When Fear Paralyzes

There are various forms of anxiety disorder that are common and debilitating. Fortunately, effective treatments are available.

All of us have experienced anxiety at some time or another. And in just the right doses, anxiety can actually be of benefit to us, helping us mentally prepare for important or challenging tasks, making us take caution when it’s prudent to do so, and even heightening our ability to learn. But excessive anxiety can overwhelm and debilitate us. And there are individuals who, for various reasons, experience anxiety on a level that painfully interferes with their ability to carry on the activities of normal daily life. For folks who suffer from the various types of anxiety disorders, fear and worry can paralyze.

According to statistics provided by the National Institute of Mental Health, researchers have found that approximately 18 percent of adults and 25 percent of children and adolescents have experienced debilitating anxiety at some point during their lifetime. And a significant proportion of these individuals have at some point been diagnosed with an anxiety disorder classified as severe enough to greatly impact their ability to function adaptively in the home and working life. The symptoms of anxiety can be quite distressing. They can include such sensations as feeling like your heart is pounding or racing, being cold yet sweating in the extremities, feeling apprehensive and jittery, having dry mouth, feeling short of breath, trembling, dizziness, and nausea. And because the symptoms themselves are so unnerving, many times anxiety over the symptoms actually increases a person’s distress. It’s a vicious cycle that’s hard to break without professional intervention.

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There are several types of anxiety disorder. Four of the more commonly diagnosed conditions include:

Phobias

A phobia is when excessive or irrational and uncontrolled anxiety is attached to an identifiable stressor, either social or object or situation-specific (e.g., fear of crowds, high places, certain animals, public speaking, etc.). And people who suffer from phobias will generally go to great lengths to avoid exposing themselves to the circumstances that give rise to anxiety.

Panic

People with this condition experience “attacks” of extreme anxiety. These episodes are sometimes triggered by particular circumstances. But they can also appear “out of the clear blue sky” and without warning, often adding to a person’s distress. As with phobias, individuals who suffer from panic often begin to avoid placing themselves in circumstances in which they fear panic symptoms might occur. And sometimes this can lead to them avoiding many social and occupational situations that are essential to their overall welfare.

Obsessive-Compulsive Disorder (OCD)

Obsessions are intrusive thoughts that are sometimes irrational and excessive yet hard for a person afflicted with them to shake off. Compulsions on the other hand are strong urges to engage in certain actions or perform certain ritualistic behaviors. Obsessions and compulsions can engender anxiety in themselves. But more often, individuals with OCD engage in their compulsive habits or mental fixations to stave off even higher levels of anxiety.

Post-Traumatic Stress Disorder (PTSD)

PTSD is an often misunderstood condition. It’s not simply experiencing the understandable mixed emotions that follow a painful circumstance. Rather, folks that suffer from PTSD have experienced a life-threatening or severely traumatic event and often have recurring bouts of anxiety following that event. They also might have “flashbacks” of the traumatizing experience, anxiety and avoidance associated with situations or circumstances that in some way are reminiscent of the trauma, and a variety of other symptoms including emotional instability, difficulty sleeping and nightmares, depression, uncharacteristic behavior, and a lowered threshold for stress tolerance.

Whereas some once thought anxiety disorders were a manifestation weakness in one’s character, we have known for some time now that there are many factors that contribute to the development of such conditions, including a family predisposition toward such illnesses, a person’s biological makeup, certain developmental and personality factors, and abnormalities in brain functioning and neurotransmitter chemical balances. For some, the various biological factors are so influential that anxiety can occur in relatively stress-free circumstances, whereas for others, problems surface when stress levels have become high. But in any case, having an anxiety disorder is not a sign of weakness, but rather an indication of a neurobiological system out of tilt.

As distressing as the various anxiety disorders can be to experience, there is good news for sufferers, in that most can be effectively treated with proper intervention. In fact, treatment for anxiety disorders enjoys one of the highest intervention success rates of all the various psychological maladies. Sometimes treatment involves only the use of medications. Other times, non-chemical therapies are employed. Many times, it’s a combination of medication and various psychotherapies, especially cognitive-behavioral therapy (CBT) that proves the most effective course. Treatment can be relatively circumscribed and time-limited, or in some cases, more long-term. There’s a variety of options, all of which have demonstrated effectiveness, and certain of which appear more appropriate for particular conditions.

Long before I began specializing in disturbances of character and wrote my books In Sheep’s Clothing and Character Disturbance, I worked primarily with individuals suffering from anxiety disorders, especially Panic Disorder. And long before research had emerged that supported the notion, it became apparent that those caught in the trap of avoiding certain situations (e.g., going to school, driving a car, going to the supermarket, etc.) weren’t so much fearful of the places per se, but rather fearful of experiencing the dreaded anxiety symptoms they had grown to anticipate might occur in those places. And long before CBT became popular and had research support for its effectiveness, I had the good fortune to witness many individuals use the strategies of changing their thoughts and actions to break the vicious cycle of panic escalation, and heal. The science of treatment for anxiety has improved considerably since those early days, and there is every reason for a person paralyzed by intense or irrational fears to have hope that proper intervention will help free them to enjoy life once again.

• anxiety and stress
• OCD
• phobia