I think that everything that we did this week in Family Week helped me to move forward to become a better person for myself and for my family. Thank you to everyone for helping me learn so much to move forward to a healthy happy future for our whole family.
— John P.
Anxiety Disorders
- Anxiety Disorder
- Generalized Anxiety Disorder
- Specific Phobias
- Social Phobia
- Panic Disorder
- Obsessive-Compulsive Disorder
- Post Traumatic Stress Disorder
- Dual Diagnosis
- The Path to Healing
Everybody knows what it’s like to feel anxious — the butterflies in your stomach before a first date, the tension you feel when your boss is angry, the way your heart pounds if you’re in danger.
Anxiety rouses you to action. It gears you up to face a threatening situation. It makes you study harder for that exam, and keeps you on your toes when you’re making a speech. In general, it helps you cope. Anxiety disorders aren’t just a case of “nerves.” They are illnesses, often related to the biological makeup and life experiences of the individual, and they frequently run in families. But if you have an anxiety disorder, this normally helpful emotion can do just the opposite -it can keep you from coping and can disrupt your daily life. There are several types of anxiety disorders, each with its own distinct features.
The conditions classified as anxiety disorders include panic disorder, phobias, obsessive- compulsive disorder, post-traumatic stress disorder and generalized anxiety disorder.
An anxiety disorder may make you feel anxious most of the time, without any apparent reason. Or the anxious feelings may be so uncomfortable that to avoid them you may stop some everyday activities. Or you may have occasional bouts of anxiety so intense they terrify and immobilize you.
Anxiety disorders are the most common of all the mental disorders. Many people misunderstand these disorders and think individuals should be able to overcome the symptoms by sheer willpower. Wishing the symptoms away does not work -but there are treatments that can help. That’s why Rimrock Foundation’s Mental Health Division has produced this Fact Sheet -to help you understand these conditions, describe their treatments, and explain the role of research in conquering anxiety and other mental disorders.
“I always thought I was just a worrier. I’d feel keyed up and unable to relax. At times it would come and go, and at times it would be constant. It could go on for days—I just couldn’t let something go.”
Generalized Anxiety Disorder (GAD) is much more than the normal anxiety people experience day to day. It’s chronic and exaggerated worry and tension, even though nothing seems to provoke it. Having this disorder means always anticipating disaster, often worrying excessively about health, money, family, or work. Sometimes, though, the source of the worry is hard to pinpoint.
Anxiety disorders usually come on gradually and most often hits people in childhood or adolescence, but can begin in adulthood, too. It’s more common in women than in men and often occurs in relatives of affected persons. It’s diagnosed when someone spends at least 6 months worrying excessively about a number of everyday problems.
In general, the symptoms seem to diminish with age. Research into the effectiveness of medications, such as benzodiazepines and antidepressants, is ongoing. Also useful are cognitive-behavioral therapy, relaxation techniques, and biofeedback to control muscle tension.
“I’m scared to death of flying, and I never do it anymore. It’s an awful feeling when that airplane door closes and I feel trapped. My heart pounds and I sweat bullets. If somebody starts talking to me, I get very stiff and preoccupied. When the airplane starts to ascend, it just reinforces that feeling that I can’t get out. I picture myself losing control, freaking out, climbing the walls, but of course I never do.”
Phobias can occur in several different forms. A specific phobia is a fear of a particular object or situation. Social phobia is a fear of being painfully embarrassed in a social setting. Agoraphobia is a fear of being in any situation that might provoke a panic attack, or from which escape might be difficult if one occurred.
Many people experience specific phobias including intense, irrational fears of certain things or situations -dogs, closed-in places, heights, escalators, tunnels, highway driving, water, flying, and injuries involving blood are a few of the more common ones. Phobias aren’t just extreme fear; they are irrational fear.
Specific phobias strike more than 1 in 10 people. No one knows just what causes them, though they seem to run in families and are a little more prevalent in women. Phobias usually first appear in adolescence or adulthood. They start suddenly and with only about 20 percent of adult phobias vanishing on their own.
When phobias interfere with a person’s life, treatment can help. Successful treatment usually involves a kind of cognitive-behavioral therapy called desensitization or exposure therapy, in which patients are gradually exposed to what frightens them until the fear begins to fade. Three-fourths of patients benefit significantly from this type of treatment. Relaxation and breathing exercises also help reduce anxiety symptoms.
Although this disorder is often thought of as shyness, the two are not the same. Shy people can be very uneasy around others, but they don’t experience extreme anxiety in anticipating a social situation or avoid circumstances that make them feel self-conscious. In contrast, people with social phobia aren’t necessarily shy. They can be completely at ease with people most of the time, but particular situations, such as walking down an aisle in public or making a speech, can give them intense anxiety.
People with social phobia are aware that their feelings are irrational. Still, they experience a great deal of dread before facing the feared situation, and they may go out of their way to avoid it. Even if they manage to confront what they fear, they usually feel very anxious beforehand and are intensely uncomfortable throughout. Afterward, the unpleasant feelings may linger, as they worry about how they may have been judged or what others may have thought or observed about them.
About 80 percent of people who suffer from social phobia find relief from their symptoms when treated with cognitive-behavioral therapy or medications or a combination of the two. Therapy may involve learning to view social events differently, being exposed to a seemingly threatening social situation in such a way that it becomes easier to face, and learning anxiety-reducing techniques, social skills, and relaxation techniques.
“For me, a panic attack is almost a violent experience. I feel like I’m going insane. It makes me feel like I’m losing control in a very extreme way. My heart pounds really hard, things seem unreal, and there’s this very strong feeling of impending doom.”
People with panic disorder have feelings of terror that strike suddenly and repeatedly with no warning. They can’t predict when an attack will occur, and many develop intense anxiety between episodes, worrying when and where the next one will strike. In between times there is a persistent, lingering worry that another attack could come any minute.
When a panic attack strikes, most likely your heart pounds and you may feel sweaty, weak, faint, or dizzy. Your hands may tingle or feel numb, and you might feel flushed or chilled. You may have chest pain or smothering sensations, a sense of unreality , or fear of impending doom or loss of control. Attacks can occur any time, even during nondream sleep. While most attacks average a couple of minutes, occasionally they can go on for up to 10 minutes. In rare cases, they may last an hour or more.
Panic disorder strikes between 3 and 6 million Americans, and is twice as common in women as in men. It can appear at any age -in children or in the elderly- but most often it begins in young adults. Not everyone who experiences panic attacks will develop panic disorder -for example, many people have one attack but never have another. For those who do have panic disorder, though, it’s important to seek treatment. Untreated, the disorder can become very disabling.
Cognitive-behavioral psychotherapy teaches patients how to view the panic situations differently and demonstrates ways to reduce anxiety, using breathing exercises or techniques to refocus attention. Studies have shown that proper treatment — cognitive- behavioral therapy, medications, or possibly a combination of the two — helps 70 to 90 percent of people with panic disorder. Significant improvement is usually seen within 6 to 8 weeks.
Depression often accompanies panic disorder, and when it does, it needs to be treated as well. The feelings of sadness, apathy, and hopelessness, the changes in appetite or sleep, and the difficulty concentrating that often characterize depression can be effectively treated with antidepressant medications, or, depending on their severity, by psychotherapy.
Obsessive-Compulsive Disorders
“I” couldn’t do anything without rituals. They transcended every aspect of my life. Counting was big for me. When I set my alarm at night, I had to set it to a number that wouldn’t add up to a “bad” number. I would wash my hair three times as opposed to once because three was a good luck number and one wasn’t.”
These disturbing thoughts or images are called obsessions, and the rituals that are performed to try to prevent or dispel them are called compulsions. Obsessive-Compulsive Disorders (OCD) are characterized by anxious thoughts or rituals you feel you can’t control. If you have OCD, you may be plagued by persistent, unwelcome thoughts or images, or by the urgent need to engage in certain rituals.
You may be obsessed with germs or dirt, so you wash your hands over and over. You may be filled with doubt and feel the need to check things repeatedly. You may spend long periods of time touching things or counting; you may be preoccupied by order or symmetry .
OCD strikes men and women in approximately equal numbers and. It can appear in childhood, adolescence, or adulthood, but on the average it first shows up in the teens or early adulthood. The course of the disease is variable -symptoms may come and go, they may ease over time, or they can grow progressively worse. Depression or other anxiety disorders may accompany OCD and some women may develop an eating disorder. In addition, they may avoid situations in which they might have to confront their obsessions. Or they may try unsuccessfully to use alcohol or drugs to calm themselves.
Post-Traumatic Stress Disorder
Post-Traumatic Stress Disorder (PTSD) can be an extremely debilitating condition that can occur after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that can trigger PTSD include violent personal assaults such as rape or mugging, natural or human-caused disasters, accidents, or military combat.
With Post-Traumatic Stress Disorder ordinary events can serve as reminders of the trauma and trigger flashbacks or intrusive images. A flashback may make the person lose touch with reality and reenact the event for a period of seconds or hours or, very rarely, days. A person having a flashback, which can come in the form of images, sounds, smells, or feelings, usually believes that the traumatic event is happening all over again.
Many people with PTSD repeatedly re-experience the ordeal in the form of flashback episodes, memories, nightmares, or frightening thoughts, especially when they are exposed to events or objects reminiscent of the trauma. Anniversaries of the event can also trigger symptoms. People with PTSD also experience emotional numbness and sleep disturbances, depression, anxiety and irritability or outbursts of anger.
Antidepressants and anxiety-reducing medications can ease the symptoms of depression and sleep problems. Psychotherapy, including cognitive-behavioral therapy, is an integral part of treatment. And, support from family and friends can help speed recovery .
Rimrock Foundation is a nationally recognized treatment center for the treatment of dual diagnoses. The term “dual diagnosis” refers to the presence of one or more addictions complicated by a psychiatric disorder such as major depression.
These patients represent a challenge to treatment professionals. They frequently utilize services from both fields and are often shuttled back and forth between numerous treatment systems. They are more prone to relapse and are often the most difficult clients to treat effectively because of their many problems. Dual diagnosis patients require the comprehensive, flexible Rimrock Foundation treatment approach that recognizes their special needs and provides integrated treatment for the multiple disorders identified.
Rimrock Foundation meets the needs of these patients and their families with our state-of-the-art assessment and treatment approaches. Essential in the process is close collaboration among our multidisciplinary professionals including psychiatrists, psychologists, psychiatric social workers, and certified chemical dependency counselors.
Many people with anxiety disorders can be helped with treatment. Medications, although not cures, can be very effective at relieving anxiety symptoms. Today, thanks to research, there are more medications available than ever before to treat anxiety disorders.
For most of the medications that are prescribed to treat anxiety disorders, the doctor usually starts the patient on a low dose and gradually increases it to the full dose. Every medication has side effects, but they usually become tolerated or diminish with time. Research has also shown that behavioral therapy and cognitive- behavioral therapy combined with medications can be effective for treating several of the anxiety disorders.
When you’re looking for a health care professional, it’s important to inquire about what kinds of therapy he or she generally uses or whether medications are available. It’s important that you feel comfortable with the therapy. If this is not the case, seek help elsewhere. However, if you’ve been taking medication, it’s important not to quit certain drugs abruptly, but to taper them off under the supervision of your physician.
Remember, though, that when you find health care professionals you’re satisfied with, you should all be working as a team. Together you will be able to develop a plan to treat your anxiety disorder that may involve medications, behavioral therapy, or cognitive-behavioral therapy, as appropriate. Treatments for anxiety disorders, however, may not start working instantly.
Rimrock Foundation has four newly licensed Crisis Stabilization beds available for patients who may need a short-term stay for the purpose of stabilizing them on prescribed medications or who may need a safe place with medical monitoring and evaluation but who do not require the full services of an acute psychiatric facility. These beds serve as an alternative to hospitalization and may be accessed by referral from the patient’s physician, case manager or therapist. Call our Crisis Program Coordinator or our Admissions Department for more information or to make a referral.
For further information on Rimrock Foundation’s treatment of Anxiety Disorders, call Jamie Hixson, Admissions Supervisor at 1-800-227-3953 or 1-406-248-3175, or visit our website at rimrock.org. For more educational information on Anxiety Disorders, contact the Rimrock Foundation Library at 1-800-227-3953 or 1-406-248-3175.
