The Many Faces of Anxiety
by Dr. Robert Schnurr
Dr. Robert Schnurr, a psychologist in London, Ontario, has joined our guest contributors. He has been in practice for more than 20 years. His practice is geared towards individuals who have suffered psychological and/or physical injuries. Most of the injuries he sees are related to motor vehicle collisions or work-related accidents but he also sees individuals with other injury-related problems. In addition to suffering from pain, many of the individuals he sees and treats suffer from anxiety, depression, PTSD, relationship problems, loss of employment or ability to work, and job stress or job-change problems. He can be reached in London at 519-858-0491 or by email at firstname.lastname@example.org. This is the second of his series meant to help vets and their families recognize PTSD and develop coping skills. Vets are invited to submit questions for Dr. Schnurr to work answers into his articles or to comment. BONNIE
Often when I ask a new client if he or she is anxious I get a puzzled look. I’ve come to realize that not everyone knows what this means. Anxiety comes in many shapes and sizes. Most of us know what it is like to have “butterflies” or “knots” in the stomach. There is that nervous, tense feeling that we get before something important, e.g., asking someone out, waiting for the exam to start, going into the field, patrolling, or public speaking. When anxious, some people have to urinate more frequently, others get “the runs.” All of us experience anxiety at one time or another and this is perfectly normal. Most of the time we deal with it and it subsides.
As the level of anxiety increases, we may experience other symptoms such as sweating, a cold, clammy feeling, shaky or unstable legs, hand tremors, shortness of breath, dizziness, a lump in the chest, and difficulty breathing. In its more extreme form, we may experience hyperventilation (rapid breathing) and on occasion one may faint although this is not common. When the anxiety gets to the level where one feels like he or she is going crazy or may be having a heart attack, then this is called panic. When it first happens, the anxiety is so severe that the individual may go to an emergency department where the heart and other vitals are checked and if all is ok, the diagnosis of panic disorder is made. It’s reassuring to know that you won’t die from it, but when you are in the midst of an attack, this thought seems far away.
An episode of panic usually doesn’t last very long, whereas more generalized feelings of anxiety can last throughout the day or for days. Both prolonged anxiety and panic attacks can lead to fatigue and mental exhaustion. PTSD is another type of anxiety.
For acute (short term) episodes of anxiety, a physician may prescribe a muscle relaxant such as Lorazepam (Ativan) or Clonazepam. These drugs work very quickly to calm the person down and settle the anxiety. However, in general, they are not meant to be taken on a long-term basis and withdrawal is often a problem. A lot of people try to control the anxiety with alcohol but we know where that can lead!
Psychological treatments are often very effective in treating anxiety. This includes learning how to control one’s breathing, managing thoughts, and approaching the anxiety evoking situation in a more effective way.
There are a number of good websites to visit for information on anxiety and dealing with it. Check these out.
- http://www.allaboutdepression.com/relax/ A very useful site to learn about relaxation.
- http://www.cci.health.wa.gov.au/resources/minipax.cfm?mini_ID=21 This site provides information on generalized anxiety as well as panic disorder.
- http://www.changeways.com/resources/aboutanxiety/aboutanxiety.html Dr. Randy Patterson is based in Vancouver and offers help to people with a variety of problems. His site has information on anxiety and depression.
- http://www.paniccenter.net A self-help based website.