Anxiety: A Treatable Disorder

Colette Dowling, LMSW

Social phobia is a particular type of anxiety disorder. An example is the horror of going to a party and having to talk with people you don't know. Will you be thought smart enough, articulate enough, funny enough? Can you tell a story so people will listen? The anticipatory anxiety over having to "perform" in social situations can keep you housebound just to escape the out-and-out terror caused social phobia. Some people are plagued by perfomance anxiety, the panic over having to give a performance of some sort--a speech, say, or playing an instrument for a show or recital. Difficulty in writing reports or articles can also be manifestations of performance anxiety. The dread manyy graduate students feel about completing a thesis is often nothing other than performance anxiety.

A Hyperactive Alerting System

Some people's anxious personalities may not even start in the psyche, according to Arnold Cooper of the Cornell Medical School, but are the result of "biologic dysregulation", or glitches in the way the brain is firing up its GABA neurotransmitters--the body's calming agents. Speaking at a symposium in the mid-eighties, Dr. Cooper presented his colleauges with a revolutionary idea: many who are chronically anxious, or phobic, or who are vulnerable to panic attacks, performance anxiety and social phobias, may be suffering from "a hyperactive alerting system," the result of a small flaw in brain's metabolism. The flaw has to do with the very delicate balance of serotonin that's needed to maintain table mood.

Hormones Kick In Too

Women are two-and-a-half times as likely to suffer from anxiety disorders as men. Often they experience spikes in their anxiety levels during the week to ten days that they're pre-menstrual. Researchers believe this is related to the lowering of serotonin that occurs when estrogen levels drop. (Estrogen is required for the brain's production of the calming serotonin.) Some women take very low doses of antidepressant medication ONLY premenstrually, and find that their mood stays stable during this time. Treatment Works Today, antidepressant medication is considered the gold star treatment for panic disorder. Ideally it is combined with psychotherapy, which helps people "unlearn" the behaviors they developed in order to cope with the panic states. But for the physically intense panic symptoms themselves--the "My God, I must be dying" sensation--nothing will stop them as effectively as medication. More and more therapists are recognizing this and suggesting that their panic-ridden patients seek an evaluation from a psychopharmacologist.

Patients of mine who've been treated medically for their anxiety disorders have been amazed by how quickly their conditions change. No more heart palpitations, or hyperventilation. No more obsessive list-making, or panicky hyper-alertness, or irrational fears.

What's important is that treatment is available. You don't have to let your social life and work performance be impaired by the irrational fears and physical symptoms that anxiety causes. Such impairment, when it goes on long enough, will undermine your self esteem and can even affect your sense of personal identity.

While there undoubtedly is a psychological as well as biological basis for anxiety, it is not so elusive and difficult to treat as once was thought. Those afflicted with anxiety should seek help. Don't wait because anxiety disorders can worsen without treatment.

For more information on anxiety disorders see Colette's website on women's wellbeing and mental health.

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For further information, or to seek a consultation with Colette, see her profile at Psychology Today.