Anxiety disorders and how to cope

Identifying and overcoming the anxiety “trick”

Everyone feels anxious under stress from time to time. Situations such as meeting tight deadlines, important social obligations or even driving in heaving traffic, often bring about anxious feelings. Such mild anxiety may actually help make you more alert and focused when facing threatening or challenging circumstances. On the other hand, anxiety disorders cause severe distress over a period of time and disrupt the lives of individuals suffering from them. The frequency and intensity of anxiety involved in these disorders is often debilitating, but fortunately, with proper and effective treatment, they can be managed.

Getting rid of anxiety disorders isn’t the same as taking out the trash. If you take your trash out to the curb, it’s gone forever, and won’t come back. But when you try to dispose of chronic anxiety, every effort you make to fight against it invites more of it.

The fears, phobias, and worries that you experience with chronic anxiety often seem irrational, and difficult to overcome. That’s because there is a “trick” to chronic anxiety problems. Have you ever wondered why fears and phobias seem like such difficult problems to solve? The reason is that chronic fears literally trick you into thinking and acting in ways that make the problem more chronic. The outcome of the anxiety trick is that people get fooled into trying to solve their anxiety problems with methods that can only make them worse. They get fooled into putting out fires with gasoline.

The Key Fears

There are six principal anxiety disorders. The fears are different, but each one relies on the same anxiety trick and draws upon the same kinds of anxiety symptoms.  And in each case, the person tries to extinguish the fears by responding in ways that actually make the problem worse and more chronic.

Here are the key fears, and typical responses, of each anxiety disorder.

Panic Disorder and Agoraphobia

A person with Panic Disorder and Agoraphobia fears that a panic attack will disable him in some way – kill him, make him crazy, make him faint, and so on. In response, he often goes to great lengths to protect himself from a panic attack, by avoiding ordinary activities and locations; by carrying objects, like water bottles and cell phones, that he hopes will protect him; by trying to distract himself from the subject of panic; and numerous other strategies that will ultimately make the problem more persistent and severe, rather than less.

 

Social Anxiety Disorder (or Social Phobia)

A person with Social Phobia fears becoming so visibly and unreasonably afraid in front of other people that they will judge her as a weak, inadequate person, and no longer associate with her. In response, she often goes to great lengths to avoid social experiences, hoping that this avoidance will save her from embarrassment and public humiliation. However, her avoidance of social situations leads her to become more, rather than less, fearful of them, and also leads to social isolation.

The fear of public speaking, and the broader fear of stage fright are considered to be specific instances of Social Phobia.

Specific Phobia

A Specific Phobia is a pattern of excessive fear of some ordinary object, situation, or activity. A person with a fear of dogs, for instance, may fear that a dog will attack him; or he may be afraid that he will “lose his mind”, or run into heavy traffic, on encountering a dog.

People with phobias usually try to avoid what they fear. Unfortunately, this often creates greater problems for them. Not only do they continue to fear the object, but the avoidance restricts their freedom to enjoy life as they would see fit.

A specific phobia is usually distinguished from Panic Disorder by its narrow focus. A person with a fear of flying who has no fear of other enclosed spaces would likely be considered to have a specific phobia. A person who fears airplanes, elevators, tunnels, and bridges is usually considered to have Panic Disorder or claustrophobia. However, the fear of public speaking is usually considered to be a part of Social Phobia. A person with a Blood Phobia may fear a variety of situations, but they all involve the prospect of seeing blood. What’s more, the official definitions of some of these disorders will change in 2013, so don’t get preoccupied with the label.

Whether you have one or multiple phobias, these are very treatable conditions.

 

Obsessive Compulsive Disorder (OCD)

A person experiences intrusive, unwelcome thoughts (called obsessions) that are so persistent and upsetting that he fears the thoughts might not stop. In response, he tries to stop having those thoughts with a variety of efforts (called compulsions). Unfortunately, the compulsions usually become a severe, upsetting problem in themselves.  For example, a man may have obsessive thoughts that he could pass swine flu on to his children, even though he doesn’t have the flu himself, and subsequently washes his hands repetitively in an effort to get rid of that thought. Or a woman may have obsessive thoughts that she left the garage door open, and repeatedly checks on it all night in an effort to stop thinking that thought. Not only do these efforts fail to rid the person of the unwelcome thoughts, but they become a new form of torment in that person’s life.

 

Generalized Anxiety Disorder

A person with Generalized Anxiety Disorder worries repeatedly and continually about a wide variety of possible problems, and becomes so consumed by worry that she fears the worry will eventually kill her or drive her to a “nervous breakdown”. In response, she often tries a wide variety of “thought control” methods she hopes will enable her to “stop thinking about it.” Distraction is one such effort. Unfortunately, the effort to stop thinking about it actually makes the worrisome thoughts more persistent.

Post Traumatic Stress Disorder (PTSD)

A person who has witnessed or experienced some dangerous or life threatening event (a shooting or a car crash) fears that the subsequent thoughts and powerful reminders of that event will lead to a loss of control or mental illness. The powerful symptoms of fear and upset a person experiences when recalling a terrible event are reactions to that event. However, the person gets tricked into responding to these reactions as if they were warnings of an upcoming danger, rather than reminders of a past one.

Depression, too?

It’s very common for people to experience depression in response to the way anxiety has disrupted their lives. Less frequently, people experienced a strong depression before the anxiety set in. This is a different kind of problem. Either way, depressive symptoms need to be addressed in recovery, so it’s useful to know something about how depression and anxiety disorders are related.

Doctors within our practice who focus on Anxiety, Fear, Worry issues:

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