Anxiety Disorders, Panic Attacks
What are Anxiety Disorders?
Do you worry constantly, or feel nervous a lot of the time, or are you afraid of things that don't bother most other people? If so you probably are aware that you suffer from anxiety. Anxiety is what happens when our body's emergency system - the "fight or flight" response - starts working overtime.
Many people may have too much anxiety, yet not realize that anxiety, or how they cope with it, is the cause of their problems. Perhaps you are frequently tense and irritable, or find that others consider you to be controlling, rigid, or angry. Perhaps you are confident in most situations, but have specific fears or phobias such as heights, closed-in spaces, crowds of people, flying in airplanes or driving over bridges. Or you may have obsessions (persistent, unwanted thoughts that keep running through your mind) or compulsions (the urge to do something repeatedly for little or no logical reason, such as washing hands over and over, touching the doorknob three times before opening a door, or checking and re-checking repeatedly to see if you have turned off the stove).
All of these are examples of anxiety disorders. Anxiety disorders are very common: nearly 20% of U.S. adults experience an anxiety disorder in their lifetime. But anxiety can cause severe suffering, and if left untreated, can worsen over time. For example, people who have suffered even one panic attack may develop agoraphobia, or fear of going out, because they are so afraid of having another.
What is a Panic Attack?
Panic attacks involve sudden, overwhelming fear, with little or no explanation. The person has difficulty breathing, feels their heart racing, may feel light-headed or dizzy and may experience chest tightness so severe that many are rushed to the emergency room to be checked for a heart attack. Typically they are told "it's just anxiety" and may be given a pill to calm them down, but this will not prevent future episodes and the condition may worsen because of fear that the terrible feeling will come back. Panic disorder, in fact, has been called "the fear of fear itself."
What causes anxiety disorders?
There are several possibilities. A tendency toward anxiety can be inherited, so that you may be anxious in part because your mother or father was anxious. Some infants are born with especially strong startle reflexes, and these children will continue to be easily startled or frightened as they grow. Anxiety can also be learned - from an anxious parent who inadvertently teaches you to be afraid as he or she is. And anxiety can be the result of suffering terrifying traumatic experiences such as abuse, violence, or a life-threatening accident. The more trauma you have experienced, the more likely you are to have developed anxiety as a result, especially if you have a genetic tendency to cope with life in an anxious manner. Traumatic experiences actually affect the nerve pathways, so that anxiety becomes "wired" into your brain, and anxiety-producing chemicals, such as adrenaline, keep your brain flooded with the signals that produce the sensation of fear.
Treatment of Anxiety and Panic
The good news is that anxiety can be treated. You can learn to handle your anxiety differently, and as a result, experience fewer and less troubling symptoms.
Cognitive therapy can teach you to think differently about things that frighten or worry you. For example, you may be taught to differentiate between a worry that is a signal - a sign that you should do something, such as make a doctor appointment - and a worry that is just "noise" - a meaningless or useless worry, such as worrying that you got a bad grade on a test that you have already taken (so it is too late to study for it any more!) If a worry is a signal, then you can resolve the worry by taking appropriate action. If it's "noise," you can learn to set the worry aside and replace it with a positive thought.
Behavioral or cognitive-behavioral therapy can teach you to change your behavior in order to change your feelings. For example, you may practice exposure treatment: very gradually exposing yourself to what you fear, until it no longer provokes anxiety - kind of like walking into the pool at the shallow end, one toe at a time, until you are finally swimming. You will also be taught strategies such as breathing exercises, guided imagery, and relaxation techniques that can help alleviate symptoms.
Everyone can benefit from slow, deep, even breathing. Try it now: breathe in slowly, with your mouth closed, while you count silently to 5. Then breathe out slowly, mouth still closed, while you count again to 5. Do this a few times, and you may notice your heart rate slowing and your body relaxing.
Psychodynamic (or insight oriented) therapy treats anxiety by helping you explore the underlying feelings that may have led you to develop anxiety symptoms. By exploring the feelings you have not been able to recognize or express fully - such as anger or grief - you can learn to master these feelings, and have what is known as a corrective emotional experience. This therapy is usually goes deeper into underlying feelings and past memories than cognitive or behavioral work, which allows it to have deeper and more lasting effects. Therapists who use this approach will often include cognitive and behavioral techniques as needed, to help prepare you to face deeper feelings.
Your therapist can explain these treatments in more detail, and may be able to suggest other treatments, such as EMDR and biofeedback, that may be very helpful as well.
Psychodynamic (or insight-oriented) therapy can help you by enabling you to talk about key events in your past that may have led to your Anxiety. When you share these past events and relationships in the safe, supportive environment of therapy, you can often release years of hurt, grief, guilt and shame that have kept you from experiencing joy and success in life.
Medical Treatments: Anxiety symptoms can be reduced with medications and supplements that your doctor or nurse practitioner may prescribe or recommend. These treatments directly affect the brain chemistry that underlies anxiety symptoms. When your symptoms decrease in intensity, it will be easier for you to develop new ways to cope with them. Medication generally works best in conjunction with one or more of the psychotherapy options described above.
If you have further questions about the treatment of Anxiety, please feel free to contact us.