Q.
What is an anxiety disorder?
A. Everybody knows what it’s like to feel anxious -- the butterflies in
your stomach before a first date, the tension you feel when your boss is
angry, the way your heart pounds if you’re in danger. Anxiety rouses you
to action. It gears you up to face a threatening situation. It makes you
study harder for that exam, and keeps you on your toes when you’re making
a speech. In general, it helps you cope.
But if you have an anxiety disorder, this normally helpful emotion can do
just the opposite -- it can keep you from coping and can disrupt your daily
life. Anxiety disorders aren’t just a case of "nerves." They are
illnesses, often related to the biological makeup and life experiences of
the individual, and they frequently run in families. There are several types
of anxiety disorders, each with its own distinct features. They include
generalized anxiety disorders, obsessive-compulsive disorder, panic
disorder, phobias, and post-traumatic stress disorder.
Anxiety disorders are among the most common of all the mental disorders.
Many people misunderstand these disorders and think individuals should be
able to overcome the symptoms by sheer willpower. Wishing the symptoms away
does not work -- but there are very effective treatments that can help.
Q. How can someone tell if they have an anxiety disorder?
A. Generalized anxiety disorder (GAD) is much more than the normal anxiety
people experience day to day. It's chronic and exaggerated worry and
tension, even though nothing seems to provoke it. Having this disorder means
always anticipating disaster, often worrying excessively about health,
money, family, or work. Sometimes, though, the source of the worry is hard
to pinpoint. Simply the thought of getting through the day provokes anxiety.
People with GAD also seem unable to relax. They often have trouble falling
or staying asleep. Their worries are accompanied by physical symptoms,
especially trembling, twitching, muscle tension, headaches, irritability,
sweating, or hot flashes. They may feel lightheaded or out of breath. They
may feel nauseated or have to go to the bathroom frequently. Or they might
feel as though they have a lump in the throat.
Many individuals with GAD startle more easily than other people. They tend
to feel tired, have trouble concentrating, and sometimes suffer depression,
too. Usually the impairment associated with GAD is mild and people with the
disorder don't feel too restricted in social settings or on the job. Unlike
many other anxiety disorders, people with GAD don't characteristically avoid
certain situations as a result of their disorder. However, if severe, GAD
can be very debilitating, making it difficult to carry out even the most
ordinary daily activities.
Q. How do I get help for an anxiety disorder?
A. If you, or someone you know, has symptoms of anxiety, a visit to the
family physician is usually the best place to start. A physician can help
you determine whether the symptoms are due to an anxiety disorder, some
other medical condition, or both. Most often, the next step is to get
treatment for an anxiety disorder from a mental health professional.
Among the professionals who can help are psychiatrist, psychologists, social
workers, and counselors. However, it’s best to look for a professional who
has specialized training in cognitive-behavioral or behavioral therapy and
who is open to the use of medications should they be needed.
Psychologists, social workers, and counselors sometimes work closely with a
psychiatrist or another physician, who will prescribe medications when they
are required. For some people, group therapy or self-help groups are a
helpful part of treatment. Many people do best with a combination of these
therapies.
When you’re looking for a health care professional, it’s important to
inquire about what kinds of therapy she or he generally uses or whether
medications are available. It’s important that you feel comfortable with
the therapy. If this is not the case, seek help elsewhere. However, if you’ve
been taking medication, it’s important not to quit certain drugs abruptly,
but to taper them off under the supervision of your physician. Be sure to
ask your physician about how to stop a medication.
Remember, though, that when you find a health care professional you’re
satisfied with, the two of you are working as a team. Together you will be
able to develop a plan to treat your anxiety disorder that may involve
medications, behavioral therapy, or cognitive-behavioral therapy, as
appropriate. Treatments for anxiety disorders, however, may not start
working instantly. Your doctor or therapist may ask you to follow a specific
treatment plan for several weeks to determine whether it’s working.
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