Archive for the ‘Anxiety’ Category

What is Normal Anxiety? Abnormal?

Monday, May 30th, 2011

     “Have you suffered from any of these symptoms in the last six months:

Difficulty is getting breath or over breathing?

Skipping or racing of the heart?

Sensation of rubbery or ‘jelly legs’?

Bouts of excessive sweating?

Smothering of choking sensation or lump in throat?

Tingling or numbness in parts of body?

Feelings that surroundings are strange, unreal, foggy, or detached?

Difficultly in falling asleep?

Avoiding situations because they frighten you?

If you have answered ‘yes’ to one or more of the preceding questions, it is possible that you have a biologically based anxiety disorder that is fundamentally different from the common anxiety that results from specific conditions of stress” according to David M. Sheehan, M.D. Dr. Sheehan writes in his book, The Anxiety Disease, that “panic attacks are clusterings of several spells of different symptoms at once… usually there is strong mental terror that accompanies the physical sensation of the body running out of control.”

     If panic attacks persist, phobias often develop.  These types of phobias usually relate to where the person was when panic attacks were experienced. Example:  If a panic attack occurred in church, the person will fear churches.  The anxiety in effect becomes attached to places or situations by association.  People avoid that which triggers anxiety. This is basic classical or Pavlovian conditioning. 

     Anxiety, or fear, is an emotion that ranges across the continuum from a healthy alert to a real danger to a disabling of one’s ability to function. Dr. Bessel A. van der Kolk writes that “the critical difference between a stressful but normal event and trauma is a feeling of helplessness to change the outcome.”  He continues: “Brain function is shaped by experience that is automatically processed on a subcortical level (unconscious) that takes place outside of awareness. Certain early attachment disorders, overwhelming childhood experiences and horrific adult experiences ‘set’ psychological expectations and biological selectivity.” Biological responses to this anxiety and fear would include numbness, withdrawal, confusion, shock or speechless terror.

     Dr. van der Kolk says that if these people are not able to “reset their equilibrium” after a traumatic experience, they are more “prone to develop the cluster of symptoms that are called PTSD….The imprint of the traumatic event comes to dominate how victims organize their lives. …At the core of  PTSD is that certain sensors or emotions related to traumatic experiences are dissociated, keep returning in unbidden ways, and do not fade with time.  Because recalling the trauma can be so painful, many people with PTSD choose not to expose themselves to situations, including psychotherapy, in which they are asked to do so.  The challenge in treating PTSD is to help people process and integrate their traumatic experiences without feeling retraumatized – to process trauma so that it is quenched, not kindled.”

     There are three critical steps in treating severe anxiety disorders:

1. Safety – physical and psychological

2. Psychological intervention and, perhaps, medication

3. Learning to find a language for understanding and communicating their experiences without being retraumatized.

     In summary it is important to understand how the combination of emotional, cognitive, social, and biological forces interact in human development and experience. The brain takes all of these factors into consideration as it reacts and directs one’s feelings, thoughts, and behavior.

     It is valuable for people to be attuned to the level of anxiety present.  Many people block this awareness.  Periodic check ups by a physician for the body and a psychotherapist for the mind can assist in this assessment, along with the appropriate therapeutic interventions so indicated.  Maintaining anxiety in the normal range is extremely important for optimal health and productive behavior.