Feeling excessively anxious? Help is available

Everyone encounters people who are prone to anxiety, worry and fearful anticipation of life situations. These “worriers” often get reassured, encouraged, debated with and eventually labeled as “negative” people. The partner of the anxious individual as well as family members and friends become discouraged about being able to cheer up the fretful person.

Most people tend to become anxious and worried when they face challenging, uncertain circumstances. Doubt and concern during times of health, financial or situational crises, are natural responses. Yet, it is important to distinguish normal anxiety in the face of challenges from an overwhelming, exhausting, chronic state of worry.

Anxiety is also a common condition for older people. It stands to reason that with age physical and practical limitations tend to reduce one’s control over one’s autonomy. This gradual disempowerment understandably produces fear, anxiety and uncertainty. Yet, this is not necessarily an anxiety disorder.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), if you experience an ongoing state of excessive worry, anxiety and distress about everyday life, most days of the week for longer than six months, coupled with three or more of the following symptoms; restlessness, fatigue, concentration or sleep difficulties, you may be suffering from a generalized anxiety disorder (GAD). It usually appears between early adulthood and the mid 50’s and studies estimate that it affects at least 5-6% of people in their adult life.

General health complications of anxiety were reported by David H. Barlow’s “Anxiety and Its Disorders: The Nature and Treatment of Anxiety and Panic” in which people with GAD have more somatic complaints about chest pains and irritable bowel problems, have more doctors visits and work absences, may struggle with problem solving, cognitive and sexual interferences.

This excessive worry is emotionally depleting and discouraging. Yet, it is also most amenable to treatment with cognitive behavioral psychotherapy as a first choice of treatment. Getting a reprieve from incessant worrying without the need of medication can be reassuring for those who can benefit from talk therapy.

Researcher Dan J Stein in: “Anxiety Disorders Comorbid with Depression” states “The role of psychotherapy in the treatment of anxiety disorders and depression should not be ignored. Psychoeducation is undoubtedly a key component in the treatment of both. Furthermore, cognitive-behavioral therapy (CBT) in particular has proved useful in many of the anxiety disorders as well as in depression.”
In the 2007 “Cochrane Database of Systematic reviews”, Dr. Hunot reports that 46% of elderly patients with anxiety (including but not restricted to generalized anxiety disorder) were helped by CBT as compared to 14% of those in the control group.
Though the “Harvard Mental Health Letter” reported that “ A review of 32 studies concluded that medications were more effective than psychotherapy in reducing symptoms of anxiety in the elderly”, they also warned about the downsides of the use of medications with older adults. Thus, it is wise to start treatment with cognitive behavioral therapy and use medications later, if needed.
If you are an adult or a partner of one who is being plagued by excessive worry and anxiety,
• Understand that when one of you suffers, you both are stressed and not enjoying your life to the fullest.
• Assess the circumstances that led to this state and take steps to solve some life problems to reduce your worry.
• Understand that anxiety and worry are not only emotional concerns but may have additional physiological symptoms affecting your physical health.
• Talk to your physician about your symptoms to rule out a Generalized Anxiety Disorder.
• Be reassured that the discomfort and stress both you and your mate are going through may be remediated with cognitive behavioral psychotherapy prior to the undertaking of a medication regimen.
• Know that reducing your worry and stress will positively affect your health, relationship, family and quality of life.

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About Author

Offra Gerstein, Ph.D. is a licensed psychologist in clinical practice in Santa Cruz, California for over 25 years, and specializes in relationship issues for couples and individuals for improved quality of life. Her work includes: mate selection, marriage, long term relationships, gay and lesbian couples, work relationships, parenting issues, family interactions, friendships, and conflict resolutions. Offra has lectured extensively to various groups, conducted support groups for several organizations, and has been writing a weekly column "Relationship Matters" for the Santa Cruz Sentinel since 2001.

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