Anxiety disorders often treatable
April 19, 2010 · Updated 3:18 PM
Anxiety disorders affect about 40 million American adults age 18 years and older – about 18 percent – in a given year, causing them to be filled with fearfulness and uncertainty. They are also among the most common mental, emotional and behavioral problems to occur during childhood and adolescence. About 13 of every 100 children and adolescents ages 9 to 17 experience some kind of anxiety disorder; girls are affected more than boys.
Unlike the relatively mild, brief anxiety caused by a stressful event – like speaking in public or a first date – anxiety disorders last at least six months and can get worse if they are not treated. They commonly occur along with other mental or physical illnesses, including alcohol or substance abuse, which may mask anxiety symptoms or make them worse. In some cases, these other illnesses need to be treated before a person will respond to treatment for the anxiety disorder.
Types of Anxiety Disorders
• Generalized anxiety disorder
• Panic disorder
• Phobic disorders, such as agoraphobia and social phobia
• Obsessive-compulsive disorder
• Post-traumatic stress disorder
• Separation anxiety disorder
Generalized anxiety disorder and panic disorder are most common. Anxiety disorders are usually caused by a combination of psychological, physical and genetic factors and treatment is, in general, very effective.
The signs of anxiety fall into four general categories: tense muscles, which can lead to shaking, trembling, muscle restlessness and fatigue; increased nervous system activity, which can lead to shortness of breath, rapid heart rate, sweating, dry mouth, dizziness, nausea, diarrhea, flushes or chills, frequent urination or difficulty swallowing; overly watchful or alert, easily startled, having difficulty concentrating, having trouble falling asleep or staying asleep, feeling irritable; changes in behavior or normal routines that are used to reduce anxiety, like avoiding specific situations, withdrawing or generally decreasing activities outside the home. Sometimes, specific behaviors, e.g., checking up on things or hand washing, are repeated over and over.
Effective therapies for anxiety disorders are available and research is uncovering new treatments that can help most people with anxiety disorders lead productive, fulfilling lives. If you think you have an anxiety disorder, you should seek information and treatment right away.
In general, anxiety disorders are treated with medication, specific types of psychotherapy, or both. Treatment choices depend on the problem and the person’s preference.
A doctor must conduct a thorough exam to determine whether a person’s symptoms are caused by an anxiety disorder or a physical problem. If an anxiety disorder is diagnosed, the type of disorder or the combination of disorders that are present must be identified, as well as coexisting conditions like depression or substance abuse.
People with anxiety disorders who have undergone treatment in the past should tell their current doctor and report what medication was used, the dosage, side effects and whether the treatment seemed to help. If they received psychotherapy, they should describe the type of therapy and how often they attended sessions.
Often people believe that they have “failed” at treatment or that the treatment didn’t work for them when, in fact, it was not given for an adequate length of time or was administered incorrectly. Sometimes, people must try several different treatments or combinations of treatment before they find the one that works for them.
Many with anxiety disorders benefit from joining a self-help or support group and sharing their problems and achievements with others. Internet chat rooms can also be useful in this regard, but any advice received over the Internet should be used with caution, as Internet acquaintances have usually never seen each other and false identities are common. Talking with a trusted friend or member of the clergy can also provide support, but it is not a substitute for care from a mental health professional.
Stress management techniques and meditation can help people with anxiety disorders calm themselves and may enhance the effects of therapy. There is preliminary evidence that aerobic exercise may have a calming effect. Since caffeine, certain illicit drugs and even some over-the-counter cold medications can aggravate the symptoms of anxiety disorders, they should be avoided. Check with your physician or pharmacist before taking any additional medications.
The family is important in the recovery of a person with an anxiety disorder. Ideally, the family should be supportive but not help perpetuate their loved one’s symptoms.
Kevin McKeighen is a board-certified family physician with special interests in hypertension, diabetes and migraine headaches. He practices at Enumclaw Medical Center, part of Franciscan Medical Group.