What Statistics About Anxiety Say

According to the National Institutes of Mental Health, more than 13% of American adults aged 18-54 experience a diagnosed form of anxiety each year---that’s more than 19 million people. This number does not include the millions more who suffer anxiety but do not seek treatment from doctors or psychotherapists. Nor does it count the times that most of us feel a little anxious about common situations of normal life, such as going to the dentist, having surgery, going to court, taking an exam, losing a job, getting married or divorced, and so forth.

The costs of diagnosed anxiety disorders total up to more than $42 billion a year, almost one third of the $148 billion total mental health bill for the entire US. In addition, nearly $23 billion of those costs are associated with the repeated use of healthcare services, as those with anxiety disorders seek relief for symptoms that mimic physical illnesses, such as heart problems, high blood pressure, respiratory distress, asthma, loss of consciousness, loss of concentration, etc.

In the 18-54 year old age group, about 4 million ---or nearly 3 % of us---feel anxious all the time, but without having a specific triggering cause. This is called Generalized Anxiety Disorder (GAD). People who grow up in chaotic homes, or in families with high and exacting expectations, may be prone to GAD. People who are known as perfectionists may be affected by GAD. Their perfectionism is a coping mechanism for the underlying anxiety that they live with on a minute to minute basis.

Decades ago, psychologists used to talk about neurosis, and neurotic clients. Today this is no longer a diagnostic term as we have come to understand that a certain degree of neurosis is within the range of normal for some people. The primary determining factors by which psychologists decide if a neurotic client is suffering from GAD are the degree to which anxiety interferes with normal daily functioning, and to what extent the client’s usual coping mechanisms are effective or dysfunctional.

There are also those who take the biomedical approach and consider that GAD is primarily a neurochemical imbalance, for which medications can be prescribed. This can be helpful, depending on the severity of the anxiety and the individual involved. Psychotherapists sometimes suggest combining medication with suggestions like those found in this book. Although the personal growth approach is not opposed to medication when it’s useful, its followers tend to see GAD within a context of multiple factors that can be changed by a variety of methods, most of which are inexpensive, easy, and in the client’s personal control.

The pace of our daily lives, the demands of nanosecond technology and 24/7 availability by fax, cell phone and email, the very real threats of the geopolitical scene, the drive to out do our parents and show up our neighbors and provide every consumer luxury for our kids---all these factors and more contribute to GAD. It can be understood primarily as a lifestyle disorder. And that’s the good news, because holistic treatments that aim to restore lifestyle balance are an effective, permanent strategy. Pharmaceutical medications aimed at helping you tolerate the distress may help provide the break you need to begin the more holistic approaches. Still, drugs, whether prescribed or not, generally only treat the symptoms, not the causes of GAD.

Women are twice as likely as men to be diagnosed with GAD. That’s no surprise, given that women still have less control over their lives and choices than men have, particularly in the workplace. Persons who feel like their life is under their control have less anxiety. Women in general are also twice as likely as men to go to a psychotherapist or doctor when feeling the symptoms of anxiety, whereas men in general tend to ignore physical and emotional symptoms, and instead channel their anxiety into problem-solving, harder work, and adrenaline discharging sports.

Post Traumatic Stress Disorder (PTSD) became a familiar term in the Vietnam War era as veterans returned home emotionally shattered, physically injured, greatly disillusioned about the American government and sorely misunderstood by American society. But military men and women are not the only sufferers of PTSD. More than 5 million Americans aged 18-54 are diagnosed with PTSD each year---and more women than men are included in this statistic.

Symptoms of PTSD include most of the anxiety symptoms detailed in the previous chapter, and a few additional symptoms as well such as:

Rape and child abuse are the primary causes of PTSD in non-veterans. While more women than men are raped, 65% of men who are raped will develop PTSD, while PTSD is the diagnosis given to only 49% of women who are raped. The available statistics do not distinguish between stranger and date rape, nor do they account for sexual orientation. We do know that straight men are primarily raped in jail, while gay, transgendered and transsexual men are susceptible---just as all women are---to being raped anywhere at any time. The figures for men who have been raped may be increased as the sex and power abuse scandals in religious institutions make their way into the statistics.

Childhood sexual or physical abuse are considered strong likely lifetime predictors of PTSD. Other experiences in childhood may also trigger later PTSD episodes, such as witnessing the accidental death or suicide of a parent or sibling, violent home invasion by strangers, witnessing physical abuse of a parent by the other parent, witnessing a mass casualty event such as a deadly fire, a highway collision, or a terrorist attack, and other such intensely traumatic events.

PTSD is a difficult form of anxiety to treat solely with self-health measures because the triggering event is so overwhelming to the average person’s psyche. Usually, there are other emotional issues and states present that further complicate healing through PTSD, such as grief, depression, sleep disorders, substance abuse, possibly eating disorders, diminished sexual interest, and dissociative disorders.

Because of the potential complexity of PTSD, professional help is usually the best approach. Medications may provide a useful respite from symptoms, while working through the trauma in psychotherapy is, from the personal growth point of view, the most proven long term strategy for healing post traumatic stress disorder. Various combinations of other treatment modalities can also provide episodic relief. Persons suffering from PTSD can learn to apply several self-health techniques including focused breathing and relaxation, and corrective experience therapy that may help resolve PTSD symptoms. Homeopathic and flower essence remedies can also augment therapy and other medications for extra relief.

Psychotherapists who are specialists in the emerging sciences of trauma or somatic psychology are the best options to handle your PTSD. Most likely, they will suggest healing strategies similar to some of those in this booklet. Family practice doctors who are not specialists in psychology can be relied on to prescribe anti-anxiety medication, which may be of short term value in getting through the roughest periods of healing. The goal in working through PTSD is to be able to acknowledge the triggering event and how it changed your life while still being intellectually and emotionally available to do the psychological work needed to heal from it.

Approximately 2.4 million people experience an extreme form of anxiety called Panic Disorder. More women than men are diagnosed with panic, but this again may be due to the fact that more women than men go to a psychotherapist or doctor when panic occurs. Panic often co-exists with depression, making medication strategies or nutritional supplementation sometimes difficult to get precisely right. Panic disorder differs from Post Traumatic Stress Disorder in that there is often no immediate awareness of a clear triggering event in the individual’s life that could explain the source of the panic. However, persons with PTSD may well experience panic attacks as part of their symptom pattern.

Roughly 50% of people who experience panic attacks are unable to sustain employment. Some 38% of patients with panic develop poor to fair emotional health due to misdiagnosis or ineffective treatment. Panic patients who do not seek emotional health help tend to rely on hospital emergency rooms for treatment because they misunderstand the origin of their symptoms. This is an expensive and anxiety-increasing strategy since doctors will look for physical causes first, and may likely investigate panicked patients for heart attacks, running up huge ER bills.

Approximately 27% of persons with undiagnosed panic attacks self-medicate with drugs or alcohol in an effort to deal with, and not feel, what they are experiencing. About 25% of panic disorder patients considered suicide in the week preceding their ER visit, compared with 5% of anxiety patients without panic disorder. Roughly 20% of persons with panic disorder have attempted suicide at least once.

Panic shares many of the symptoms of anxiety, although your experience of those physical, nervous system activities is heightened dramatically. You can feel your heart beating so rapidly and strongly that you fear it will explode. You can’t catch your breath, and you hyperventilate, which reduces your peripheral vision, making you feel like the world is closing in on you, so then you feel claustrophobic in your skin. Your urge to run, to escape, and perhaps to scream is nearly uncontrollable. Some people get hysterical during panic. For many, there is little chance of applying logic, examining your options, or thinking your way through a panic attack.

A distinguishing feature of panic is that it overwhelms you before you have the chance to recognize what is going on and stop it. You may feel possessed by your emotions and desperate to not be feeling what you’re feeling. Panic is tricky. It sneaks up on you before you can employ what you’ve learned in personal growth, or before self-health measures can take effect. Pharmaceutical medications can help moderate the flood of panic chemicals cascading through your body.

For those who prefer more natural alternatives, Rescue Remedy---a Bach Flower Essence remedy available in health food stores and even at most Fred Meyer stores---can be quite effective, especially when combined with other self-health techniques. Some people have found that using Rescue Remedy in addition to their medications is also useful.

This is not to say that the personal growth approach can’t be effective for panic, just that the effectiveness curve is longer. That is, most people need help from a personal growth counselor in applying what they are learning during several panic attacks before they feel ready to weather those storms alone. This help may involve medications that are designed specifically to address the immediate symptoms of panic disorders. These medications can allow you to begin to feel some control over your situation.

It is best to work with psychotherapists who have a grounding, calming presence if you are prone to panic attacks. You can use your trust in their strength as an anchor when panic takes you over. This builds the sense of knowing that ultimately you are safe. When you are able to believe that you are safe even when feeling anxious, you’ll be ready to try self-health techniques without the presence of a professional.

A phobia is an anxiety that is narrowly focused around one thing, such as a fear of heights, or the fear of snakes, etc. It is possible to have more than one phobia, and many of us do. More than 11.5 million Americans have one or more phobias including social anxiety, agoraphobia, or specific phobia. While social anxiety---the extreme discomfort of being in a group---effects men and women equally, women are more likely to have a specific phobia. This difference is likely due to women being overtly and covertly raised to not take risks, whereas men tend to be raised to confront the thing they fear, and to not seem weak by appearing to be afraid.

Phobias can co-exist with other types of anxiety. About 1 in 3 people with panic disorder, for example, develop agoraphobia, a fear of being in any place or situation where escape might be difficult or help unavailable in the event of a panic attack. This combination of anxiety types often goes untreated simply because sufferers are extremely reluctant to leave home to get help.

Depending on the type of phobia, professional help may be needed. Similar to panic, when a phobia is triggered, you can lose your ability to view the situation in a rational way. When you can’t approach something with an open, trusting, willingness to examine it and explore its consequences, self-health techniques alone won’t serve you the best. Agoraphobia may be the most difficult phobia to resolve, and anti-anxiety medication may be most beneficial in these cases.

Social anxiety can also be a complex issue complicated by physical or emotional abuse in childhood, self esteem damage, and lack of training in social skills. Personal growth education in combination with psychotherapy and appropriate flower essence remedies or homeopathy can be quite effective for persons suffering from social anxiety.

Specific phobias are a mixed bag, and releasing yourself from them depends a lot on the nature of the phobia, what triggered it, how it impacts your daily life, and how acceptable it is to simply avoid the causative agent. Many of us, for example have an irrational fear of snakes, but we can also easily avoid them with no daily life impact. Systematic desensitization techniques can be effective in overcoming specific phobias.

Obsessive Compulsive Disorder (OCD) is an extreme form of anxiety that manifests as intrusive thoughts or repetitive behaviors that, taken as a whole, are far beyond the range of normal. Jack Nicholson’s 1998 Oscar-winning performance as a man with OCD in As Good As It Gets, and more recently the hit television show Monk on USA cable stations provide some glimpse into the world of one who suffers with OCD. More than 3 million Americans experience OCD, with men and women being equally represented in that number.

Most persons with this disorder had early symptoms in childhood which may include recurrent and persistent thoughts, impulses or images experienced as unnecessary or inappropriate to the situational context, excessive use of ritualized thoughts (such as silently repeating words and phrases), or actions (such as hand washing or checking a set number of times) to suppress the experienced distress. Children often use somatic complaints in obsessive-compulsive ways, which as adults can become a somatoform disorder----that is, an emotional problem that manifests as physical illness.

OCD is very difficult to resolve without professional help. Medication may be more useful than any personal growth or self-health techniques, although there is divided opinion about this among psychologists. A holistic alternative to pharmaceutical medication is homeopathy, which can be very effective for emotional distress of all kinds. Homeopathy is an energy medicine. See the chapter on Energy Medicine for more information.

To get the best benefit from homeopathic remedies, however, it is necessary to work with a well-trained homeopath. In the United States, most of the excellent homeopaths are also naturopathic doctors (NDs), and can be located through the American Association of Naturopathic Physicians at www.naturopathic.org. In Washington, search for a local ND at the Washington Association of Naturopathic Physicians (WANP) at www.wanp.org.

From the holistic health perspective, prescription medications can be helpful when the anxiety is so overwhelming that you are unable to do the psychotherapy or personal growth work that can get at the emotional roots. Here, medication is most effective in short term use while other strategies are learned and applied. However, chronic use of prescription medications can be ineffective if the origins are not organic---that is, not the result of some biochemical process gone awry----but are caused by the environmental pressures and meaning-making processes of one’s lifestyle and coping strategies. In such cases, using prescription medication is suppressing the symptoms without curing the precipitating cause.

Often the best solution is to ask for the lowest dosage medication to start with, and to pair taking it with active psychotherapy or personal growth work to decrease the amount of time you will need the drug. Remember, you goal is not to simply manage the symptoms of anxiety, but to learn how to not become debilitatingly anxious in the first place.

Anxiety, when left untreated by medication and/or psychotherapy, personal growth education or other holistic approaches, sometimes propels us to seek unhealthy means of self-medication. Notably alcohol, cigarettes and caffeine are used in an effort to calm down and feel more in control. Alcohol does have a sedative effect, but it not only just treats the symptoms, it also creates additional problems when over used. Nicotine actually stimulates the nervous system, compounding anxiety. Even caffeine, which is a stimulant, though it can be calming if one is accustomed to using it on a regular basis, will ultimately cause more anxiety.

Food is also often a drug of choice for self-medicating. Like alcohol, some foods--particularly chocolate, fats, and some carbohydrates-- do have a calming effect and might be a better choice than liquor, still as a lone coping strategy eating to not feel anxiety is ultimately a self defeating remedy that also creates other health problems. In fact any substance or activity used addictively as a form of self-medication can produce unwanted results while also not being effective in the long term for overcoming anxiety. This book offers suggestions on healthy options for self-health.