Taking Charge of Anxiety

Two years ago 33 year-old LaTasha Wilson awakened one night with chest pains, a feeling that she was suffocating, and a rapidly beating heart. Terrified, she telephoned a neighbor, who rushed over. After a short time she felt better and decided she probably wasn’t having a heart attack after all. But the next day she went to her HMO. It turned out that there were no signs of heart problems, but the physician told her that the symptoms she had experienced were classic symptoms of a panic attack. He asked if she had been feeling more stressed than usual. She and her husband had separated three months before, and while she was doing fine at work and keeping in close touch with friends and relatives, she was aware that it was a difficult period in her life. The physician explained that a first panic attack often occurs during a period of increased stress, and not uncommonly at night. Although he couldn’t be sure she would have more, he suggested that she might want to see a psychiatric social worker. She wasn’t sure, but a week later, after an episode at work, she made an appointment.

The therapist helped her learn new ways of thinking about life events, which reduced her general level of anxiety. In response to the social worker’s suggestion, she also experimented with reducing her coffee intake and increasing her exercise, which she decided were useful. A nurse practitioner prescribed an antidepressant, explaining that it is one of the most effective medication therapies for panic disorder. After several months, the medication was gradually stopped, and LaTasha has had very few panic episodes since that time. She learned from her therapy to better recognize stressful events. When they occur, she uses the strategies she learned to reduce her overall level of tension and her chances of having a panic attack.

For most of Tony Gioletto’s life, whenever anything problematic occurred, his tendency was to regard the problem as the first stage of a situation that would end in catastrophe. At the age of ten he began to think that whenever he left a room he had to turn the light switch off and on five times, touching the wall in specific places between each flick of the switch. His mother had received treatment for obsessive-compulsive disorder, so she quickly recognized the symptoms in her son and took him to a psychologist. From his therapist, Tony learned how to change his catastrophizing thought patterns. For the next several years, with some effort, he was able to keep his disorder under control and do most of the things his friends did. Although he never made first string, he was on his junior high basketball squad.

But when he was 15 he moved to a new city with his mother and stepfather. Tony felt completely out of place in a situation where he didn’t know anyone. His old symptoms returned and, in addition, he began to regard door handles as a dangerous source of germs. His mother finally persuaded him to see a psychiatrist who worked mostly with adolescents. This therapist coached him in using the thought-management strategies the earlier therapist had taught him. But because Tony had to develop new friends, new activities, and new skills (like driving a car) in a whole new city, the situation was especially stressful. So the therapist urged him to take medication as well. Initially Tony refused, saying that the very idea made him think all the time about becoming a drug addict. Later, as he grew more comfortable with the therapist and began to more fully realize how difficult the move had been for him, he agreed to try medication. Two years later, he still takes medication and sees his therapist, although less frequently. He is a high school senior, has his driver’s license, and has several friends. He is getting into more activities and is currently working to develop dating skills.

LaTasha and Tony each experienced an anxiety disorder. Anxiety disorders are common, and they affect people of all ages. Frequent symptoms are feelings of nervousness and impending doom. Unpleasant feelings are sometimes prevented by avoiding situations or objects that trigger them (like going out alone or being in high places) or carrying out behaviors to neutralize them (like repetitive hand washing or checking or tidying). Generally, people with anxiety disorders recognize that their reactions are out of proportion to the situation, but they feel anxious anyway. Feelings of embarrassment often keep people from telling others about their disorder. In the examples above, the two individuals sought assistance and, as a result, they are in charge of their lives, not their anxiety.

Do you have questions about anxiety? For information that will help you understand and learn more about anxiety related disorders, click the appropriate question mark.

ANXIETY
PANIC
SOCIAL PHOBIA
POST TRAUMATIC STRESS DISORDER

For additional information about anxiety disorders, check out these sites:

Anxiety Disorders Association of America
(www.adaa.org)

Freedom From Fear
(www.freedomfromfear.org)

National Institute of  Mental Health
(www.nimh.nih.gov)