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Anxiety Basics:
Highlights of the Disorder, Why We Have Anxiety, How It’s Treated
By: Judith A Persley, MSA, LMSW, EFCT
Following, is a brief overview of Anxiety. For more details about Anxiety Disorder, follow this website for additional articles on the subject. This article attempts to concentrate on:
a) Why does a person have anxiety? How do you get it?
b) What exactly is anxiety?
c) What are the best-practice treatments for anxiety?
Why Do Some People Have Anxiety (Generalized Anxiety Disorder)?
People with Generalized Anxiety Disorder often ask me why they have it. If they don’t ask why, they’re typically wondering why. Asking why one has Anxiety Disorder is a legitimate question.
Anxiety Disorder is either:
a) inherited,
b) turned on by one or more, or a series, of traumas (broadly defined),
c) or caused by both.
Anxiety Disorder is the Result of a Physical Malfunction
Anxiety Disorder is a disorder with physical origins, meaning, there is a physical malfunction causing a series of physiological events, manifesting in physical and emotional symptoms. These physical and emotional symptoms then bring on psychological symptoms. Examples of physical symptoms are: increased heart rate, increased blood pressure, physical arousal, more rapid breathing, jitters, perspiration. Examples of emotional symptoms are: worry, fear, feeling overwhelmed, spinning thoughts. Examples of psychological symptoms are: feeling less than, feeling incompetent, feeling unable to handle life, feeling embarrassed, feeling shame.
Most people who I see for Anxiety do believe it is their fault. They believe they just don’t have life right. They believe they are “weak”. Most believe they aren’t trying hard enough. They believe they don’t have the wisdom or the power like other people have, and they believe that they suffer with anxious thoughts and even physical manifestations of anxiety because of their own shortcomings. This couldn’t be further from the truth.
The truth is, people with anxiety typically work very, very hard at managing and trying to control their anxiety. It may or may not look like that to others. But the truth is, depending on the severity of the Anxiety Disorder, it’s a lot to carry around with you …. every single day. And it’s NOT the person’s fault that they have anxiety.
Anxiety Disorder is a disorder caused by a malfunction in the fight or flight system.
The fight or flight system is an autonomic system in the body (responds automatically without thought) responsible for identifying and responding to danger. This system is designed to turn on when a person encounters danger, or danger encounters the person, and it is designed to turn back off when the danger subsides or no longer exists. With Anxiety, the fight or flight system is turned up when there is no imminent danger. There is a malfunction in the fight or flight system – it is falsely operating, firing, responding to danger when there is no imminent danger.
Why is the Fight or Flight System Malfunctioning?
The exact reasons the fight or flight systems is malfunctioning is not exactly understood. In simple terms, however, much research points to the role of Serotonin in the brain. Serotonin is responsible for the transmission of messages in the brain. If messages are not transmitted properly, there are, of course, problems. This is further demonstrated by the reduction in symptoms clients with anxiety often feel when place on an SSRI (Specific Serotonin Reuptake Inhibitor). Note: not all treatment calls for or requires a pharmaceutical intervention for the reduction and management of symptoms. With anxiety, it is believed that a faulty messaging system is turning on the fight or flight system when it does not need to be turned on.
How is Anxiety Treated?
If you Google “treatment for anxiety”, you will find a variety of treatment philosophies, recommendations, and claims. Following is this therapist’s treatment approach based on “best practice and evidence-based research”.
An integrative approach to the treatment of Anxiety draws from the best of the scientific, physical, and cognitive constructs.
Our goal in treatment is to reduce and improve symptoms and improve the quality of life. The following integrative practice approach is proven to reduce anxiety and improve the management of anxiety. No treatment has been proven to eliminate anxiety. Like other health disorders, we can reduce symptoms and learn how to navigate remaining symptoms in a way that they have minimal impact on our daily life.
Therapy / Counseling: Research shows that Cognitive Behavioral Therapy (CBT) remains the “best practice” approach for Anxiety Disorders and the reduction of systems long term. In very simple terms, the CBT approach uses and exercises the analytical brain that is not in fight or flight mode. The more we exercise that part of the brain, the more we “turn up the volume” on the analytical side v. the fight or flight side, which is more reactive and less analytical. When there is not imminent danger, we need more analysis than a fight/flight response.
Breathing Relaxation / Mindfulness / Meditation: Breathing Relaxation Exercises (BRE) conducted proactively (not in response to a specific event, but as method to train the fight or flight response), multiple times a day, has shown a consistent success rate among those who practice the exercise consistently. 100% of my clients report solid benefits. BRE’s help to re-calibrate the fight or flight response, and reduce physical symptoms, thereby reducing emotional and psychological symptoms. BRE’s are an excellent tool to reactively reduce anxiety and symptoms as well (use in the moment when anxiety is high), and are especially beneficial when BRE’s are being practiced proactively on a daily basis.
Medication: For moderate to severe anxiety, medicines in the SSRI category may be used for a short duration or long term. The SSRI category of medications help to improve Serotonin levels in the brain and thereby improve brain messaging. Effective brain messaging is essential for a healthy fight or flight response operating system – the system presently believed to be malfunctioning for people with anxiety disorder. (SNRI’s and NRDI’s work with neopinephrine and dopamine, and may also improve brain messaging and thereby reduce anxiety).
Medicines that work on the central nervous system, such as Xanex, a Benzodiazepine, may be used to treat anxiety but are effective for short term reduction in symptoms only. Benzodiazepines are typically best used to help a person stabilize symptoms while Therapy (CBT) (and possibly an SSRI) are being used for long terms results.
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