Psyche & Soul 37: ANXIETY DISORDERS

 Podcast link:

 https://anchor.fm/boscom/episodes/2-37-Psyche--Soul--81-esduqh

Hello, this is Jose Parappully, Salesian priest and clinical psychologist at Sumedha Centre for Psychospiritual Wellbeing at Jeolikote, Uttarakhand, with another edition of Psyche & Soul.

 

In this weekend’s edition, I shall present anxiety disorders from which very many people suffer.

Anxiety is the body’s response to worry and fear. Anxiety operates on many different levels and to different degrees. There is a wide range in how deeply anxiety affects us and to what extent it interferes with our quality of life. Accordingly there are different anxiety disorders.

Causes of Anxiety Disorders

Genetic (inherited) factors contribute in some degree to anxiety, just as they do in other mental illness. Brain chemicals called neurotransmitters, as well as a pair of structures inside the brain called the amygdalae, seem to play a big role. Personality, experiences and environmental situations also contribute.

 

There are a number of medical disorders and the medications used to treat them that can cause anxiety. Some of these include: hyperthyroidism, heart disease, diabetes, respiratory disorders, emphysema, and asthma

At the root of anxiety is fear that works mostly at an unconscious level. According to MacKinnon & Michels, authors of the classic text The Psychiatric Interview in Clinical Practice,  anxiety “is the psychological response to danger, and is often seen when the individual feels that there is an ongoing threat to his [or her] welfare” The source of this threat may often lie at the unconscious level.

Generalized Anxiety Disorder

It is quite natural for us to worry during stressful times. But some of us feel tense and anxious day after day, even with little to worry about, and without any perceived trigger to provoke it. When this lasts for 6 months or longer, it would be diagnosed as Generalized Anxiety Disorder (GAD), which is the most common of anxiety disorders. What sets generalized anxiety disorder apart from ordinary worrying is the feeling that we can't stop worrying. Worry becomes chronic, almost second nature to us. This will begin to affect our social, work, and family life.

Persons of any age, even children, can develop generalized anxiety disorder. It tends to appear gradually, with the first symptoms most likely to happen between childhood and middle age. An estimated 31% of all adults will experience an anxiety disorder at some point in their life. Anxiety disorders are more prevalent in women (23%) than in men (14%) worldwide.

The main symptom GAD is a constant and exaggerated sense of tension and anxiety. We may not be able to pinpoint a reason why we feel tense. Or we may worry excessively and frequently about ordinary things, such as bills to be paid, our relationships, the safety of our children, or our health. This can lead to sleep problems and distortions in thinking. Poor sleep, in turn, can lead to irritability and strain relationships. It can also lead to restlessness, fatigue, feeling on edge, and difficulty in concentrating. Severe cases can hamper work and daily activities.

When we suffer from GAD, we are vulnerable to developing depression, alcoholism, or drug addiction. Anxiety disorders can also cause physical problems. These include: muscle tension or pain, headaches, nausea, stomach upsets and trembling. we can also develop other disorders that involve anxiety such as panic disorder, phobias, obsessive-compulsive disorder, and posttraumatic stress disorder

Panic Disorder

Panic disorder involves sudden attacks of terror triggered by an object or situation that can reach their peak within minutes. Persons who experience panic attacks may try to avoid situations or constantly worry about when the next panic attack might happen.

Symptoms can include a pounding heart, sweating, dizziness, nausea, trembling, shortness of breath, chest pain and a feeling of being out of control. We may think we are having a heart attack, or facing imminent danger or destruction, or even dying.

Phobias

A phobia is an intense fear or apprehensiveness about specific objects or situations that in reality are not likely to cause any harm. Even when some of these objects or situations may have reason to cause fear, the fear felt by the individual is disproportionate to the actual danger posed.

Common phobias include fear of heights, closed-in spaces like elevators, flying, water or creatures like ants and spiders. One woman I know is so afraid of flying that she never takes a plane, and so does not do any international travel, though she would love to visit many places.

During the height of the Covid pandemic, many people would not leave the home even for essential work, for intense fear of catching the contagion.

Social Anxiety Disorder

Social Anxiety Disorder is a common specific form of phobia. Those afflicted with this disorder feel panicky and self-conscious even in ordinary social situations. They are intensely anxious about being judged or rejected in social situations. Even when they realize their worry is unreasonable, they cannot avoid being anxious. Symptoms include a sense of dread before social events, with sweating, blushing, nausea, or trouble speaking during the events.

 

There are two other common disorders that have anxiety as one of the key symptoms but are no longer classified as anxiety disorders in the DSM-5 (The Statistical Manual of Mental Disorder, volume 5). These re Obsessive Compulsive Disorder or OCD, and Post Traumatic Disorder or PTSD.

Obsessive-Compulsive Disorder

Obsessive-compulsive disorder or OCD is a disorder where individuals have recurring, unwanted thoughts, ideas, or sensations (obsessions); or the urge to do something repetitively (compulsions).  Some people have both obsessions and compulsions.

When we suffer from obsessive-compulsive disorder (OCD), we will have troubling thoughts that we feel we cannot control. We may repeat a name, phrase, or behavior because we fear something bad will happen if don’t do that. We feel the need to repeat actions again and again, such as washing hands or checking that the door is locked. We may be obsessed about dressing in a certain order or count objects for no good reason. They may for example lay out items clothing in a particular order, pick them up in the exact order in which they were laid out, believing if the order is changed some mishap will happen to them. They may also feel they have to touch a particular object before they open the door, in order to ward of any danger.

Posttraumatic Stress Disorder

Posttraumatic stress disorder (PTSD) arises in the aftermath of some terrifying event, such as physical attacks in which we fear we may killed, severe sexual abuse, involvement in terrifying accident, or terrorist attack such as the one on the World Trade Centre..

Symptoms may happen months or longer after the event. These may include recurrent vivid flashbacks and nightmares about the event, Avoidance of things related to the event: people, places, or situations and a loss of interest in activities that were once enjoyable.

Treatment

The treatment for anxiety disorders follow the same model as described in dealing with depression and schizophrenia.

Antidepressant drugs, especially the newer variety, work well to lower anxiety. However, some of these drugs carry a risk of dependence.

Psychotherapy, especially cognitive behavioral therapy is very effective in treating anxiety. The focus here is on identifying negative thoughts and changing them. Since feelings and behaviour are primarily triggered by our thoughts, when we change our negative thoughts to more positive ones, our mood changes.  Clients are also taught calming techniques, such as meditation, that help them to calm themselves.

A few simple changes in our daily living can help. Caffeine, sugar, and even some medicines, can boost anxiety symptoms. Getting enough rest and eating healthy foods have a positive effect on anxiety. Use of relaxation techniques, such as meditation also help. Exercise can refresh the body and calm the mind.

Anxiety vs. Depression

It is important to note that there is a difference between anxiety and depression. In a very basic sense, anxiety is an excessive feeling of worry and apprehension, while depression is excessive feelings of hopelessness and worthlessness. It is possible for a person to have both anxiety and depression at the same time.

Introspection and Prayer

Have we experienced any type of anxiety disorders described here? If so, what was the experience like?

We often find Jesus in the Gospels exhorting his disciples not to be anxious. A classic case is that of the disciples caught in the storm at sea (Mark 4, 35-49). Jesus asks them “Why are you anxious?”  Elsewhere he asks them not to worry about their life, for their heavenly father provides them with everything (Mathew 6, 25-34).

We could read or contemplate any of these passages, stay with whatever these evoke in us, and spend time in the company of Jesus who is with us here and now, assuring us there is no need to be anxious and bring to him all our worries and anxieties and ask him to calm our fears.

 

Have pleasant weekend. Be safe. Be healthy. Be blessed.

Thank you for listening/reading.

Picture: Courtesy Google Images

Jose Parappully SDB, PHD

sumedhacentre@gmail.com