By: Schatzie Brunner, Founder, New Way Now

Let’s talk about anxiety, the first cousin of depression. (And by the way, I got this information from the American Psychiatric Foundation.)

Everyone experiences anxiety, and it can be useful in avoiding dangerous situations.  Or in motivating you to solve problems.  But that’s normal anxiety, which is not the same as an anxiety disorder.  So how are they different?

An anxiety disorder lasts longer, it is more intense, and it can interfere with someone’s work, activities or relationships.  Approximately 18% of US adults will have an anxiety disorder in any given year.  What’s more interesting is that the median age of onset is 11 years old.  Anxiety disorders often occur with a mood disorder or a substance use disorder, and they are more common in females.

Here are some symptoms of anxiety and panic attacks:

• a pounding heart
• chest pain
• shortness of breath
• dizziness
• headache
• choking
• nausea
• vomiting
• diarrhea
• muscle aches and pains especially in the neck, shoulders and back

Sometimes this disorder can make a person’s mind race or go blank.  It can also decrease a person’s concentration and memory.  And it can make them indecisive, irritable, impatient or confused.

There are about 7-8 different types of anxiety disorders, which I won’t detail in this report. What I do want to distinguish is the difference between a panic attack and a panic disorder.

A panic attack is a sudden onset of fear or terror.   They can begin suddenly, and they are inappropriate in the circumstances.  Once a person is having one of these, they often fear another attack in the future and may avoid the places where attacks have occurred. They might even avoid exercise or any other activity that could produce physical sensations similar to those of a panic attack.

A person with a panic disorder has recurring panic attacks for at least a month and is persistently worried about possible future panic attacks. Every one of us is different.  Some may experience panic attacks without developing a disorder. Yet, others with a disorder can go on to develop agoraphobia, which makes them avoid places for fear of another attack.

Phobic disorders.  Someone with this type of disorder avoids activities because of persistent fear.  Whether that fear is of specific places, events, or objects.

Agoraphobia is another disorder.  And it involves avoiding situations where the person fears having a panic attack.  The focus is on possible embarrassment if a panic attack occurs or if there will be no one else there who can help.  Some may avoid only a few situations or places, others may avoid leaving home altogether.

Let’s look at social anxiety disorder. It is a fear of any situation where public scrutiny could occur.  Think of it as a fear of behaving in a way that is embarrassing or humiliating.  Some of the most common types of a social anxiety disorder include public speaking, dating, and social events.  There are also specific phobias.

These are phobias of specific objects or situations.  Such as spiders, snakes, or heights.  They can even include blood, injections, storms or enclosed places. These are less disabling than agoraphobia and social phobia.

Another one, which we hear a lot about, is post-traumatic stress disorder, which occurs after a frightening or catastrophic event.  Some common examples are war, accidents, assault, family violence, or even just seeing a significant event.  If a traumatic event includes large numbers of people, like a terrorist attack or mass shooting, they too can turn into acute stress disorder.  In acute stress disorder, the person gets over the event within a month, but with PTSD, the distress lasts longer.

Some who have acute stress disorder may go on to develop PTSD.  A major symptom of these is re-experiencing the trauma.  Sometimes in dreams or flashbacks or memories of the original trauma.

Now let’s talk about Obsessive-Compulsive Disorder (OCD).  It is the least common of the anxiety disorders, but it can be very disabling.  Obsessive thoughts and compulsive behaviors are part of the anxiety.  Such as fear of contamination, the need for exactness, safety issues, and even religious preoccupation.

What causes anxiety disorders?

They are caused by perceived threats. Some people are more likely to react than others.  Who is most at risk?  Very sensitive people may see the whole world as threatening, or they might have a history of anxiety in childhood or adolescence.  It is more common in females.  It’s more common in those who abuse alcohol.

Some family factors increase risk. One example is a difficult childhood, which can include physical or emotional abuse or even over-strictness.

Another family factor can be poverty, or family history, parent’s with alcohol problems, separation or divorce.  And some medical conditions can create anxiety symptoms, or fear can be a side effect of prescription drugs.

These are not all of the causes, but they are among the most common.

Anxiety disorders must be recognized and treated early.  They often develop in childhood and adolescence, and if these disorders are not treated, it may mean depression, alcohol, drug abuse and suicide in later years.

First Aid for Anxiety Disorders is very much like the first aid for depression, which is based on the A-N-G-L-E approach of Ask, Non-Judgement, Give Support, Listen and Encourage Professional Help.

The ANGLE approach is essential to remember if a person looks like they are having a panic attack. Be aware of a possible risk of suicide in anxiety disorders.  So be alert to any of the warning signs of suicide.

Often the details of the ANGLE approach are very much like the approach for depression.

So, what are some treatments for anxiety disorders?

There is medication, and there’s cognitive behavioral therapy, which can include exposure – response therapy to feared situations or symptoms.  Some people respond to emotional regulation through relaxation and learning to detach from intense anxiety.

But what if a person doesn’t’ want help?

If you feel comfortable enough, you might want to ask the reason why they don’t want help?  For example, the person might be worried about finances or about not finding a doctor they like.  Offer to help that person to overcome their worry about help.  If they still don’t want to go forward, let them know that if they change their mind, just ask you.  Respect the other person’s right not to seek help unless, of course, there is a risk of harming either themselves or others.

Finally, when you encourage self-help and support strategies, you might suggest relaxation training, exercise, self-help books based on cognitive behavioral therapy and meditation.