Anxiety & Anxiety Disorders

Help and Support  -  More Information

Marketing the Illness Before Selling the Drug

Anxiety disorders are the most common of all the mental disorders.  They affect an estimated 8 to 10 of every 100 children and adolescents.

Everybody knows what it's like to feel anxious — the butterflies in your stomach before a first date, the tension you feel when your boss is angry, the way your heart pounds if you're in danger.  Anxiety rouses you to action.  It gears you up to face a threatening situation.  It makes you study harder for that exam, and keeps you on your toes when you're making a speech.  In general, it helps you cope.

Anxiety disorders, however, are defined as illnesses that cause people to feel frightened, distressed and uneasy for no apparent reason.  Young people diagnosed with anxiety disorders experience excessive fear, worry, or uneasiness that interferes with their daily lives.

Anxiety disorders aren't just a case of "nerves."  They are considered to be illnesses, thought to be related to the biological makeup and life experiences of the individual, and have been found to frequently run in families.  These disorders can dramatically reduce productivity and significantly diminish an individual's quality of life, if left untreated.

There are several types of anxiety disorders, each with its own distinct features.

Anxiety disorders include:

• Phobia - Two major types of phobias are social phobia and specific phobia.  People with social phobia have an overwhelming and disabling fear of scrutiny, embarrassment, or humiliation in social situations, which leads to avoidance of many potentially pleasurable and meaningful activities.  People with specific phobia experience extreme, disabling, and irrational fear of something that poses little or no actual danger; the fear leads to avoidance of objects or situations and can cause people to limit their lives unnecessarily.

• Generalized anxiety disorder - Constant, exaggerated worrisome thoughts and tension about everyday routine life events and activities, lasting at least six months.  Almost always anticipating the worst even though there is little reason to expect it; accompanied by physical symptoms, such as fatigue, trembling, muscle tension, headache, or nausea.

• Panic disorder - Repeated episodes of intense fear that strike often and without warning.  Physical symptoms include chest pain, heart palpitations, shortness of breath, dizziness, abdominal distress, feelings of unreality, and fear of dying.

• Obsessive-compulsive disorder - Repeated, unwanted thoughts or compulsive behaviors (such as counting or hand-washing) that seem impossible to stop or control.

• Post-traumatic stress disorder - A pattern of flashbacks and other symptoms that occurs in children who have experienced a psychologically distressing event such as physical abuse or sexual abuse, being a victim or witness of violence, or exposure to some other traumatic event such as a bombing or hurricane.

It is common for an anxiety disorder to accompany another anxiety disorder, or in some cases depression, eating disorders or substance abuse.  Anxiety disorders can also co-exist with illnesses such as heart disease, high blood pressure, irritable bowel syndrome, thyroid conditions, and migraine headaches.  In such instances, these disorders will also need to be treated.  Before undergoing any treatment, it is important to have a thorough medical exam to rule out other possible causes.

Many people with anxiety disorders can be helped with treatment.

Many people misunderstand anxiety disorders and other mental illnesses and think individuals should be able to overcome the symptoms by sheer willpower.  Wishing the symptoms away does not work.

Therapy for anxiety disorders often involves medication or specific forms of psychotherapy.

Medications, although not cures, can sometimes be effective at relieving anxiety symptoms.  Today, there are more medications available than ever before to treat anxiety disorders.  So if one drug is not successful, there are usually others to try.  In addition, new medications to treat anxiety symptoms are under development.

For most of the medications that are prescribed to treat anxiety disorders, the doctor usually starts the patient on a low dose and gradually increases it to the full dose.  Every medication has side effects, and it is important to know what these are.  If side effects become a problem, the doctor may advise the patient to stop taking the medication and to wait a week — or longer for certain drugs —  before trying another one.  When treatment is near an end, the doctor will taper the dosage gradually.

Behavioral therapy and cognitive-behavioral therapy can be effective for treating several of the anxiety disorders.

Behavioral therapy focuses on changing specific actions and uses several techniques to decreases or stop unwanted behavior.  For example, one technique trains patients in diaphragmatic breathing, a special breathing exercise involving slow, deep breaths to reduce anxiety.  This is necessary because people who are anxious often hyperventilate, taking rapid shallow breaths that can trigger rapid heartbeat, lightheadedness, and other symptoms.  Another technique — exposure therapy — gradually exposes patients to what frightens them and helps them cope with their fears.

Like behavioral therapy, cognitive-behavioral therapy teaches patients to react differently to the situations and bodily sensations that trigger panic attacks and other anxiety symptoms.  However, patients also learn to understand how their thinking patterns contribute to their symptoms and how to change their thoughts so that symptoms are less likely to occur.  This awareness of thinking patterns is combined with exposure and other behavioral techniques to help people confront their feared situations.  For example, someone who becomes lightheaded during a panic attack and fears he is going to die can be helped with the following approach used in cognitive-behavioral therapy.  The therapist asks him to spin in a circle until he becomes dizzy.  When he becomes alarmed and starts thinking, "I'm going to die," he learns to replace that thought with a more appropriate one, such as "It's just a little dizziness — I can handle it."

Information provided by the National Institute of Mental Health.

Marketing the Illness Before Selling the Drug

The strategy of marketing the illness before selling the drug has become a trend in the post-Prozac era, says Dr. Leon Mosher, former chief of the Center for Studies of Schizophrenia at the National Institute of Mental Health (NIMH).

Few people had heard of social anxiety disorder before the spring of 2001.

According to a survey in 1989, fewer than 1.2 percent of the population had been diagnosed with it.  But by the spring of 2001, the media were filled with news items urging people to watch for symptoms of irritability, fatigue, sweating and muscle tension.  Subsequent medical reports described generalized anxiety disorder (GAD) as leaving its victims paralyzed with irrational fears.

The timing of the media frenzy was no accident.  On April 16, 2001, the FDA approved the antidepressant Paxil for the treatment of GAD.

Help and Support

Anxiety Disorders Association of America ~ Promotes the prevention, treatment and cure of anxiety disorders and works to improve the lives of all people who suffer from them, including a listing of support groups in the USA, Canada, Mexico, Australia, and South Africa.

The Anxiety Panic Internet Resource - Free Internet self-help and support resource for those suffering from anxiety disorders.

Anxiety Treatment Australia ~ Information about anxiety disorders, treatment options, psychologists around Australia who treat anxiety disorders, group therapy and workshops, support groups, articles, and resources.

Benzodiazepine Awareness Network International ~ Dedicated to the responsible and informed use of addictive prescription drugs through education, advocacy, research and support.

Divided Heart ~ Online Christian community dedicated to overcoming destructive behaviors and healing from them whether you are struggling yourself or you are close to someone who is.

National Anxiety Foundation ~ Educational organization that offers information and resources on anxiety issues and disorders.

Panic Survivor ~ Online community focused on shifting the anxiety and panic "sufferer" from "victim attitude" to "survival attitude."  Comprehensive site.

More Information

Anxiety Disorders ~ Information from the Surgeon General.

Anxiety Disorders in Children and Adolescents (pdf) ~ Comprehensive paper by Dr. James Chandler.

The Causes of Anxiety and Panic Attacks ~ Anxiety is scientifically known as the fight/flight response since its primary purpose is to activate the organism and protect it from harm.  Associated with this response are a number of physical, behavioral, and mental changes.  Importantly, once the danger has gone, many of these changes (especially the physical ones) can continue, almost with a mind of their own, due to learning and other longer term bodily changes.  When the physical symptoms occur in the absence of an obvious explanation, people often misinterpret the normal fight/flight symptoms as indicating a serious physical or mental problem.  In this case, the sensations themselves can often become threatening and can begin the whole fight/flight response over.

Lyme Disease and Panic Attacks ~ The author describes the histories of three patients with panic-like episodes that turned out to be related to underlying, previously unsuspected tick-borne diseases.

Mental Disorders Are Not Diseases ~  Anxiety, depression, and conflict do exist -- in fact, are intrinsic to the human condition -- but they are not diseases in the pathological sense.  Psychiatrists and their allies have succeeded in persuading the scientific community, courts, media, and general public that the conditions they call mental disorders are diseases -- that is, phenomena independent of human motivation or will.  Because there is no empirical evidence to back this claim, the psychiatric profession relies on supporting it with periodically revised versions of its pseudo-scientific bible, the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Health Disorders DSM-IV-TR.

Nutritional Causes of Anxiety and Panic Attacks ~ Nutritional imbalances can result in anxiety, panic attacks and phobias.  Many people with these disorders have deficiencies of essential minerals, an excess of toxic metals, hypoglycemia and other biochemical imbalances.

Suppressing the Passion of Anxiety Overwhelm with Drugs: The Minor Tranquilizers, Including Xanax, Valium, BuSpar, Ativan, and Halcion, and the Antidepressant Anafranil ~ Even without doctors pushing these drugs, people would want them.  Indeed, they are actively sold illegally on the street. This is not surprising, since people often resort to taking anything that promises even temporary relief from anxiety.  Obsessions, compulsions, and phobias also can be seen as efforts to control anxiety.

Why Anxiety And Depression Are Over-Diagnosed And Over-Treated ~ Understanding the underlying problems may lead to a non-pharmacological cure which will work far more effectively than drugs (and last longer) because it offers a fundamental solution which strikes at the very root of the problem instead of merely papering over the cracks.