Information Thread: Anxiety Disorders

by **Butterfly Faerie** » Wed May 17, 2006 4:30 pm

Long-term, predisposing causes
A. Heredity
B. Childhood Circumstances
1. Your parents communicate an overly cautious view of the world.
2. Your parents are overly critical and set excessively high standards.
3. Emotional insecurity and dependance.
4. Your parents surpress your self-assertiveness.

C. Cumulative stress over time.
Bological causes
1. Physiology of panic.
2. Panic attacks.
3. Generalized anxiety.
4. Obsessive-compulsive disorder.
5. Medical conditions that can cause panic attacks or anxiety.

Short-term triggering causes
Stressors that precipitate panic attacks
1. Significant personal loss.
2. Significant life change.
3. Stimulants and recreational drugs.

Conditioning and the origan of phobias
Trauma, simple phobias, and post-traumatic stress disorder

Maintaining causes
1. Avoidance of phobic situations.
2. Anxious self-talk.
3. Mistaken beliefs.
4. With held feelings.
5. Lack of assertiveness
6. Lack of self-nurturing skills.
8. Muscle tension.
9. Stimulants and other dietarty factors
10. High-stress lifestyle.
11. Lack of meaning or sense of purpose[/color]

For all that is written here I will write out below what they mean, please be paitent with this as it could talk awhile. Considering it's from a book and I need to make it into my own words abit.

More info on this coming soon.

by **Butterfly Faerie** » Wed May 17, 2006 4:32 pm

Heredity

Are anxiety disorders inherited? Some people believe that they are, at least in part. It is estimated that 15-25 percent of children growing up with at least one agoraphobic parent become agoraphobic themselves. While the rate of agoraphobia in general is only roughly 5%.

It doesn't prove that agoraphobia is inherited, however it could be argued that children learn from there parents...(which I can see happening, and it was actually brought up to me in therapy.)

More evidence come from studies of identical twins who of course have exactly the same genetic makeup. If one twin has an anxiety disorder the probability of the other twin having an anxiety disorder ranges from 31-8%. (My twin has suffered anxiety, but not to the severity of mine.)

When a faternal twin as an anxiety disorder the odds of the other twin having an anxiety disorder range roughly about 0-38%. Having the same genetic makeup as someone else with phobias or anxiety makes it more twice as likely that you will have a similar problem.

Growing up in the same family having the same parenting, contributes at least something to the development of anxiety disorders. Both nature and nuture seem to have an impact.

What is it that seems to be inherited? It seems that you do not inherit agoraphobia, social phobia or panic attacks specifically from your parent. What is inherited seems to be the general personality type that predisposes you to be overly anxious. This is an excitable, reactive personality that you might develop one or another anxiety disorder depending on your environment and upbringing.

An example of this would be: Whether you develop agoraphobia might depend on how much you learned to feel ashamed of situations where you were expected to perform. Whether you develop panic attacks or not might depend on the degree of stress you are exposed to during adolescence and early adulthood. While heredity might cause you to be born with a more excitable nervous system, childhood expierences, conditioning and stress all serve to shape certian types of anxiety disorders you subsequently develop.

by **Butterfly Faerie** » Wed May 17, 2006 4:32 pm

Childhood Circumstances

What childhood expierences or family enviornments might predispose you to develop an anxiety disorder? Researchers have found that panic attacks and agoraphobia are often followed by seperation anxiety disorder in childhood. This is a condition is when you are seperated from your parents when going to school or before going to sleep. As adults these same people expierence anxiety when seperated from a "safe" place or person. This might lead to seperation anxiety.

Your parents might commuicate overally cautious views of the world

Parents of people who suffer from phobias either tend to have phobias themselves or else are fearful or anxious then average. They are uneasy about the potential dangers to their child. Thare are likely to say things such as: "don't go out in the rain, you will catch a cold," "Don't watch too much tv, you'll hurt your eyes." The more that they correspond a fearful over-cautious attitude toward their child the more the child comes to view the wold as a dangerous place. When you learn that the ouside world as menacing you automatically restrict your exporation and risk-taking. You grow up to excessively worry and be overly concerned about your safety.

Your parents are overly critical with high standards

Child growing up with critcal parents are never quite sure of their own acceptability. There is always doubt about whether you are good enough. You are constantly trying to make the effort to please your parents. As an adult you may overally eager to please or look good at the rate of your true feelings and your role for assertiveness. When you grow up feeling insecure you may become dependant on a safe person or safe place and may limit yourself from joining public or social situations where you may risk loosing face. You often come to iternalize your parents values, become a perfectionist and self-critical (as well as being critical of others.)

Emotional insecurity and dependancy

Up to the age of 4 or 5 children are fully dependant on their parents, especially their mothers. Any requirement that creates insecurity during this time can leasd to extreme dependancy later on. Extreme Evaluation and flawless standards on the part of the parent seems to be a common source of instability for people who later develop anxiety disorders. Experiences of neglect, rejection, abandonment through divorce, death, sexual or physical abuse can also effect the kind of basic instability as well as emotional dependancy that form a backdrop for anxiety disorders.

A common denominator in the backdrop of adult children of alcoholics, adult survivors of other forms of abuse are the mose people who develop anxiety disorders. The degree of insecurity and the way children react to it, will decide whether they later develop a particular sort of anxiety disorder, as opposite to say an addictive personality or some other behavior upset. When children respond to insecurity with excessive dependancy the platform is set for the overreliance on a safe person or safe place later in like. This is what is a normal backdrop for agoraphobia.

Your parents disclose your expression of feelings and self-assertiveness

Parents may not only nourish dependency but may disclose your innate role to distinct your feelings to affirm yourself. For example: As a child you may have been often scolded or disciplined for speaking out or getting angry. After you grew up applying a restrictive even inflicting attitude towards your own expression of implulses and feelings. If these urges and feelings are smothered over a long period of time they will suddenly under stress may make anxiety or panic. People who learn to bottle their feelings and self-expression up as children are nervous and more likely to be anxious and unable to express themselves as adults.

by **Butterfly Faerie** » Wed May 17, 2006 4:33 pm

Physiology Of Panic

What happens to the body during panic? Panic is an ultimate version of an alarm reaction your body naturally goes through in response to and type of threat. It is also called the fight or flight response. It is a built in technique that permits all the higher animals to activate a great deal of energy fast in order to cope with predators for immediate threat to their survival. This alarm reaction suits us well in situations that are dangerous. Most of us also expierence the fight or flight response in any situation that is seen as dangerous, threatening or overwhelming. A disagreement with a loved one or having to get up and go to work when you have had a blad sleep can cause noticable stress response because you fee; ot as threatening or overwhelming even though it'a no direct risk to your survival.

There may be no distinguished threat as all. The reaction may come out of the blue without any detectable stimulus. Somehow the fight or flight response has gotten out of control. That it occurs out of context without visible reason. The brain mechanism that controls the response is not working properly.

The nervous system has 2 reactions, voluntary and involuntary. There is a voluntary nervous system that controls that muscles and follows your direct command. Your involuntary nervous system controls automatic functions naturally outside the unforced control, such as heartbeat, respiration and digestion. The involuntary system is itself seperated into branches: the sympathic and parasympathic nervou systems.

The sympathic nervous system is responsible for organizing a number of reactions throughout the body whether you are emotional or excited. The parasympatheic nervous system does the opposite function. It supports the normal, smooth functioning of your different internal organs during times of calm and rest. In a panic attack your sympathetic nervous system sets off several different bodily reactions fast and intense. It causes your adrenal glands to release large amounts of adrenaline. What you feel is a sudden jolt is usually accompanied with feelings of dread or terror. Within seconds the bounty of adrenaline can cause 1. your heart to race, 2. your respiration to become rapid and shallow, 3. alot of sweating, 4. tremblings and shaking, 5. cold hands and feet. Your sympathetic nervous system also makes muscles contractions (in most extreme cases "freezing" in fear), possibly leading you to expierence strong contractions in your chest or throat along with a fear of not being able to breathe. Other reactions caused by the sympathetic nervous system include an abundance release of stomach acid, inhibition of digestion, release of red blood cells by the spleen, a release of stored up sugar by the liver, an increase in the metabolic rate, and dilation of the pupils.

All of these reactions occu to lesser degree when you are emotional or excited. The problem in panic is that they elevate to such an extreme level that you feel overwhelmed, scared, and have a strong urge to run. It is important to realize that the adrenaline released during panic tensed to be reabsorbed by the liver and kidneys within a few minutes. If you can "ride out" the symptoms of panic without fighting them or telling yourself how horrible they are they will subside.

While physiological reactions are less well understood the mechanisms in the brain that aquainted these physiological reactions are less well understood. A rescent hypthesis about a particular imblance in the brain thouht to be responsible for panic attacks.

by **Butterfly Faerie** » Thu May 18, 2006 2:52 pm

Medical Conditions That Can Cause Anxiety or Panic Attacks

The various propsed explanations of the biological mechanisims involoviing different neurotransmitter systems of the brain are at present still speculated. It is important to keep in mind that these biological hypotheses apply to a majority but not all cases of panic attacks and generalized anxiety. Sometimes panic reactions can emerge from medical conditions that are quite seperate from recongized anxiety. Hyperthyroidism and Hypoglycemia for example can cause panic attacks that by all appearences indentical to those seen in panic disorder.

Hyperventilation Syndrome

Rapid, shallow breathing at the level of your chest can sometimes lead to extreme lowering of carbon dioxide in your bloodstream. In symptoms very similar to those of a panic attack, including light-headedness, dizziness, feelings of unreality, shortness of breath, tembling and/or tingling of your hands, feet and lips. These symptoms may be seen as dangerous and may animate a bona fide panic attack.

Hypoglycemia

For a large number of people blood sugar levels have fall too low as a result of poor diet or simply stress. People expierence an assortment of symptoms similar to panic. This includes anxiety, shakiness, dizziness, weakness, or disorientation. Hypoglycemia can cause panic attacks or more often can aggravate panic reactions which can caused by other agents.

Hypothyroidism

Immoderate secretion of thyroid hormone can lead to heart palpitations, sweating, and generalized anxiety. Other symptoms of hypothyroidism is weight loss, elevated body temperature, insomnia and bulging eyes. If you have several of the above symptoms you might want to have your doctor do a thyroid panel to see if this condition is contributing to your anxiety or panic symptoms.

Mitral Valve Prolapse

Mitral valve prolapse is a harmless condition which causes heart palpitations. It is caused by a slight defect in the vavle seperating the upper and lower chambers on the left side of your heart. Blood moves through the mitral valve as it passes from the upper to lower chamber. With mitral valve prolapse, the valve does not close completely and some of the blood can flow back from the lower to upper chamber, causing the heart to beat out of rhythm. The resulting rhythm disturbance can be akward enough to cause some people to panic but it is not dangerous. Mitral valve prolapse is not a cause of heart attacks. For reason that are unclear, mitral valve prolapse occures more often in people with panic disorder then the population at large. In severe cases it can be treated through the use of beta-blocking drugs such as Inderal.

Premenstral Syndrome

If you are a woman it is important to watch whether yourp anic reactions or generalized anxiety worsen around this time just before your period. If so, treatment for PMS may be enough to help your problem with panic or anxiety. Treatment usually involves improvements in diet and exercise, taking supplements such as vitamin B6 and in some cases taking a natural progesterone.

Inner Ear Disturbances

For a small ratio of the population panic attacks seem to be associated with a disturbance in balance caused by swelling of the inner ear (due to infection, allergy, Meniere's syndrome or other problems.) If dizziness, light-headedness or unsteadiness are a noticable part of your problem with anxiety you may want to consult with an otolaryngologist to check the labryrinth system off your inner ear.

Other medication conditions which can cause panic or anxiety include:

-Acute reaction to cocaine, amphetamines, caffeine, aspartame, or other stimulants

-Withdrawal from alcohol, sedatives or tranqulizers

-Thyrotoxicosis

-Cushing's syndrome

-Parathyroid disease

-Complex partial seizures (temporal lobe epilepsy)

-Post-concussion syndrome

-Deficiencies of calcium, magnesium, potassium, niacin, or vitamin B12

-Emphysema

-Pulmonary embolism

-Cardiac arrhythmias

-Congestive heart failure

-Essential hypertension

-Environment toxins such as mercury, carbon dioxide, hydrocarbons, food additives, and pesticides

To adequately rule out any medical conditions that could be causing or aggravating your particular problem, have your doctor give you a thorough examination including a blood panel, before adopting behavioural an psychological strategies for recovery.

by **Butterfly Faerie** » Thu May 18, 2006 2:52 pm

Stressors that precipitate panic attacks

Long-term causes such as heredity. childhood enviromnent, and gradual stress creates a predisposition to anxiety disorders/ Yet it takes more specific conditions, operating over a short period of time to actually trigger panic attacks or phobias.

Some to be considered are:
Specific stressors that often follow a first panic attack
Conditioning processes that produce phobias
The role of trauma in certain simple phobias and post-traumatic stress disorder.

Significant personal loss. loss of a significant person through death, divorce, or seperation seems very often to be a trigger of a first panic attack. Other important losses, such as loss of employment, loss of health through illness, or a major financial change in status can also precipitate a first panic attack.

Significant life change. A major life evening causing a period of adjustment lasting several months can sometimes precipitate a first panic attack. Examples: getting married, having a baby, going off to college, changing jobs, developing an extended physical illness etc. It may be that any major stressor, whiether it is a significant loss or a moagor life change can trigger a panic attack for the first time in a person, who is already vulnerable for other reasons.

Stimulants and Recreational Drugs. It is not unusal for a first time panic attack to happen after excessive intake of caffeine. Often people are not aware that their use of caffeine is excessive until a full-blown panic attack brings it to their attention. Even more is the occurance of panic attacks in people using cocaine. Cocaine is such a strong stimulant that may cause panic attacks even in people who are not predisposed to panic disorder by long-term factors previously described. Amphetamines speed, PCP, LSD, high doses of marijuana, and withdrawal from narcotics, barbiturates, or tranqulizers can also jolt a person to have their first panic attacks.

by **Butterfly Faerie** » Thu May 18, 2006 2:53 pm

A phobia is a presistent and illogical fear of a specific object, acitivity or situation that results in a strong desire to avoid that dreaded object, activity, or situation. There are 3 characteristics which identify a phobia from the ordinary, everyday fears. You are continually afraid of the object or siutation over a long period of time. You know that your fear is unreasonable even though this recognition does not help to scatter it. What is most characteristic of a phobia is the avoidance of the situation that you fear. Being unreasonably afraod of something is not yet a phobia. The phobia begins when you actually start to avoid what you are afraid of.

What is avoided tends to vary among different type of phobias. If you are agoraphobia you ten to avoid situations that you are afraid of and cannot easily escape. If you have social phobia you tend to avoid situations where you might be humiliated, examples include publc speaking, parties, job interviews. Simple phobias cause you to fear potential death or injury caused by natural disasters. Or the fear of becoming trapped.

How do these types of phobia's develop? There are 2 types of methods which are most commonly responsible: Conditioning & Trauma. Trauma does not always involve in the creation of a phobia, but the conditioning process are always present. There are 2 types of conditioning that bestow to the formation of a phobia: 1. conditioning by association and 2. conditioning of avoidance.

In conditioing by association a situation that was originally nutral begins ot elicit strong anxiety because on a certain day you panicked or had a strong anxiety reaction in that same situation. For example, you are driving on the freeway and spontaneously have a panick attack. The panic is made worse by fearful thoughts suck as "how do I get out of here?" Your mind forms a strong association betwen being on the freeway and expierencing anxiety. So later being on or near or thing about freeways elicits anxiety. You have learned an association with anxiety the first time you try public speaking may lead to an association between the 2. Afterward everytime you attempt to speak before others, or even think about doing it, the strong anxiety is automatically triggered.

Conditioning by association may cause you to develop a fear towards a particular object or situation, it does not by itself create a phobia. Only when you start to avoid the situation or object do you learn to be a phobic. Avoiding a situation that you are anxious about is obviously rewarded being the reduction of anxiety. Each time you avoid the situation the reward of being relieved of anxiety follows, and so your avoidance behaviour gets stronger and tends to repeat to do so is what comprises conditioning by avoidance. Avoidance conditioning is the most critical process of the formation of any phobia. It is directly reveresed and ovecome by the processes of imagery and real life exposure.

by **Butterfly Faerie** » Thu May 18, 2006 2:57 pm

Trauma, simple phobia and post-traumatic stress disorder

Agoraphobia and social phobia tend to develop primarily as a result of a conditioning processes just described in the above post. Certain simple phobias on the other hand can develop in the wake of a specific traumatic expierences. For example as a child this person had a fear of bees as a result of having picked up the bee and getting stung at a young age. This is an example of conditioning by association. The fear felt at the time when the child got stung came into play when he/she later started running away from the bees whenever he/she saw them near him/her. Also being in a car accident can cause a person to be subsequently fear of driving or even being in a car. Or nearly drowning may lead to subsequent phobia about water. Many simple phobias can be traved back to some kind of traumatic event in childhood. Others especially those we have from a very early age, like the fear of darness or fear of insects may be part of our unfolding heritage. Such fears may have been biologically programmed into the nervous systems of all mammals to promote survival of the species. These unborn fears people often grow up with can not be considered phobias unless 1. they lead a persistent avoidance and 2. they persist into adulthood.

A different outcome to trauma is the occurrence of PTSD. No specific phobias develop; instead you tend to develop an arrangement of symptoms that re-create the original trauma. Distressing recollections and dreams about what happened are the mind's attempt to gain control of the orginal event and to balance out the emotional change that it carries.

by **Butterfly Faerie** » Thu May 18, 2006 2:57 pm

Maintaining causes of anxiety disorders are what tend to keep them going. They involve ways of things, feelings and coping that serve to extinguish anxiety, panic and phobias. The following list maintaing causes isn't thorough and includes those which are more obvious.

Avoidance of Phobic Situations

Phobias develop because it is very rewarding to avoid facing situations that cause us anxiety. As long as you continue to avoid dealing with a phobic situation, activity, object the phobia will remain safetly in place. Trying to thonl your way out of phobia simply will not work if you continue to avoid confronting it directly. As long as you avoid the situation, you will tend to worry about whether or not you can ever handle it.

Overcoming a phobia means that you have to unlearn certain responses while teaching yourself others. When you begin to finally face the situation you can unlearn both the fear in advance, the anticipatory anxiety about possibly panicking in the situation and the avoiding the situation completely. You give yourself the oppurtunity to learn that you can enter and remain in a situation without undue anxiety. You learn to eventually tolerate and be comfortable in any situation if you approach it in small steps.

Anxious Self-Talk

Self-talk is what you say to yourself in your mind. It's the internal monologue that you enthrall much of the time, it may be so automatic that you don't even notice it unless you pay attention. Your anxiety created by the statements you make to yourself begining with words "What if", for example: "What if I panic again?", "What if I loose control?" This type of self-talk anticipates the worst before it even happens. The more common term for it is "worry."

Self-talk can contribute to creating a full-blown panic attack. An attack may start off with symptoms of the body such as tightness in the chest, heart palpatations, or dizziness. If you can accept these symptoms without letting them scare you, they will soon start to subside. All too often you tell yoursef such things as "Oh no, I am going to panic!", "What if I have a heart attack!" This scare talk only aggravates the physical symptoms, which in turn produce more scare talk in the extreme leading to a vicious cycle that will cause a full-blown panic attack.
The good news is that you learn to recognize anxiety provoking self-talk, stop or and replace it with more postive, calming statements to help yourself.

Mistaken Beliefs

Your negative self-talk comes from the underlying beliefs about yourself, others and the way that the world is. If you beliefve that you cannot be safely alone you will talk yourself and everone else into assuming that there must always be someone with you. If you truly believe that life is always a struggle, then you will tell yourself that something is wrong whe nyou start to feel better, or when others offer you help. The belief that the outside world is unsafe does not promote an attitude of trust or a reluctance to take any risks to overcome a condition like agoraphobia.

Remaking your basic beliefs about yourself and your life takes more time and work then simply reversing negative self-talk. To do so you will have far-reaching effects on your self-esteem, your reluctance to accept any faults in yourself and others, and on your peace of mind in the long run.

by **Butterfly Faerie** » Thu May 18, 2006 2:58 pm

Withheld Feelings

Denying feelings of anger, sadness, frustration or even excitement can contribute to a state of "free-floating" anxiety. Free-floating anxiety is when you feel slightly anxious without know why. You may notice that after you let out angry feelings that you had or had yourself a good cry you feel calmer. Expressing feelings can have a distinct phsychological effect that results in a reduced level of anxiety. Anxiety-prone people often are born with a predisposition to be more emotionally reactive or impulsive. They are grow up in families where obtaining parental appoval takes priority over expressing their needs and feelings. As adults they still feel it is more important to attain perfection or always be pleasing than to express strong feelings. The tendancy to deny deep emotionals can lead to a chronic state of tension and anxiety. It is believed by some that the external thread avoided by the phobic is actually a stand-in for deeper lying internal threat: the fear of a long repressed feeling surfacing. Panic may happen when such feelings threaten to breath through. For example, if you have a phobia about water this might be viewed as a stand-in for a deeper lying fear of denied feelings. Or a fear of a animals might symbolize a deeper lying fear of experiencing your own anger and needs not met from which it flows. This emotion based theory of phobias may at least be partially right.

Lack of Assterivemess

In order to express feelings to other people it is important that you develop an assertive style of communicating, that allows you to express yourself in a direct manner. Assertive communication strikes the right balance between submissiveness, where you are afraid to say what you want, and agressiveness, where you demand what you want through coercion or threat. If you are prone to anxiety you will tend to act submissively. You avoid asking directly for what you want, and afraid to express strong feelings, especially anger. Often you are afraid of imposing on others you don't want to compromise your self image as someone who is pleasing or nice. Or you are afraid of assertive communication will alienate your safe person. The one person that you feel dependant on for your basic sense of security. The problem with lack of assertiveness is that it breeds feelings within yourself of resentment or confinement. And resentment and a ssense of confinement are notorious for aggravating anxiety.

Lack of Self-Nurting Skills

Common background for many people with anxiety is a pervasive sense of insecurity. This is apprarent in the agoraphobic, where the need to stay close to a safe place or safe person can be very strong. Such insecurities arise from a variety of conditions in childhood, including parent neglect, abuse, overcriticism, and abandonment. Since they never recieved constant or reliable nurturing as children, adult "survivors" of these various forms of deprivation often lack the capacity to properly take care of their own needs. Unaware of how to love and nuture themselves they suffer from low self-esteem, and may feel anxious or overwhelmed in the face of adult demands and responsibilities. This lack of self-nuturing skills only serves to immortalize anxiety.
The last solution to parental abuse was deprivation is to become a good parent yourself.

Information Thread: Anxiety Disorders

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