Anxiety – Which Disorder is it, anyway?
Anxiety – Which Disorder is it, anyway?
It starts with a feeling of restlessness. I can’t sit still in one place too long. I try to listen to music. Read. Surf the Internet. Nothing catches my interest. The restlessness grows.
Am I hungry?
Am I thirsty?
I try satiating both. Nothing helps.
Now, I’m getting nervous, my heart beats faster. My eyes blink more, darting from here to there, trying to take it all in. What is it that will make this feeling go away?
I know, I have to go to the bathroom.
It doesn’t help.
My breathing shallows, I catch my breath every other time. Let’s try some deep breathing.
I take a walk. Listen to my music while I try and concentrate.
Focus on my happy place.
Damn, my happy place. I can’t relax. My hands shake; my arms hug myself without conscience. My feet tap as my leg trembles.
There’s no stopping it now; full-blown anxiety attack and I know it will only get worse and turn into a panic attack. It’s only a matter of time.
I head for my last resort, like a horse heading home to the barn on instinct. I go to my bedside table and find my bottle of Ativan. Shake out a pill and swallow it gratefully.
I will be calm. I will relax. I will feel better.
What is anxiety? According to Dr. David D. Burns in The Feeling Good Handbook, “there are three competing theories about the causes of anxiety. A cognitive therapist would claim that negative thoughts and irrational attitudes cause anxiety. A psychoanalyst would argue that repressed conflicts make you anxious. Finally, some psychiatrists think that an imbalance in your body chemistry causes feelings of fear and panic.” (1)
“Anxiety (also called angst or worry) is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral components. It is the displeasing feeling of fear and concern. The root meaning of the word anxiety is 'to vex or trouble'; in either presence or absence of psychological stress, anxiety can create feelings of fear, worry, uneasiness, and dread. Anxiety is considered to be a normal reaction to a stressor. It may help an individual to deal with a demanding situation by prompting them to cope with it. When anxiety becomes excessive, it may fall under the classification of an anxiety disorder.” (2)
1- The Feeling Good Handbook, by David D. Burns, M.D. Copyright 1990, 1999
These are the following types of Anxiety Disorders:
• panic disorder,
• obsessive-compulsive disorder (OCD),
• post-traumatic stress disorder (PTSD),
• social phobia (or social anxiety disorder),
• specific phobias, and
• generalized anxiety disorder (GAD).
They all have similar symptoms and unique characteristics. Just for the record, I suffer (is that the right word?) I’ve experienced all of these at one time or another as part of my mental illness make-up including Bipolar Disorder.
“Panic disorder is a real illness that can be successfully treated. It is characterized by sudden attacks of terror, usually accompanied by a pounding heart, sweatiness, weakness, faintness, or dizziness. During these attacks, people with panic disorder may flush or feel chilled; their hands may tingle or feel numb; and they may experience nausea, chest pain, or smothering sensations. Panic attacks usually produce a sense of unreality, a fear of impending doom, or a fear of losing control.
A fear of one’s own unexplained physical symptoms is also a symptom of panic disorder. People having panic attacks sometimes believe they are having heart attacks, losing their minds, or on the verge of death. They can’t predict when or where an attack will occur, and between episodes many worry intensely and dread the next attack.
Panic attacks can occur at any time, even during sleep. An attack usually peaks within 10 minutes, but some symptoms may last much longer.” (3)
Obsessive-compulsive disorder (OCD)
“Obsessive-compulsive Disorder is an anxiety disorder characterized by uncontrollable, unwanted thoughts and repetitive, ritualized behaviors you feel compelled to perform. If you have OCD, you probably recognize that your obsessive thoughts and compulsive behaviors are irrational – but even so, you feel unable to resist them and break free.”
Like a needle getting stuck on an old record, obsessive-compulsive disorder (OCD) causes the brain to get stuck on a particular thought or urge. For example, you may check the stove twenty times to make sure it’s really turned off, wash your hands until they’re scrubbed raw, or drive around for hours to make sure that the bump you heard while driving wasn’t a person you ran over.” (4)
Post Traumatic Stress Disorder (PTSD)
“Post-traumatic stress disorder (PTSD) is a mental health condition that's triggered by a terrifying event. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event.
Many people who go through traumatic events have difficulty adjusting and coping for a while. But with time and taking care of yourself, such traumatic reactions usually get better. In some cases, though, the symptoms can get worse or last for months or even years. Sometimes they may completely shake up your life. In a case such as this, you may have post-traumatic stress disorder.” (5)
Social Phobia/Social Anxiety Disorder
“People with social anxiety disorder (or social phobia) are extremely anxious about what they will say or do in front of other people. This includes public speaking and day-to-day social situations. But it is more than just being shy or nervous before public speaking. The fear can begin weeks or months before an event. It can cause a fast heartbeat and make it hard to focus.
Some people fear only one or a few types of social situations. For other people, many situations cause stress. This problem affects your daily life. You may be so stressed or afraid that you avoid public situations, including missing work and school.” (6)
“A specific phobia is an intense, irrational fear of something that poses little or no actual danger. Some of the more common specific phobias are centered around closed-in places, heights, escalators, tunnels, highway driving, water, flying, dogs, and injuries involving blood. Such phobias aren’t just extreme fear; they are irrational fear of a particular thing. You may be able to ski the
world’s tallest mountains with ease but be unable to go above the 5th floor of an office building. While adults with phobias realize that these fears are irrational, they often find that facing, or even thinking about facing, the feared object or situation brings on a panic attack or severe anxiety.
Specific phobias affect an estimated 19.2 million adult Americans1 and are twice as common in women as men. They usually appear in childhood or adolescence and tend to persist into adulthood. The causes of specific phobias are not well understood, but there is some evidence that the tendency to develop them may run in families.
If the feared situation or feared object is easy to avoid, people with specific phobias may not seek help; but if avoidance interferes with their careers or their personal lives, it can become disabling and treatment is usually pursued.
Specific phobias respond very well to carefully targeted psychotherapy.” (7)
Generalized Anxiety Disorder (GAD)
“Overwhelming anxiety, if not treated early, can consequently become a generalized anxiety disorder (GAD), which can be identified by symptoms of exaggerated and excessive worry, chronic anxiety, and constant, irrational thoughts. The anxious thoughts and feelings felt while suffering from GAD are difficult to control and can cause serious mental anguish that interferes with normal, daily functioning.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) includes specific criteria for diagnosing generalized anxiety disorder. The DSM-IV states that a patient must experience chronic anxiety and excessive worry, almost daily, for at least 6 months due to a number of stressors (such as work or school) and experience three or more defined symptoms, including, “restlessness or feeling keyed up or on edge, being easily fatigued, difficulty concentrating or mind going blank, irritability, muscle tension, sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying sleep).”
If symptoms of chronic anxiety are not addressed and treated in adolescence then the risk of developing an anxiety disorder in adulthood increases significantly. “Clinical worry is also associated with risk of comorbidity with other anxiety disorders and depression” which is why immediate treatment is so important.
Generalized anxiety disorder can be treated through specialized therapies aimed at changing thinking patterns and in turn reducing anxiety-producing behaviors. Cognitive behavioral therapy (CBT) and short-term psychodynamic psychotherapy (STPP) can be used to successfully treat GAD with positive effects lasting 12 months after treatment. There are also other treatment plans that should be discussed with a knowledgeable health care practitioner, which can be used in conjunction with behavioral therapy to greatly reduce the disabling symptoms of generalized anxiety disorder.” (8)
That’s a lot of information to take in all at once, don’t you think? How do they get treated? How can you tell one from the other when the symptoms cross over?
There are three basic treatments: Cognitive Behavioral Therapy, Medication, and Emotional / Psychoanalytical Therapy. I’m currently undergoing all three types of treatment for my anxiety disorders.
One that helped very well with PTSD, is EMDR (Eye Movement Desensitization Reprocessing) (9) therapy. I had twelve sessions to go through the numerous PTSD issues in my life. I can now barely recall them, and if I do, I do not have the panic or anxiety that used to occur when I thought of the events.
I also see a cognitive behavioral therapist for regular sessions. We are going to start hypnotherapy very soon. I’m looking forward to that experience.
And, of course, I take Ativan (anti-anxiety medication) as my go to, back up, if all else fails treatment.
So, how does a person with all these anxiety disorders function? Very well, if I stay cognizant of my surroundings, plan my days, and stay on top of any symptoms that I may experience throughout the day. Overall, I function very well. It’s the rest of the people around me who may have to make adjustments now and then, but I try very hard not to let my disorders be other people’s disorders.
You can have the same success if you just slow down, concentrate, and are aware of your body, it’s symptoms, and how it reacts to various treatments.
“Much strength goes to everyone else that has anxiety. It's a hard disorder to deal with. And no one truly understands unless they have it.” (10)
10- Unknown Author