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Anxiety

For many, everyday life is a worry

Do you know the difference between generalized anxiety and a panic attack? Have you personally experienced either? Some 40 million American adults—18 percent of the population—are affected by anxiety disorders. According to the Anxiety and Depression Association of America, Generalized Anxiety Disorder (GAD) affects 6.8 million adults, or 3.1 percent of the U.S. population. Women are twice as likely to be affected as men. Panic Disorder affects 6 million adults and as with GAD, women are twice as likely as men to be affected.

Generalized Anxiety is a chronic state,” says Diane Thompson, MD, Medical Director of Behavioral Health and Integrative Services with Penrose-St. Francis and South State Operations. “People with GAD spend most of their time worrying or feeling nervous. A panic attack is an isolated event that happens ‘out of the blue’ and can include pounding heart, breathlessness, chest pain and shaking. During a panic attack, people may fear they are dying. If it is their first attack, they may go to the emergency room with concerns that they are having a heart attack.”

Olivia, a longtime Colorado Springs resident, was diagnosed with GAD years ago. “I think I’ve had it for a long time, but it wasn’t until an epic panic attack in 2003—and I was overwhelmed with anxiety afterwards—that I was finally diagnosed. I had symptoms long before I was diagnosed—mostly tingling in the face if I was upset or worried, but I didn’t know what it was.”

Certain situations, says Olivia, can trigger anxiety. “Driving in unfamiliar areas. Driving long distances, though I’m fine if someone else is driving. Serious life changes. The ‘what if’ this or ‘what if’ that. I’ve learned that focusing on the anxiety only makes it worse, so it’s critical to distract myself when it happens and get out of that mindset.”

“Generalized Anxiety Disorder,” says Dr. Thompson, “is a medical diagnosis that must be present for at least six months. The symptoms include excessive worry, fatigue, irritability, muscle tension, decreased concentration and sleep problems… Most cases probably include a variety of factors including genetics, a recent stressful event and a history of depression or anxiety.”

People who are exposed to extremely stressful situations are more likely to develop anxiety disorders, says Thompson. “For example, Post-Traumatic Stress Disorder is a type of anxiety disorder more commonly seen in soldiers and victims of abuse. I specialize in treating cancer patients and they are also at high risk; they may develop anxiety symptoms, not only from the illness but also from the various cancer treatments.”

People diagnosed with anxiety disorders are often relieved, says Thompson, to know that anxiety is a real medical issue and that they are not alone. “Treatment is very successful. Both psychotherapy and medication are effective, and frequently the combination is the ideal treatment. There are a wide variety of non-addictive medications that are well tolerated and FDA approved for GAD. However, there are also many types of talk therapies. These can be equally effective but the time to response is often a bit longer.”

Olivia says she’s learned to distract herself when she’s in the middle of an anxiety experience, and to focus on something that requires her full attention. “If I’m driving, I turn the radio up and concentrate on whatever’s on, or think about exactly what I need to accomplish on the specific trip, especially if I’m at a stop light. After my panic attack and resulting anxiety, my doctor prescribed Xanax in a low dose. I rarely use it and only take a quarter tablet when necessary. I carry it in my purse just in case. Sometimes it’s just enough to know I have it.”

Imaging studies of patients with anxiety disorders show increased activity in a specific part of the brain (prefrontal cortex) and decreased activity in another (amygdala), says Dr. Thompson. “In addition to new medications, scientists are looking at the potential to use magnets to address the brain activity. Transcranial magnetic stimulation is a non-invasive therapy that is currently used to treat depression. Anxiety can decrease one’s ability to find joy in activities and function at the highest level possible.”

Anxiety is a very treatable illness, says Dr. Thompson. “The most important step is the first step: discuss your symptoms with your health care provider.”