NY psychotherapist Colette Dowling, LMSW, author of the following article on anxiety, has written eight books, including The Cinderella Complex: Women's Hidden Fear of Independence, which was published in 23 languages. Anxiety: A Treatable DisorderColette Dowling, LMSWAnxiety, panic and social phobias plague a good twenty-five percent of the population. Anxiety, today, is understood quite differently than it was twenty-five years ago. In our parents' time, anxiety tended to be thought of as strictly neurotic, a manifestation of some deep inner conflict. Conflict certainly can play a role in making us feel anxious, but brain chemistry too is an important component. In fact, all the following types of anxiety disorder are related to neurotransmitter changes in the brain. Social phobia is a type of anxiety disorder familiar to many. Oh 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 by social phobia. Some people are plagued by performance 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 many graduate students feel about completing a thesis is often nothing other than performance anxiety. Not that that's nothing. Performance anxiety can really keep you underperforming. Its no fun.
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. Dr. Cooper presented his colleauges with what, in the eighties, was 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 stable 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 during the week to ten days when 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. Today, antidepressants are considered the gold star treatment for panic disorder. Ideally they are combined with psychotherapy, which helps people to unlearn the behaviors they developed while trying to cope with panic states. But for the physically intense panic symptoms themselves--the "My God, I must be dying" sensations--nothing is as immediately effective as medication. More and more therapists are recognizing this and suggesting that their panic-ridden patients seek medical treatment in addition to their therapy. Patients who are treated for anxiety are often 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. The good news is that treatment is effective. You don't have to let your social life and work performance be impaired by irrational fears. 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, the condition is not so difficult to treat as once was thought. Those afflicted with anxiety should seek help. Don't wait. Anxiety can worsen without treatment. If you are seeing a therapist for anxiety and she or he hasn't suggested a medical evaluation, ask for one. Likewise, if you are seeing a doctor for anxiety medication but he or she hasn't recommended a therapist, ask for a referral. Studies have shown the combination of psychotherapy and medication to be the most effective treatment in most(but not all) cases. If you are not interested in taking medication, certain natural amino acids can be very helpful in lowering anxiety levels.
NYC psychotherapist Colette Dowling, LMSW, received her masters degree from the Smith College School for Social Work and has done advanced training at The Institute for Contemporary Psychotherapy, in New York. She has a private practice in New York and specializes in the treatment of women. For a consultation or further information, you may call Colette at 718-594-0201, or write dowlingcolette@earthlink.net. To hear Colette speak on what it's like starting therapy with someone new, click the button.
For a description of Colette's therapy practice click here.
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