me. I was too embarrassed to
stand off in a corner by myself, but I couldn't think of anything to
say to anybody. I felt so clumsy,I couldn't wait to get out."
Social phobia is an intense fear of becoming humiliated in social
situations, specifically of embarrassing yourself in front of other
people. It often runs in families and may be accompanied by depression
or alcoholism. Social phobia often begins around early adolescence or
even younger.
If you suffer from social phobia, you tend to think that other people
are very competent in public and that you are not. Small mistakes you
make may seem to you much more exaggerated than they really are.
Blushing itself may seem painfully embarrassing, and you feel as
though all eyes are focused on you. You may be afraid of being with
people other than those closest to you. Or your fear may be more
specific, such as feeling anxious about giving a speech, talking to a
boss or other authority figure, or dating. The most common social
phobia is a fear of public speaking. Sometimes social phobia involves
a general fear of social situations such as parties. More rarely it
may involve a fear of using a public restroom, eating out, talking on
the phone, or writing in the presence of other people, such as when
signing a check.
Although this disorder is often thought of as shyness, the two are not
the same. Shy people can be very uneasy around others, but they don't
experience the extreme anxiety in anticipating a social situation, and
they don't necessarily avoid circumstances that make them feel
self-conscious. In contrast, people with social phobia aren't
necessarily shy at all. They can be completely at ease with people
most of the time, but particular situations, such as walking down an
aisle in public or making a speech, can give them intense anxiety.
Social phobia disrupts normal life, interfering with career or social
relationships. For example, a worker can turn down a job promotion
because he can't give public presentations. The dread of a social
event can begin weeks in advance, and symptoms can be quite
debilitating.
Phobias aren't just extreme fear;
they are irrational fear. You may be
able to ski the world's tallest
mountains with ease but feel panic
going above the 10th floor of an
office building
People with social phobia are aware that their feelings are
irrational. Still, they experience a great deal of dread before facing
the feared situation, and they may go out of their way to avoid it.
Even if they manage to confront what they fear, they usually feel very
anxious beforehand and are intensely uncomfortable throughout.
Afterwards, the unpleasant feelings may linger, as they worry about
how they may have been judged or what others may have thought or
observed about them.
About 80 percent of people who suffer from social phobia find relief
from their symptoms when treated with cognitive-behavioral therapy or
medications or a combination of the two. Therapy may involve learning
to view social events differently; being exposed to a seemingly
threatening social situation in such a way that it becomes easier to
face; and learning anxiety-reducing techniques, social skills, and
relaxation techniques.
The medications that have proven effective include antidepressants
called MAO inhibitors. People with a specific form of social phobia
called performance phobia have been helped by drugs called
beta-blockers. For example, musicians or others with this anxiety may
be prescribed a beta-blocker for use on the day of a performance.
For More Information or Help
Phobics Anonymous
P.O. Box 1180
Palm Springs, CA 92263
(619) 322-COPE (-2673)
Psychology Resource Links
The National Institute of Mental Health (NIMH) conducts and supports
research nationwide on mental illness and mental health, including
studies of the brain, behavior, and mental health services. NIMH is a
part of the National Institutes of Health (NIH), the principal
biomedical and behavioral research agency of the United States
Government. NIMH is a component of the U.S. Department of Health and
Human Services.
To find more articles by this author, run a search on her
last name from this page:
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http://selfhelpmagazine.com/about/staff/drm.html
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