Every person feels anxiety on occasion; it is a part of life. All of us know what it is like to feel worry, nervousness, fear, and concern. We feel nervous when we have to give a speech, go for a job interview, or walk into our boss’s office for our annual performance appraisal. We know it’s normal to feel a surge of fear when we unexpectedly see a photo of a snake or look down from the top of a tall building.
Most of us manage these kinds of anxious feelings fairly well and don’t allow them to disrupt our lives. But millions of people (an estimated 15 percent of the population) suffer from devastating and constant anxiety that severely affects, and sometimes highly restricts their lives. They experience panic attacks, phobias, extreme shyness, and obsessive thoughts and compulsive behaviors. The feeling of anxiety is a constant dominating force that disrupts their lives. Some become prisoners in their own homes, unable to leave to work, drive, or visit the grocery store. For these people, anxiety is much more than just an occasional wave of apprehension.
WHAT IS ANXIETY?
An anxiety disorder affects a person’s behavior, thoughts, feelings, and physical sensations. The most common anxiety disorders include the following:
- Social Anxiety Also called social phobia, this disorder is a fear of being around other people. People suffering from it always feel self-conscious around others. They always have the feeling that everyone is staring at them and being critical in some way. Because the anxiety is so painful, people suffering from it learn to stay away from social situations and avoid other people. Some eventually need to be alone at all times, in a room with the door closed. The anxiety is pervasive and constant, and it even happens with people one knows. People with social anxiety know that their thoughts and fears are irrational. They know that others are not actually judging or evaluating them at every moment. But this knowledge does not make the anxiety disappear.
- Panic Disorder A person with this disorder has panic attacks without warning. According to the National Institutes of Mental Health, about 5 percent of the adult population in the United States suffers from panic attacks. Some experts say that this number is actually higher, since many people experience panic attacks but never receive treatment. A panic attack is extremely upsetting and frightening. It typically lasts several minutes, but in some cases, it lasts longer or strikes several times within a short time period. Often, a panic attack is followed by feelings of depression and helplessness. Most people who have experienced a panic attack say that their greatest fear is that the attack will happen again. Many times, a person who has experienced a panic attack doesn’t know its cause; the attack seems to have come “out of the blue.” Other times, a person reports having felt extreme stress or having encountered difficult times and isn’t surprised that a panic attack occurred.
- Generalized Anxiety Disorder This disorder is quite common, affecting an estimated 3 to 4 percent of the population. It fills a person’s life with worry, anxiety, and fear. People with this disorder always think and dwell on the “what ifs” of a situation. It feels like there is no way out of the vicious cycle of anxiety and worry. The person often becomes depressed about life and the inability to stop worrying. People with this disorder usually don’t avoid situations, and they don’t generally have panic attacks. However, they can become incapacitated by the inability to shut their minds off and are overcome with feelings of worry and dread, a lack of energy, and a loss of interest in life. The person usually realizes that these feelings are irrational but also knows that they are very real. The person’s mood can change from hour to hour or even day to day. Feelings of anxiety feelings and mood swings become a pattern that severely disrupts the person’s quality of life. People with this disorder often have physical symptoms including headaches, irritability, frustration, trembling, inability to concentrate, and sleep disturbances. They may also have symptoms of social phobia and panic disorder.
WHAT ARE THE OTHER TYPES OF ANXIETY?
Other types of anxiety disorders include the following:
- Phobia. Fear of a specific object or situation.
- Obsessive-compulsive disorder (OCD).
- System of ritualized behaviors or obsessions that are driven by anxious thoughts.
- Posttraumatic stress disorder (PTSD).
- Severe anxiety that is triggered by memories of a past traumatic experience.
- Agoraphobia. Disabling fear that prevents one from leaving home or other safe place.
HOW IS ANXIETY TREATED?
Most people who suffer from anxiety disorders begin to feel better when they receive the proper treatment. It can be difficult to identify the proper treatment, however, because each person’s anxiety is caused by a unique set of factors. It can be frustrating for the client when treatment is not immediately successful or takes longer than hoped for.
Some clients feel better after a few weeks or months of treatment, while others may need a year or more. If a person has an anxiety disorder in combination with another disorder (e.g., alcoholism or depression), treatment will be more complicated and will take longer.
Although a treatment plan must be specifically designed for each individual, a number of standard approaches exist. Mental health professionals who specialize in treating anxiety most often use a combination of the following treatments. There is no single correct approach.
- Cognitive therapy. The client learns how to identify and change unproductive thought patterns by observing his/her feelings and learning to separate realistic from unrealistic thoughts.
- Behavior therapy. This treatment helps the client alter and control unwanted behavior. Systematic desensitization is a type of behavior therapy often used to help people with phobias, OCD, and agoraphobia. The client is exposed to anxiety-producing stimuli one small step at a time. It requires careful monitoring. Because it may take weeks to become effective, immediate relief may require other types of treatment.
- Electroconvulsive Therapy. Also called shock treatment, electroconvulsive therapy (ECT) can be an effective treatment for patients who cannot take lithium. Following the administration of a muscle relaxant and anesthetic, ECT involves sending a small amount of current to the brain. The patient has a short seizure and may experience confusion, headache, nausea, memory lapse, and other symptoms. Most people respond to ECT very quickly, making it an effective treatment for patients who need to be stabilized immediately or who cannot take medications.
- Psychotherapy. An important component to the treatment of bipolar disorder is psychotherapy. Because of the guilt, remorse, and depression that often follow a manic phase, it is very important that patients establish and maintain a relationship with a licensed mental health professional. The therapist can encourage the patient to stay on his/her medication and help him/her build self-esteem and develop a support system. The therapist can also refer the patient to a support group for people with bipolar disorder, which can be an excellent source of assistance.
- Family Support. The patient’s friends and family members can provide some of the most important support of all. They can help by understanding that bipolar disorder is an illness, not a character defect. It is important that they learn as much as they can about bipolar disorder and that they listen empathetically, behave in a supportive manner, and plan ahead for the times when the patient experiences mania or depression. They should listen for remarks about suicide and take them seriously.