Mental Health, Mental Health Mondays

Mental Health Monday Part 1: Anxiety

theceruleanelephant

Welcome to the first Mental Health Monday! Every Monday we will be discussing a mental health disorder, it’s signs and symptoms, treatments, etc. I will also be discussing my personal experiences with the illnesses if I have them. This week we will be having a two part discussion about the two most common mental health disorders; anxiety and depression, as these typically come together although they can be experienced completely separate. Please note that some of this information is sensitive. *Reader discretion is advised.*

Anxiety

Anxiety can be a healthy coping mechanism. It helps with flight or fight and can be motivating for everyday tasks. An anxiety disorder differs in intensity, how long it lasts and interferes with work, activities and relationships. Anxiety is mostly caused by the perceived threats in the environment that may or may not be real. Anxiety is the over reaction to these threats. It can be anything from an uneasy feeling to a panic attack. Anxiety sufferers typically have a low level of dopamine. It is not known if the low dopamine causes anxiety or vice versa.

Anxiety makes up 18.1% of mental health disorders that are reported. Typically, the median age of onset is just a mere 11 years old. Anxiety is more prevalent in females than males. There are several different types of anxiety disorders, the main ones are listed below with their percentages, median ages of onset, and a brief description:

  • Specific Phobias (8.7%, 7 years) – avoidance and restriction of activities because of persistent and excessive fear. These can include places, events or objects. Commons phobias include spiders, snakes, mice, bugs, heights, animals, blood, injections, storms, flying, and enclosed spaces.
  • Social Anxiety Disorders (6.8%, 13 years) – fear of any place public scrutiny may occur. Common triggers are speaking or eating in public, dating, and social events.
  • Post-Traumatic Stress Disorder also known as PTSD (3.5%, 23 years) – occur after a distressing or catastrophic event. Common examples include war, accidents, assault, or witnessing any of these experiences.
  • Generalized Anxiety Disorders also known as GAD (3.1%, 31 years) – overwhelming, unfounded anxiety and worry about things that may or may not go wrong accompanied by physical and psychological symptoms that occur for days and then not again for at least six months.
  • Panic Disorders (2.7%, 24 years) – panic attacks are sudden onset of intense apprehension, fear and terror. To have a disorder, these attacks have to be reoccuring and for at least one month the person has to be worried about another attack.
  • Obsessive-Compulsive Disorders also known as OCD (1%, 19 years) – this is the least common but one of the more disabling disorders. Obsessive thoughts and compulsive behaviors take over the patient. Common thoughts include fear of contamination, need for perfection and symmetry, and religious preoccupation.
  • Agoraphobia (0.9%, 20 years) –  avoidance of social situations involving crowds. Typically these patients will not leave home. Type of Social Anxiety.

People most at risk for anxiety disorders include those with more sensitive natures, excessive shyness as a child, female gender, alcohol abuse, and trauma. Family influences include childhood abuse, poverty, family history of anxiety disorders, parental alcohol problems, separation, and divorce. Medical induced anxiety can come from endocrine conditions, cardiac conditions, respiratory conditions, metabolic conditions, side effects from prescribed drugs, intoxication and withdrawal from alcohol and illicit drugs.

Symptoms from anxiety can vary. There are physical, psychological and behavioral symptoms.  Some physical symptoms include pounding heart, hyper or hypoventilation, dizziness, tingling, nausea, vomiting, diarrhea, and tremors. Psychological symptoms include excessive fear, going blank, anger, irritability, restlessness, and sleep disturbance. Behavioral symptoms include avoidance, obsessive and compulsive behaviors.

There are two common treatments for anxiety disorder and they usually coincide with each other. Medication is the first treatment. Most antidepressants have been successful in treating anxiety and these are great because they can be used safely long term when under the care of a provider. Anti-anxiety medications (benzodiazepines) are also great but should be used cautiously as they are addicting. These should be used short term for crisis’. All medication is prescribed by professionals such as your primary care doctor or psychiatrist. The second treatment is cognitive behavioral therapy (CBT). Therapy has the strongest effectiveness. CBT is provided by a professional which are usually a psychologist, psychiatrist or trained counselor. CBT includes education about self management, problem solving, exposure therapy, emotional regulation through meditation and relaxation, relearning social skills, and relapse prevention and planning. Therapy can be in groups or in private.

A new “treatment” includes using marijuana. I use quotations because marijuana is not endorsed by physicians and providers. “The FDA has not recognized or approved the marijuana plant as medicine (2).” Medical marijuana or cannabis is becoming more popular and debilitating anxiety disorders are a condition for prescription, however it is as a last resort and has to be used in conjunction with prescribed medication.

If you know someone whose suffering the best thing you can do is bring it up to them. Make sure you are in a quiet place and are alone. More than likely this will be a relief but please note some of the more severe disorders may get angry. Offer to go with them to their doctor or therapist. Support them as long as it takes. If they seem to be a danger to themselves or others, do not leave them alone. If necessary, call 911 when you feel you cannot handle the situation. A few days of anger from someone beats them making rash, dangerous decisions.

I was diagnosed with generalized anxiety disorder when I was 16 although I was about 14 when the signs and symptoms first presented themselves. I would get palpitations and severe gastrointestinal distress. The thing about GAD is that usually you don’t know what your trigger is. I remember the first thing I “panicked” about was the kids walking out of high school my sophomore year to protest the firing of a long time teacher. I could not go to school because of my GI distress. The likely answer to this is that kids were going to have Saturday detention if they walked out. I was prescribed Xanax which is a short term anti-anxiety medication. It helped and I continued to use it until I was about 24. When I was 23 my anxiety and depression got out of control and I was suffering. I did end up seeking out the help of a therapist (thanks Dr. M). I had 11 months worth of cognitive therapy which included workbooks, planning, identification of triggers and lots of crying and anger. My issue…control. I did not like the unpredictability of a situation and my inability to control those situations. We came up with a slogan that I literally now have written everywhere and have passed on to other people.

You are not out of control, you are just less or more in control.

I will talk about my therapy more in part 2. Thanks for reading about anxiety. I will list my resource below and some websites you can find more information!

  1. MentalHealthFirstAid.org
  2. National Institute on Drug Abuse https://www.drugabuse.gov/publications/drugfacts/marijuana-medicine

Published by theceruleanelephant

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