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Stress and
Anxiety
Disorders
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Stress is the body's reaction to an event that is
experienced as disturbing or threatening. Our
primitive ancestors experienced stress when they
had to fight off wild animals and other threats to their
survival. Now, in the contemporary world, we are more
likely to feel stressed when we face overwhelming
responsibilities at work or home, experience loneliness,
rejection, or the fear of losing things that are important
to us, such as our jobs or friends. When we are exposed
to such events, we experience what has been called
the "fight or flight" response. To prepare for fighting
or fleeing, the body increases its heart rate and blood
pressure. This sends more blood to our heart and muscles,
and our respiration rate increases. We become vigilant
and tense. Our bodies end up on full alert - and this
allows us to take action. When stress continues over
a long period of time, however, and has a significant
impact on how we live, we may begin to suffer from one
of the anxiety disorders.
Research indicates that anxiety disorders are the
leading emotional health disorder for women
and are second only to substance abuse among men.
Within any given year, it has been estimated that fifteen
percent of the population suffers from one of the anxiety
disorders - yet only a small portion of those who suffer
receive treatment. Fortunately, treatment is available and
generally effective.
Stress can be helpful when it prompts us to take action to solve a problem. We can use our perceived
stress as a clue, in fact, that there is a problem, and that
we need to confront it. Public speakers, athletes, and
entertainers have long known that stress can motivate
them to perform much better. When we don't recognize
our anxious feelings or don't have the tools to deal with
them, we may continue to expose ourselves to the stress,
which leads to more problems.
Prolonged stress is demanding on our bodies and
our lives in general. The constant state of "fight or
flight" may cause heart palpitations, dizziness, trembling
or shaking, increased blood pressure, sweating, choking,
high stomach acidity, nausea, chest discomfort, or
muscle spasms. We may feel detached or out of touch
with reality or think we are dying or going crazy. There
is evidence that prolonged stress can lead to heart
disease and a compromised immune system. Stress
depletes our energy and interferes with concentration.
We may become abrupt with other people and engage
in emotional outbursts or even physical violence. Our
relationships and job security may be jeopardized.
People who experience prolonged stress are more prone
to self-destructive behaviors such as drug and alcohol
abuse.
The Anxiety Disorders
An anxiety disorder is longer lasting than normal
anxiety, is more intense and can lead to fears
that interfere with the ability to function in daily life.
Here are some of the more common types of anxiety
disorders -
Generalized anxiety disorder occurs when
a person has endured for at least six months a
state of being excessively worried, feeling on edge
continually, having sleep difficulty, and finding it hard
to experience pleasure and relaxation. The symptoms
include restlessness, irritability, difficulty concentrating,
feeling easily fatigued, and muscle tension. This
diagnosis is not accompanied by phobias, obsessions, or
panic attacks.
Agoraphobia, which affects about five percent of
the population, is the most prevalent of the anxiety
disorders. People who suffer from agoraphobia are
afraid of finding themselves in situations where escape
would be difficult or help might be unavailable. They
suffer from panic disorders in certain situations and
then, over time, develop a fear of finding themselves
in these situations. Common situations include using
public transportation (subways, airplanes, trains),
being at home alone, crowded public places (such
as restaurants, grocery stores, etc.), and enclosed or
confined places such as tunnels, bridges, or classrooms.
Post-Traumatic Stress Disorder can happen
if a person has been through a serious, life-threatening event, such as a natural disaster, terrorist act,
a car or plane crash, rape, assault, or other violent crime.
Those with PTSD may for months or years afterward
experience repetitive thoughts about the event with an
attempt to avoid thinking about it, nightmares, emotional
numbness, feelings of detachment, flashbacks, an attempt
to avoid activities associated with the event, a loss of
interest in pleasurable activities, and other symptoms of
increased anxiety.
Obsessive-Compulsive Disorder happens when
stress or chaos in one's world causes a person to
think and worry repetitively about something (these
are called obsessions) or else to engage in repetitive
behaviors, like hand-washing or checking on things
excessively (these are called compulsions). Obsessions
are recognized by the sufferer as irrational, but they
continue to intrude in the sufferer's thoughts for extended
periods of time. Examples of obsessions include images
of violence or doing violence to somebody else and
insecure thoughts about leaving the lights on or leaving
the door unlocked. Compulsions are behaviors that
are performed to reduce the anxiety of the obsessions.
Examples include excessive hand washing, checking
the lights or the stove time and time again, or ritualistic
behavior such as counting steps while walking.
Social Phobia involves fear of embarrassment in
situations where others scrutinize or evaluate your
behavior. This usually causes the sufferer to want to
avoid these situations, although many simply endure
the anxiety associated with these experiences. The most
common social phobia is speaking in public, but other
forms of this phobia include fear of writing in front of
others, fear of crowds, test-taking phobia, fear of spilling
food or choking in restaurants, fear of blushing in public,
or fear of using public restrooms.
Phobias are intense fears and avoidances that
occur when a person is exposed to a certain type of
situation. These fears are specific to the sufferer and are
sometimes unexplainable. Common examples include
airplane phobia (fear of flying), elevator phobia, fear of
thunder and lightning, animal phobia, acrophobia (fear of
heights), doctor or dentist phobia, blood injury phobia,
and illness phobia.
Panic Attacks are described here.
Taking Charge of Anxiety
Those who deal with anxiety
in a positive way usually have:
- a sense of self-determination
- a feeling of involvement in life's
experiences, and
- an ability to change negatives into
positives.
Self-determination refers to a personal ability to control or adapt to the events of everyday living.
A great deal of anxiety is perpetuated by how we
think about stress itself, and ourselves. Is the anxiety
in control of us, or, conversely, can we learn to control
the anxiety? Rather than seeing ourselves as helpless in trying to
overcome obstacles, we can begin to define ourselves
as problem-solvers. We can remember specific times
when we have been successful in solving problems
and then define ourselves in those terms. We can learn
to trust that we will have success in meeting life's
difficulties. When we take this approach, we begin to
face problematic situations as challenges which, when
resolved, can bring new and exciting opportunities into
our lives.
Involvement means opening ourselves up to the
world around us and defining ourselves as active
participants in life. It means letting friends and
family members into our personal lives and sharing
our private experiences with others when appropriate.
Cultivating a social network serves us well when we
are dealing with stressful situations. Talking our way
through a crisis in the presence of a supportive listener,
rather than holding it in alone, is one of our best ways
of gaining helpful feedback, putting the situation into
perspective, and sensing that we are not alone. When we
lack involvement with others, we often feel vulnerable
and may question whether we have the resources to
cope with stressful experiences.
A positive approach toward life is one of the main attributes of those who deal well with anxiety.
The life process is one of loss and gain - it's
as natural as night and day. When we trust that our
losses will give rise to new gains and life experiences,
the anxiety and worry associated with loss need not
be devastating. For example, the loss of a job can
open the door to more satisfying employment and the
opportunity for more fulfilling life experiences. The
clue is to change our negative thoughts about situations
into more positive thoughts - and positive feelings
will usually follow a change in thinking. For example,
if a close friend moves away, rather than thinking
negatively about how lonely and devastated you will
feel, think about the good memories you will always
have, how your friendship will leave a positive legacy
that will always touch your life, how you can still
keep in touch and visit, and how you can now spend
your time in new and positive pursuits. There really
is no need for overwhelming anxiety in this situation.
We can choose to move toward the open doors of life
rather than futilely knocking on closed ones.
The clue to handling
stress and anxiety well is to acquire the skills we
need to feel empowered. This requires a good,
honest exploration into our lives. We need to
explore the strengths that we already have
for coping with stress, as well as to learn new skills. A professional therapist
has a number of specific techniques for the treatment
of stress and anxiety, as well as overall life strategy
plans for dealing with these problems and other life
experiences. We need to be able both to comfort
ourselves and to let others nurture us as well. All of us
can learn, with some healthy exploration, to manage
anxiety successfully.
What is a Panic Attack
One of the most debilitating
manifestations of stress is the panic
attack. These dramatic episodes of
anxiety seem to come out of the blue and
happen even when there is no real danger. They
are usually intense for a few minutes and then
subside. The sufferer may experience chest
pains, the feeling of smothering, dizziness,
heart pounding, depersonalization, hot and cold
flashes, sweating, numbness, or nausea. These
symptoms may be accompanied by fears of
dying, going crazy, and losing control. Those
who experience panic attacks often live in fear
of their next attack, and this may prevent them
from leaving the house, being alone or driving.
Panic attacks are not triggered by a specific
phobia. They seem to come spontaneously and
unexpectedly.
One of the factors that seems to
perpetuate panic attacks is the fear of
having another one. The perception
that a panic attack is coming on can magnify
an awareness of symptoms and then the person
begins to tense up and harbor thoughts of doom
- just the conditions that drive a panic attack.
If you feel a panic attack coming on,
it is helpful just to let it happen, as
uncomfortable as this may seem. As is true
of any phobia, you have to expose yourself
to the feared situation in order for the fear
to decrease over time. If you don't tense up,
the symptoms will generally subside within a
few minutes. Tensing up will perpetuate the
episode. You may feel faint, but you won't
really faint (blood is going to your muscles
as you tense up and not to your brain, and
this may bring on the sensation of fainting
- but your blood pressure and heart rate have
increased, so you're actually less likely to
faint). During a panic attack, try to contain your
thoughts. Challenge your negative thinking
(you are not having a heart attack; you will not
suffocate; you are not going crazy; you will not
die). Trust that this will end soon. Tell yourself
the following: "Well, here it is again. Let me
watch my body respond to this, just like I've
done before. I will survive this and I can handle
it. This may be unpleasant, but it's only anxiety
and it will pass. Let me flow through this."
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