What is this strange sensation?
Annie goes to bed early, exhausted and fretting tomorrow. Everything appears to be fine, and at nine p.m. she falls asleep, a calm before the storm. At midnight she wakes, as if from a nightmare. Her heart beats quickly, her blanket drips sweat, and her mind races out of control. She thinks she’s having a heart attack. She feels sick but can’t move.
An hour passes and she’s gotten up to turn the lights on and go to the bathroom. She’s panicky and confused. Tired but doesn’t dare lay down. Instead, she paces back and forth through her home. The symptoms finally decline by two a.m. and she falls asleep on her couch.
What happened to Annie happens to millions of Americans every year. She wasn’t sick, nor was she having a heart attack. Annie had her first panic attack, at twenty-three-years-old, and will have two more similar episodes before she finally seeks help.
Annie is lucky. When she goes to see her family doctor he plainly explains to her what has happened, that she is suffering from a panic attacks, and that there is help. Unlike Annie, many other anxiety prone individuals do not seek help-suffering in silence-and when they do, the doctors they speak to may not know enough to help. Anxiety, unlike influenza, heart attacks, or other common medical conditions, is still, even after years of research and study, not fully understood but by those dealing with it every day.
Anxiety disorders, ones like and ones very different from Annie’s, are much more than the usual fear and anxiousness before big situations, or the every day stress of work or family. Anxiety disorders often revolve around irrational thoughts and fears.
To treat anxiety, mild or severe, you first must understand it. This can be a big problem. When people have their first anxiety attack, it is often one of the strongest, irrational feelings they’ve ever experienced. It’s easy to believe you are dying or going insane since you don’t know what these feeling are. Try to put yourself into the shoes of a Native American who saw a Spaniard and his horse for the first time. Having a first panic attack is uncharted ground.
First make sure it’s not something else.
Annie’s doctor first made sure she wasn’t having a medical condition that would affect her body and cause her to feel many of the same symptoms of anxiety. The doctor checked her blood sugar level to make sure she didn’t have hypoglycemia. He checked her breathing to make sure she breathed normally and didn’t suffer from hyperventilation syndrome. After ruling out hypothyroidism and several other common causes of anxiety disorders, he gave Annie a blood panel and finished the very thorough physical examination by asking her how her life has been.
Many medical conditions have symptoms that mimic those of panic attacks. “Hyperventilation syndrome can cause a decrease in carbon dioxide in the blood, which causes shortness of breath, dizziness, feelings of unreality, and trembling. (1)” A low blood sugar level due to hypoglycemia can add weakness and disorientation to the list of anxiety-like symptoms. Too much thyroid hormone can cause heart palpitations and sweating, two of the main symptoms Annie experiences with her panic attacks.
If you suspect you may have an anxiety disorder, always go to your doctor and have a thorough physical examination. If Annie’s doctor had not ruled out other medical conditions as a cause for anxiety, she may have missed the real cause of her symptoms. Treating the wrong disease, even if the symptoms are the same, is a waste of precious time.
The symptoms may be uncomfortable, and numerous, but none are dangerous.
There are six major types of anxiety. Agoraphobia, social anxiety disorder, generalized anxiety disorder, post-traumatic stress disorder, obsessive compulsive disorder, and panic disorder. Annie’s condition is panic disorder. She has panic attacks “out of the blue,” often occurring after stressful situations. Panic attacks like hers can happen at any time but happen differently for each person. Some people may be more susceptible in the morning, midday, or at night. Symptoms vary from person to person. Some may have shortness of breath and fatigue while others may have irritated bowels and sweating.
Other common symptoms of a panic attack are nausea or diarrhea, dry mouth, hyperventilation, dizziness or a light-headed feeling, faintness, cold, clammy hands, a fluttery stomach, irregular heartbeats, heart palpitations, a fast heartbeat, or feelings of being partially paralyzed.
Physical symptoms of an anxiety attack often occur with catastrophic thoughts, thoughts of being out of control, dying, or feeling as though something (anything) bad will happen. These are worst case scenarios, general and illogical, but strong and hurtful none-the-less.
How do you know, before you go to the doctor, if you are suffering from anxiety? If you have any of these symptoms suddenly, in a short period of time (anywhere from five minutes to two or three hours). A common myth is that an anxiety attack can last for only thirty minutes before the body uses up the adrenaline causing many of the symptoms.
Many sufferers of chronic panic attacks can tell you this is not true, that anxiety attacks can last for hours and return not long after they’ve stopped. But no matter how long they last, they cannot harm you. The hormones released into your body to make you feel the way you do during even the worst attack are harmless and often, within minutes, are reabsorbed and neutralized.
Panic disorders cause the sufferer to have recurring panic attacks, out of the blue, or at regular times but without apparent reason. Annie’s case is common, but not all Panic attacks need a trigger, not all sufferers need to be stressed out.
Why us?
Annie’s life was stressful, full of anger and frustration from home and at work. She went on to tell the doctor she hated waking up each day, knowing her boss would tell her to work harder, faster, differently. Nothing was ever enough for him. Her home life was none better. Her mother was ailing from cancer and none of her siblings would offer a helping hand. Annie was stuck with both the financial and emotional costs of watching her mother slowly die.
The doctor asked her if anyone else in her family had anxiety disorders. Annie thought about this and remembered she had an aunt who had many of the same symptoms Annie suffered from. Panic often times runs in the family, whether it is genetic or simply learned behavior.
Stress can be the triggering factor for anxiety, but stress is not the only reason people panic.
Adrenalin, and other hormones, released into the body due to the fight or flight reaction to fear causes many of the symptoms of anxiety.
Getting help.
Annie’s doctor explained what she was suffering from and how to get the best help. There are two distinct ways to treat most anxiety disorders, along with many other homeopathic or experimental options. Medication (SSRIs like Zoloft or Lexapro, or Benzodiazepines such as Xanax or Valium, among others) prescribed by psychiatrists or general practitioners, side by side with therapy, are typically the first options taken when treating any severe anxiety disorder.
Educating yourself on anxiety is the best way to help yourself. There are many sources on the internet to help you along, and there are also many good books written by doctors who have spent their careers in the field of anxiety related medicine. The Anxiety and Phobia Workbook by Edmund J. Bourne is a great resource for learning about and coping with your anxiety disorder.
Finding the right doctor is also a very important factor to healing yourself. Annie was lucky because her family doctor knew what she was suffering from, how to help treat it, and who better to talk to. But be careful, medical issues are many and doctors cannot know every subject thoroughly. Find one you are comfortable with, preferably a psychologist or councilor who is an expert in panic disorders. Though Annie’s family doctor spotted the symptoms of anxiety, he knew a specialist could help her more and gave her the name of a good councilor.
Other common anxiety disorders:
1. OCD
2. Generalized Anxiety
3. PTSD
4. Agoraphobia and Social Anxiety
1. OCD (Obsessive Compulsive Disorder) is a mental condition causing the person’s mind to play like a broken record: “obsessive, distressing, intrusive thoughts and related compulsions (tasks or ‘rituals’) which attempt to neutralize the obsessions (2).” OCD patients spend much of their time repeating ideas or thoughts to themselves, and then trying to get rid of the thoughts by repeating actions they hope will fix things. One OCD patient may wash his hands continuously to keep from getting sick, and after a time, he may not even realize he is doing it or why. For an OCD patient, it is nearly impossible for them to alter their behavior due to the power of their own thoughts constantly urging them on.
Many anxiety sufferers also suffer from mild OCD. A need for things to be “just right” instigates generalized anxiety and can interfere in everyday tasks. Feeling a need to have things even, whether it’s your body, or books on a bookshelf are clear signs of OCD.
2. Generalized Anxiety Disorder is not as severe as other anxiety disorders, but it can still interfere with your life. We all get stressed out over work, school, life in general, but the person suffering from generalized anxiety takes the problems of life and magnifies them, stressing over the simplest things; situations that wouldn’t affect other people. The constant, irrational worry can lead to serious medical problems-fatigue and ulcers. Chronic stress on the body breaks down the immune system and enhances burn-out and nervous breakdowns. Worry is always uncomfortable, but when transformed and kept consistent over a long period of time can be dangerous to the body.
If you go to bed worrying about tomorrow, wake up worrying about the mistakes of yesterday, and have had physical ailments for months caused by your constant, on edge nervousness, generalized anxiety disorder may be the culprit, but like Annie’s panic attacks, it’s best to see your doctor and make sure it’s not another medical condition causing your symptoms.
3. Post-traumatic Stress Disorder (PTSD) is an extreme reaction to a prior event, often times a violent or emotionally disturbing one. The most common sufferers of PTSD are rape victims, soldiers coming back from war, those in sudden disasters (earthquakes, tornadoes, or fires), and cancer survivors.
PSTD sufferers are unable to process, or “come to grips with” the eventful emotional experience and continue to re-experience the traumatic event in dreams or flashbacks. Sufferers of PSTD may use avoidance to stay safe from any other similar event. A rape victim may quit the college in which she was raped at. A person who has survived a car accident may refuse to drive.
4. Agoraphobia and Social Anxiety (or Social Phobia) can go hand in hand, but statistically, social anxiety is far more common than agoraphobia. The symptoms are identical for each disorder and can be easily confused.
Agoraphobic individuals are fearful of entering a place they cannot easily escape from if they have a panic attack. An agoraphobic person may choose to stay home where she feels safe instead of going to school or work where she cannot easily alleviate her panic symptoms. Agoraphobia can keep the sufferer from talking on the telephone, driving a car, or flying on a plane. Many people, but not most, who suffer from panic disorders also develop Agoraphobia in reaction to their panic attacks in an attempt to reduce panic by avoiding the places they most often have attacks.
Social anxiety is the fear of social situations where the sufferer may have to face many people. Social anxiety is not a direct result of a panic disorder as Agoraphobia is, but a fear of making a mistake in public that will be scrutinized or subject the sufferer to criticism. In other words, it’s the fear of embarrassment, and keeps many of the socially phobic from enjoying life with others. Social anxiety may keep a person from going to school, work, weddings, or parties.
References:
(1) The Anxiety and Phobia Workbook by Edmund J. Bourne, PH.D.
(2) Wikipedia: Obsessive-compulsive disorder, http://en.wikipedia.org/wiki/Obsessive-compulsive_disorder
