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About the author: Jill H. Stout works with people who have physical and developmental disabilities. She is an Indianapolis native who now lives in North Carolina. Contact her at jhstout50@yahoo.com
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Everyone is familiar with anxiety: a lost spouse, a new home, a new medical diagnosis. You have butterflies in your stomach, perspire freely, feel anxious. But some people have a more serious problem. Anxiety that lasts at least six months can get worse if not treated by a mental health professional. These disorders often co-occur or are caused by other mental or physical illnesses, or by alcohol or substance abuse.
Anxiety disorder is the most common mental illness in the United States, according to the Anxiety and Depression Association of America (ADAA) in 2020. The National Institute of Mental Health (NIMH) estimates that about 9% of adults over age 60 have anxiety disorder, and these statistics unfortunately apply only to those cases that are recognized and diagnosed.
There are a number of anxiety disorders, and all these disorders are slightly different but are characterized by excessive fear and dread.
Medications can offer significant relief from anxiety, especially with certain types of psychotherapy. Common types of medications are predominantly antidepressants, called selective serotonin reuptake inhibitors (SSRIs); benzodiazepines, effective but usually prescribed for shorter periods of time; and beta-blockers, also used to treat heart conditions, and which can prevent some of the physical symptoms of anxiety. All these types of drugs control some of the physical symptoms of anxiety.
Cognitive behavior therapy (CBT) is a common type of talk therapy backed by much scientific evidence; the therapy generally lasts for a limited time, usually six to nine weeks, which is helpful if you have restrictions on your Medicare or supplemental insurance. Behavioral therapy (BT) can help the person change problem behaviors into adaptive behaviors. CBT and BT will teach you to change your thoughts and behaviors regarding your anxiety; they will teach you coping mechanisms to ease the severity of your anxiety attacks.
Here are the definitions of the six major types of anxiety disorders:
* PANIC DISORDER is described as sudden attacks of terror, often accompanied by a pounding heart, sweating, faintness, or weakness. These attacks can occur at any time, even during sleep. They include a fear of losing control or of impending doom. Panic disorder is very treatable with medication and cognitive therapy. SSRIs are often prescribed for panic disorder.
* OBSESSIVE-COMPULSIVE DISORDER (OCD) is characterized by persistent, upsetting thoughts (obsessions) and use of rituals (compulsions) to control the anxiety produced by those thoughts. Most of the time, the person becomes controlled by the rituals. If you ever watched the TV show Monk, the main character was an excellent, if exaggerated, example of a person with OCD as a result of the trauma of losing his wife. SSRIs are medications used for OCD, and exposure-based psychotherapy is effective in many cases.
* GENERALIZED ANXIETY DISORDER (GAD) is typified by exaggerated worry and tension not related to a particular
stressor. Both adults and children have a nonspecific sense of impending doom and tension throughout his or her day. Talk therapy involves some aspects of CBT and of BT, and SSRIs can be an effective adjunct treatment.
* POST-TRAUMATIC STRESS DISORDER (PTSD) is a result of exposure to a terrifying ordeal such as armed forces service in war-ravaged areas, or mugging, rape, robbery, kidnapping, even a car accident, and could be far in the person’s past. The ordeal could have happened to the person or a loved one, or even strangers. Persons with PTSD may become emotionally withdrawn from loved ones and friends; they lose interest in things they used to enjoy. They may become irritable or aggressive. They can be treated with SSRIs and CBT.
* SOCIAL ANXIETY DISORDER (or Social Phobia) is distinguished by overwhelming anxiety and excessive self-consciousness in social situations. People with social phobia are intensely and chronically in fear of being watched and judged and find it difficult to engage in ordinary activities. Sometimes these people can overcome their fear and be around other people, but they are tense and worry for hours afterward about how they are perceived. SSRIs and benzodiazepines are effective treatments. Behavioral therapy is also helpful.
* SPECIFIC PHOBIAS are such things as fear of spiders or other insects, fear of dogs or cats or other household pets, and fear of flying. Behavioral therapy, particularly desensitization, is effective in treating phobias. If anxiety is ongoing, SSRIs and benzodiazepines are effective with psychotherapy.
If you have anxiety that is out of control, you should first see your family physician, who can then refer you to a psychotherapist who specializes in anxiety treatment. The therapist may prescribe medications for your particular type of anxiety, and treat you with cognitive behavior therapy or behavioral therapy.
You are never too old to get a handle on your anxiety!
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