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Paging Dr. Frischer - Anxiety Disorders
WRITTEN BY :   Dr. Alan Frischer

If you tend to have feelings of panic, fear, and uneasiness, it’s possible that you are suffering from an anxiety disorder.
Anxiety disorders affect at least 19 million adult Americans, and tend to begin in childhood, adolescence, or early adulthood. They occur slightly more often in women than in men, and appear with similar frequency among whites, African-Americans, and Hispanics.
The many symptoms of anxiety disorders include excessive worry, tension, restlessness, nightmares, irritability, muscle tension, headaches, uncontrolled obsessive thoughts, repeated thoughts or flashbacks of traumatic experiences, ritualistic behaviors, sweating, difficulty concentrating, fatigue, frequent urination or defecation, nausea… and the most common symptom: trouble falling asleep and staying asleep.
We all get feelings of anxiety from time to time. Anxiety is a normal human emotion, and a quite normal and appropriate response to many situations that life throws at us. We may feel anxious or nervous when faced with a problem at work, before taking a test, or when making an important decision. It becomes an anxiety disorder, however, when the response to everyday life events is exaggerated or excessive. The resulting level of distress can interfere with the ability to lead a normal life.
Do not underestimate: an anxiety disorder is a serious mental illness. Worry and fear can be constant, excessive, overwhelming, and even crippling. Anxiety becomes dominant and interferes with health, work, school, social activities, and relationships.
There are many types of anxiety disorders, including:
Panic disorder: People with this condition have feelings of terror that strike suddenly and repeatedly without warning. A panic attack includes sweating, chest pain, palpitations (irregular heartbeats), and a feeling of choking.
Obsessive-Compulsive Disorder (OCD): People with OCD are plagued by constant thoughts or fears that cause them to perform certain rituals or routines. The disturbing thoughts are called obsessions, and the rituals are called compulsions. An example is a person with an unreasonable fear of germs who constantly washes his or her hands.
Post Traumatic Stress Disorder (PTSD): PTSD is a condition that can develop following a traumatic and/or terrifying event, such as a sexual or physical assault, the unexpected death of a loved one, involvement in a war, or a natural disaster. People with PTSD often have lasting and frightening thoughts and memories of the event, and may tend to be emotionally numb.
Social Anxiety Disorder: Also called social phobia, this disorder involves overwhelming worry and self-consciousness about everyday social situations. The worry often centers on a fear of being judged by others, or fear of embarrassment or ridicule.
Specific phobias: A specific phobia is an intense fear of a specific object or situation, such as snakes, spiders, heights, or flying. The level of fear is usually inappropriate to the situation and may cause the person to avoid common everyday experiences.
Generalized Anxiety Disorder: This disorder involves excessive, unrealistic worry and tension, even if there is little or nothing to justify the anxiety.
The precise cause of anxiety disorders is unknown; but anxiety disorders – like other forms of mental illness – are not the result of personal weakness, a character flaw, or poor upbringing. What is becoming clear is that the tendency to anxiety is likely “pre-wired” in the brain due to genetics. Studies are showing that anxiety disorders tend to run in families, and can be inherited from one or both parents, like hair or eye color.
Anxiety has been associated with chemical imbalances of certain neurotransmitters in the brain. This alters the way the brain reacts to life situations. Other studies demonstrate that people with certain anxiety disorders have changes in the actual brain structures that control memory or mood.
Environmental factors including trauma and stressful events, emotional abuse, the death of a loved one, divorce, change of job or school, or the use of chemicals (such as alcohol, caffeine, nicotine, and other recreational drugs) may trigger an anxiety disorder in people who have an inherited susceptibility.
It is apparent that many anxiety disorders are caused by the interplay between genetics, changes in the brain, and environmental stress.
A diagnosis is made by a doctor’s clinical exam; there are no laboratory tests. The doctor will make sure that the symptoms are not related to some other physical disorder, such as an overactive thyroid. A final diagnosis of anxiety disorder requires a demonstration that anxiety is causing problems in the functioning of daily life for an extended period of time.
Most people gain substantial relief from their symptoms with proper treatment. The most effective treatments usually involve a multi-pronged approach. Eliminating caffeine, alcohol, excess sugar, and eating a balanced diet can be a great place to start. Physical activity helps a great deal; adding yoga, meditation, or aerobic exercise (such as a brisk walk four or five times a week), and focusing on sleep can make a substantial difference. Therapy is often valuable. Medication may be recommended.
For short-term anxiety, there are potent but potentially highly addictive drugs known as benzodiazepines that give the patient a great sense of calm. For longer-term treatment, non-addictive anti-depressant/anti-anxiety drugs include Lexapro, Prozac, and Zoloft. Buspar is also used for chronic anxiety, with no addictive qualities.
Anxiety disorders are difficult to prevent. However, if you feel that you are susceptible, or if anxiety runs in your family, here are some things that you can do to control or lessen symptoms:
•Stop or reduce your consumption of products that contain caffeine, such as coffee, tea, cola and chocolate.
•Exercise daily and eat a healthy, balanced diet.
•Practice stress management techniques like yoga or meditation.
•Speak with your doctor or pharmacist before taking any over-the-counter medicines or herbal remedies. Many contain chemicals that can actually increase the symptoms of anxiety.
•Seek counseling and support after a traumatic or upsetting experience.
May you live a low-stress and healthy life!
Dr. Alan Frischer is former chief of staff and former chief of medicine at Downey Regional Medical Center. Write to him in care of this newspaper at 8301 E. Florence Ave., Suite 100, Downey, CA 90240.

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Published: October 28, 2010 – Volume 9 – Issue 28



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