"[My relationships were] like I was in these movies where the script was only half-written. When I’d get to the end of this half-script, the other actors wanted me to ad lib. But I had never gotten the hang of that. That’s why these movies were always box-office failures. Six of them in the past twenty years. I always blew the lines." ~ from my horrible first novel "Learn How To Pretend." (unpublished)(obviously)

Saturday, March 30, 2013

Chronic Worrying and Anxiety Disorders

In an article presented on the website About.Com, Cathleen Henning, a former sufferer of panic disorder, agoraphobia, social anxiety and depression, discusses chronic worrying and presents some recommendations to those who feel the disorder may have taken over their lives. In her article, Henning delivers an empathetic presentation of the disorder, assuring readers that, while everyone does indeed worry, when worry/anxiety becomes disruptive to their lives there is help available. Due to her status as a nonprofessional, Henning reminds readers that a mental health provider must make diagnosis.
 Several warning signs are mentioned to help the reader distinguish between what may be seen as common everyday worry and an anxiety disorder that needs treatment. A link is available to more in-depth information from the National Institute of Mental Health on various anxiety disorders, though the general warning signs are synopsized. Warning signs mentioned include feelings of continual anxiety, inability to express the source of the anxiety, avoidance of anxiety producing situations, loss of interest in formerly enjoyable pursuits and immobilizing fear. Also mentioned are physical symptoms, including sleep disorder, headache, irritability/depression, lightheadedness and difficulty breathing or concentrating. Henning notes that conditions tend to worsen when untreated and highly recommends that persons suffering with these symptoms seek professional treatment.
 The majority of the article focuses on the use of cognitive-behavioral therapy as treatment used by professional mental health care providers, although, for those who choose not to seek professional treatment, the author offers similar methods. Henning breaks this therapy down into two basic areas, “Changing how you think about the problems that cause you to worry,” and “changing what you do about the problems that cause you to worry.”
 Common thinking patterns mentioned regarding chronic worriers include expecting the worst outcome in a situation and dwelling on situations that are unlikely to occur. Henning suggests journaling as a method of identifying negative thinking patterns. Negative thoughts, once identified, are rewritten in the form of positive “counter thoughts.” During times of anxiety, the resulting list is used as a reference.
In addition to changing the thinking patterns (the cognitive aspect), mention is made of changing the behavior. One of the major disruptive effects of chronic worry is that the worrier generally has difficulty in focusing on the tasks at hand. The sources of worry may often be exacerbated by the seeming inability to act creating a vicious circle. To break this circle, Henning recommends the use of a time management system. Additional recommendations include relaxation in the form of relaxation techniques, meditation and exercise as ways to help regain focus.
As discussed in class, anxiety disorders are characterized by difficult to control anxiety. They may also present themselves as maladaptive behaviors whose goal is the reduction of anxiety. Henning’s article discusses the differences between the normal worry that most people deal with and the types of worry that are excessive and begin to interfere with normal function. In this we see clear examples from class lecture regarding anxiousness and physical symptoms which significantly disrupt the life of the patient, whether it be at work, home or socially. In the Myers text, we are presented with a case study of Tom, a 27-year-old electrician. Tom “complains of dizziness, sweating palms, heart palpitations, and ringing in his ears. He feel edgy and sometimes finds himself shaking” (Myers 627).  Tom’s disorder has caused him to avoid or limit social contact, thereby interfering with normal function.
Difficulty in controlling the worry, presented in the class as one of the defining characteristics of the disorder, is brought up as Henning looks at cognitive-behavior therapy. The patient must make conscious decisions to overcome the behaviors. Myers refers to a study by J.M. Schwartz regarding patients with obsessive-compulsive disorder. Though the disorder is different, the effect of the treatment is similar. In this case, when patients recognized they were feeling compulsive urges they would verbally reinforce the fact that it was abnormal brain activity. They would then engage in fifteen minutes of a behavior they found pleasurable. “This helped ‘unstick’ the brain by shifting attention and engaging other parts of the brain” (Myers 671).
In discussion regarding anxiety, the class was taught that there is generally no specific focus of the anxiety (as in Generalized Anxiety Disorder), or that the anxiety may be excessive or unreasonable (in the case of a Specific Phobia.) Henning talks about common patterns such as the negative exaggeration of the outcome of particular problems as well focusing on events that will probably never happen to the patient. Myers cites a case study regarding a woman with a fear of thunderstorms (Myers 628). She would become non-functioning during thunderstorms, hiding from windows and closing her eyes so that she would not even see the lightning. Despite that fact that it is highly unlikely that this woman would ever be hurt by the storms, she displayed anxiety-related behavior if the weatherman mentioned even the possibility of a storm later in the week. This woman was otherwise normal.
An additional symptom brought out in class discussion regarded problems with concentration. Henning spends time on this issue and offers ways in which a person suffering from an anxiety disorder might overcome this problem. Myers also mentions difficulty in concentration as being caused by the patient switching from worry to worry (627).
Throughout her article, Henning confirms symptoms discussed in class and the Myers text including continuous anxious feelings, inability to control feelings, concentration, avoidance and disruption of normal lifestyle.

Works Cited
Henning, Cathleen. “What you can do if worry has taken over your life.”  About.com 
20 Feb. 2005 http://panicdisorder.about.com/cs/gadbasics/a/chronicworry.htm

Myers, David G. Psychology. 7th Ed. Holland MI: Worth, 1986

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