Coping with Anxiety and Phobi... Health Article

Coping with Anxiety and Phobias

We live in anxious times. Around the clock, we hear news of war, murder, natural disasters, and ominous threats such as terrorism and bird flu. If you're lucky enough not to be directly affected by major catastrophes, more personal issues can still provoke anxiety, such as your physical health, your job and financial security, and your relationships with family and friends. Even relatively small-scale things such as getting stuck in traffic, fixing a computer problem, or preparing for a work presentation can be significant sources of stress.

While it's natural to sometimes worry, feel scared, and experience anxiety from these and other sources, it's not normal for fear and anxiety to dominate your life. For example, anxiety can make you so uneasy around people that you isolate yourself, skirting social gatherings and passing up potential friendships. It can fill you with such obsessive thoughts or inexplicable dread of ordinary activities that you cannot work. It can even cause chest pain so severe that you think you're having a heart attack.

Getting help has always been easier said than done. As with many mental health issues, there has long been a stigma surrounding anxiety. People are ashamed to admit to phobias (fears of specific objects or circumstances) and persistent worries, which seem like signs of weakness. The shame, combined with the tendency of people with anxiety to avoid others, is perhaps the biggest obstacle to relief and recovery. Without treatment, many individuals become more fearful and isolated.

Consider seeking advice. You're not alone. Anxiety disorders include problems such as panic attacks, phobias, post-traumatic stress disorder, and obsessive-compulsive disorder. They are the most prevalent type of psychiatric condition in the United States, affecting about 23 million American adults. For every individual with an anxiety disorder, many more are affected by it, including spouses, children, other relatives, friends, and employers.

This report provides up-to-date information about the causes and treatment of anxiety disorders, including behavior therapies, relaxation techniques, and medications. And we hope that it gives you something more: an incentive to seek help and feel better.What are anxiety disorders?

It's likely that if you ask any two people with an anxiety disorder to describe it, they'll paint different pictures. One person might dread speaking in public, while another is gripped by intense fear at the mere thought of getting on an airplane. Someone else might describe herself as a "chronic worrier" because she regularly frets about all sorts of things. Another experiences unpredictable episodes of panic, with shortness of breath, sweating, and chest pains. Many people would undoubtedly mention that they have trouble sleeping.

Why the broad array of symptoms? It's because anxiety disorders aren't actually a single condition, but rather a spectrum of related disorders, including panic attacks, panic disorder, phobias, obsessive-compulsive disorder, post-traumatic stress disorder, generalized anxiety disorder, anxiety due to a medical condition, and substance-induced anxiety (see Table 1). However, some of the same imbalances in brain chemistry are thought to underlie many different anxiety disorders, which helps explain why more than half of all people with one anxiety disorder also have another. While each anxiety disorder has its own set of symptoms, they also have some symptoms in common (see "Common symptoms," below).

It's not that people with anxiety disorders have these symptoms and other people never do. At some time, most people feel afraid, tense, or even anxious enough to become short of breath. The difference is that individuals who don't have anxiety disorders experience these reactions in response to genuine threats. For example, when a fire is raging in the house next door, anxiety can be a lifesaver, spurring an individual to flee the area near the burning building. But people with anxiety disorders face worry and fear in ordinary, relatively harmless situations. For example, while tapping the keyboard of a computer, they may fear contracting a life-threatening disease (a sign of obsessive-compulsive disorder). They may be gripped by worry nearly every day about getting into a car accident, losing their jobs, having their children do poorly in school, or other possible but unlikely prospects (a sign of generalized anxiety disorder). People with anxiety disorders are hypersensitive to the possibility of danger, but their extreme vigilance serves no purpose. They are spinning their neurological wheels, so to speak.

It's possible to live with a mild anxiety disorder. But when the anxiety is severe enough to interfere with everyday life, treatment is usually the only way to control the disorder. Treatment options include medication, psychotherapy, or both. Without treatment, it's likely that the disorder will worsen or that another anxiety disorder will develop. Treatment is also important for conditions, such as depression and alcohol or drug dependence, that often accompany anxiety.