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Anxiety Disorders take Several Forms,  by Kathryn Harris

From ON YOUR MIND, articles in the Wilmington News Journal


Q.  I've recently been told I have an anxiety disorder and am not sure what that means.  What exactly is anxiety?  How is it different from worry or fear?  What is the difference between "normal" anxiety, an anxiety attack, and an anxiety disorder?  And what do I do about this?


A.  If you have been diagnosed with an anxiety disorder by a doctor or mental health professional you should ask that person specifically what that diagnosis means for you.  The formal diagnosis refers to one or more of twelve different types of anxiety-based problems such as phobias, obsessive-compulsive behavior, anxiety disorder and panic attacks.


            Anxiety tends to be a learned response to fear itself, i.e. we become concerned about whether we will be able to handle a particular threatening situation.  Generalized anxiety is when aware of the uncomfortable feelings but not of the cause of the threat, i.e. we have got the feelings but not the understanding of the cause.  This can be particularly uncomfortable.  An anxiety attack usually refers to a sudden, and often unexplained, experience of the physical symptoms, and the feelings of dread and panic with the accompanying fearful thoughts that are associated with anxiety.  The unpredictability of these events lead them to be particularly worrisome and debilitating while they are happening.   Anticipating the possibility of such attacks is itself a contributor to them.


            Simply stated, when we talk about 'worry' we are usually talking about thoughts that disturb us, while we use 'fear' to refer to feelings which come from a broad range of automatic physiological reactions producing a fight or flight response to an anticipated threat.  In fact, our worried thoughts tend to increase our fear, and our fearful feelings  tend to add to worried thoughts.  So thoughts and feelings become interlocked in a self reinforcing cycle.  We usually think of anxiety as a combination of these worried thoughts and uncomfortable feelings:  an abnormal or overwhelming sense of dread or concern usually accompanied by  physical indicators of fear (tension, increased pulse, perspiration, and agitation).


            Anxiety, however, like depression, is a very normal experience for us all.  The reality is that we all face lots of demands and feel pressure to perform when we are not at all sure that we can.  Anxiety, like fear, can be useful in that it can put us on the alert--heighten attention to what is around us, help us to focus on the task at hand, and give extra energy to do what needs to be done.  A bit of pre-test anxiety can motivate studying and enhance learning. Too much anxiety, however, can do just the opposite, causing disrupted sleep, appetite disturbance, obsessive thinking, self doubt, and other responses which  tend to get in the way of living.  As with any other emotion or response, learning what the reaction is and how to work with our response can make the difference between our anxiety being an asset or a liability.


      Since anxiety combines the feelings of our body's fear reactions and  our learned thought responses to these feelings, we can work with anxiety by addressing either the feelings or the thoughts, or both.    Different approaches to managing anxiety include: 

  • learning to exercise control over the physical aspect of anxiety  by  consciously changing the biochemistry  of your response to stress.  Resources for this include: regular relaxation and enjoyable times; meditation; physical exercise; being attentive to caffeine intake and a good diet; and making sure that your body is generally healthy.  Since anxiety is a physiological response, it is important to note that it can be a result of many different physical conditions including shifting hormones (PMS), high blood pressure, side effects of medication, or an indicator of other physical problems.   

  • identifying  particular ways in which you distort your thinking and learning a structured process to change some of the self-defeating thought habits which keep the anxiety-cycle going.  This cognitive behavioral approach is an effective, straightforward method which can help shift  established thought patterns and give you some control over the anxiety response.

  • seeing a mental health professional who can be helpful in helping you to identify the cause of the stress, and to develop effective strategies and  coping skills to face the challenges of your life. There are times when our stress or conflicts are internal and may be difficult to identify ourselves.  

  • considering a trial of an anti-anxiety medication to help you break the anxiety cycle if you and your doctor decide that the anxiety is a product of environmental stress.  If stress is external, you must either change your response to the stress, or change the stressors.  Anxiety is a signal that needs to be taken seriously because chronic anxiety can take a serious toll on our health and the general quality of our lives. 


              It is important to remember that although we have  inherited predispositions to anxiety, we can learn how to work with our learned responses and have a wide variety of community resources available to help in that task.  The Mental Health Association (656 8308) sponsors several peer support groups for anxiety disorders where group members share their experiences and their coping skills.  The MHA also sponsors an annual Anxiety Screening Day in many locations throughout the state during  the month of May.


              Another fine resource for helping you evaluate anxiety and  learn to skills of changing distorted thinking patterns is The Feeling Good Handbook by Dr. David Burns.  Local bookstores and libraries have many other good resources for information about specific anxiety disorders. 


            Do remember that anxiety is a signal from our body that needs to be taken seriously to address.  Chronic anxiety can take a serious toll on our health and the general quality of our lives.


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