ANXIETY, PANIC DISORDER, AND PHOBIAS – THE SCARY AND THE SCARED
No one alive has escaped the feeling of anxiety. It may consist of that isolated worry but most women admit to at least one or two periods in their lives when their anxiety was overwhelming.
Is anxiety something we should avoid or get rid of? Not at all. An anxiety response is a perfectly normal response that we experience when we face the unknown, the difficult, or the unpleasant. I always remind the women in my midlife support group that if they are not experiencing ANY anxiety, they are probably not making any changes in their lives or trying anything new. They are maintaining a safe status quo.
When is anxiety the worst? The level of anxiety PRIOR to an event or activity is always more intense than the level of anxiety when that event or activity actually takes place. We are nervous before the speech, before the big date, before we make an important decision in our lives. AVOIDING events or activities because of high levels of ANTICIPATORY anxiety is a mistake. I guarantee you will feel better once you have followed through.
What are the symptoms of anxiety? Most people just feel plain scared. Or they may feel excessively worried to the point where they are not sleeping or eating. They have ruminating thoughts about the future event or activity. They are filled with foreboding. They find themselves having a very pessimistic attitude about the future.
Most anxiety is caused not by situations themselves but by our thoughts and beliefs about those situations. We think about the upcoming speech and say to ourselves, “I\’ll probably forget what I\’m supposed to say”…and magic presto, we are anxious. We worry that the plane will go down when everyone else on the flight appears to be relaxed and comfortable. We make ourselves sick over the past or dread the future.
What\’s one thing to try? Try my airplane trick. Ask yourself, “Is it going down NOW?” If it IS, then enjoy…scream, cry, pray, or call home. But if it is NOT, forbid yourself from thinking about it, divert your attention to something else, and focus on your breathing. This can apply to any anticipated event…not just flying. The key to handling anxiety is to STAY IN THE PRESENT. The ONE DAY AT A TIME philosophy is a proven one.
What is a panic attack? When anxiety is very high, you can have a panic attack. It may last 10 to 20 minutes. You experience a severe sense of dread, may feel you are going crazy or having a heart attack. Your heart races or beats out of your chest. Your hands are cold and clammy. You may feel dizzy or nauseous. Your arms may feel tingly or numb. Your face may be flushed. You may have chest pains. You feel as though you cannot get enough air and have shortness of breath. Things don\’t look real. You don\’t feel like your normal self. The world may be closing in on you.
Many persons go to the emergency room or call an ambulance when they are having these symptoms. After a complete examination, they are told that their heart is okay and that “nothing is the matter”. There IS something the matter…they have had a severe panic attack. This is the natural response of the brain and body when there is danger. The brain helps the body get ready to FIGHT or FLEE. Blood goes away from the stomach (the “butterflies”) and the skin (cold hands) and to the large muscles. Heart rate and breathing rate both increase. As you breathe faster you begin blowing off too much carbon dioxide and begin feeling like you\’re not getting in enough oxygen. So you breathe even faster, and may this hyperventilation worse and worse.
Can panic attacks last longer than a few minutes? Yes, they can in some individuals. And because people get “scared” about the symptoms, they precipitate more and more panic attacks. Once people understand the symptoms and can label what they are feeling as a “panic attack”, they can begin to do things to help themselves calm down.
Can medications help with Panic Disorder? Sometimes tranquilizers are prescribed for very brief use when the symptoms kick in. But this kind of medication is potentially addictive and should not be taken on a long-term basis. Anti-depressant medication (especially Paxil and Prozac) are effective also for panic symptoms and there is no risk of addiction.
What else can you do? You can place a brown paper bag over your mouth and nose and try to breathe more slowly—this forces carbon dioxide back into your system and the symptoms decrease. You can learn general breathing and relaxation techniques (go to the Recommended Reading Self-Help Favorites section at www.doctorflamingo-online.com for the books to help with anxiety and phobias).
A phobia develops because we try to AVOID what we are feeling anxious about. Instead of facing our fears, we find ways to sidestep them. With some phobias, like a fear of elevators, we can take the escalator or the stairs, unless, of course, we work on the 53rd floor! Many people become experts at avoidance. They may even find themselves completely housebound…but they feel safe. Others venture out but run home at the first sign of anxiety or panic. This reinforces the fear and the avoidance response.
How do we get over phobias? By facing the fear. By using relaxation, thought-stopping strategies, and breathing techniques. EXPOSURE therapy is the recommended treatment. Using techniques to quell the anxiety or panic response, you gradually take back ground that has been lost, an inch at a time. For example, going over a very small bridge dozens of time (preferably within a short period of time) until that is comfortable before you start on the next bigger one.
NEXT MONTH: POST TRAUMATIC STRESS DISORDER (PTSD)