Personally Speaking is our quarterly newsletter in which we discuss mental health topics.  The purpose of our newsletter is to inform and educate the community on personal issues, concerns facing our community, methods of treatment, and developments in related fields.  It is Avenues intent to not only provide care for individuals but to promote and create a healthy environment for our families.

Teenage Romance: Puppy Love or Addicted Love Disaster?
The Many Faces of Anxiety
Looking to the Mirror to Find Themselves
ADHD vs. the Bipolar Child: Facts vs. Fiction
Self-Mutilation vs. Suicide Attempts: The Tragedy of Mood Instability
Coping with Trauma
The Power of Perception
Sharpen Your Saw this Spring

The Many Faces of Anxiety

Research conducted by the National Institute of Mental Health has shown that anxiety disorders are the number one mental health problem among American women, and are second only to alcohol and drug abuse among men.  Anxiety disorders affect more than 13% of the population!

Many individuals do not even realize they suffer from an anxiety disorder, attributing their symptoms to physical problems.  A majority of these individuals are not seen by mental health professionals but present to medical care settings with anxiety-related physical complaints. Actually, people with anxiety-related problems represent approximately 30% of patients seeking help from their primary care physicians. They typically complain of somatic symptoms, such as a racing heart, stomach ache, diarrhea, chest tightness, and dizziness.  It is iportant to recognize anxiety in patients who are not even complaining of it.

High levels of anxiety can exacerbate and even mimic a wide variety of medical conditions, including:

• Gastric and duodenal ulcers
• Mitro valve prolapse
• Hyperthyroidism
• Hyperventilation syndrome
• Premenstrual syndrome
• Inner ear disturbances
• Ulcerative colitis
• Asthma
• Hypertension
• Hives
• Hypoglycemia
• Seizure disorder

Prior to diagnosing an anxiety isorder, it is important to adequately rule out any medical conditions by having a doctor perform a thorough physical exam, including a blood panel.

Diagnosing an anxiety disorder is not simple.  In many situations it is appropriate and reasonable to react with some anxiety.  However, anxiety disorders can be distinguished from everyday, normal anxiety in that they involve anxiety that 1) is more intense, 2) lasts longer (i.e., anxiety that persists for months instead of going away after a stressful situation has passed), or 3) leads to phobias that interfere with your life.

The most common diagnosable anxiety disorders in the United States are:

• Agoraphobia
• Social Anxiety Disorder
• Obsessive-Compulsive Disorder
• Panic Disorder

Other less common anxiety disorders include Generalized Anxiety Disorder, Anxiety Disorder due to a general medical condition, Post Traumatic Stress Disorder, and Specific Phobia.

Out of all the anxiety disorders, agoraphobia is the most common, affecting about 5% of the population. Agoraphobia is a fear of panic attacks, resulting in the person avoiding places from where escape might be difficult.  The avoidance of crowded public places or enclosed spaces is very common.  Agoraphobics are very fearful of what others will think of them if they lose control and have a panic attack.  Many are even more fearful of being away from a safe place or a "safe person".

Panic Disorder typically develops during late adolescence or early twenties.  Panic disorder is characterized by sudden episodes of acute apprehension or intense fear that occurs "out of the blue". During the panic, any of the following symptoms may occur:

• Shortness of breath
• Heart palpitations/discomfort
• Dizziness/faintness
• Trembling or shaking
• Feeling of choking
• Abdominal distress/nausea
• Feeling of unreality as if you are "not really here"
• Numbness or tingling in hands and feet
• Hot and cold flashes
• Fear of going crazy or losing control
• Fear of dying

Four of these symptoms must be present to classify as a full-blown panic attack. Since many of these symptoms mimic a wide variety of medical concerns, it is difficult to distinguish a panic attack from a general medical condition.

Social Anxiety Disorder, affecting 2-3% of the population, involves a fear of embarrassment or humiliation in situations where you are exposed to the scrutiny of others.  Typically, the person's concern is that they will say or do something that will cause others to negatively judge or evaluate them.

Obsessive-Compulsive Disorder is characterized by obsessions, which are recurrent and persistent thoughts, impulses, or images that cause marked anxiety or distress, and/or by compulsions, which are repetitive behaviors (i.e., hand washing checking, ordering) or mental acts that the person feels driven to perform in response to an obsession, which serve to neutralize the anxiety.  Obsessive-compulsive disorder also affects 2-3% of the population.

Long term causes of anxiety disorders include a combination of heredity, childhood circumstances, and cumulative stress over time that was not dealt with in a healthy way.  Short term, triggering causes to anxiety disorders include any significant life change or personal loss.

Self-destructive, distorted thoughts, and a mistaken belief system can also contribute to any anxiety disorder.  Over-worrying, anxious self talk, a lack of assertiveness, pent-up feelings, and a lack of self nurturing skills all play a role in the intensity and length of time an axiety disorder affects one's life.  A person's diet can also play a role in the perpetuation of an anxiety disorder, such as the over consumption of caffeine, nicotine, and sugar.

Without treatment, less than 25% of all patients who seek medical care will truly recover.  Treatment options for people who have anxiety disorders includes a combination of:

• Medication therapy
• Individual psychotherapy
• Stress management training
• Cognitive behavioral therapy
• Self-esteem and assertiveness training

People suffering from anxiety disorders can lead more productive, happier lives with treatment and support from family and friends.

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