Anxiety and Anxiety Disorders

Man Scratching HeadWorry and stress can be quite disturbing and interfere with normal functioning. Symptoms can range from very mild worry to intense panic. When we become indecisive and stress and worry intensify, it can be paralyzing. Also, symptoms begin to show up. They can reduce concentration and memory function, produce physical illness such as headaches, stomachs, insomnia and increase mistakes. Ongoing stress can cause depression, phobic reactions. We may lose our appetite and our interest in doing things with others. We may experience weight loss or weight gain. Anxiety can cause us to become more irritable and difficult to cope with others. Phobic reactions can make us want to avoid situations.

When the stress feels like danger, we experience a “Flight-Fight” reaction. We may become afraid of our own physiological response to the danger. The neurobiology of that reaction, while protective and aimed at keeping us alive, may be unfamiliar and cause panic. The activation of the sympathetic nervous system causes the adrenal gland to release catecholamines. These hormones increase heart rate, cause rapid and shallow breathing and increased perspiration. The reason for these reactions is to deliver more energy in the form of glucose to the muscles. When when you burn fuel (glucose) you need more oxygen, thus the rapid breathing. Finally, when you burn energy you produce heat. To cool down the cells, you perspire. All of these reactions serve the body’s reaction to danger, allowing us to run or fight from the danger. When we are unaware of the danger or are paralyzed by the fear, we experience the reaction as Anxiety and we may panic due to the strong physiological sensations-pounding heart beat, sweating, hyperventilation.

When we experience paralyzing fear in reaction to a specific stimulus we can’t function normally any more. Phobias, for example, can be expressed as fear open spaces (agoraphobia), fear of socializing (social phobia) which leave us feeling isolated and alone, fear of animals, etc. Some fears can appear quite irrational to others. For example, the fear of contamination, germs, touching people’s hands, sitting on toilet seats, etc. These things can send us into panic due to anticipating extreme discomfort.

Individuals with Generalized Anxiety Disorder worry intensely in anticipation that things will go wrong. They  feel keyed up and can’t act quickly or efficiently. They may begin to feel panicky and think they are having heart palpitations or an attack.

In Obsessive Compulsive Disorder, people may ruminate or have unwanted thoughts, images or impulses that intrude into their mind. Their worry may manifest itself in “checking” behaviors such as repeated hand washing, compulsive monitoring or scrutinizing of other’s behavior. They may worry if they left the door unlocked, the stove left on, or if they counted correctly, etc. They may attempt to control their obsessive worrying through repeated ritualistic behaviors, such as counting, always going to the right, performing some action in a particular way that has some personal (or delusional) significance (e.g., avoiding stepping on a crack in the sidewalk because they may think, “step on a crack, break your mother’s back”), etc.  They may have unwanted disturbing intrusive thoughts, (e.g., “I am a freak,” or “I’m going to hurt her.”)

Paranoia is another manifestation of anxiety. The intensification of fear of rejection and abandonment can lead to mistrust, suspicion, and jealousy. Performance anxiety which may include “test anxiety” or a fear of failure may make performance on tests worse.

When several of these symptoms are present at the same time we become overwhelmed. Diagnosed as Generalized Anxiety Disorder (GAD), GAD can be emotionally crippling. We may constantly worry about health, money, work, or family which invites a host of symptoms described previously. GAD affects twice as many woman as men. When their anxiety is mild, individuals with GAD can function socially and at work. When their anxiety is high, they have difficulty making even simple decisions. They suffer from fatigue, poor concentration and may get depressed. Self-medicating with drugs or alcohol is common. These symptoms could be accompanied by panic, or anxiety attacks. Sometimes the stress or anxiety is internalized and expressed in somatic complaints such as stomach aches, headaches, muscle tension, nausea, feeling out of breath, etc.

Treatment for Anxiety Disorders

Treatment can be brief, take several months or longer than a year depending on the presence of other conditions, (e.g., depression, substance abuse, etc.). Exposure Therapy, Systematic Desensitization, Cognitive Behavior Therapy, Mindfulness, Eye Movement Desensitization and Reprocessing (EMDR) are evidenced-based treatments for many anxiety disorders. Complimentary treatments include Yoga, exercise, herbal remedies, acupuncture and massage are also reported to reduce symptoms.

Anxiety and  Medication

When anxiety disorders make your life unbearable, or get complicated by substance use or abuse, co-occur with other disorders such as depression or ADHD, psychiatric evaluation for pharmacological interventions can give you immediate relief. When taken in combination in combination with psychotherapy, treatment is more effective than psychotherapy or medication alone.

Psychological testing can be helpful in the diagnosis of anxiety and how it affects cognitive, emotional and personality functioning. Identifying the intensity (mild, moderate or severe) of the anxiety can provide a benchmark against which we can measure improvement.

Get your life back on track. Help is available, don’t put it off any more. Call for an appointment to set up an initial interview at (770) 729-0123.

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