Anxiety and Panic Disorders

Anxiety is a normal part of life, but when anxiety becomes extreme or when we feel constantly anxious, it can become a serious psychological problem for many people. On the mild end of the anxiety continuum, we may feel worried, jittery or nervous about something or anxious when we anticipate taking a test or before a job interview.  This is normal anxiety.  In the middle of the continuum we may feel considerable anxiety when we see others around us being downsized out of their jobs, when we face a health crisis or when a child or spouse is seriously ill or in an accident. Again, this is normal anxiety.

An anxiety disorder occurs when the worry is constant and frequently out of proportion to the situation about which we are feeling anxious.  Normal anxiety subsides and we are able to feel comfortable again after the stressful situation passes or when we become accustomed to the stressful situation (e.g. a new job or birth of a child).

Pathological anxiety can be almost constant and is accompanied by physical symptoms such as rapid heartbeat, sweaty palms or tightness in the chest or other parts of the body.  At the extreme, anxiety attacks can become panic attacks. During panic attacks, we may feel as if we are in danger or that we are about to die, even in the absence of any obvious life-threatening situation.  Severe anxiety or panic can even interfere with being effective in different life areas such as school, work or relationships or prevent us from driving or getting out of the house and socializing with friends.

If you suffer from anxiety or panic attacks, it can be beneficial to seek counsel with an experienced therapist in dealing with anxiety. Dr. Beth Firestein offers personal anxiety and panic attack treatment and counseling for the Loveland, Colorado area. Contact Inner Source today to schedule a free 15-minute consultation.

Dr. Firestein wrote a monthly Q & A column for the Healthline magazine called Uncommon Sense for seven years.  Below are excerpts from previous columns.

Question: I am a guy who is about to turn 60 later this year and it is freaking me out.  I never thought I would be this old. I had a pretty wild younger life and with all the chances I took I figured I would die before I was 40. Well, that obviously didn’t happen. Sixty sounds really old to me and I feel like something bad might happen to me anytime now. Ironically, now that I have made it this far I really don’t want to die.  Help. 

Answer: It sounds like you are going through some significant anxiety related to aging.  You are definitely not alone in that. To state the obvious, everyone else in your life and everyone around you are also getting older and getting older at the same pace as you.  We give a lot of importance to numbers, especially to numbers like our chronological age and our bank accounts.  While numbers are not unimportant, neither are they all they’re cracked up to be. They are not all-determining.

Aging is a tricky thing.  You have to recognize the changes that are occurring in your body, your energy, and your interests, but people often give up on activities and pleasures that they really don’t have to give up because of their stereotypes about what it means to get older.   I lead a support group for older women here in Loveland and it’s amazing to see how alive and interesting and energetic these women are; most are in their 60s, 70s and 80s.  To a fairly great extent you get to influence your experience of aging.

Personal choices, fortune, and circumstances influence how you age, but so do beliefs and attitudes. It’s important to become aware of your own thoughts, assumptions and beliefs about aging.  We all have them.  We can’t live in this culture and not absorb some of these stereotypes; and these beliefs run deeper into our subconscious minds than we realize.  Most of these beliefs involve sentences that start with “I’m getting old, so I can’t…….”.

A useful exercise to combat these stereotypes in our minds is to challenge ourselves to make a list beginning with the words, “I’m getting older, so I can. . . . . .”.  It’s actually not that hard once you get the hang of it. Some of my favorites are, “I’m getting older, so I don’t have to be so concerned with what other people think of me.” “I’m getting older, so I can put comfort over fashion and who really cares, anyway?” and another one, “I’m getting older, so I don’t have to run through life at a breakneck speed anymore; I can relax and enjoy the ride.”

Don’t get me wrong. Getting older is not a piece of cake.  As the saying goes, “Getting old is not for sissies”.  There are definitely losses and hardships along the path and eventually we all meet the end of our personal road. That’s not a welcome idea for most of us to contemplate.  However, even the culture around aging is starting to change.  Conventional wisdom now holds that 50 is the new 30—so is 60 the new 40?  As long as you have your health, 60 can be whatever you make it—perhaps with just a couple of limitations here and there.

You might consider joining the (gasp!) senior center in your local community.  There are some amazing people there as well as events and resources.  Even better, you will feel like a youngster there and that’s not a bad feeling at all, especially when you’re turning 60.

Question: I am a 30 year old single woman in graduate school and I also work part-time. Lately I have been having a problem I never had before.  I have started to feel nervous and anxious about things that never made me anxious before:  taking tests, writing papers, and irrational worry about developing cancer, which I have no reason to suspect. I have also started having what I can only describe as “panic attacks” for no reason when I am driving on the highway. I have never suffered from anything like this before.  Do you think this is a physical or a psychological problem and what do I do to deal with it?

Answer: It clearly sounds like you have been experiencing symptoms of anxiety and might be developing some kind of anxiety problem or disorder.  Anxiety can have both psychological and/or physical causes. Everybody experiences some anxiety.  This can take the form of nervousness, varying levels of worry about a person or situation and sometimes a feeling of agitation, restlessness, or jitteriness.  For most people this is not something they experience all the time, but rather comes and goes with stressful situations.  This is normal anxiety.

Some percent of people have a tendency toward anxiety and may have a slight degree of worry or obsessiveness all the time.  These traits are just personality traits and they are very bothersome to some people and not too bothersome to others.  Some people seek treatment for low-level chronic anxiety and some do not.  When anxiety becomes acute (very intense) or chronic and is at moderate to severe levels, it is important to seek help.

Chronic and severe anxiety frequently have both psychological and physical components. People who have family members that suffer from anxiety often develop those problems as well at some point in life. In your case, it sounds like you don’t have a history of severe anxiety and this has developed rather suddenly.  If you can’t identify a particular stressor or trauma that has triggered your anxiety, it may be a chemical brain imbalance that is biological in nature.

You should see your health practitioner and see what strategies she recommends for addressing this issue.  She or he may recommend meditation, exercise, learning deep breathing techniques and other ways of controlling your symptoms.  Others may recommend natural calming agents such as herbs and supplements to assist in reducing your anxiety symptoms.

These are effective for some people and are definitely worth trying but some anxiety problems are too severe to be corrected by these methods. In those cases, anti-anxiety medications or anti-depressants (many of which actually also treat anxiety) may be prescribed.  Because anxiety problems can also make you “anxious about being anxious” there is almost always some benefit to seeing a counselor or therapist who understands and treats anxiety problems to work through the psychological dimensions and fears that can arise and coordinate care with your physician.  You may also discover that there are actually situational triggers or stressors that you didn’t realize might be contributing to your anxiety.

Please be assured that in the great majority of cases, anxiety can be effectively controlled and treated.  This is especially true for people who don’t have a pre-existing tendency toward anxiety in the first place.  Even people with biologically based anxiety disorders or anxiety disorders that developed as a result of trauma can be greatly helped.  Anxiety is a common part of life that sometimes gets out of control.  Try not to worry about being worried; just seek help and you can get relief from your anxiety problems.