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Attacking anxiety and panic

Sun Advocate writer

Anxiety is the most common form of mental illness in the United States. The Anxiety Disorders Association of America has estimated that more than 40 million adults suffer from such a disorder ??' 18 percent of the population. And, according to the ADAA, only a third of the of those suffering actually receive treatment.

In recent years, while much has been done to educate the general public about mental illness and to promote positive mental health practices, the discussion of anxiety, however, has often taken a back seat to topics like depression, attention deficit disorder and bipolar disorder.

So what exactly is anxiety? According to the Random House Dictionary, anxiety is defined as distress or uneasiness of mind caused by fear of danger or misfortune. Feeling anxious may not be enjoyable, but it is entirely normal and in many cases can actually be helpful. For example, it can help a person study hard for an exam, manage a difficult situation at work or stay focused during a public speech.

But when feelings of anxiety or panic persist for months on end and inhibit a person's ability to function normally, it is likely an anxiety disorder that they're suffering from. For them, anxiety has become an irrational feeling of fear so intense and overwhelming that it interferes with daily life.

Anxiety can take on many different forms, but chronic worrying (GAD), social phobia, specific fears or phobias, obsessions or compulsions, post-traumatic stress disorder (PTSD) and agoraphobia - a fear of being in places where escape might be difficult or where help might not be available - are probably the most common. In fact, it is very common for anxiety sufferers to have more than one type of trigger.

To make matters worse, anxiety disorders commonly coexist with depression. A number of researchers have postulated that anxiety could cause depression, or that perhaps the depression can cause anxiety. Others have opined that there may be a common underlying cause for both conditions. Regardless of the causes, anxiety and depression can be extremely debilitating, especially since they do often coincide.

For many, anxiety can quickly turn into a panic attack, causing an overly frightening experience. Symptoms may include heart palpitations or "racing" heart, feeling weak, faint, or dizzy, and tingling or numbness in the hands and fingers. In some cases, chest pains and breathing difficulties are also present. An attack can be accompanied with a sense of terror, of impending doom or death, or feeling that a loss of control is imminent. It is clear among medical health practitioner circles that while a panic attack may be uncomfortable, it has never killed anyone.

So what causes anxiety disorders? No one yet knows for certain, but many mental health experts cite several popular theories. One is that the anxiety is the result of a "chemical imbalance" in the brain. Two popular classes of drugs, the selective serotonin reuptake inhibitors (SSRIs) like Prozac, Paxil, Zoloft, and Celexa, and serotonin norepinephrine reuptake inhibitors (SNRIs) like Cymbalta, Pristiq and Effexor are often prescribed by medical professionals as a first line of treatment.

Recent placebo studies, however, have shed doubt on the effectiveness of such drugs towards the treatment of anxiety or depression. As a result, many mental health practitioners have started embracing a number of alternative, drug-free therapies.

Another popular theory is that anxiety is the result of distorted cognitions, or thoughts, that are effectively telling the person that something bad is always about to happen. In simpler terms, this theory says that a person feels the way that they think, and that if a person can change the way he or she thinks, they will change the way that they feel. Many mental health professionals use a technique called Cognitive Behavioral Therapy (CBT) to help patients identify and change their own distorted thoughts and habits. CBT is considered highly effective for the treatment of anxiety and depression, and has become the mainstay of treatment for most mental health professionals in the United States.

David Burns, M.D., a psychiatrist and adjunct professor emeritus in the Department of Psychiatry and Behavioral Sciences at the Stanford University School of Medicine, has indicated in his book, When Panic Attacks, that sometimes anxiety and panic attacks are the result of a hidden problem or emotion (or can be exacerbated by them). The anxiety sufferer likely does not intentionally hide the problem, but rather is not aware of it.

In his book, Burns goes on to say that "niceness" is a cause of anxiety, and that people bury or hide the thing that is bothering them from their conscious mind because they want to be nice and not offend or upset anyone.

It may very well be that there is at least some truth to all of these theories. When it comes to anxiety sufferers, every situation is different, and every treatment is different.

Regardless of the causes, the mental distortions that may accompany an anxiety sufferer are often the same. Rigid "all or nothing" thinking, jumping to conclusions and overgeneralization are common. Catastrophizing (fearing the worst case scenario in a feared situation) is also extremely common, especially in those that suffer from Generalized Anxiety Disorder (GAD). Blaming (self or others) and labeling also tend to contribute to the distorted thinking. Some anxiety sufferers are perfectionistic, hoping that making something "perfect" will mean avoiding uncertainty that could lead to further worries. And many sufferers are also procrastinators, avoiding doing things that are causes for worry or anxiousness - aversion is the ultimate hallmark of anxiety.

There are many treatment options for those who are suffering from some kind of anxiety disorder. Again, Cognitive Behavioral Therapy (CBT), by way of a psychotherapist or other mental health professional, is an extremely effective therapy, especially for the long term outlook. There are also all kinds of literature and self-help techniques that can empower people to overcome anxiety on their own, which can be helpful for those who don't have access to a good therapist.

An effective treatment plan may also involve consulting with a medical professional to rule out any physical conditions that could be causing or contributing to the anxiety symptoms. The thyroid, a small butterfly-shaped gland located behind the throat can often be to blame if it is producing too much or too little hormone, which can impact a person's mood and metabolism.

Mindfulness meditation techniques, breathing exercises and other relaxation techniques can help calm many of the physical symptoms of anxiety and make coping easier. Maintaining a healthy diet low in fat and starch and getting plenty of sleep are an important part of any anxiety treatment regimen. Avoiding stimulants like caffeine and nicotine are also important, because stimulants can exacerbate anxiety symptoms.

The National Alliance for Mental Illness, or NAMI, is a national organization that provides various resources for sufferers of panic and anxiety and other mental illnesses such as depression or bipolar disorder. In Carbon County, NAMI provides training and education for those with mental illnesses and for their families. NAMI also hosts a local support group that meets every Wednesday evening at the Sun Advocate office.

To contact NAMI's Carbon County representative, contact Stella at 637-1371 or visit NAMI Utah's website at

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