Anxiety Disorders

Many of us have suffered from anxiety from time to time due to the pressures we may experience, managing family and professional lives so we understand that anxiety disorders are fairly common.  But there are some anxiety disorders that can give symptoms which are intense and create a painful experience of anxiety, often accompanied by feelings of guilt or worthlessness.  The person with this type of anxiety disorder typically feels nervous and afraid, and may appear frightened or terrified for no apparent or logical reason.  Persons with these disorders may try to defend against the anxiety by denying, rejecting, fixating or repeating behaviors.  One of my elderly clients just recently went through a combination of depression and anxiety disorders right after the passing of her spouse of 60 years.  She cancelled every appointment both socially and professionally.  Her neighbors finally decided to take matters in their own hands and contacted me for help when she began experiencing physical symptoms such as trouble breathing, headaches, bowel distress, stomach upset, and insomnia. But hyperactivity, fatigue, trembling, palpitations and dizziness may also be experienced.  Individuals with anxiety disorders may additionally experience flushes or chills, sweating, frequent urination, and / or sleep problems.

Anxiety disorders include conditions such as panic attacks, obsessive-compulsive disorder (OCD), post-traumatic stress disorder, and generalized anxiety disorder, as well as general and specific phobias.  When a person has a panic attack, he/she experiences intense fearfulness and terror which is often associated with feelings of impending doom. 

We've all seen the Monk TV show (left) which depicts the recurrent obsessions of this detective character which are intrusive and cause distress to his co-workers.  The person with OCD may respond to such compulsions aimed at either preventing an event or situation, or directly in response to the obsessive thoughts.  For example, a person may have intrusive thoughts or images about whether or not he/she has locked all the windows and doors in the house.  In response to these thoughts, the person gets up hourly during the night to check all the windows and doors. 

Post-Traumatic Stress Disorders (PTSD) follow psychologically disturbing events that are beyond the usual human experience.  Veterans of combat and victims of childhood sexual abuse often experience this type of disorder.  This disorder typically creates intense fear, helplessness, avoidance of reminders of the event, and increased arousal.  Individuals with PTSD may have difficulty falling asleep, may re-experience the event (flashbacks), or have recurring nightmares, and often maintain a state of watchfulness.  They may also startle easily and unexpectedly.  In addition, they may have difficulty concentrating and often become depressed.  

Someone with a generalized anxiety disorder may experience persistent and excessive anxiety and can worry about a number of events for at least six months.  Minor tranquilizers often are used to help reduce anxiety, agitation, aggression, and hyperactivity associated with anxiety disorders.  Several practical techniques may be also used to help reduce anxiety such as: providing a calm and quiet environment where a person can go and sit quietly, listen to music or relaxation tapes; establishing daily routines that are structured as much as possible, scheduled every day at the same time to alleviate some of the anxiety; using non-threatening affirmations of worth or recognition of positive personality traits or accomplishments; acknowledging fears or anxieties experienced and never dismissing them as "silly"  or unsubstantiated; and using activities to divert attention.  Soothing music or massage may reduce a person's fears and anxiety.  Others may benefit from involvement in a focused activity such as gardening or arts and crafts.  Yoga and deep breathing exercises are also helpful as well as participating in insight and/or behavior therapy modes. In my client's case, we formed a team, collaborating with the psychiatrist, psychotherapist, medical doctor, and care manager to match competent, compassionate and professional caregivers to the client's personality.  Once the right medication was prescribed and with good nutrition and counseling, she rejoined her neighbors in daily activities.  Sometimes it just takes a village.