CAN PHYSICAL ILLNESS OR MEDICATION PRODUCE ANXIETY LIKE SYMPTOMS?

Anxiety-like symptoms can be associated with a variety of illnesses, as well as various medications. It is essential to rule out possible physical causes before concluding that you have an anxiety disorder. As you will note several times throughout this book, we recommend a comprehensive medical evaluation if you are struggling with ongoing problems with anxiety. The description below provides some information about how physical and medical influences are related to anxiety symptoms.

The conditions of hyperthyroidism and hypoglycemia can produce anxiety-like symptoms. People with hyperthyroidism have persistent increases in heart rate, whereas psychiatric anxiety produces transient and periodic rises in heart rate. It is common to have a fine tremor with hyperthyroidism. Other classic symptoms include bulging eyes and a neck goiter, though neither is always present. Thyroid dysfunction is also found in people with generalized anxiety disorder and panic disorder—keep in mind that thyroid screening is very important! Hypoglycemia stems from plummeting blood sugar levels and is frequently associated with a strong sense of anxiety. This distress may be quickly relieved by drinking a sweetened beverage.

Of course, someone experiencing an acute heart attack will report terrible anxiety and often will be sweating profusely. He may also complain of a crushing pain in his chest as if an elephant is standing on him. Other medical problems that look like anxiety disorders include: mitral valve prolapse (heart murmur), hyperparathyroidism (a condition that results in elevated calcium levels in the blood), cardiac arrhythmias, coronary insufficiency, pheochromocytoma (tumor of the adrenal gland), true vertigo, drug withdrawal, and alcohol withdrawal. Women also frequently report anxiety-like symptoms when they are beginning and going through menopause.

Many medicines produce anxiety-like symptoms, as a result of either use or discontinuation of the medicine. Nervousness can be a side effect of medications that facilitate breathing for people with asthma or chronic obstructive pulmonary disease. Some decongestants produce restlessness, as do some over the counter “antiappetite” pills for weight loss. Caffeine is a stimulant, and it can make people nervous and jittery. Other very powerful stimulants include cocaine and amphetamines. Any stimulant can result in your feeling shaky or “revved up,” including nicotine. If someone is physiologically dependent on alcohol, benzodiazepines, or barbiturates and suddenly stops using them, he may go into a serious withdrawal syndrome that includes anxiety symptoms. A person going through withdrawal is medically at risk, and if that individual has other physical illnesses, serious medical attention is crucial.

Source: The Anxiety Answer Book by: Laurie A. Helgoe, PhD, Laura R. Wilhelm, PhD, Martin J. Kommor, MD

WILL I JUST GROW OUT OF MY ANXIETY IF I LEAVE IT ALONE?

Some of the anxiety disorders go away without treatment. For example, an anxiety disorder may develop during a very stressful set of circumstances (loss of a job, job search, divorce, custody battle, cancer diagnosis). When the stressors are more accepted and better managed, or even resolved, the anxiety may decline. Of the diagnosed anxiety disorders, specific childhood phobias are the most likely to diminish naturally. For example, if your child is fearful of insects, storms, or the dark, keep in mind that it is common for this type of problem to subside with age. Parents benefit from understanding that children experience typical childhood fears across different age spans, but parents also need to watch for extended, extreme suffering and reduced functioning in their child. These difficulties may signal the need for professional treatment.

Some people just continue to live with anxiety until they feel like they can't cope on their own anymore and finally talk to their doctor. Other individuals let the nervousness wear them down, ultimately giving up and resigning themselves to their suffering. Research suggests that anxiety disorders can lead to depressive disorders if left untreated. Clinical depression is a particularly debilitating medical disease that requires aggressive treatment. Although you may avoid treatment due to the constraints of time and money, it is important to remember that successful treatment is available. Usually, the earlier you seek effective treatment, the better the results for your mental well-being and quality of life. Upon finding relief through meeting with trained mental health professionals, people frequently remark “I wish I would have gone in for help sooner.”

Source: The Anxiety Answer Book by: Laurie A. Helgoe, PhD, Laura R. Wilhelm, PhD, Martin J. Kommor, MD

DOES THE WAY I WAS RAISED MAKE ME MORE OR LESS LIKELY TO BE ANXIOUS?

The way you were raised can certainly influence your anxiety level as an adult. Other factors, such as your biological make-up and your personality style, can also either buffer or amplify your parents' influence. In general, if your parents were calm themselves, provided consistent limits and feedback, and expressed trust and confidence in your capacities, you are likely to be less anxious. Here are some ways parenting can contribute to anxiety.

If you were exposed to many terrifying or frightening situations and had little opportunity for protection or consolation from your parents, you may be at a higher risk for anxiety problems as a child, and as an adult. Such frightening events may include threats to you or the witnessing of threats to loved ones.

If your parents were anxious and consistently responded to life's circumstances with anxiety, you might be at risk to copy your parents' ways of doing things. Without realizing it, parents may also reinforce or reward their children's anxious behavior. If I want my child to stay with me and do not allow her to be curious and explore the world, I might praise her for her fearful response to any adventuresome behavior. She may learn to please me with her anxious behavior, and find that her anxiety draws attention and care.

Another way parents increase anxiety is to add their alarm to yours. Have you noticed how young children will look up to an adult after falling? It is as if they are trying to figure out how to respond. If the parent is calm, the child assumes she's okay and keeps playing. If the parent is alarmed and yells out “oh no!” the child becomes alarmed and breaks into tears.

Some parents may be inconsistent with their expectations and limit-setting. As children, then, we may do something that we think is okay, but have doubts lurking in the back of our minds. That lack of clarity and doubtfulness sometimes generates anxiety.

Source: The Anxiety Answer Book by: Laurie A. Helgoe, PhD, Laura R. Wilhelm, PhD, Martin J. Kommor, MD

DO MY GENES MAKE ME MORE LIKELY TO HAVE ANXIETY?

Researchers have indeed identified a genetic component in anxiety disorders. We know this through twin studies, which provide an important key to the role of genetics. When twins—who share the same genes—are raised separately in adoptive families, the similarities that develop are likely to be genetic. So if one twin develops an anxiety disorder, we record whether the other twin also gets one.

 It appears that there is about a 25% chance that twins raised apart will both have an anxiety disorder. In order for this chance to be significant, it needs to be higher than the average stranger's chance of developing an anxiety disorder, and this figure is. Findings show that about 10% of the general population will have an anxiety disorder at some time in their lives. So, the twin studies provide some evidence of a genetic component.

However, if the whole cause of anxiety were genes, then twins raised separately would both develop anxiety disorders 100% of the time. Obviously, genes are not the only factor involved.

It seems that anxiety disorders are caused by a combination of genetic and environmental influences. Posttraumatic stress disorder (PTSD) is a good example. The trauma is the experience that triggers the anxiety, but genetic factors may help explain why only certain individuals exposed to similar traumatic events develop full-blown PTSD.

For some people, a life-threatening experience may lead certain brain cells to communicate differently with neighbor cells, and an illness may ensue. In contrast, other individuals may not be as biologically susceptible to the emotional impact of a life-threatening event and may recover more easily.

Source: The Anxiety Answer Book by: Laurie A. Helgoe, PhD, Laura R. Wilhelm, PhD, Martin J. Kommor, MD.

CAN A PERSON BE HOSPITALIZED FOR ANXIETY?

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It's possible but unlikely. Anxiety is a psychiatric disorder, so a patient with anxiety would need to be admitted to a psychiatric ward. However, most psychiatric wards only admit patients who are so psychiatrically ill that they are suicidal, homicidal, dangerously psychotic, or unable to feed or bathe themselves. Although some people with anxiety problems are actually disabled by the illness, most of these illnesses are never so severe that they meet the above criteria.

When people with anxiety disorders do become that ill, it may be due to additional complications, such as the development of a major depressive disorder or a substance abuse problem. Such complications may be associated with feelings of helplessness and utter hopelessness that make suicide seem like a logical solution.

Admission may be essential under those circumstances. Although less likely, hospitalization may be recommended when a doctor wants a patient observed while beginning a certain medication. While most psychiatric units only admit patients in acute distress, some private psychiatric hospitals are set up to provide intensive treatment to people with less severe problems. These hospitals are often expensive, and the services may not be covered by insurance.

Source: The Anxiety Answer Book by: Laurie A. Helgoe, PhD, Laura R. Wilhelm, PhD, Martin J. Kommor, MD.

WARNING SIGNS THAT ANXIETY NEEDS TREATMENT

Anxiety becomes a disorder when it seriously impairs your ability to work, love, or play. Excessive anxiety also takes its toll on your body. Here are some symptoms that impair functioning and signal the need for treatment:

1.    You become exhausted or easily fatigued.

2.    You have trouble thinking through standard problems like how to sequence the errands of the day.

3.    You are so tense that you can't experience comfort, joy, or a sense of accomplishment.

4.    You engage in special rituals to fend off intrusive thoughts or images.

5.    Your symptoms convince you that you're dying or losing your mind.

6.    Preoccupation with anxiety impairs your productivity.

7.    You dread common social situations such as going out in public, with friends, or even to work.

8.    You worry so much that it is difficult to fall asleep or stay asleep.

9.    Emotional tension leaks into your skeletal muscles, leaving you stiff, tense, and aching.

10.      You avoid everyday errands and responsibilities out of fear of experiencing a panic attack.

If you have trouble functioning, you may tend to worry more, and a vicious cycle is set in motion. Treatment is necessary to interrupt the cycle, provide hope, and restore functioning.

Source: The Anxiety Answer Book by: Laurie A. Helgoe, PhD, Laura R. Wilhelm, PhD, Martin J. Kommor, MD.