Anxiety begins
“Anxiety weighs down the human heart, but a good word cheers it up.”
IT is Easter. It is Day 0 for anxiety for everything resets today. Anxiety is the uncomfortable feeling or sensation that something, usually something terrible, is about to happen. There are no signs of impending disaster but the anxious person worries anyway. Anxiety is different from fear. Fear is what you feel looking down the barrel of a gun pointed at you. Anxiety is waiting for fear to happen. Anxiety is feeling that a stranger will poke a gun at you in a dark alley. When anxiety worsens to a point that the person is unable to go about her daily activities, it becomes an anxiety disorder. That person will need help.
Forms of Anxiety. GAD or generalized anxiety disorder is constant and exaggerated thoughts preventing the individual from functioning normally. When confronted, he is unable to pinpoint an identifiable cause for worry. Physically, the GAD-affected is jumpy – with muscle tension, headache, nausea, headache, or fatigue, even an upset stomach.
In panic disorder, the person is suddenly struck down with an overpowering terror, usually irrational, causing physical paralysis. The heartbeat gallops, there may be chest pain and abdominal distress. There is shortness of breath and dizziness. It’s like getting out of the roller coaster after friends dragged you in for the ride. The panic attack may last for about 10 minutes and can be triggered by a specific cause (too much caffeine, alcohol, or nicotine) or a situation such as being in large crowds or enclosed spaces like elevators and motels.
In post-traumatic stress disorder, the person is immobilized by a personally catastrophic event such as rape, kidnapping, torture, etc. Whatever the trauma, the person is debilitated because the event is relived in recollections in the daytime or in nightmares.
The obsessive-compulsive disorder is about being plagued by anxious thoughts and rituals. For example, the person may be obsessed with germs (like Howard Hughes) and will wash hands again and again until the skin becomes dry and scaly. Disturbing thoughts and images are called obsessions and can consume up to an hour of a day in the affected person.
There are two kinds of phobias that qualify as anxiety disorders. In social phobia, there is overwhelming anxiety and extreme self-consciousness in otherwise everyday social situations. Going to the supermarket is nearly impossible not because there’s no money to spend (that happens too!), but of the irrational fear of being watched, embarrassed or humiliated.
In a specific phobia, there is intense fear of something that poses little or no actual danger. Phobias vary from fear of heights, spiders, snakes, but the important element is that they are irrational. There are scuba divers who nearly empty their tanks staying down at 60 feet but panic treading on the surface.
Do you need help? You may want to see a psychologist, usually the guidance counselor in school, your family medicine practitioner or the psychiatrist. These professionals, particularly the doctors, will first make sure that your mental problems are not organic. After all, you really may be having panic attacks because your heart is failing!
Treatment. It would be prudent NOT to list medications for anxiety disorders. This is one area where self-medication is not only foolish but dangerous. The psychiatrist is in the best position to advise you on drugs. Non-drug treatment methods are behavioral therapy techniques in which the focus is changing specific actions or stopping unwanted behavior; cognitive-behavioral therapy which begins with understanding and then changing thinking patterns that lead to unwanted actions.
These are anxious times. Cracking up may not be an option.
Fact/Factoid. Our Latin quip of the week comes from Seneca the Elder (Controversiae, II, 6,3): Bibamus, moriendum est. (Death is unavoidable, let’s have a drink). Dr Pujalte is an orthopedic surgeon. email jspujalte@yahoo.com