Posts Tagged ‘anxious’

Separation Anxiety

December 23rd, 2009

http://www.familyresource.com/parenting/behavior-issues/separation-anxiety
familyresource.com
By: James P. Krehbiel

When I was working as an elementary school counselor, I had a parent who brought her second grader to me due to an excessive fear of attending school. The mother would drive the youngster to school because the child was afraid to take the school bus and dreaded attending class.

The child would ask to leave class frequently due to stomach aches and would be sent to the nurses’ office. After visiting the nurse, she would get on the phone and plead with her mother to come to the school and take her home. Frequently, the mother would feel sorry for her daughter and consent to pick her up from school and take her home for the day. Then the process of fear and anticipatory anxiety would cycle as the child reluctantly prepared for the next day of school.

What I have described is not an uncommon scenario. Often, children experience separation anxiety in the process of experiencing everyday tasks. The pattern starts with the child avoiding an independent task and then developing increased fear and anxiety in the process of avoiding it. A cycle of separation anxiety emerges out of the child’s need to cling dependently to a parent and resist age-appropriate self-directed behavior.

Like the second grader who finally made it to my office for assistance, most children experiencing separation anxiety complain of somatic symptoms. Their emotional conflict gets played out as physical ailments such as headaches, stomach aches, heart- palpitations, sweating, and shallow breathing fostering hyperventilation. These symptoms will then become the primary focus for the child and/or parent, and will be used as an excuse for avoiding specific socially appropriate behaviors.

The key to managing separation anxiety involves changing the interactional pattern for the child and family. What are some factors that intensify the problem of separation anxiety and what can be done about it?

* Anxious, enabling adults promote dependent children. Never show that you are afraid for your children when they are placed within new responsibilities. If you take your child to daycare, drop him off and leave promptly! If your child displays fear about another familiar adult touching or holding him, back off and give your child an opportunity to get acclimated. If your child calls home because she is school phobic, let the school handle the problem without interference.
* Couples who have a strained relationship will often triangulate with their child. This means, one partner may use the child to meet her needs. I have counseled couples whose relationship was so dysfunctional that a child was permitted to sleep in the parent’s bed. A parent will excuse this behavior as “normal” nurturing.
* In divorce situations, a parent may dependently cling to a child as a way of assuaging guilt or calming psychic pain. The parent may also use the child as a pawn in the nasty game of manipulation directed toward the ex-partner.

Separation anxiety is typically the byproduct of a family system where the parents are overly-protective, anxious, and needy. They are continuously worried or fearful for their children. They protect them from new experiences, frustration, and pain. They are scared to let their children feel afraid or experience disappointment and mistakes. In the process of trying to keep them out of harms way, they compound the problem by actually placing their children in greater emotional jeopardy. Unknowingly, they teach their children that people and life are not to be trusted and that they need to be protected by their parents. Here are some ideas on what can be done to alter the pattern of separation anxiety:

* Permit your children to launch out and experience new adventures and activities.
* Don’t let your children’s fear keep you from nudging them into the unknown of experience. Risk-taking is an important quality in the process of developing independence.
* Don’t let your children off the hook when they have misbehaved. Let them experience the logical consequences of their actions.
* Let your children learn through failure, mistakes, and disappointment.
* Never use your kids to meet your own emotional needs. They will learn to resent it and will feel trapped by their need to support you.
* Be firm about your limits when it comes to children managing their anxiety. Don’t rescue them from moving forward in spite of fear no matter how difficult it may be for you to observe.
* Don’t let anxious children pick up cues that you are fearful for them. Maintain a certain degree of detachment when you children experience psychological pain.
* Don’t get hooked into your children’s temper tantrums. Remove yourself from their negative behavior, it will eventually diminish.

Parents may need counseling assistance in order to learn new ways of responding to a child who uses fear and anger as a method of avoiding social contact. For parents, changing interactional patterns will take time, patience and determination. At first, you can expect a counter-reaction from your child. He will bulk at the changes that you are trying to establish. Stay firm and consistent and your child will eventually “get on board.”

Separation Anxiety In Children: What’s Normal And What’s Not

December 23rd, 2009

http://www.articlesnatch.com/Article/Separation-Anxiety-In-Children–What-s-Normal-And-What-s-Not/618957
articlesnatch.com

Many children go through a phase in which they show anxiety and restlessness in the presence of unfamiliar people or situations. A baby may be unsettled by a new babysitter. A four year old may cry persistently during the first few days at kindergarten. These are perfectly normal situations and reactions.

One in every 25 children experiences some form of separation anxiety which can often be allayed by allowing the child to have a period of adjustment to his new situation. However, a child five or older who demonstrates unremitting resistance to camp, school or daycare for an extended period of time (3 weeks or more) may be suffering from separation anxiety disorder.

What is Separation Anxiety Disorder?

This is a condition in which the child becomes physically agitated over the thought of being separated from his primary caregiver or home. It is not confined to children. Adults can experience separation anxiety as well; it is known as “agoraphobia,” or fear of being separated from a safe person or home. “Agora” in Greek means marketplace and the word “agoraphobic” refers to people who are terrified of leaving home for the market.

What are the Symptoms of Separation Anxiety Disorder?

-The child complains of headaches or stomach aches. Sometimes he or she throws temper tantrums.
-The child has an irrational fear that something bad will happen if she leaves the house or caregiver.
-The child shows unusual concern about being kidnapped or taken away.
-The child fears that the caregiver might die.
-The child fears being alone, even in a separate room.
-The child has nightmares of being separated.
-The child cannot fall asleep unless caregiver is nearby.

What Can Be Done about Separation Anxiety Disorder?

If the child’s anxiety is so excessive it interferes with normal functioning at home and at school, it is wise to consult professional help. Cognitive Behavioral Therapies provide a framework in which children can learn about their fears and how to deal with them.

In essence, Cognitive Behavioral Therapies help children identify negative thoughts rather than external events, as the source of anxious feelings and behavior. They also help children develop skills for self reliance and self help. They help them practice alternative responses to anxiety so that new neural pathways can replace old circuitry in the brain. Achievement of goal is predicated on the children’s ability to unlearn old patterns and replacing them with new responses.

Why is Professional Treatment important?

Research suggests that anxiety disorders in children should be taken seriously and that parents should seek professional treatment because untreated children usually perform poorly at school, have repeated absences from school, experience problems relating with peers and siblings or become alcohol or drug dependent when they grow older.

Separation Anxiety in Young Children

December 23rd, 2009

http://library.adoption.com/articles/separation-anxiety-in-young-children.html
adoption.com

As a former infant and toddler teacher, I have witnessed on numerous mornings a young child, who was previously comfortable coming to day care, suddenly throwing a tantrum as the parent tries to leave, clinging to the parent’s arm or leg as he or she tries to walk out the door. While this was distressing, I wondered what had happened the previous day to suddenly lead to such behavior. It was even more upsetting to the surprised parent as he or she was on their way to work.

Similar situations are frequently described by parents who submit questions through our AskERIC service, whether it is with a toddler who attends day care or with a 9-month-old who is going to stay at grandma’s while mom and dad go out to dinner. As a parent or caregiver, it can be extremely difficult to resist a crying child who throws herself into your arms as you try to leave.

Such behaviors, while disturbing to the adults around them, are a sign that the child is reaching an important developmental milestone. At about 8 months of age, children will begin to become anxious, clinging, and easily frightened about unfamiliar people or objects (American Academy of Pediatrics, 1993). This phase is commonly called separation or stranger anxiety. Separation anxiety usually peaks between 10 and 18 months and then gradually fades during the last half of the second year.

Keep in mind, however, that these age ranges are only general guidelines. Because of individual differences in children’s development, some children may never experience major episodes of separation anxiety while others may not display any of the behaviors associated with separation anxiety until the second year with the behaviors lasting until beyond the third birthday (Eisenberg, Murkoff, & Hathaway, 1994). In addition, separation anxiety can be more exaggerated for children who are experiencing other stresses in their life such as: moving, a new child care situation, the arrival of a new sibling, or relationship problems between the parents.

Why Do Children Have Separation Anxiety?

The child’s unwillingness to leave a parent or caregiver is a sign that attachments have developed between the caregiver and child (Brazelton, 1992). The child is beginning to understand that each object (including people) in the environment is different and permanent (American Academy of Pediatrics, 1993). This means that your child is learning that there is only one of you. In addition, the child begins to understand that when he cannot see you, you have gone somewhere else, and he shows these anxious behaviors because he wants you to remain close to him.

Also, because young children cannot yet understand time, they do not know when or even if you will ever come back (American Academy of Pediatrics, 1993). As a result, a child may fuss and cry when you go into the next room, scream when you leave him with someone else, and may even refuse to go to sleep at night. Fortunately, as children get older, their memories will begin to provide comfort as they learn that you will come back. This is why it is important to keep your promise to return at a certain time (after nap or after snack time) so that they begin to build these memories of your return.

Nevertheless, it can be confusing to watch a toddler who is growing more independent everyday by putting on her own shoes or wanting to feed herself actually become more dependent with these emotional displays. It is important to remember that the child is working through a stage where she is struggling between feelings of striking out on her own and yet wanting to stay safe by your side (Eisenberg, Murkoff, & Hathaway, 1994).

How Can I Help My Child with Separation Anxiety?

Here are a few suggestions for easing separation anxiety.

* Because your child will be more susceptible to separation anxiety when tired, hungry, or sick, try to schedule departures after naps and mealtimes (American Academy of Pediatrics, 1993).

* Prepare your child before the separation occurs by reassuring him that you will return (Brazelton, 1992). Let him know when you will be back. Because your child cannot understand time, use concepts that he can understand such as “I’ll be back when you are having snack,” or “I’ll be back on the day that you go to the library.” Be sure to stick to that time or call if there is an emergency or something that will delay your return.

* Take the anxiety seriously and react with understanding, patience, and confidence (”I know you don’t want me to leave, but I will be back after lunch”) instead of by teasing (”Oh, you’re so silly crying like that”) or annoyance (”You make me feel so mad when you cry like that!”) (Eisenberg, Murkoff, & Hathaway, 1994).

* Stay calm, matter-of-fact and, sympathetic. “I know you are upset that I have to go into the kitchen, but I need to cut up the carrots for dinner.” Go into the kitchen with the child on your leg if necessary (Eisenberg, Murkoff, & Hathaway, 1994).

* Make your toddler feel secure when you’re around by giving lots of love and attention. Young children will learn faster when they receive necessary attention and affection than by the parent’s taking a “learn the hard way” attitude (Eisenberg, Murkoff, & Hathaway, 1994).

* “Practice” short-term separations around the house (American Academy of Pediatrics, 1993; Eisenberg, Murkoff, & Hathaway, 1994). As you go into the next room out of sight, talk to your baby: “Where did mommy go?” When you return, let her know: “Here I am!” These repeated separations can help your child learn that your disappearance is only temporary.

* Don’t sneak away from your child (Eisenberg, Murkoff, & Hathaway, 1994). While tempting, this approach will only lead the child to be more guarded and resistant the next time you leave.

* Try to keep your own anxieties (difficulty in letting go, anxiety about the caregiver, guilt about leaving) under control. If your child senses or sees your distress at leaving, that will tell him that there must be something wrong (Eisenberg, Murkoff, & Hathaway, 1994).

Separation Anxiety

December 23rd, 2009

http://online.wsj.com/article/SB120345823890778045.html
online.wsj.com
By THOMAS DE WAAL

Twenty years ago today, the ghosts of history stirred in Europe and a conflict that no one had paid attention to since the Treaty of Versailles re-erupted in the depths of the Soviet Union. The Nagorno-Karabakh dispute between Armenians and Azerbaijanis was the first bonfire in a series of ethno-territorial conflicts that burned through the Caucasus and the Balkans. European Union enthusiasts had thought that the only conflicts left on the Continent were about sheep and cod quotas — but they were dead wrong.

In the week when Kosovo embarks on a path of EU-guided independence and Serbia and Russia voice angry resistance, it’s worth asking whether the nationalist gunmen or the European dreamers will win the argument.
* * *

The dispute that kicked it off in the southern Caucasus is still unresolved. On Feb. 20, 1988, the local Armenian soviet in the tiny territory of Nagorno-Karabakh decided to take Lenin’s dictum of “all power to the soviets” literally and vote for secession from Soviet Azerbaijan and join Soviet Armenia. The Armenians said that Karabakh was an historic Armenian homeland that had been unjustly incorporated into Azerbaijan by Stalin, the Azerbaijanis that an Armenian fifth column was breaking up their republic and stealing their territory. The region was so obscure that even most people in Moscow knew nothing about it. Mikhail Gorbachev wisely chose not to use violent repression to solve the dispute but found he had no other instruments that worked.

Strikes, demonstrations, pogroms and deportations degenerated into full-scale war. The dispute tore up the notion of Soviet brotherhood and began to weaken the architecture of the U.S.S.R. as a whole. Within a couple of years, the same forces would bring about the violent death of Yugoslavia.

Hundreds of thousands perished and millions were displaced. The blame in all these nasty wars — Abkhazia and South Ossetia in the Caucasus and Croatia, Bosnia and Kosovo in the Balkans — is shared unevenly, but it can safely be said there were no angels in them. The victims one day became ethnic cleansers the next. Those who suffered most were those most attached to some kind of modern, multi-ethnic notion of identity, such as the cosmopolitan families and mixed marriages of Baku and Sarajevo.

Twenty years on, politicians in the Caucasus continue to give inflammatory speeches about victory, justice and “no surrender.” Armenian and Azerbaijani historians still seek to prove that the other ethnic group “never lived” in the disputed territory and that therefore it is their undisputed historical homeland. These bogus theories are now being taught in classrooms.

Now the emergent state of Kosovo poses both challenges and threats.

The standard Western line about Kosovo’s independence, from the White House to Brussels, is that it “does not set a precedent.” The Kosovars, the argument goes, suffered so egregiously under Slobodan Milosevic’s Serbia that they deserved the U.N. mandate that gave them de facto independence. That state of affairs is merely being made de jure, albeit with continued international supervision.

It goes without saying that all these conflicts are different. Kosovo is certainly larger than the disputed Caucasian territories and its years under U.N. supervision have prepared it to be a more viable state. But whether the West likes it or not, Kosovo’s independence will have a strong ripple effect. Consider the calculation made by the de facto leaders of Abkhazia or Nagorno-Karabakh when they hear the news from Kosovo: They will be even less likely to try to sell a bargain to their people that entails “return” to the sovereignty of Azerbaijan or Georgia.

That knowledge further frustrates the leaders of Azerbaijan and Georgia, who fear that they are losing the breakaway territories and drop ever heavier hints that they could use military action to reconquer them. Thanks to new Caspian Sea oil revenues, Azerbaijan has the fastest-growing defence budget in the world, while the Georgian government recently renamed its conflict resolution ministry into the more aggressively titled “ministry for reintegration.”

Kosovo is further thawing conflicts that have been mistakenly called “frozen.” The peace processes are already all but dead. Around Nagorno-Karabakh, now under Armenian control, snipers exchange deadly fire across a 200 kilometer cease-fire line. Shooting incidents and kidnappings set nerves jangling in Abkhazia and South Ossetia.

In truth, neither side here will get what they want. Full independence for these territories is highly implausible, especially when large minority populations remain in exile and are not consulted; but integration of these territories into Azerbaijan or Georgia, places they have had nothing in common with since Soviet times and fought wars against is also fantasy. The only way “reintegration” can be achieved is through another catastrophic war. Everyone knows that some kind of shared sovereignty must be the eventual outcome. But how to arrive at it?

The worrying aspect of Kosovo’s “supervised independence” — and the most awkward for the European Union as it simultaneously proclaims its trans-national identity — is the perception that the reward for intransigence is a full national state, with all the old-fashioned trappings attached to it. The new Europe is supposed to be about less borders, not more.
* * *

But if the emphasis is put on supervision, rather than independence, something good could still be borrowed from the Kosovo model.

In theory at least, the Kosovo model honors the aspirations both of the Kosovo Albanians and the Serbs, puts conditionality on the choices made by the new state, introduces some Western-style institutions and keeps an international security presence.

The key word here is security. If the Balkans have moved further ahead, it is thanks in large part to a belated but massive international effort. The Dayton agreement for Bosnia was in effect a huge international security blanket smothering the conflict in the expectation that EU expansion would lull the conflicting sides into a state of prosperity. The Kosovo experiment is also predicated on the idea of continuing security for both Kosovo Albanians and Serbs.

The underside of the violent nationalist exterior of many people in the Balkans and the Caucasus is genuine fear. In my travels in Armenia, Azerbaijan and Georgia, I have met well-educated people who say that they fear “genocide,” the extinction of their ethnic group. I have met people who took up arms against their former school mates and neighbors because you had to take sides and kill or be killed. They did not trust the socialist state to look after their security and began to look instead to their own young men with guns over their shoulders. Only an overarching international security architecture can stifle that fear and allow people to see their former enemies as traders and potential neighbors again, not as threats to their existence.

This is the security structure that Western powers have tried to erect in Bosnia and Kosovo in the last decade and a half, with partial success. They have not managed to do so in the Caucasus partly because they lack the resources and the commitment, partly because this can only be done in partnership with Russia. The European Union is barely present in the South Caucasus, while the United States has a stronger presence but several competing agendas, shaped by energy investments, the domestic Armenian lobby and relations with Russia.

That calculation may need to change, as the Georgian and Armenian-Azerbaijani conflicts begin to unfreeze and Western politicians notice, for example, that the Armenian-Azerbaijani cease-fire line runs just 20 kilometers from the Baku-Tbilisi-Ceyhan pipeline that connects Caspian oil fields with European markets. Interests are at stake here, not just ordinary lives. The fighters of the nationalist wars have not disappeared; they just left their guns in the cellar, waiting to see what the future brings.

Separation Anxiety 101

December 23rd, 2009

http://www.education.com/magazine/article/separation-anxiety-101/
education.com
by Alisa Stoud

“Please don’t make me go to school.” If you are hearing this from your child, it might be a sign of separation anxiety. While separation anxiety can happen any time, the American Academy of Child and Adolescent Psychiatry says it’s most common in children between the ages of 5-7 and 11-14—when kids have to deal with new challenges in elementary and middle school.

“About 10-15% of all school children can experience separation anxiety at some time, for a variety of reasons,” notes Diane Peters Mayer, a psychotherapist and author of Overcoming School Anxiety: How to Help Your Child Deal With Separation, Tests, Homework, Bullies, Math Phobia, and Other Worries. The key is to recognize what’s happening with your child and helping her learn to control her emotions. Here are answers to common questions about separation anxiety.

What are the symptoms of separation anxiety?

While tantrums, clinging, and refusing to be left alone are some of the main symptoms of separation anxiety, children may also experience the following:

* Stomach aches
* Headaches
* Shakiness or trembling
* Rapid heart rate
* Sweating
* Revved up respiration
* Excessive worry that something bad will happen to their parents or themselves
* Diarrhea
* Vomiting

Children may certainly not exhibit all of these symptoms, and they will generally not recognize these symptoms as being “anxious”, notes Peters Mayer. They will likely tell you: “My stomach hurts,” or “I have a headache,” and will be vocal about not wanting to leave home.

When children experience separation anxiety, it’s nearly impossible to get them to participate and benefit from the lessons of school, let alone have fun. “It’s almost impossible for children with separation anxiety to think, reason, or socialize in school because they are truly in survivor mode,” says Peters Mayer. “All they know is they want to go home, and the school environment becomes very stressful—every part of it becomes stressful.”

What causes separation anxiety?

First day jitters are 100% normal, so don’t attribute night before nervous feelings to separation anxiety. However, there are particular traits and temperaments that make some children more prone to experiencing anxiety.

“Some children’s temperament or their degree of sensitivity makes them more prone to having anxiety,” notes Peters Mayer. “Additionally, if a parent in the house has anxiety, this increases the child’s chances of developing separation anxiety or separation anxiety disorder.”

When the first day of school comes, a sensitive child may become stressed and have physical manifestations of the stress such as having a stomach ache after being left alone at school. When Day 2 comes around, Peters Mayer explains that these kids remember their feelings from the previous day and start to anticipate feeling their symptoms again–thus causing anxiety to form around the act of going to school.

How long does separation anxiety last?

Most children adjust to school and get over separation anxiety eventually, but how long this takes depends on the child. In general, kids will start to learn that their parents will come to pick them up at the end of each day, and will adjust within a couple of weeks.

“The rule of thumb is that if your child is not adjusting within a month of starting school, then you want to go to the school for help,” suggests Peters Mayer. You can talk to the teacher, the school guidance counselor, and others who may be able to team up with you to help your child learn to calm himself and adjust to school.

How can you treat separation anxiety?

Luckily, there are a number of thing parents can do to help ease and even prevent separation anxiety, including:

* Encourage independence early. Young children, especially those who are shy and sensitive can benefit from time away from parents. Drop them off with a grandparent or a sitter, and tell them the time you’ll be back. Be sure to show up when you say you will, as this is key in helping children trust that you will come back for them at the end of the school day.
* Learn to calm yourself. Kids can read when their parents feel anxious, even when you say otherwise. Peters Mayer suggests learning how to take calming breaths and practice relaxing your face muscles in front of a mirror.
* Explain what’s happening. An analogyPeters Mayer uses to explain separation anxiety to children is a fire alarm that goes off when mom is cooking. Peters Mayer says she tells children, “There was really no fire, but the alarm doesn’t know it, and when you go to school your brain says ‘Hey, this is dangerous, I don’t like this,’ and sets off the same kind of alarm.’” Understanding what’s happening to them will help children recognize their feelings rather than becoming consumed by them.
* Teach them to calm themselves. Depending on the child, just practicing deep belly breathing can be quite soothing.  Others might benefit from carrying a small object from home in their pocket or backpack.Figure out what works best for your child, and let the teacher know so she can encourage the child to use the technique in school as well.

Child Separation Anxiety: Does Your Child Have It?

December 23rd, 2009

http://www.separation-anxiety-solution.com/child-separation-anxiety.htm
separation-anxiety-solution.com

If you are a parent, then more than likely you may face the common problem of separation anxiety in your child. What exactly is child separation anxiety? In a nutshell, this is the type of anxiety or stress your child may encounter when you leave him/her alone and they get upset or cry due to the separation involved. The reason they get upset or cry is because the child learns to remember objects or specific people, and when those objects or people become absent, anxiety sets in.

The separation can be scary to a child because they are not sure if you are leaving them for good. They are more aware of you being around all the time and used to it. What they aren’t familiar with is you leaving and returning. In most cases, this type of separation anxiety or stress is very common. But, if it persists, it may become chronic and have lasting effects on the child down the road. Typical instances when your child may face separation anxiety may be when you drop your son or daughter off at the babysitters or even during those first few days of daycare or school. The child will typically cry, become withdrawn, and be difficult to deal with.

So the big question is, when does separation anxiety in your child need to be looked at more closely? And most importantly, what should be done to stop it early so it doesn’t have lasting effects on the child as they get older?

One must remember when dealing with a child with child separation anxiety, anxiety can be contagious. The more you show it, the more your child will pick up on it and make the situation more difficult. An easy way to get on top of the situation early is to play small “leave and return” games with your child. This way, they get accustomed to you being gone in short intervals, and most importantly…get accustomed to you returning. A simple “peek a boo” game or “hide and seek” around the house may do the trick.

The more you can do these exercises, and the longer amounts of time you can be separated is key to overcoming child separation anxiety. The ebook, “The Separation Anxiety Solution” is full of tips, tricks and helpful advice that has helped many kids overcome this difficult and common problem. It can be found at www.separation-anxiety-solution.com.

If your child still shows strong symptoms of child separation anxiety after weeks of doing exercises to get them use to you being away, it may be time to see a doctor or therapist. The earlier you can get this problem under control, the better it will be not only for your child, but also for you. You may have detected separation anxiety in your child, but now you know there is hope!

Anxiety disorders – Risk Factors

December 23rd, 2009

http://www.umm.edu/patiented/articles/who_gets_anxiety_disorders_000028_3.htm
umm.edu

Description
An in-depth report on the causes, diagnosis, treatment, and prevention of anxiety.
Alternative Names

Obsessive-compulsive disorder; Panic disorder; Phobias; Post-traumatic stress disorder
Risk Factors:

As many as 25% of all American adults experience intense anxiety sometime in their lives. The prevalence of true anxiety disorders is much lower, although they are still the most common psychiatric conditions in the United States and affect more than 20 million Americans.
General Risk Factors for Anxiety Disorders

Gender. With the exception of obsessive-compulsive disorder (OCD), women have twice the risk for most anxiety disorders as men. A number of factors may increase the reported risk in women, including cultural pressures to meet everyone else’s needs except their own, and fewer self-restrictions on reporting anxiety to doctors.

Age. In general, phobias, OCD and separation anxiety show up early in childhood, while social phobia and panic disorder are often diagnosed during the teen years. Studies suggest that 3 – 5% of children and adolescents have some anxiety disorder. Children and adolescents who have an anxiety disorder are at risk of later developing other anxiety disorders, depression, and substance abuse.

Personality Factors. Children’s personalities may indicate higher or lower risk for future anxiety disorders. For example, research suggests that extremely shy children and those likely to be the target of bullies are at higher risk for developing anxiety disorders later in life. Children who cannot tolerate uncertainty tend to be worriers, a major predictor of generalized anxiety. In fact, such traits may be biologically based and due to a hypersensitive amygdala — the “fear center” in the brain.

Family History and Dynamics. Anxiety disorders tend to run in families. Genetic factors may play a role in some cases, but family dynamics and psychological influences are also often at work. Several studies show a strong correlation between a parent’s fears and those of the offspring. Although an inherited trait may be present, some researchers believe that many children can “learn” fears and phobias, just by observing a parent or loved one’s phobic or fearful reaction to an event.

Social Factors. Several studies have reported a significant increase in anxiety levels in children and college students in the past two decades compared to children in the 1950s. In several studies, anxiety was associated with a lack of social connections and a sense of a more threatening environment. It also appears that more socially alienated populations have higher levels of anxiety. For example, a study of Mexican adults living in California reported that native-born Mexican Americans were three times more likely to have anxiety disorders (and even more likely to be depressed) as those who had recently immigrated to the U.S. The longer the immigrants lived in the U.S., the greater their risk for psychiatric problems. Traditional Mexican cultural and social ties seemed to protect recently arrived immigrants from mental illness.

Traumatic Events. Traumatic events generally trigger anxiety disorders in individuals who are susceptible to them because of psychological, genetic, or biochemical factors. The clearest example is post-traumatic stress disorder. Specific traumatic events in childhood, particularly those that threaten family integrity, such as spousal or child abuse, can also lead to other anxiety and emotional disorders. Some individuals may even have a biological propensity for specific phobias, for instance of spiders or snakes, that have been triggered and perpetuated after a single exposure.

Medical Conditions. Although no causal relationships have been established, certain medical conditions have been associated with increased risk of panic disorder. They include migraines, obstructive sleep apnea, mitral valve prolapse, irritable bowel syndrome, chronic fatigue syndrome, and premenstrual syndrome.
Specific Risk Factors for Generalized Anxiety (GAD)

GAD affects about 1 – 5% of Americans in the course of their lives and is more common in women than in men. It is the most common anxiety disorder among the elderly. GAD usually begins in childhood and often becomes a chronic ailment, particularly when left untreated. Depression commonly accompanies this anxiety disorder and depression in adolescence may be a strong predictor of GAD in adulthood.
Specific Risk Factors for Panic Disorder

Age and Panic Disorder. Studies indicate that the prevalence of panic disorder among adults is between 1.6 – 2% and is much higher in adolescence, 3.5 – 9%. Panic disorder usually first occurs either in late adolescence or in the mid-30s.

Gender and Panic Disorder. Women have about twice the risk for panic disorder as men. Panic attacks are very common after menopause. In one study, nearly 18% of older women reported panic attacks within a 6-month period, with over half of these attacks being full-blown. They tended to be associated with stressful life events and poor health. The effects of pregnancy on panic disorder appear to be mixed. It seems to improve the condition in some women and worsen it in others.
Specific Risk Factors for Obsessive-Compulsive Disorder (OCD)

Obsessive-compulsive disorder occurs equally in men and women, and it affects about 2 – 3% of people over a lifespan. Most cases of OCD first develop in childhood or adolescence, although the disorder can occur throughout the life span.
Specific Risk Factors for Social Phobias

Social anxiety disorder is currently estimated to be the third most common psychiatric disorder in the U.S. Studies have reported a prevalence of 7 – 12% in Western nations.

Age and Phobias. The onset of social anxiety disorder is usually during the early teenage years.

Gender and Phobias. Women are more likely to develop social anxiety disorder than men, although equal numbers of men and women seek treatment for it. Most people seeking treatment have had symptoms for at least 10 years.
Specific Risk Factors for Post-Traumatic Stress Disorder

A lifetime risk for PTSD in the U.S. may be as high as 8%. People exposed to traumatic events, of course, are at highest risk, but many people can go through such events and not experience PTSD. Studies estimate that 6 – 30% or more of trauma survivors develop PTSD, with children and young people being among those at the high end of the range. Women have the twice the risk of PTSD as men.

After the September 11 attack on the World Trade Towers, an estimated 7.5% of New York’s population reported PTSD within the month of the event, which declined to 0.6% at 6 months.

Researchers are trying to determine factors that might increase vulnerability to catastrophic events and put people at risk for develop PTSD. Some studies report the following may be risk factors:

* Pre-existing emotional disorder. People are at higher risk for PTSD if they have a history of an emotional disorder, particularly depression, before a traumatic event.
* Drug or alcohol abuse
* A family history of anxiety
* A history of abuse, particularly that which threatens family integrity, such as spousal or child abuse. Studies of individuals who had suffered physical or sexual abuse or neglect as children suggest that up to one-third develop PTSD.
* An early separation from parents
* Lack of social support and poverty
* Sleep disorders. Insomnia and excessive daytime sleepiness even within a month after a traumatic event are important predictors for the development of PTSD. One specific sleep disorder — sleep apnea — may even intensify symptoms of PTSD, including sleeplessness and nightmares. Sleep apnea occurs when tissues in the upper throat (or airway) collapse at intervals during sleep, thereby blocking the passage of air. Sleep apnea has also been associated with a risk for panic disorder. [For more information, see In-Depth Report #65: Sleep apnea.]

Various types of Anxiety Disorders

December 23rd, 2009

http://www.approvedarticles.com/Article/Various-types-of-Anxiety-Disorders/10499
approvedarticles.com
By: Juliet Cohen

Anxiety is a feeling of unease. Anxiety is only considered to be a mental health problem when it is prolonged, severe and is interfering with everyday activities. Fortunately, most anxiety disorders are highly treatable with psychotherapy, drugs, or a combination of both. There are at least nine identified types of anxiety disorders, include generalized anxiety disorder, social anxiety, obsessive compulsive disorder, panic disorder, post traumatic stress disorder, specific phobia, separation anxiety, school avoidance, and agoraphobia. Anxiety disorders in children can range from a simple adjustment disorder to more difficult and debilitating disorders such as panic disorder and posttraumatic stress disorder. It’s normal to feel anxious when facing something difficult or dangerous, and mild anxiety can be a positive and useful experience. Excessive anxiety is often associated with other mental health problems, such as depression. Unfortunately, many people with anxiety disorders don’t seek treatment because they do not believe they have a legitimate illness, or they fear the reaction of family and friends.

Sometimes anxiety can be associated with a physical illness, such as thyroid disorder. For this reason it’s advisable to see your GP in order to rule out a physical cause. Symptoms occur with varying frequency and intensity but may include all of those listed above as well as trembling, chest pain, nausea, and fear. You may fear you are going crazy or dying. Some people may also have a sense of being detached from reality. Anxiety can be a long-term disorder where you feel worried most of the time about things that might go wrong. Cognitive behavioral therapy is often used, as is psychotherapy and stress management techniques. Drugs used to treat anxiety include selective serotonin reuptake inhibitors, tricyclic antidepressants, beta-blockers, and monoamine oxidase inhibitors. Often, a combination of therapies works best.

What are the types of Anxiety disorders?

There are several major types of anxiety disorders:

1. Generalized Anxiety Disorder (GAD): People with Generalized Anxiety Disorder feel anxious nearly all of the time, though they may not even know why.

2. Phobias: A phobia is an unrealistic or exaggerated fear of a specific object, activity, or situation that in reality presents little to no danger. Common phobias include fear of animals such as snakes and spiders, fear of flying, and fear of heights.

3. Social Phobia: Social anxiety disorder can be thought of as extreme shyness.

4. Obsessive Compulsive Disorder (OCD): It is characterized by unwanted thoughts or behaviors that seem impossible to stop or control.

5. Separation Anxiety: Separation anxiety is a normal part of child development.

6. Panic Attacks and Panic Disorder: Panic disorder is characterized by repeated, unexpected panic attacks.

Symptoms of Anxiety:

The symptoms can include:

1. Abdominal discomfort.

2. Rapid heartbeat or palpitations.

3. Shortness of breath.

4. Frequent urination

5. Feeling worried or uneasy all the time

6. An inability to concentrate

7. Depersonalisation.

Treatment For Anxiety disorders:

The treatment will depend upon which type of anxiety you are experiencing and how severe it is. Cognitive-behavior therapy is very effective in the treatment of anxiety disorders. Tranquilisers, such as benzodiazepine tablets, may help to relieve some short-term stress-related anxieties. However, they shouldn’t be taken for long periods because of the risk of addiction. For this reason they aren’t usually prescribed. Antidepressants can treat certain anxiety disorders such as generalised anxiety disorder, social phobia, OCD, and anxiety associated with depression.

Why Anxiety And Depression Are Over Diagnosed And Over Treated And How Most Cases Of Both Can Be Safely And Effectively Treated Without Drugs

December 23rd, 2009

http://www.vernoncoleman.com/aadsr.htm
vernoncoleman.com

The medical profession, and the international drugs industry which pulls its strings, spends more and more money but sadly seems to do less and less good.

The incidence of big killers such as cancer and heart disease is increasing and infectious diseases are coming back with a vengeance. Despite the expenditure of vast amounts of money there are virtually no major areas of medicine in which doctors can claim to have made any significant progress in the last half a century.

The treatment of mental disease is no exception.

Anxiety and depression are today wildly over diagnosed and over treated with usually inappropriate, often ineffective and frequently dangerous products.

I have absolutely no doubt that, generally speaking, doctors treating these two conditions do far more harm than good. Electro-convulsive therapy, psychosurgery, drugs and frequently self-serving psycho-analysis (often built upon unproven, unprovable theories and a wildly over-exaggerated faith in the significance of long forgotten, often imagined, irrelevances) can, and do, cause great and sometimes lasting distress. We may pride ourselves on having progressed from the days when mentally ill patients were tied up and beaten, but regrettably I believe that the treatments most doctors dish out today are frequently just as irrelevant and hazardous as the treatments favoured a century or two ago.

Serious Side Effects

If the drugs doctors were handing out for anxiety and depression were harmless then the current epidemic of overprescribing would not matter so much (though it would still be a significant factor in the cash crises faced by private and state health care services everywhere).

But these drugs are certainly not harmless.

Potentially serious side effects are commonplace and addiction is a constant worry with many drugs in this general category. Given the hazardous nature of the treatments usually prescribed for mental illness the over-diagnosing of disease is a significant and serious problem.

A Profitable Growth Area

The statistics clearly show that mental disease is on the increase, with the number of patients with mental illness needing to be admitted to hospital rising by 10% every decade. Between one in seven and one in eight individuals will, at some stage in their lives, suffer from mental illness regarded as severe enough to warrant their admission to a mental hospital. This very real growth in the incidence of serious mental illness is however, merely the tip of a much larger iceberg.

The majority of patients regarded as requiring treatment for mental ill health are treated at home – with drugs. For decades now the treatment of patients with mental illness has been one of the biggest growth areas in medicine.

There are several reasons for this.

Frustration And Dissatisfaction

The first reason is that frustration and dissatisfaction are now much commoner than at any time in history. We take pride in our allegedly civilised and so called sophisticated society but our complex and ever changing world is constantly creating new pressures and stresses.

Most of us are totally dependent on other people and quite unable to control our own destinies. If someone else’s motor car breaks down on our route to work then we will be late. Frustration (a major cause of stress, anxiety and depression) is inevitable.

Fear, jealousy, suspicion, socially inspired ambitions and endless layers of guilt are mixed together to create physical disorders such as irritable bowel syndrome, asthma and high blood pressure as well as mental disorders such as anxiety and depression.

Fear is commonplace and widespread but so are greed and dishonesty (a fact which will probably be confirmed by anyone who has bought or sold a house recently).

Aggression is now widely regarded as a fine and essential quality for success and millions of women are suppressing their innate gentleness and femininity and struggling to acquire male-like toughness in order to succeed in a harsh and cruel world. The ultimate purpose of living now often seems to be simply to keep living. We spend much of our energy struggling to find ways to live longer and forgetting to live the lives we have.

We are constantly vulnerable to the lies of the pseudoscientists and the media manipulators whose agendas are so well hidden.

Life is now so complicated that only the specialists understand what is going on in any particular area of life. Finding the truth is nigh on impossible. Perception is now everything.

We look at where we are going but rarely at where we are. We are encouraged to think always of the joy that will come tomorrow (for example, when we retire) because this distracts us from the pain and disappointment of today.

Self satisfied and ignorant teachers kill creativity and teach their students to imitate. Originality is punished as dangerous and subversive. Children are trained not to do what they want (or are good at) but what others want them to do. We are all taught to distrust our own opinions and to respect the voice of authority.

We are in such a hurry that we never get a chance to talk. We live monotonous and shallow lives, constantly hurrying but for ever wondering where all the time went: we go through life as spectators.

People who care about what they do are regarded as eccentric. We are taught to be afraid (and even ashamed) of emotions and passions – even though there is clear evidence to show that suppressing emotion is a short cut to stress related illness such as anxiety and depression.

Many people have completely lost their faith in the future of mankind. The world is increasingly seen as a dangerous and violent place. We have no privacy. Ugliness is all around us and contaminates our lives so that we suffer spiritually and aesthetically.

Large corporations, ruthlessly and deliberately polluting the planet, are run by men and women who have all the sensitivity and sense of responsibility of rude and thoughtless house guests. We have created a world in which we are strangers to ourselves; prisoners of the expectations of others.

Millions feel isolated and lonely. Old, simple truths are constantly being replaced with new, complex, half truths.

The bottom line is that although the human soul is fragile it is constantly subjected to great strain. And it frequently cracks.

Expectations Have Risen

The second reason for the increase in the number of patients requiring treatment for mental illness is that expectations have risen dramatically in recent decades.

We are encouraged to believe that we do not have to accept ups and downs in life. In the bad old days ups and downs were regarded as being as inevitable in life as they are on a fairground roller coaster. But doctors and journalists (encouraged by the drug industry marketing experts) have made us believe that we do not have to put up with the inevitable vicissitudes of living in the late twentieth century.

The result is that unhappiness and disappointment are no longer acceptable variations on the everyday pattern of life. I have heard people say ‘I feel really depressed today’ when they mean that the world isn’t going quite their way.

I’ve also heard people say: ‘I don’t understand why I feel like this. I have a wonderful home and a lovely partner. I know I should be happy but I’m not. And so I feel guilty about not being happy.’

Big Profits

The third reason for the rise in the number of people being treated for mental illness is that the drug industry long ago targeted anxiety and depression as two of the most profitable areas for future growth.

Treating anxiety and depression offers two big commercial advantages. The potential number of patients who can be diagnosed as suffering from one or both of these conditions is virtually limitless. And these are both long term, chronic conditions. Once a patient is started on treatment it is likely that he or she will stay on it for months or years to come.

Drug companies love diseases which affect lots of people who will never be cured: through such disorders they can make big profits.

And so the drug companies have encouraged their marketing aides (family doctors) to prescribe anti-anxiety and anti-depressant drugs virtually on demand.

(Sadly, doctors don’t take much persuading when it comes to handing out drugs. It is a lot easier and quicker to write out a prescription for a new ‘wonder’ drug than it is to talk to a patient, find out what is wrong and offer support, encouragement or advice.)

Anxiety Is No Longer Fashionable

A decade or two ago the fashionable diagnosis to make was ‘anxiety’. Millions of patients around the world were given benzodiazepine tranquillisers (such as Valium and Ativan) for a whole host of conditions which could be classified under the general heading of ‘anxiety’.

Since the late 1980s the benzodiazepine tranquillisers have been out of fashion and the well documented addictive problems associated with these drugs have meant that drug companies (and therefore doctors) have had to look for an alternative marketing ploy.

In 1988 I predicted that depression would be the new fashionable diagnosis and that doctors would soon be flooded with information about new anti-depressant drugs. That is exactly what has happened.

One Of The Fastest Growing Diseases In The World

If, a few years ago, you went to see your doctor complaining that you felt miserable and down in the dumps he would have probably prescribed a harmless tonic, chatted to you for twenty minutes and told you to try and get out and enjoy yourself a bit more. The chances are that you would have left the consulting room reassured and comforted.

Today, if you go to see your doctor and complain that you feel vaguely under the weather he will probably diagnose you as depressed. There is an excellent chance that he will then start you on one of the many new powerful chemicals now available.

Up until recently depression was a fairly uncommon disease. Just a short while ago the value of world wide sales of all anti-depressants and similar drugs was below a billion dollars a year.(Shared out among the world’s drug companies that’s small change – hardly worth bothering to take to the bank).

But things have changed and today depression is one of the fastest growing diseases in the world. Sales of Prozac alone have reached around $2 billion a year. Millions of people are now labelled as suffering from ‘depression’. And, strangely enough, the boom in the diagnosis of ‘depression’ has coincided with the development of special, new, expensive, chemical anti-depressants.

My very real fear is that the diagnosis of ‘depression’ is now often being made when patients are simply rather miserable or unhappy or generally fed up with their lives.

Patients who would, a year or two ago, have been described as ‘sad’ are now diagnosed as being ‘depressed’ and are, consequently, being treated with powerful drugs.

Why Are Doctors Making This Diagnosis So Often?

Doctors are diagnosing ‘depression’ more often because the drug industry (which now controls medical education and, therefore, the prescribing habits of doctors) wants to sell more anti-depressants. Despite the hazards known to be associated with their use the majority of doctors seem happy to prescribe them by the bucket load.

My fear is that the drugs which are now being prescribed with the enthusiasm which was shown for the benzodiazepine tranquillisers in the 1970s (and, by many doctors, for patients with remarkably similar non specific ‘I-feel-miserable-but don’t-know-why’ symptoms) may turn out to produce massive problems of their own.

I am prepared to accept that people with real depression, who suffer such symptoms as constant crying, an inability to sleep, a total feeling of worthlessness, a loss of appetite, suicidal tendencies or other serious symptoms of a genuine depression, may benefit from sophisticated, caring, professional help – and may sometimes even be helped by taking drugs. And I recognise that some cases of depression may be caused by physical or biological factors which may be of significant, even predominant influence. (Though I am generally sceptical about the value of many anti-depressant drugs).

However, although I have absolutely no doubt that there is more sadness, despair, and unhappiness in our society than there has ever been in any previous society I strongly suspect that many of the patients diagnosed as suffering from ‘depression’ may well be ‘sad’ (and suffering from the disorder which I call The Twentieth Century Blues) rather than clinically ‘depressed’, and may need help of a different kind.

Better Mental Health In Three Hours (Or Less)?

I believe that instead of automatically dosing all their unhappy patients with powerful and potentially hazardous chemicals, and attempting to tackle a vague and ill defined disease, doctors should be encouraging more of the sad, the despairing and the unhappy to try to tackle the specific causes of their unhappiness, their anxiety or their ‘depression’ themselves.

It can be done. In this edition of VCHL I have outlined my plan and my advice for finding some sense in an increasingly unpleasant and hostile world.

None of the solutions offered here are complex or expensive. None require years of psychotherapy or bucketfuls of vitamin pills. But if just one of the tips or thoughts I’ve included here helps you then this special edition of VCHL will have been well worth writing.

The best solutions, it seems to me, always appear simple when you’ve found them.

Anxiety And ‘Depression’: Common Causes And Simple Cures

It is often believed that there are two main types of depression.

The first type is caused by some internal malfunction; a chemical or electrical imbalance within the brain.

And the second type is caused by a clearly defined external problem (unemployment, a divorce, bereavement or some other major personal crisis). Patients suffering from depression for which no clear cause can be found are neatly slipped into the first category.

I don’t believe that ‘depression’ (or, indeed, anxiety) is quite this simple. Sadness is not always (or even often) caused by uncontrollable chemical changes in the brain. Nor is it frequently caused by specific problems or life crises. It is most often a result of a general feeling of dissatisfaction, disappointment and frustration.

Unfulfilled Expectations

We live in a world which is already complex and which is getting steadily more complex by the day and I believe that the conditions which we often describe as anxiety and ‘depression’ (along with some other troublesome and significant mental disorders) frequently develop because the individual concerned can no longer cope with the barrage of pressures and problems to which they are repeatedly subjected.

Expectations are raised and then left unfulfilled. Feelings of pointlessness and a sense of general despair about the way the world is going are commonplace.

Frustrations, disappointments, ‘toxic stresses’ and an apparently unending sequence of problems over which the individual has little or no control are common causes of the condition now often officially (and profitably) labelled ‘depression’.

The first step, therefore, should be to examine and dissect a ‘depression’ (or anxiety state) so that instead of struggling to tackle a vague, amorphous, ill defined sense of ‘depression’ it becomes possible to assess all the influences and factors which might be responsible for the ‘depression’ and to then tackle each specific cause of the unhappiness.

Understanding the underlying problems may lead to a non-pharmacological cure which will work far more effectively than drugs (and last longer) because it offers a fundamental solution which strikes at the very root of the problem instead of merely papering over the cracks.

Chaos Is A Natural State

One huge problem is that many of us spend our lives struggling to keep control over the small worlds in which we live. We do not understand that uncertainty, unpredictability and chaos are natural states and so we must inevitably fail in our efforts to keep control over our immediate environment. Our failure leads to guilt, confusion and despair. We try harder to take control. We continue to fail. The guilt, confusion and despair grow and various shades of anxiety and ‘depression’ are inevitable.

A century or two ago it was possible for a family or a community to have a good deal of apparent control over their lives.

Food, clothing and shelter were the three priorities. People grew their own food, made their own clothes, collected their own fire wood and were responsible for building and repairing their own homes. If they fell ill they looked after one another.

Expectations were low and people were largely independent of other communities. They were constantly subjected to the stress of finding food and staying alive but these basic problems were largely under their own control.

The uncertainty, the unpredictability and the chaos were provided by nature in the form of such hazards as storms and droughts.

Things are very different now. We are all dependant on huge numbers of other people – most of whom we do not know and will never meet. Our super-sophisticated society has led to specialisation and so we have lost control over our own lives.

Trains are late, workmen don’t turn up, machines which we have learnt to regard as indispensable break down and so on. Every time we deal successfully with one problem another problem appears. We go to bed at night pleased that we have conquered some real or perceived threat and wake up the next morning to find out that life has come up with a new problem even more worrying than the last one.

It has long been recognised that change is a source of stress and yet in our world change is the only constant. What was fashionable yesterday will be laughably out of date by tomorrow.

‘What’s new?’ is much more commonly asked than ‘What’s best?’ We are subjected to an endless variety of fashionable trivia. We are constantly encouraged to think of the future, and to plan ahead as though we can control our ultimate destiny.

The only way to get through these endless crises is to accept the fact that uncertainty and chaos are normal and to deal with life on a day to day basis as a series of short term problems.

A Lonely And Frightening World

I was walking through London the other day when my hat blew off and flew over a railing. I could see the hat but didn’t think I could reach it. I needed something with a hook on with which to retrieve it and so when an elderly man strolled along, twirling a walking stick, I politely stopped him, explained what had happened and asked if I could borrow his stick for a moment.

The man looked at me, looked at my hat and then, having clearly decided that there was no advantage to him in helping me, shook his head and walked on. If you wouldn’t help because he was frightened I might steal his stick, or even attack him with it, that too is sad.

(I retrieved my hat but had to kneel down on the wet pavement, poke my arm at full stretch through the railings and drag my hat through a tiny gap.)

I relate this incident, not because I think it is particularly exceptional (I know it isn’t) but because I think it is, sadly, symptomatic of the society in which we live. It is hardly surprising that ‘depression’ and despair are so commonplace when we live in a world where strangers refuse to help one another – even when the cost to themselves will be minimal or non existent.

The only way we can protect ourselves against this type of behaviour is to build up and treasure our relationships with our close friends and loved ones. Taking care of our relationships with our loved ones is an essential part of protecting ourselves from the sense of isolation and loneliness which pushes so many people into ‘depression’.

Distrust, Despair And Suspicion

Success and failure are both scorned and kindness and understanding and sympathy are too often regarded as signs of weakness rather than strength. When there is a background of distrust, despair and suspicion it does not take much to create a deep feeling of unhappiness and dissatisfaction with life and the world.

Look at the faces of the other passengers next time you are travelling on a suburban train or bus.

At best you are likely to see a great deal of indifference. At worst there will be outright hostility.

Try smiling at a stranger, or simply making eye contact, and the chances are high that they will turn away.

Much the same is true of shops, offices and restaurants. Almost everyone is in a hurry to be somewhere else, doing something else. Vehicles in nose to tail city traffic jams seem to be all involved in funeral processions.

Everyone seems to be thinking about where they would like to be, rather than where they are. Everyone rushes by as though hurrying to a meeting that is going to save the world.

During a three lane motorway hold up recent I tried a small experiment: I smiled benignly at the several dozen motorists whose vehicles I slowly passed (or whose vehicles passed mine). Not one motorist returned the smile. Quite a high proportion looked at me as though I was mad. One woman (after looking away) quickly wound up her window.

Without a sense of humour such behaviour would make anyone feel depressed (let alone paranoid).

Dealing with and overcoming this constant background of hostility and indifference is not easy. But it has to be done if we are to retain our sanity.

It probably helps to know that we all suffer the same way. The hostility and indifference is not personal.

Making an effort to build up slight but significant relationships with the people we meet regularly is important. (Smile at all the people you see every day and eventually one or two of them will smile back. Before you know it you will be on nodding terms.)

The Lunatics Have Taken Over The Asylum

There once was a time when (at least some) politicians were honest and honourable and led from the front: inspired by personal beliefs and a sense of duty. There was a time when politicians would resign in disgrace and embarrassment if found guilty of wrong doing or poor judgement. That time has long gone.

Today’s politicians react rather than act and believe in expediency rather than integrity. Modern politicians are followers, not leaders, and they adapt their policies (if that is not too grand a word) to fit what they think are the requirements of the mass of the people, or what they believe will be the best interests of themselves and their corporate sponsors. (There was an excellent, if light hearted, example of the way politicians follow rather than lead during the recent football World Cup. At the end of one important match I watched with amusement as a leading world political figure followed the crowd around him as though playing ‘Simple Simon’. After the crowd around him clapped he started to clap. After they climbed onto their seats he climbed onto his seat. Every movement he made mimicked the crowd around him. He always followed and never led.)

Modern politicians may start out with ideals, principles and convictions but they gradually convince themselves that they have to be pragmatic and practical in order to achieve power.

Once they have the power they continue to prevaricate, partly because they are used to it, partly because they have left their principles so far behind that they have forgotten what it means to do something solely because you believe it is the right thing to do, and partly because they have fallen in love with the trappings of power, prestige, fame and success – all of which they are desperate to retain at any cost.

Politicians excuse their failure to act by claiming that if they did act they might prejudice their political careers – neatly and conveniently forgetting the fact that their original reason for acquiring political power was to be able to do the very thing they are now saying they cannot do because it might jeopardise their position.

Political parties used to have ideals and principles. Without those essential ingredients all that is left is layer upon layer of half truths and downright lies.

Today’s politicians sell the power and responsibility they have been loaned to the corporate sponsors with the deepest pocket.

Government departments are run not for the people but for big business. Health departments work for drug companies. Agriculture departments work for farmers and food companies. Defence departments work for armament companies.

The great political leaders (Lincoln, Churchill and de Gaulle spring to mind as examples) didn’t follow polls or focus groups or devote themselves to telling everyone what they believed they wanted to hear. They didn’t employ hordes of scriptwriters, advisers, make up artists and campaign consultants. They didn’t have image advisers and they didn’t have their teeth capped or their hair dyed. They did have ideas, beliefs and a philosophy to offer.

It is hardly surprising that the honest, sensitive, thoughtful citizens who do care tend to feel demoralised and despondent and to lose hope in the future.

When footballers behave badly on the field no one is surprised when the fans behave badly on the terraces and in the stands.

When politicians behave dishonestly it is hardly surprising that the nations they lead become devoid of courage and moral fibre. When politicians do what they think they can get away with, and are driven solely by a need to be re-elected, when they take no notice of what they have promised and are unconcerned with what is right or wrong, it is hardly surprising that there is a general feeling of spiritual malaise.

Political integrity may seem a long way away from endemic social ‘depression’ but it isn’t. And taking drugs or blasting electricity into brain tissue isn’t going to deal with ‘depression’ which is even partly caused in this way.

The solution is to live your own life, to be loyal to those whom you care about but not to expect your country to love you – because it won’t. Regard tax paying as unavoidable protection money paid to a bunch of gangsters and plan your life so that you are as independent as possible. And however corrupt the politicians may become you must always keep your spirit alive. Do not allow yourself to be frightened into silence over things you care about.

The truth is the one weapon which will eventually control the politicians. The truth terrifies modern politicians just as much as sunlight terrifies Dracula.

Speak out on topics you care about. The politicians will ignore you today. And they will ignore you tomorrow. But eventually the truth will win. It always does.

What Were You Doing On April 8th 1994? (You Can’t Remember? So How Come You Can Remember What You Were Doing When You Heard About JFK?)

Can you remember where you were when you heard that John F. Kennedy had been assassinated? When Neil Armstrong first stepped onto the moon? When you heard that Elvis Presley had died? When John Lennon died? When you first made love?

If you have ever had a brush with the law I bet you can remember everything about it. Memories of birthdays, weddings and funerals remain with us in some clarity. We can see what happened as though watching it on video. Surprisingly small details of important days remain in our memories for years. You can probably remember the first time you kissed and held someone who is today close to you.

Significant moments in our lives make a mark on our memory because we concentrate fully on what is happening. We live those moments with great intensity and so everything that happens stays with us. Things seem to happen at half or quarter speed.

But most moments in our lives flash by without our really being aware of them. We only live at full power on rare occasions. Most of the time we fly through life in a semi conscious state, only concentrating on what is happening with a very small part of our brain. With the rest of our brains we are either thinking of something that has happened in the past or thinking about something that might happen in the future. Or we are simply not thinking of anything at all.

What a waste!

People who live without thinking about what they are doing become trapped in unlived or half-lived lives. They go through the weeks and the years without ever focusing on where they are at any particular moment.

By always focusing on the future (or the past) they fail to get the most out of their lives and consequently they never arrive anywhere that they want to be.

Edgy, Nervous And Irritable

Dreams are a vital part of everyone’s life. But if you spend all your time dreaming about the future then you will never live the present properly – and your chances of achieving the future you dream about will be dramatically reduced.

If you spend your days planning for the future and worrying about what might happen tomorrow, next month or next year then you will miss out on the life you are living. Before you know it your life will be over and you will have missed out on the real joy of living.

I have met people who could never truly enjoy something they had looked forward to for months because when that occasion arrived they were already looking forward to something else – and worrying about what might go wrong with that.

Constantly postponing happiness means that we become edgy, nervous and irritable.

If you want to know what you’re missing watch small children playing. Children are very good at enjoying the good moments in their lives. They look forward to birthdays, holidays and Christmas but when those good times come they know how to enjoy them. They don’t wake up on the first day of a summer holiday worrying about what they’re going to get for Christmas.

If you learn to pay attention to each moment in your life then you will get far more from your life. You will be living your life to the full and far better able to take advantage of every opportunity and experience which comes your way.

(Are you really concentrating on what you are reading at the moment? Or is your mind only half here? Are you thinking about something else you should be doing? Or are you worrying about something that has happened?)

Try to focus on these lines with as much intensity as you can muster. Concentrate hard and exclude all other thoughts from your mind.

(If anything comes into your mind, and interrupts, write it down so that you can think about it later.) By experiencing each moment in your life with some intensity you will also become far more aware of the ways in which you are damaging your physical and mental health.

Instead of meandering through life in a job you hate or a relationship which isn’t ever going to give you any real satisfaction (and ending up miserable and ‘depressed’) you will be far more likely to take action that will be liberating and allow you to live your life to the full.

Many people go through life hardly ever getting out of first gear. They meander along from day to day, hardly ever truly awake and aware of what is going on around them. Only on rare and special occasions (such as the death of someone significant or a birthday, wedding or funeral) do they wake up and become alert and alive. (The death of Diana, Princess of Wales, made a huge impact because it woke many people up and made them think.)

Because they go through life without really waking up to what is going on around them such individuals ignore the messages their bodies give them.

They never listen to their bodies and so never take advantage of their bodypower. They never listen to their minds either. They close their hearts and souls to the injustice and cruelty in the world around them – never speaking out against things they know are wrong.

Your life will become more intense and more enjoyable if you learn to pay complete attention to each moment. Consciously and knowingly experience where you are, what you do and how you feel. Let yourself go. Don’t worry about trying to control the present or the future.

A Warning

Once you become aware of your life – and the way you are living it – you may need to make changes.

We often shut off our awareness of the world outside because we simply can’t bear the reality which surrounds us.

When you become truly aware of the world around you then you may suddenly discover that you have acquired the strength to stand up for yourself, to turn away from bad relationships or to leave a job you hate.

Make Your Own Destiny

We aren’t born naturally unhappy.

We learn to be unhappy.

Many people become miserable (and ‘depressed’) because their lives are virtually devoid of joy.

This is hardly surprising because it is hard to stay cheerful if you spend every waking hour doing chores which you hate.

Take a cool look at the way you spend your life.

Are you doing what you want to do with your life? How much time do you spend doing things that you hate? How much time do you spend doing things that you enjoy? Is your life meaningful? When your life comes to an end will you look back wishing that you had spent your time differently? If you knew that you had only one year left to live how would you spend it?

If you spend your days doing things you hate would it be logical for you to feel anything other than depressed?

Don’t Ignore Today Because You Are Thinking About Tomorrow

We have more ‘things’ and more ‘comfort’ than any other civilisation in history. But ‘depression’ and unhappiness are probably commoner than in any other civilisation.

Our society values material acquisitions more than anything else. We are taught that we will only find contentment by increasing our level of consumption.

Happiness comes with a bigger house, a bigger car and more expensive clothes.

And so we are pushed to go through our lives acquiring expensive ‘stuff’ which we may neither really need nor truly want.

Our goals become materialistic instead of personal.

We forget to live because we believe that we will only truly be happy when we have achieved another goal. But when will we know when we have enough?

Will $50,000 be enough? What about $500,000? $5,000,000? $ 50,000,000?

And if we are driven only by the happiness we think we will find when we have reached a certain goal what will we have to look forward to if we ever do have enough? (And if we admit that we will never have enough then we are admitting that we are dooming ourselves to permanent disappointment and frustration.)

As Maurice Sendak said: ‘There must be more to life than having everything.’

Constantly Postponed Happiness

We are encouraged to think that we will be happy when something happens in the future. We decide that we will be happy when we give up the job we hate, when the kids leave home, when we get a promotion, when we lose weight, when the business begins to take off, when we have a new car and so on. But if you are constantly postponing happiness when will you ever give yourself a chance to be happy?

Life is only really present in the here and now. Life isn’t in the future because the future isn’t yet here. And it isn’t in the past because the past is gone.

Practice Random Acts Of Kindness And Senseless Acts Of Beauty

I am told that this phrase was originally thought up by a Californian called Anna Herbert. She was the woman who began paying the toll on a bridge for cars behind her and planting wild flowers on ugly plots of land.

Practising random acts of kindness is easy to do. There are plenty of opportunities. The person (or animal) who receives your kindness will feel good – and so will you.

Limit Your Input Of Sad News

I restrict my exposure to TV news. And I do not buy newspapers every day. I no longer expose myself to a daily diet of misery. This is not because I am disinterested in the problems of the world – I fight for the things I believe in and I read enough news magazines and news agency summaries to know about the important things going on in the world. (And I read journals, books and reports from around the world on health care so that I make sure I keep up to date in the area of health – and can help you keep up to date through VCHL too.)

But I know that I can only cope with so much misery and sadness.

I protect myself because if I allowed myself to be subjected to a constant daily diet of misery and horror I would not be able to cope – or have the strength to fight for the things in which I believe.

I don’t know whether there is any more violence or horror in the world today than there was five hundred years ago. I suspect not. But that is an academic and irrelevant question. The point is that modern communications methods make these horrors available to us all on an hourly basis. At any one time there are around forty wars going on around the world. All these wars – and the accompanying horrors – are brought into our homes through the magic of television.

Modern communications techniques mean that you and I receive more information every day than our ancestors had to cope with in years.

Our brains are constantly hurrying to process information. When human beings are overexposed to information and stimulation they become anxious, violent and mentally ill.

When much of that information is depressing and disturbing the response is even faster.

Naturally, the more sensitive and thoughtful the individual the greater will be their potential susceptibility to this type of stress.

(The people who do cruel things do not feel bad about anything much. If they were the sort to feel bad they would not do the things they do. In our world the sensitive suffer for everyone while the ruthless simply go from strength to strength because they genuinely don’t care and don’t suffer.)

The modern media enables us to expose ourselves to many horrors and injustices about which we can do nothing. Television gives us instant access to other people’s pain.

But however much we care we can’t fight against every injustice in the world.

I believe that one of the reasons why so many people do not seem to care these days is that they are protecting themselves by deliberately staying aloof and not allowing themselves to respond to what they hear about.

People numb themselves and suppress their emotions in order to survive.

They become unfeeling because they are overexposed to horror and they simply cannot cope. They close their eyes and their hearts to protect themselves (and because the horrors they see and hear about are endless they do not believe they can do anything that will make a difference).

We Feed Our Children Violence

Many people have become so immune to awful news that they need strong stimulation to make them sit up and take notice.

The growth in and popularity of documentaries and dramas based on violence, crime and miscellaneous horrors is a symptom of the new need for constant excitement and stimulation.

People who are unmoved by genuine tragedy are naturally unmoved by what they see on their TV screens – even if it includes real live human beings being arrested or being treated in hospital.

Television chat shows used to be vehicles for movie stars to tell engaging anecdotes; these days they are full of angry people talking without shame or embarrassment about their unhappy sex lives, sharing their hostility for their neighbours and blaming their parents for their misery.

And I have a suspicion that the popularity of realistic horror movies among young people these days is merely a sign of the fact that they have become immune to ordinary fears and terrors.

The horror movies that were popular a few decades ago would not frighten today’s teenagers in the way that they frightened my generation.

Today’s teenagers and children need new horrors to stimulate their deadened imaginations.

We feed our children a constant diet of horror, abuse and violence and then express surprise when they become violent themselves.

If you want to stay alert but sensitive to the world’s problems then I suggest that you too limit your exposure to news programmes.

Limiting your exposure to the daily diet of horror and injustice will enable you to retain the strength to do what you can to fight for truth and justice.

In my experience the real news junkies – the people who seem to take the greatest interest in world events and who watch every available news bulletin even when on holiday – are the people who do least towards trying to improve the world.

Spend More Time Doing Things That Make You Happy

Do you even know what makes you happy? Do you know when you are happy? How many moments of happiness did you have last week?

You have to make time for happiness. You have to be ready for it. And you have to work at it.

When the good times come you have to make a real effort to enjoy them; to look around and take notice of the world so that you can savour and remember your happiness (and use it to keep you going when the times get rough).

Ask yourself these four simple questions – you might find the answers illuminating.

What in your life gives you most fun? How much time do you spend doing it?

What in your life gives you most pain? How much time do you spend doing that?

Learn To Ask Yourself Why?

The best, simplest and least asked question in the world is ‘Why?’

Why do you want a better job? Why do you want to save money? Why do you want to move house? Why do you want to buy a holiday home?

Only when you ask yourself ‘Why?’ will you know what you really need and what you are prepared to do for it.

Most people earn and spend without ever asking themselves ‘Why?’ They blindly sell their time (which is the same as selling their lives) for money which they spend on things they neither want nor need.

Ask yourself ‘Why?’ more often and you will learn more about yourself and what you are doing.

But be warned. Asking yourself this simple question can be unnerving.

You may get answers.

And if you have been going through life for years without knowing where you were headed (or why) then you may find the answers you get rather startling.

Assess all the influences on your life and ask yourself how these things contribute to your life and your potential for enjoyment and satisfaction.

Consider each influence and ask yourself: ‘Should I discard it or give it more of my energy?’

Save Time And Labour By Not Using Too Many Time And Labour Saving Machines!

No one does one thing at once any more.

Everyone is in such a hurry that they have to do several things at the same time.

People drive to work listening to the news on the wireless and using the telephone to make routine calls. They have business meetings over breakfast, lunch and dinner.

Why are they saving the time? Is what they are doing worth doing at all?

Are they focusing on anything they are doing?

Are they obtaining enjoyment or satisfaction from any of these things?

I suspect not.

Mobile phones are great for keeping in touch but I have seen two people sit in a restaurant and eat a meal while both talking to other people on their mobile phones.

They weren’t aware of who they were with or what they were eating (and they certainly weren’t living memorable moments) because they were both constantly talking to and presumably thinking of someone else.

Used properly mobile phones can be a boon. But they can be a burden too. Mobile phones mean that there is nowhere to hide. (The easiest way to use them is to keep them turned off. Check your messages when you want to. When I told one editor that I kept my mobile phone turned off most of the time I thought he was going to have a fit.)

We have become novelty junkies.

I constantly meet people who are surprised that I do not use e-mail. But why do I need e-mail? The fax machine sends out letters almost instantaneously. How much faster than almost instantaneous do I want to send mail?

Technology is worshipped endlessly and pointlessly and people are swamped with information (and information technology) which they neither need nor want.

People use new technology not because they need it or because it is genuinely useful but because it is there.

I have tried using the Internet but I found it slow and cumbersome and tiresome and ineffective.

I don’t believe it can ever be as secure or as confidential as using the fax machine or the much derided ‘snail mail’.

You don’t have to use the technology just because it is there or fashionable.

New technology is often slow and it often goes wrong and it is consequently a major cause of unhappiness, frustration, dissatisfaction – and ‘depression’.

Beautiful Or Useful?

We change our cars and our shoes not because they don’t function but because they are either not fashionable or not impressive enough.

To earn the money to pay for these fripperies which we don’t really need we give our time (the most valuable and only truly finite possession we have) doing things we don’t enjoy doing. Have we all gone stark raving mad?

I know a man who has a very small lawn. But he has an expensive petrol driven lawn mower so that he can cut his small lawn in style. Every time he gets the mower out of his garage he has to spend an hour fiddling with it to make it start. Because he no longer gets any exercise from cutting his lawn he now keeps an expensive exercise bicycle in his garage so that he can keep fit.

Modern artefacts are so often poorly made, badly designed and faulty that frustration and disappointment are more common than delight and pleasure.

Our society encourages the mass production of mediocre, shoddy products. Manufacturers have forgotten that quality should be inherent in the making of something; they assume that quality can be provided with a label.

Real quality is not fashionable and yet life with no quality is no life.

On a practical level it is worth remembering William Morris’s advice. We should ensure that our homes contain things which are beautiful or useful or both.

Look around at the stuff you have surrounding you which is neither beautiful nor useful.

Then work out how much of your life you spent earning the money to pay for it. How much stuff do you really need to be happy?

‘You never gain something but that you lose something,’ said Henry David Thoreau.

Constantly changing tastes, new fashions and endless technological wonders may fuel the economy but they also create deep dissatisfaction, great sadness and, ultimately, great waves of ‘depression’.

Value Your Time

‘Time management’ has become a widely accepted phrase. There are probably university courses in it.

People of all ages buy organisers and schedule their lives to the minute.

‘I have a window between 11.47 and 11.53,’ the busy executive/housewife/schoolchild will say.

Hardly anyone hangs out and has spontaneous fun any more. We are encouraged to fill every moment of our lives in the mistaken belief that by doing this we will create more happiness for ourselves and succeed in fighting off the malaise which they feel growing.

But does all this ‘time management’ really mean that we get more out of our lives?

I don’t think so.

People rush about being busy but what are they busy about? How much of it really matters? Just being busy isn’t anywhere near enough. And it certainly isn’t a recipe for happiness.

(I am delighted to say that this obsession with time management has not yet become universal. I walked into one of my favourite Paris cafes the other day and was greeted with a broad smile of welcoming recognition by the waiter. It was a hot day but I had been walking quickly because I wanted a little exercise. ‘I have been walking too quickly!’ I explained, wiping a few beads of sweat from my brow. The waiter gave me a gently admonishing look. ‘You should take your time and enjoy what you see as you walk through the city,’ he told me.)

Stick To Your Principles

A magazine recently listed a well known writer’s ten pieces for advice for young people.

One piece of advice was never to do anything solely as a matter of principle.

How terribly sad.

No one – whatever their age – should keep quiet when something is happening of which they disapprove.

It is true that telling the truth may not do your career much good but what is a career worth if you have no professional integrity?

If we make choices and decisions based on what we believe (rather than what is convenient or popular) we have the pleasure of living life on our terms.

Sadly, we are all under constant pressure to betray our principles.

We are constantly encouraged and rewarded for editing our honest feelings.

We say things we don’t really mean because we don’t want to offend someone. We hide our feelings if we think they may cause embarrassment to others. We keep quiet when someone is criticising a friend because we don’t want to make a fuss or cause trouble. We are tempted to do this so often that it becomes second nature. We end up denying our identity and integrity.

If we don’t speak out against people who do things that are wrong then we are as guilty as the people doing the things we know are wrong.

Before you worry too much about what will happen if you speak out ask yourself this question: ‘What is the worst that can happen? What is the bottom line?’

I know a number of people whose lives are miserable because they are treated badly by their bosses. None of them ever dare defend themselves because they are frightened that they will be sacked.

But is being sacked from a job you hate – and which has taken your integrity and therefore your identity – really such a bad thing?

Never Do Another Day’s Work In Your Life

If you must compromise your values and hide your beliefs in order to do and keep your job then you are betraying yourself. And true happiness will always be out of reach.

I once had a letter from a vegetarian who worked in an abattoir. She told me off for writing something critical of abattoir workers and claimed that she had to do the job she did in order to feed herself and her family. She admitted that she hated her job but insisted that she had no choice. ‘It’s a good job,’ she said. ‘It pays well.’

I didn’t believe her self justification then and I don’t believe her now.

Of course she had a choice.

She chose to work in an abattoir because the pay was better than a job doing something else.

If doing your job means that you have to deny your beliefs every day then you will be living a lie.

Every day, when that woman went to work, she abandoned her beliefs and her self respect. ‘Depression’, under those circumstances, is almost inevitable.

If you define work as something you don’t enjoy doing but do solely for money then the secret of finding happiness (and limiting your exposure to anxiety and ‘depression’) must surely be to go through life doing as little work as possible.

The way you feel when you are doing something you really want to do is how you should feel when you are working.

If you can manage this then you will work better (and probably more successfully) and your life will be smoother.

Finally: Remember That You Are Dying!

If you knew that you were going to die in twelve months time would you change anything about the way you live your life?

Would you do anything differently?

If you have answered ‘yes’ to either of those questions then you should think carefully about the way you are living your life now for the truth is that we are all dying. We just don’t know when.

Why put off living your life the way you would like to live it until the moment when you know for certain that the end is near?

Don’t keep all your hopes for your retirement. Who knows what will happen before then. Take your retirement now in small stages; enjoy your life.

We tend to do many things out of habit. We do things because other people tell us to do them (and it is easier to do them than to say ‘no’).

We should do things because doing them gives our lives more quality than not doing them.

Be prepared for the worst, do your best, relax and see what happens.

Take a break when you are doing something that is difficult. Do not be ashamed to enjoy yourself and take pleasure.

Find some inner calm and peace by being aware of who you are, what you are and what you want.

You should live your life the way you want to live it – not the way that will satisfy advertisers, politicians or neighbours. Ask yourself what you think your life is for, what you want out of life and where you are heading.

And are you satisfied with the way your life is going?

Do not reach the end of your time full of regrets, remembering that you have wasted most of your life doing things that you only did because other people wanted you to do them.

The Causes of Anxiety and Panic Attacks

December 23rd, 2009

http://www.algy.com/anxiety/files/barlow.html
algy.com
Ron Rapee, Michelle Craske, David Barlow

PHYSIOLOGY OF ANXIETY

Anxiety is probably the most basic of all emotions. Not only is it experienced by all humans, but anxiety responses have been found in all species of animals right down to the sea slug. Anxiety experiences vary tremendously in their severity from mild uneasiness to extreme terror and panic. They can also vary tremendously in their length from a brief, almost fleeting flash, to a constant, all day affair. While anxiety, by its nature and definition, is an unpleasant sensation, it is not in the least dangerous. It is this last point which forms the basis of this article. The aim of the next few pages is to teach you about the components (physical and mental) of anxiety in order that (1) you realize that many of the feelings which you now experience are the result of anxiety and (2) you learn that these feelings are not harmful or dangerous.

Definition of Anxiety
While an actual definition of anxiety which covers all aspects is very difficult to provide (indeed whole books have been written on the subject), everyone knows the feeling which we call anxiety. There is not a person who has not experienced some degree of anxiety whether it is the feeling upon entering a school room just before an exam, or the feeling when one wakes in the middle of the night, certain that they heard a strange sound outside. What is less known, however, is that sensations such as extreme dizziness, spots and blurring of the eyes, numbness and tingling, stiff almost paralyzed muscles, and feelings of breathlessness extending to choking or smothering can also be a part of anxiety. When these sensations occur and people do not understand why, then anxiety can increase to levels of panic since people imagine that they must have some disease.

Fight/Flight Response
Anxiety is a response to danger or threat. Scientifically, immediate or short term anxiety is termed the fight/flight response. It is so named because all of its effects are aimed toward either fighting or fleeing the danger. Thus, the number one purpose for anxiety is to protect the organism. Back in the days when we were cave people, it was vital that when faced with some danger, an automatic response would take over causing us to take immediate action (attack or run). Even in today’s hectic world this is a necessary mechanism. Just imagine if you were crossing a street when suddenly a car sped toward you blasting its horn. If you experienced absolutely no anxiety, you would be killed. However, more probably, your fight/flight response would take over and you would run out of the way to be safe. The moral of this story is a simple one – the purpose of anxiety is to protect the organism, not to harm it. It would be totally ridiculous for nature to develop a mechanism whose purpose is to protect an organism and yet, in doing so, harms it.

Anxiety manifests itself through three separate systems and it is important to identify these systems since each one can be primary in any individual person. The three systems are: the mental system (which includes the actual feelings of nervousness, anxiety and panic and also includes thoughts such as “there is something wrong”); the physical system (which includes all the physical symptoms such as dizziness, sweating, palpitations, chest pain, and breathlessness); the behavioral system (which includes the actual activities such as pacing, foot tapping and avoidance). In panic attacks the physical system becomes the most important since it is these symptoms which are most easily mistaken as indicating some serious disease.

Systems of Anxiety
The best way to think of all of the systems of the fight/flight response (anxiety) is to remember that all are aimed at getting the organism prepared for immediate action and that their purpose is to protect the organism.
Physical System

Nervous and Chemical Effects
When some sort of danger is perceived or anticipated, the brain sends messages to a section of your nerves called the autonomic nervous system. The autonomic nervous system has two subsections or branches called the sympathetic nervous system and the parasympathetic nervous system. It is these two branches of the nervous system which are directly involved in controlling the body’s energy levels and preparation for action. Very simply put, the sympathetic nervous system is the fight/flight system which releases energy and gets the body “primed” for action while the parasympathetic nervous system is the restoring system which returns the body to a normal state.

One important point is that the sympathetic nervous system tends to be largely an all or none system. That is, when it is activated, all of its parts respond. In other words, either all symptoms are experienced or no symptoms are experienced; it is rare for changes to occur in one part of the body alone. This may explain why most panic attack involve many symptoms and not just one or two.

One of the major effects of the sympathetic nervous system is that it releases two chemicals called adrenalin and noradrenalin from the adrenal glands on the kidneys. These chemicals, in turn, are used as messengers by the sympathetic nervous system to continue activity so that once activity in the sympathetic nervous system begins, it often continues and increases for some time. However, it is very important to note that sympathetic nervous system activity is stopped in two ways. First, the chemical messengers adrenalin and noradrenalin are eventually destroyed by other chemicals in the body. Second, the parasympathetic nervous system (which generally has opposing effects to the sympathetic nervous system) becomes activated and restores a relaxed feeling. It is very important to realize that eventually the body will “have enough” of the fight/flight response and will activate the parasympathetic nervous system to restore a relaxed feeling. In other words, anxiety cannot continue forever, nor spiral to ever increasing and possibly damaging levels. The parasympathetic nervous system is an inbuilt protector which prevents the sympathetic nervous system from getting carried away. Another important point is that the chemical messengers, adrenalin and noradrenalin take some time to be destroyed. Thus, even after the danger has passed and your sympathetic nervous system has stopped responding, you are likely to feel keyed-up or apprehensive for some time because the chemicals are still floating around in your system. You must remind yourself that this is perfectly natural and harmless. In fact, this is an adaptive function because, in the wilds, danger often has a habit of returning and it is useful for the organism to be prepared to activate the fight/flight response.

Cardiovascular Effects
Activity in the sympathetic nervous system produces an increase in heart rate and the strength of the heartbeat. This is vital to preparation for activity since it helps speed up the blood flow, thus improving delivery of oxygen to the tissues and removal of waste products from the tissues. In addition to increased activity in the heart, there is also a change in the blood flow. Basically, blood is redirected away from the places where it is not needed (by a tightening of the blood vessels) and toward the places where it is needed more (by an expansion of the blood vessels). For example, blood is taken away from the skin, fingers, and toes. This is useful because if the organism is attacked and cut in some way, it is less likely to bleed to death. Hence, during anxiety the skin looks pale and feels cold and fingers and toes become cold and sometimes experience numbness and tingling. In addition, the blood is moved to the large muscles such as the thighs and biceps which helps the body prepare for action.
Respiratory Effects

The fight/flight response is associated with an increase in the speed and depth of breathing. This has obvious importance for the defense of the organism since the tissues need to get more oxygen in order to prepare for action. The feelings produced by this increase in breathing, however, can include breathlessness, choking or smothering feelings, and even pains or tightness in the chest. Importantly, a side effect of increased breathing, especially if no actual activity occurs, is that blood supply to the head is actually decreased. While this is only a small amount and is not at all dangerous, it produces a collection of unpleasant (but harmless) symptoms including dizziness, blurred vision, confusion, unreality, and hot flushes.
Sweat Gland Effects

Activation of the fight/flight response produces an increase in sweating. This has important adaptive functions such as making the skin more slippery so that it is harder for a predator to grab, and cooling the body to stop it from overheating.

Other Physical Effects
A number of other effects are produced by activation of the sympathetic nervous system, none of which are in any way harmful. For example, the pupils widen to let in more light which may result in blurred vision, spots in front of the eyes, etc. There is a decrease in salivation, resulting in a dry mouth. There is decreased activity in the digestive system which often produces nausea, a heavy feeling in the stomach and even constipation. Finally, many of the muscle groups tense up in preparation for fight or flight and this results in subjective feelings of tension, sometimes extending to actual aches and pains as well as trembling and shaking.

Overall, the fight/flight response results in a general activation of the whole bodily metabolism. Thus, one often feels hot and flushed and, because this process takes a lot of energy, afterwards the person generally feels tired, drained, and washed out.

Behavioral System
As mentioned before, the fight/flight response prepares the body for action – either to attack or to run. Thus, it is no surprise that the overwhelming urges associated with this response are those of aggression and a desire to escape wherever you are. When this is not possible (due to social constraints), the urges will often be shown through such behaviors as foot tapping, pacing or snapping at people. Overall, the feelings produced are those of being trapped and needing to escape.
Mental System

The number one effect of the fight/flight response is to alert the organism to the possible existence of danger. Thus, one of the major effects is an immediate and automatic shift in attention to search the surroundings for potential threat. In other words, it is very difficult to concentrate on daily tasks when one is anxious. Therefore, people who are anxious often complain that they are easily distracted from daily chores, that they cannot concentrate, and that they have trouble with their memory. This is a normal and important part of the fight/flight response since its purpose is to stop you from attending to your ongoing chores and to permit you to scan your surroundings for possible danger. Sometimes, an obvious threat cannot be found. Unfortunately, most humans cannot accept having no explanation for something. Therefore, in many cases, when people cannot find an explanation for their sensations, they turn their search upon themselves. In other words “if nothing out there is making me feel anxious, there must be something wrong with me.” In this case, the brain invents an explanation such as “I must be dying, losing control, or going crazy.” As we have now seen, nothing could be further from the truth since the purpose of the fight/flight response is to protect the organism not harm it. Nevertheless, these are understandable thoughts.

Panic Attacks
Up until now, we have looked at the features and components of general anxiety or the fight/flight response. However, you may be wondering how does all this apply to panic attacks? After all, why should the fight/flight response be activated during panic attacks since there is apparently nothing to be frightened of?

Following extensive research, it appears that what people with panic attacks are frightened of (i.e., what causes the panic) are the actual physical sensations of the fight/flight response. Thus, panic attacks can be seen as a set of unexpected physical symptoms and _then_ a response of panic or fear of the symptoms such as illustrated below:

pounding heart             fear  ——–>  pounding heart
——–>
dizziness, etc.            panic <——– dizziness, etc.

The second part of this model is easy to understand. As discussed earlier, the fight/flight response (of which the physical symptoms are a part) causes the brain to search for danger. When the brain cannot find any obvious danger, it turns its search inward and invents a danger such as “I am dying, losing control, etc.” This is illustrated below:

pounding heart          misinterpretation         fear  —-> symptoms
—->                      —->                 |
dizziness, etc.         e.g., “I’m dying”         panic   <——-

The first part of the model is harder to understand. Why do you experience the physical symptoms of the fight/flight response, if you are not frightened to begin with? There are many ways these symptoms can be produced, not just through fear. For example, it may be that you have become generally stressed for some reason in your life and this stress results in an increase in production of adrenalin and other chemicals which from time to time produce symptoms. This increased adrenalin could presumably be maintained chemically in the body even after the stressor has long gone. Another possibility is that you tend to breathe a little too fast (subtle hyperventilation) due to a learned habit and this also can produce symptoms. Because the over-breathing is very slight, you easily become used to this level of breathing and do not notice that you are hyperventilating. A third possibility is that you are experiencing normal changes in your body (which everyone experiences but most don’t notice) and, because you are constantly monitoring and keeping a check on your body, you notice these sensations far more strongly than most people.

Even if we are not exactly certain why you experience the initial symptoms, we can assure you that they are a part of the fight/flight response and therefore are _harmless_.

Thus, our final model of panic attacks (simplified) looks like this:

hyperventilation      pounding heart       misinterpretation       fear

arousal         —>  dizziness      —>  e.g., “I’m dying” —>  panic –
^      |
adrenaline            breathlessness                               |      |
symptoms <- normal body changes etc.

Obviously, then, once you truly believe (100%) that the physical sensations are not dangerous, then the fear and panic will no longer occur and you will eventually no longer experience panic attacks. Of course, once you have had a number of panic attacks and you have misinterpreted the symptoms many times, this misinterpretation becomes quite automatic and it becomes very difficult to consciously convince yourself during a panic attack that the symptoms are harmless.

In Summary
Anxiety is scientifically known as the fight/flight response since its
primary purpose is to activate the organism and protect it from harm.
Associated with this response are a number of physical, behavioral, and
mental changes.  Importantly, once the danger has gone, many of these
changes (especially the physical ones) can continue, almost with a mind of
their own, due to learning and other longer term bodily changes.  When the
physical symptoms occur in the absence of an obvious explanation, people
often misinterpret the normal fight/flight symptoms as indicating a serious
physical or mental problem.  In this case, the sensations themselves can
often become threatening and can begin the whole fight/flight response over.

MYTHS AND MISINTERPRETATIONS
Going Crazy

Many people, when they experience the physical symptoms of the
fight/flight response, believe they are “going crazy.”  Within this belief,
they are most likely referring to a severe mental disorder known as
schizophrenia.  Let us look at schizophrenia to see how likely this is.

Schizophrenia is a major disorder characterized by such severe symptoms as disjointed thoughts and speech, sometimes extending to babbling, delusions or strange beliefs (for example, that they are receiving messages from outer space), and hallucinations (for example, that there are voices in their head). Furthermore, schizophrenia appears to be largely a genetically based disorder, running strongly in families.

Schizophrenia generally begins very gradually and not suddenly (such as during a panic attack). Additionally, because it runs in families, only a certain proportion of people can become schizophrenic and, in other people, no amount of stress will cause the disorder. A third important point is that people who become schizophrenic will usually show some mild symptoms for most of their lives (such as unusual thoughts, flowery speech, etc.). Thus, if this has not been noticed in you yet, then the chances are you will not become schizophrenic. This is especially true if you are over 25 since schizophrenia generally first appears in the late teens to early 20’s. Finally, if you have been through interviews with a psychologist or psychiatrist, then you can be fairly certain that they would have known if you were likely to become schizophrenic.
Losing Control

Some people during a panic attack believe they are going to “lose
control.”  Presumably, they mean that they will either become totally
paralyzed and not be able to move, or that they will not know what they are
doing and will run around wildly killing people or yelling out obscenities
and embarrassing themselves.  Alternatively, they may not know what to
expect but may just experience an overwhelming feeling of “impending doom.”

From our earlier discussion, we now know where this feeling comes from. During anxiety the entire body is prepared for action and there is an overwhelming desire to escape. However, the fight/flight response is not aimed at hurting other people (who are not a threat) and it will not produce paralysis. Rather, the entire response is simply aimed at getting the organism away. In addition, there has never been a recorded case of someone “going wild” during a panic attack. Even though the fight/flight response makes you feel somewhat confused, unreal, and distracted, you are still able to think and function normally. Simply think of how often other people even notice that you are having a panic attack.
Nervous Collapse

Many people are frightened about what might happen to them as a result
of their symptoms, perhaps because of some belief that their nerves might
become exhausted and they may collapse.  As discussed earlier, the
fight/flight response is produced chiefly through activity in the
sympathetic nervous system which is counteracted by the parasympathetic
nervous system.  The parasympathetic nervous system is, in a sense, a
safeguard to protect against the possibility that the sympathetic nervous
system may become “worn out.”  Nerves are not like electrical wires and
anxiety cannot wear out, damage or use up nerves.  The absolute worst that
could happen during a panic attack is that an individual could pass out at
which point the sympathetic nervous system would stop its activity and the
person would regain consciousness within a few seconds.  However, actually
passing out as a result of the fight/flight response is extremely rare, and
if it does occur, it is adaptive since it is a way of stopping the
sympathetic nervous system from going “out of control.”

Heart Attacks

Many people misinterpret the symptoms of the fight/flight response and
believe they must be dying of a heart attack.  This is probably because many
people do not have enough knowledge about heart attacks.  Let us look at the
facts of heart disease and see how this differs from panic attacks.

The major symptoms of heart disease are breathlessness and chest pain as well as occasional palpitations and fainting. The symptoms in heart disease are generally directly related to effort. That is, the harder you exercise, the worse the symptoms and the less you exercise, the better. The symptoms will usually go away fairly quickly with rest. This is very different to the symptoms associated with panic attacks which often occur at rest and seem to have a mind of their own. Certainly, panic symptoms can occur during exercise or can be made worse during exercise, but they are different to the symptoms of a heart attack since they can occur equally often at rest. Of most importance, heart disease will almost always produce major electrical changes in the heart which are picked up very obviously by the EKG. In panic attacks the only change which shows up on the EKG is a slight increase in heart rate. Thus, if you have had an EKG and the doctor has given you the all clear, you can safely assume you do not have heart disease. Also, if your symptoms occur any time and not only upon exertion, this is additional evidence against a heart attack.