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What's Your Self Image?
Anxiety and Depression: Its Symptoms and Treatments |
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 Anxiety
and Depression affect millions of Americans each year. These two illnesses manifest themselves differently in terms
of the degree of severity and the type of symptoms. In this article, I will touch upon the most common anxiety
disorders; Generalized Anxiety Disorder (GAD) and Panic Disorder. In addition, I will address one of the most formidable
mood disorders, Major Depressive Disorder.
Generalized Anxiety Disorder (GAD), afflicts more than five million adult Americans each year. While the exact
cause of GAD is not fully understood, a person's biochemistry, family history, psychological and spiritual profile
all seem to contribute to the development of anxiety.
Twice as many women than men suffer from this disorder, which often develops gradually in adolescence, but can
begin in adulthood as well. It is characterized by excessive, exaggerated, and disproportionate anxiety and worry
about everyday life events. To GAD sufferers, the proverbial glass is always half empty. They anticipate the worst
even when there is reason to expect the best. They always expect disaster, and life becomes a perpetual state of
worry, fear, and dread, which interferes with daily activities and relationships.
GAD affects the way a person thinks, but may also manifest in physical symptoms, including restlessness, muscle
tension, headaches, nausea, trembling, sweating, difficulty concentrating, and being easily startled.
Biological causes can be attributed to genetics and a person's brain chemistry. Sufferers often have an imbalance
of neurotransmitters, which are chemical "messengers" that help move information from nerve cell to nerve
cell. When out of balance, these "messengers" cannot travel through the brain properly, which can lead
to anxiety.
Psychological and social causes are generally the result of life experiences which may result in feeling out of
control. Some individuals may suffer from an unresolved trauma or abuse. Financial constraints can also trigger
GAD which results in a fear that one's material needs won't be met. Moreover, it may be the result of one's own
unrelenting perfectionism, or perpetual fear of rejection and abandonment. It can result from a living situation
where one is being constantly put down, ridiculed, or made to feel ashamed. A person may experience perpetual fear
for their own safety.
Spiritual causes that may lead to GAD are more existential in nature. Many people feel unsupported in their lives.
They don't feel grounded, and feel as though they are drifting aimlessly. These individuals often feel as though
their life has no real purpose and their existence has no meaning.
Psychotherapy effectively treats the symptoms of GAD by addressing the psychological, social, and spiritual variables
that trigger it. Cognitive Behavioral Therapy, in particular, challenges people to confront the unconscious thoughts
that often trigger anxiety, thoughts that are often distorted in nature. Therapy challenges these cognitive distortions,
and counters them with more rational, reality based thoughts. Core beliefs that we hold about ourselves and the
world are challenged and transformed, which in turn strengthens self-esteem and empowers people. One's sense of
helplessness and powerlessness, which often induces anxiety, largely diminishes. Finally, psychotherapy encourages
individuals to stop engaging in self-defeating behavior that lead to troublesome feelings.
Medications used to treat GAD include Benzodiazepines, like Xanax and Valium and the newer antidepressants, SSRI
(selective serotonin reuptake inhibitors) like Paxil and Effexor XR. These medications balance the neurotransmitters
in the brain. When the brain is deficient in neurotransmitters, these newer antidepressants can help replenish
the chemical messengers in the brain.
Panic Disorder is defined as recurring panic attacks or episodes of intense fear and afflicts three to six million
Americans. Fear and anxiety are normal reactions to stressful events in our lives. Panic Disorder, however, strikes
without reason or warning, and the fear response is out of proportion to an often non-threatening situation. Over
time, an individual develops a constant fear of having another attack, which can lead to avoidance of places and
situations, ultimately affecting the general quality of life.
Symptoms of a panic attack can include difficulty breathing, chest pain, choking or smothering sensations, dizziness
or feeling faint, trembling and shaking, sweating, nausea, chills or hot flashes, and tingling or numbness. There
is often a feeling that you are losing control or are about to die. Fortunately, panic attacks tend to be brief,
generally lasting about ten minutes. Like GAD, the exact cause of Panic Disorder is unclear, however, studies have
shown that the same set of biochemistry, family history, and psychological factors bring on this disorder. Social
or environmental factors include stressful life events and major life transitions, such as the death of a loved
one. In addition, substance abuse has been a correlative to panic disorder.
 Cognitive-Behavioral
Psychotherapy works on the theory that panic attacks are basically a learned response to something the patient
fears. Therapy focuses on helping patients "unlearn" the physical reactions. A therapist might suggest
breathing exercises or medication that can help prevent the hyperventilation that often occurs during a panic attack.
Anti-anxiety medications such as Xanaz and Klonapin and anti-depressants like Paxil or Zolft have been shown to
be safe and effective in the treatment of Panic Disorder. With this combination of therapy and medication, at least
70 percent of people can reduce or completely prevent future panic attacks. Many people feel substantial relief
in just weeks.
Both of these anxiety disorders are often accompanied by depression which is a serious medical illness, much like
diabetes or heart disease. It is estimated that 19 million Americans suffer from depression each year. If left
untreated, depression can worsen symptoms or other illnesses, lead to disability and increase the risk of suicide.
Untreated or improperly treated depression is the number one cause of suicide in the United States. Conversely,
proper treatment relieves symptoms in most depressed patients.
The shades of depression are many, ranging from mild depression (Dysthymia) to Major Depressive Disorder. Anyone,
regardless of age, gender, race, or socio-economic status can suffer from this very serious disorder.
The most common symptoms associated with Major Depressive Disorder are trouble sleeping, loss of interest in activities,
weight loss or gain, difficulty concentrating, feelings of worthlessness and hopelessness, or preoccupation with
death or suicide. The risk factors that lead to depression include a deficiency of the neurotransmitter, serotonin,
in the brain. Family history of mood disorders, chronic health problems, divorce, and occupational stress can bring
on depression. Experts estimate that women experience depression twice as often as men. Over the course of a lifetime,
nearly one in four women will experience a major depressive episode. Women are more likely to act in, and experience
guilt, weight gain, eating disorders, and increased sleep, while men tend to act out their unrecognized and denied
feelings of depression. They are apt to experience deep seeded feelings of shame for having fallen prey to the
disease. They experience anger and hostility toward others or numb their feelings with alcohol or drugs.
While depression is increasingly more common, only a small percentage of individuals will seek help. This is a
tragedy, since with proper treatment, four out of five patients will improve. Even still, only one in five women
suffering from depression will get the treatment they need. Men often worry that depression is a sign of personal
weakness or a character flaw and choose to "tough it out." Without treatment, depression can last for
weeks, months or years.
Effective treatment for depression, much like anxiety, is a combination of psychotherapy and medication. There
are three classes of anti-depressants: MAOI inhibitors, trycyclic anti-depressants, and SSRI. All three classes
of medication work to correct the imbalance of certain chemicals in the brain. SSRI's are prescribed most often
because they have fewer side effects.
Psychotherapy can take place in individual or group sessions. As in the case with anxiety, psychotherapy targets
the psychological, social, and spiritual variables that lead to depression. It is aimed at helping a person develop
new ways to identify and cope with their depression.
Many of the psychological and social issues leading to depression center around grief and loss. This includes not
only the loss of others, but can be the loss of oneself. People often choose to abandon parts of their true selves
to ensure survival. Some may abandon their true nature by learning how to take care of others, while some become
helpless, self-effacing, and apologetic. Others will become inflated, grandiose, and narcissistic. While these
adaptations may ensure self-preservation, it can bring on feelings of loss, grief, and ultimately, depression.
Depressed individuals often have low self-esteem and may believe they are unlovable and inadequate. While these
individuals already feel unlovable they are likely to seek out negative experiences that will only reinforce these
beliefs. The unlovable woman, for example, will seek out a partner who is abusive and degrading. That way her experience
in this relationship will reassure her that she is right to believe that she is indeed unlovable. After all, if
she was lovable, her partner wouldn't find reasons to degrade her.
As is the case with anxiety, a spiritual deficit can lead to depression. In our culture there seems to be a one-sided
pursuit for enlightenment, to the point of exclusion of the darkness. Spirituality that is understood in its appreciation
of psychological opposites is called "grounded" spirituality. It is my belief that "ungrounded"
spirituality can lead to self-denial and depression, while "grounded" spirituality leads to self-acceptance,
self-compassion, and a genuine sense of well-being.
Cognitive Behavioral Therapy helps a person counteract negative core beliefs and find new adaptive coping techniques,
which help them reclaim their authentic self. Ultimately their depression lifts as their self-esteem rises, and
feelings of hope and optimism settle into their heart and mind.
In conclusion, I want to strongly emphasize that while anxiety and depression are illnesses that are almost as
pervasive in our culture as the common cold, both can be treated successfully. The combination of medication and
psychotherapy can effectively target the biological, psychological, social, and spiritual variables that often
bring on troubling states of mind and body. Individuals who suffer from anxiety and/or depression stand an excellent
chance of not only overcoming these illnesses, but moving on to experience inner peace and deep joy, while leading
productive and fulfilling lives.
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