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Information Thread: Anxiety Disorders

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

Muscle Tension

When muscles are tense you feel uptight. Muscle tension tends to restrict your breathing. When you're breathing shallow and restricted you are more likely to expierence anxiety. Tense muscles also help to keep feelings surpressed which can increase anxiety. You may notice that when your body is tense, your mind races. As you relax the muscles throughout your body your mind begins to slow down, and you become calmer. A quote by Edmund Jacobson said at one time "An anxious mind cannot exist in a relaxed body." Body and mind are tangling related to anxiety. You can reduce your level of muscle tension on a consistent basis by maintaining daily programs of deep relaxation as well as vigorous exercise. One of these alone can reduce muscle tension, but the combination has an even better effect.

Stimulants & Other Dietary Factors

stimulants such as caffeine and nicotine can aggravate anxiety and leave you more vulnderable to panic attacks. You may not be aware of their impact until you reduce or eliminate them from your life. With some people panic attacks go away completely once caffieine is eliminated from their diets (caffiene not just from coffee but tea, coke and other drinks.) For some people other dietary factors such as sugar and food additives can aggravate or occasionally cause panic reactions.

High Stress Lifestyle

The role of stress as a predisposing agent and short-term case of anxiety disorders that has been mentioned earlier in some of the above posts. It is not surprising that a stressful lifestyle causes problems with anxiety. The frequency of panic attacks and the severity of phobias tends to decrease in size depending on how well you cope with the daily stresses of life. Getting a handle on things that causes anxiety like self-talk, the mistaken beliefs, with held feelings and so forth, will go along way of reducing stress that is in your life.
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Postby Butterfly Faerie » Thu May 18, 2006 2:59 pm

Looking at fear in relation to individual anxiety disorders, the fear is the specific thought/s as in :

Panic Disorder: The fear: ' I'm having a heart attack/I'm going to die/ I'm going insane'

Social Phobia: The fear: of embarrassment/making a fool of self

Obsessive Compulsive Disorder: The fear of contamination/ fear the person may hurt themselves, their loved ones, strangers/ the fear that if something is not done a certain way something will happen etc.

Post Traumatic Stress: The fear of the original trauma/ flashbacks &/or nightmares of the original trauma/ fear that a similar trauma may happen again to themselves or loved ones

Anxiety is the response to these thoughts. The fearful thoughts activate the fight and flight response which is felt as physical sensations: racing heart, over breathing, perspiration, shaking, etc. The physical sensations equal anxiety.

The fight and flight response is very necessary in a dangerous situation as it provides us with the energy to either run from the danger or to confront it. eg 'you are in a field and a bull charges at you'. The fight and flight response enables us to run/escape from the bull.

With panic disorder, social phobia and obsessive compulsive disorder, people are not in danger per se. It is the way that they are thinking that creates the 'danger' which in turn activates the fight and flight response which is then felt as anxiety/panic symptoms.

With post traumatic stress disorder, the fearful thinking is based on a life event/s that did happen and the fear/s are valid within this context.
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Postby Butterfly Faerie » Thu May 18, 2006 3:00 pm

Panicking
An article by Ann Palmer



The stuffy atmosphere in the theater was getting to me. I could no longer just sit there. The events on the screen all seemed to pertain to me and to upset me further. I could feel my heartbeat getting faster. I broke out in a cold sweat. It was getting hard to breathe.

I had entered into a completely different reality. Everything around me seemed strange, alien, happening in a world I was a stranger to. I didn’t feel well and worse, didn’t feel like I could tell my friend. I finally told him, “I have to get out of here.” I had put that off as long as possible, because saying it would make it not only true, but it meant admitting that there was something wrong.

Pulse in my throat, the sound of blood pumping in my ears, feelings of being not of this world, having no control. Simply put, I felt like I was dying, being taken over by fear and despair. Every movement I made seemed like a terrifying deja vu, slow, purposeful and unintended. All sounds were grating to my ears. Sights were painful to my eyes. I had to escape.

The world outside the dark theater seemed even more totally surreal, a nightmare, scary, alien. People’s faces were gruesome. This was what lay underneath my usual vision. THIS was what was real. My mind had finally been stripped of the last veil of illusion. I felt I had asked for this.

I tried not to look around me, tried to block out sights, sounds, sensations. I felt more afraid than I ever had. I wanted to know what was happening to me, but I was afraid of knowing the truth.

I had to stop thinking. My mind was going a million miles a minute. Saying “stop” just tripped more commands in my brain. I felt my thoughts were thinking without me. I was a visitor to my own brain.

Accepting help, asking for assistance, telling someone what was wrong -- it all would make it more real -- a permanent condition. These were inexplicable feelings. Going to the hospital, the psychiatric ward, meant accepting that what I was experiencing was a real phenomenon.

Back then, I was constantly mired in fear. Not merely afraid, I was terrified of everything. Overstimulated by people, places and things, I was paralyzed internally. There were days I imagined horrific consequences to any action I might take. It was sheer terror. The medications I was taking at the time were meant to relieve the symptoms of acute anxiety I was experiencing, but I still manifested psychotic and paranoid symptoms. For example, listening to television took on a nightmarish quality, as I believed horrendous omens were being broadcast to me; no one else in the room appeared affected by it as I was. A bus ride, sitting in a room of people, sitting alone, going to bed at night, rising in the morning -- all to face the same dreadful nature of the universe as I perceived it -- any daily activity was overshadowed by the evil tricks my mind was playing on me.

There are ways out. Wherever you are, I hope a message can get through. One sentence, one phrase, one word can help guide your way. Am I in a better place? I think so. I have made my way though terror and misery by making choices. I overcame many fears by facing, naming, accepting, and responding to them. I still do.



What can you do when you start feeling panicky or paranoid? It is ultimately up to you. Make up your own plans to manage symptoms, something, anything, that makes you more comfortable. It may seem like trading anxiety for obsessive compulsive rituals, but would you rather panic?



To cope with panic I’ve used the following suggestions:



Understandings

- I remember that although my feelings and symptoms are very frightening, they are not dangerous or harmful.

- I understand that what I am experiencing is an exaggeration of my body’s reaction to stress.

- I don’t fight my feelings, or try to wish them away. The more I am willing to face them, I trust that the less intense they will become.

- I do not add to my panic by thinking about what “might” happen.

- I stop adding frightening thoughts to my fear.

- When the fear comes, I expect and accept it.

- I choose to change my primary thought focus.

- I stay in the present. I notice what is happening in the here and now.



Behavior

- I have labeled my fear level from 0 to 10. I note that it changes.

- I carry out a simple and manageable task, i.e., dusting, going out to buy a pack of gum.

- I count things. (I have tried counting backwards from 100 by 3's.) I count words on a sign, letters, occurrences of letters. I’ve looked outside myself to count windows on a building, buttons on a shirt.

- I repeat an encouraging phrase to myself.

- I sing along with a song on the radio.

- I make up lists.

- I write down my thoughts.

- I take a deep breath, hold, release, and repeat.

- I picture my “happy place” by visualizing some place comforting or safe.

- I play simple word games (spell words backward, switch letters, count the letters in words).

- I make physical contact with the things around me.

-I have figured out for myself what is important to me.



I hope you find your way through, as well.
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Postby Butterfly Faerie » Thu May 18, 2006 3:01 pm

Agoraphobia
Social Phobia


The Facts


Agoraphobia, meaning "fear of the marketplace" in Greek, is a type of anxiety disorder. It's a condition where sufferers feel intensely anxious about being trapped in certain situations from which they can't easily escape. The result is a feeling of panic. Movie theatres, long lineups in banks or stores, and buses or subways are examples of places feared by agoraphobic people. They often end up avoiding these situations or only going with someone with whom they feel "safe." In extreme cases, they may end up housebound, terrified to go anywhere in public. Agoraphobia affects 3.8% of women and 1.8% of men in any given six-month period.


Causes



In many cases, agoraphobia develops after a person has experienced a panic attack (panic disorder). This involves feelings of intense, overwhelming terror along with physical symptoms like sweating, dizziness, a pounding heart, and shortness of breath. Although panic attacks are unpredictable, the person learns to avoid the situation that seemed to trigger the episode, for fear of having another one. Other sufferers may just feel uncomfortable in agoraphobic situations without ever having had, or going on to have, panic attacks. A few will go on to develop full-blown panic disorder. Agoraphobia is more common than panic disorder, which only affects about 1% of the population.
Symptoms and Complications



Agoraphobia can come on suddenly or develop gradually, typically developing between the ages of 18 and 35. It's an emotional and physical reaction to being put into a specific situation that triggers fear, with the following symptoms:

strong feelings of panic, dread, terror, and horror
recognizing that the anxiety is overblown, yet not being able to "talk oneself out of it"
rapid heartbeat, shortness of breath, trembling, and an overwhelming urge to flee the situation - all physical reactions associated with extreme fear
going to great lengths to avoid the situation that causes fear
Left untreated, agoraphobia tends to wax and wane in severity and can even disappear on its own. However, if the condition prevents someone from working, socializing, or otherwise living a normal life, the person should talk to a doctor to get the help they need.


Making the Diagnosis



As with most mental disorders, there are no blood tests or other "hard and fast" ways to diagnose agoraphobia. A doctor will ask many questions to find out whether someone has the symptoms and signs of agoraphobia and to make sure that it isn't another mental condition. In particular, agoraphobia should be distinguished from social phobia (social anxiety disorder), where avoidance is limited to social situations due to fear of embarrassment, and treatment interventions can be either biological (with selected antidepressants) or psychological (cognitive behavioural therapy). In addition, it's important to be sure that the anxiety isn't being caused by a medication, drug abuse or addiction, or a medical condition. A doctor may refer someone to a psychiatrist or other therapist who specializes in recognizing and treating anxiety disorders, including agoraphobia.


Treatment and Prevention



Fortunately, agoraphobia can be effectively treated with a type of behaviour therapy called exposure therapy; over 90% of patients who stick with this therapy are helped. Exposure therapy works by encouraging patients to confront the situation they fear rather than avoiding it. By deliberately staying put in the circumstance that triggers a negative reaction, they gradually become used to it - it's called habituation - and their anxiety fades away as they realize that nothing bad will happen to them.

Another form of behaviour therapy involves a technique called diaphragmatic breathing. There's good evidence that breathing deeply in a controlled way is effective in overcoming the body's fear responses. Cognitive-behavioural therapy is a different approach that teaches patients new skills to cope with triggering situations. They learn to "think their way out" of their fear to lessen or stop the symptoms.

To help the therapy work, doctors may also prescribe certain anti-anxiety medications to help combat the symptoms.

Of course, no matter what therapy is chosen, it has to be performed by a skilled therapist whom someone with agoraphobia can trust completely.
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Postby Butterfly Faerie » Thu May 18, 2006 3:01 pm

Phobias

The Facts



Phobias are fears that interfere with a person's ability to cope in certain situations. These situations are not normally dangerous or frightening, but people with phobias experience strong feelings of anxiety when they are in these situations. One in ten people will experience phobias at some point in their lives. Such people can be calm and rational in most circumstances, yet find themselves paralyzed with fear when facing certain situations.

Phobias can be categorized into a number of different types:

Social phobia is an avoidance of social situations, resulting from extreme shyness or fear of being embarrassed in public. Social phobia affects men and women equally. It often starts in childhood or adolescence and is often accompanied by other anxiety disorders or depression.
Agoraphobia is the fear of going into public places, including fear of open spaces and of crowds. Agoraphobia affects mostly women, who tend to develop the condition early in adult life.
Specific (isolated) phobias include many types of intense fear reactions. These include:
fear of animals (e.g., spiders or snakes)
environmental fears (e.g., of heights, or water)
situational fear (e.g., of enclosed spaces or elevators)
fear of injury (of potentially dangerous situations - real or imagined - or of contracting illness)
other phobias (fear of loud noises)
Twice as many women are affected as men, and tend to develop their fears in childhood or early adolescence, with the phobias persisting into adulthood.




Causes



Social and specific phobias sometimes run in families, providing evidence of a genetic connection. Some people are born with a predisposition towards anxiety, which makes them particularly susceptible to developing phobias.

Phobias may develop as a response to pressure or following traumatic events. This is known as post-traumatic stress disorder. In other cases, unreasonable fears may develop with no apparent trigger. Adults generally recognize that their fears are irrational or excessive, and this can act as an isolating factor. The affected person might not talk to friends and family about a fear that they believe is silly.

Phobias are also a natural part of development. Most children go through stages where they are scared of the dark, of monsters, or of strangers. Many teens develop anxieties associated with self-image and others' perception of them. While these fears are normal and often get left behind over time, they can sometimes persist or become incapacitating.


Symptoms and Complications



Anxiety suffered by a person with a phobia can be experienced as both mental and physical symptoms.

Mentally, a person can become so worried about encountering or avoiding a particular situation that it can disrupt sleep, cause fatigue or irritability, or even make it difficult to concentrate on other matters.

Physically, anxiety in the face of fear can make a person sweat, breathe heavily, or experience irregular heartbeats (palpitations), dizziness, or faintness. Anxiety can also cause muscle pain or tension, and may even interfere with digestion, resulting in diarrhea, for instance.

Particular phobias are identified when the fear of - or exposure to - specific situations is so extreme that the person loses the ability to cope under those circumstances. A person's attempts to avoid such situations can become sufficiently disruptive to his or her life as to be debilitating.

Panic attacks can help lead to the development of certain phobias. Panic disorder is marked by sudden, extreme feelings of terror and panic. The attack can cause a person's heart to pound and feel dizzy, faint, weak, or sweaty. Nausea, chest pains, a sense of unreality, and a loss of control often mark an episode, which can occur at any time, night or day. Panic disorder is not a phobia but an anxiety disorder. However, having a panic attack in an elevator can result in a fear of elevators or of confined spaces; fear of having attacks in public places may cause a person to avoid those places, leading to agoraphobia. Similarly, panic attacks can become symptoms of phobias, and may be triggered by exposure to the things or situations that people fear.

There are two types of social phobia. Generally, the phobia encompasses all social situations outside of family contact, and may be associated with low self-esteem and fear of criticism. Avoidance of social situations often leads to social isolation. Another type of social phobia may occur in people who are normally comfortable with informal social contact, but become excessively nervous, anxious, and flustered when they're the center of attention. This is likely to affect individuals who must perform or speak in public, even those who have considerable experience being in the spotlight (Sir Laurence Olivier developed "stage fright" at one period in his acting career).

Agoraphobia is typically associated with the lack of an easily available exit or escape route to a safe place (usually a person's home). People become frightened of being in public places, stores, or crowds, or of travelling alone, and are prone to panic attacks when they go out alone. The phobia may consist of a cluster of different fears that overlap, often resulting in people who are too frightened to leave the safety of their own homes. For this reason, agoraphobia is considered the most incapacitating of anxiety disorders.

Specific phobias generally develop in young adults and, if left untreated, persist for decades. When individuals are easily able to avoid the phobic situation, the impact of the phobia will not be as great. However, when a person has to go to great lengths to avoid fears, the phobia becomes disruptive to normal functioning. It's most important to get help. Treatment or therapy will enable a person to work and have an active social life.


Making the Diagnosis



When someone recognizes that the feelings of anxiety or distress in any type of phobia become worrying, or are interfering with daily life or relationships, a doctor or therapist can help pinpoint the problem. A health professional may start with a range of questions to evaluate if symptoms and behaviour are consistent with a phobia. This can include asking about:

the person's specific responses to certain situations
how long the condition has been evident
how often the person experiences the symptoms of a phobia
how much of the person's time is taken up by thoughts of encountering something that's feared.
Based on the answers, the particular type and cause of the phobia can be pinpointed.

Usually, the best clue to a diagnosis is if someone often or always tries to avoid any situation that triggers the symptoms. For children or teens under 18 years old, the symptoms need to have been present for at least six months for diagnosing specific phobias.


Treatment and Prevention



Treatment can either take place through use of medications or psychological interventions.

Treatment using medications involves antidepressant medications that are effective in treating the various symptoms associated with social phobia, panic attacks, and co-occurring depression. Anti-anxiety agents (benzodiazepines) and beta-blockers may also play a role in treatment. Available medications include:

SSRIs (selective serotonin reuptake inhibitors) alter the levels of serotonin in the brain, and have fewer side effects than the other anti-depressant medications.
Tricyclic antidepressants used in low doses have been widely used in treating anxiety disorders; however, these medications have side effects such as dizziness, drowsiness, dry mouth, and weight gain.
MAOIs (monoamine oxidase inhibitors) work well on panic disorder and social phobia; these medications require people to adhere to a restrictive diet that at times can be troublesome. Failure to adhere to the diet can result in very serious reactions.
Beta-blockers - normally used in the treatment of heart conditions - are effective in the treatment of social phobia. They are specifically prescribed for individuals who must perform or talk in public and require short-term medication to stop the associated physical symptoms of the phobia from developing.
Benzodiazepines are effective anti-anxiety medications that can be very helpful in the short term treatment of anxiety, for immediate use during an acute panic attack, and during behavioural treatment as a person attempts to face his or her feared situation or specific phobia.
Psychotherapy is a powerful non-medicinal psychological intervention in the treatment of social phobia, panic disorder, and specific phobias. Cognitive therapy, the specific psychological intervention that is effective in social phobias and panic disorders, aims at changing thinking patterns and finding ways of redefining or coming to terms with core beliefs behind certain fears. Behavioural therapy is effective for specific phobias where gradual exposure of the person to the specific phobia occurs as the person is taught how to cope with and manage the resultant anxiety. Confronting fears in the safety of a therapeutic environment helps to dull people's phobias, and gradually helps them put the fears - and their responses to them - into perspective.

Talking about a specific fear can help to alleviate the intense anxiety associated with it. Trusted friends and family can provide good support, especially when anxiety follows some trauma in a person's life. Self-help groups can also be eye-opening encounters by allowing people to share experiences and to find out how others with similar problems cope with their fears. Relaxation and stress-management techniques - learned from professionals, groups, or books and videos - can go a long way towards helping people to control their anxiety.
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Postby Butterfly Faerie » Thu May 18, 2006 3:02 pm

PTSD · Shell Shock

The Facts



Post-traumatic stress disorder, or PTSD, is a new name for a very old condition. Earlier in this century it was known as "shell shock" or "battle fatigue." Before then, it had no name. In PTSD, a witness or victim of a terrible event or tragedy is so haunted by memories of the event that personal health and personality is affected.

Research suggests that as many as 10% of the population will be affected at one time in their life with PTSD. Women are twice as likely to be affected as men. While 50% of the population is exposed to severe trauma at sometime during their life, less than 20% of these individuals will develop PTSD. The type of specific trauma is important in the gender distribution. For example, 20% to 30% of women exposed to a physical attack or threatened with a weapon develop PTSD while only 2% of men will develop PTSD if exposed to the same trauma. However, 20% of women who are sexually assaulted develop PTSD, while 65% of men who are sexually assaulted develop PTSD.




Causes



The kinds of events that can trigger PTSD were traditionally limited to the most violent and frightening situations, such as being involved in a plane crash, a shooting, or the collapse of a building after an earthquake or bomb. The main source of such trauma is war, and in North America the largest category of PTSD sufferers are Vietnam War veterans. Much of what we know about this syndrome comes from studies involving former soldiers.

More recently, the definition has broadened. People who suffer rape or physical or sexual abuse may react in much the same way as those who have witnessed carnage or been threatened by violent death. In this context, PTSD among children has become a major focus because they are particularly likely to develop the symptoms associated with this condition.


Symptoms and Complications



The most noticeable signs in a person suffering from PTSD are introversion and joylessness. People with this syndrome are unable to take pleasure from things they might have enjoyed in the past. They avoid the company of others and become generally more passive than before. They wish to avoid anything that will trigger memories of the traumatic event. A person with PTSD might drift out of a conversation and appear distant and withdrawn. This is known among soldiers as a "thousand-yard stare." This is a sign that unpleasant memories have returned to haunt them.

Having trouble sleeping is almost inevitable in this syndrome. Nightmares are common, and even when someone with PTSD is not thinking about the event, sleep is often disturbed. A common symptom among veterans is nocturnal myoclonus, a sudden spasm of the whole body while sleeping or drifting off into sleep. It lasts for about a fraction of a second, but may occur several times in a single night. Often people with PTSD will sleep through such a spasm, but their partner may not. Children with PTSD may have a lot of nightmares, yet those dreams may not contain anything that's obviously related to the original trauma.

Psychiatrists speak of three symptoms that define PTSD - intrusion, avoidance and hyperarousal. Intrusion is the inability to keep memories of the event from returning. Avoidance is an attempt to avoid stimuli and triggers that may bring back those memories. Hyperarousal is similar to jumpiness. It may include insomnia (trouble sleeping), a tendency to be easily startled, a constant feeling that danger or disaster is nearby, an inability to concentrate, extreme irritability, or even violent behaviour.

Depression is very likely to go hand in hand with PTSD, and in severe cases, suicide is a real danger. People with this syndrome, as with any psychiatric illness, are more likely than average to abuse alcohol or drugs. Psychiatrists see this as an attempt to self-medicate the condition, but naturally the drugs involved are very unlikely to improve the situation.


Making the Diagnosis



The diagnosis of PTSD is based on four specific features that must be present for at least one month:

1. An objective component (the traumatic event) and a subjective component (the person's reaction of fear, horror, or helplessness).

2. Re-experiencing symptoms after the trauma (e.g., intrusive thoughts or recollections, recurrent dreams of the trauma, flashbacks of the trauma).

3. Avoidance or "numbing" symptoms (e.g., avoiding thinking about the trauma, avoiding people or places that remind you of the trauma, inability to remember specifics about the trauma, detachment, or inability to see a positive future).

4. Arousal symptoms (e.g., insomnia, irritability, decreased concentration, hypervigilance, or exaggerated startle response).


Treatment and Prevention



Treatment can be effective for PTSD and involves psychological intervention as well as medications.

The main psychological treatment to treating PTSD is cognitive-behavioural therapy. This means examining the thought processes associated with the trauma, the way memories return, and how people react to them. PTSD sometimes fades over time, even without treatment, and the goal of therapy is to accelerate that natural healing or forgetting process. Because the horror may fade over time, being confronted with memories of the trauma when in a safe situation may help a person over time to become less frightened or depressed by those memories. This is called desensitization, which is often combined with cognitive behavioral therapy. Psychological treatments are particularly helpful for the "re-experiencing symptoms" and any social or vocational impairment caused by PTSD.

Medications used in treatment are serotonin re-uptake inhibitor antidepressants (SSRIs). Most people with PTSD will benefit from taking antidepressant medications, whether or not they have clinical depression accompanying their PTSD. These medications are particularly helpful in treating the avoidance and arousal symptoms as well as any concurrent anxiety and depression.
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Postby Butterfly Faerie » Thu May 18, 2006 3:02 pm

This information was taking from the book: An End to Panic. Breakthrough Techniques for Overcoming Panic Disorder.


Chronic hyperventilation is a condition that can last for months or even years. In panic the symptoms often are very anxiety provoking and can devastate a person's life. In a dizziness clinic at a university, studies showd that almost 1 in 4th of all paitents experience hyperventilation as the major or only cause for dizziness.

Hyperventilation like panic can mimic many organic diseases and can also complicate conditions such as asthma, which is another good reason for a check up so that all possible diseases can be ruled out. Most people will not show any organic cause. Hyperventilation sometimes is definatly wrong even if it is not organic in nature.

Most physicians look only for the "disease" and failing to find it, tell you "you are fine." Some paitents do not want to accept that their physical symptoms which are so real might be due merely to hyperventilation, or the fight/flight response, and insist that their symptoms are caused by illness. Most people are unaware that anxiety, depression, obsession, or internal conflict can manifest as an array of physical symptoms. Mental health professionals may see the symptoms as by-products of anxiety and depression and if they treat only the anxiety and depression, a possible hyperventilation condition may go undetected.


Panic and hyperventilation can cause identical symptoms

Here is a situation in which you might experience a variety of physical symptoms. Imagine yourself in a crowded store, or sitting in the back seat of a 2-door car. You start to feel weak in the knees, light-headed, and dizzy; your hands tingle or they are numb; you have heart palpitations and a lump in your throat; and you feel that the ground beneath you is shifting. More than the feeling of breathlessness, you have this need to take a deep satisfying breath. But no matter how hard you strain for air, you can't seem to get enough. You are hungry for air, but there is just not enough. Now you fear that you may embarrass yourself, fair ot die and you want to scream out loud, "Let me out of here!" Yet there does not seem to be enough air for even those few words, and you are now desperate to step outside and get fresh air. Once outside you finally feel that you can breathe again.

What caused these symptoms? Anxiety, panic or hyperventilation, or any combination of three can produce those sensations.
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Postby Butterfly Faerie » Thu May 18, 2006 3:03 pm

SIX TYPES OF ANXIETY

There's anxiety and then there's anxiety: In fact, psychiatrists recognize six different types: Social anxiety, phobias, post traumatic stress syndrome or PTSS, generalized anxiety disorders, panic attacks, and obsessive compulsive disorders or OCD. Anxieties tend to affect more women than men; panic attacks are extremely common. And the lifetime chance of having a phobia, which Berber says is extremely easy to fix, is about 11%.

To control your anxiety before it controls you, Berber says you need to play detective with yourself in order to discover the kind of anxiety you have. "Ask yourself, 'What am I worried about?' If you answer that correctly, you'll know which kind of disorder you have."

For example, people with a social anxiety fear being criticized and humiliated in front of others: They're terrified of public speaking, and in severe cases of using a public washroom. Phobias are obvious: They could be anything from snakes to sweaters, elevators to elephants. The fear in PTSS is that you'll re-experience the trauma, while someone with a generalized anxiety disorder or GAD fears everyday things such as their job or money.

Berber, a fan of media psychologist Dr. Phil, says that anxiety disorders can be disabling. People with social anxiety issues, for instance, can feel trapped in social situations and so avoid parties and end up leading isolated lives. Those with a generalized anxiety disorder are life's worriers. Berber can spot them through employing the mnemonic WATCHERS: They have Worry, Anxiety, Tension, a lack of Concentration, are Hyper-aroused, feel a loss of Energy, are Restless and suffer Sleep disorders. "This is not a trivial problem," says Berber.

People with panic disorders experience panic attacks that can produce sweaty palms, racing hearts and tight chests. Often, their doctors send them to cardiologists or other specialists thinking there may be something physically wrong with them. There are 13 sub-symptoms to this disorder which Berber remembers through the mnemonic STUDENTS FEAR C (the letters stand for everything from Sweating to Trembling, from FEAR of dying to Chills, Chest pain and Choking.)

OCD is an awful disease that has two components: The obsession (recurrent thoughts that keep crowding your consciousness: Did you turn off the stove?) And the compulsion (the tapping or constant washing of hands). OCD often begins in adolescence, says Berber who had one patient who spent three hours every day in the shower.

Besides offering an easy way to diagnose symptoms, Berber believes his approach demystifies the subject: "There's a lot of gobbledygook in psychiatry so we try to make the diagnosis as clear as we can." He believes that patients can quickly understand the root of their anxiety disorder, be it an inherited predisposition or a precipitating event.

Treatment of these disorders ranges from talk therapy to patient education and medications such as anti-depressants, he says. And they're important to get on top of because anxiety is found in 80% of people with depression.


COGNITIVE THERAPY

Therapy can be helpful to change the "negative self-talk" that is rampant in anxiety disorders, says Berber who explains that "if we think a certain way, we feel a certain way." This, he explains through the mnemonic BADMOODS which stands for Black and white thinking, "Awfulizing" situations, Discounting the positive, Maximizing the negative, Overgeneralizing, Overestimating the likelihood of something bad happening, Demanding too much of yourself, and full of Self-blame. If that's you, cognitive therapy can help.

Berber has accompanied patients on the elevator rides they feared, driven with highway phobics on the 401, and even prescribed lifestyle changes and eastern medicine. "I love breathing," he says, describing pranayama, a yoga technique that focuses on controlling the breath and which creates clarity and focus. "It can calm the whirlpools of the mind." That's BIBOS, for you mnemonics lovers: Breathe In, Breathe Out -- Slowly.
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