Overcoming Anxiety For Dummies, 2nd Edtion

by Smith, Laura L.

  When human beings have nothing to fight or run from, all that energy has to be released in other ways. So you may feel the urge to fidget by moving your feet and hands. You may feel like jumping out of your skin. Or you may impulsively rant or rave with those around you.

  Most experts believe that experiencing these physical effects of anxiety on a frequent, chronic basis doesn't do you any good. Various studies have suggested that chronic anxiety and stress contribute to a variety of physical problems, such as abnormal heart rhythms, high blood pressure, irritable bowel syndrome, asthma, ulcers, stomach upset, acid reflux, chronic muscle spasms, tremors, chronic back pain, tension headaches, a depressed immune system, and even hair loss. Figure 3-2 illustrates the toll of chronic anxiety on the body.

  Before you get too anxious about your anxiety, please realize that chronic anxiety contributes to many of these problems, but we don't know for sure that it's a major cause of them. Nevertheless, enough studies have suggested that anxiety or stress can make these disorders worse to warrant taking chronic anxiety seriously. In other words, be concerned, but don't panic.

  Figure 3-2: The chronic effects of anxiety.

  Defending against diabetes

  As if the misery of chronic anxiety isn't enough, excess stress can deliver another wallop: People with long-lasting stress are significantly more likely to develop type 2 diabetes. This isn't surprising, because stress increases the levels of glucose (sugar) in the bloodstream.

  Researchers at Duke University conducted a study with over 100 subjects and found that when stress management was added to the care of adults with diabetes, their blood sugar readings actually went down. These techniques weren't complex or time-consuming. In fact, many of them are the same techniques that you can read about in this book.

  The amazing result of this study was that the glucose levels of those who found out how to calm down dropped as much as would have been expected had the subjects been taking an extra diabetes-control drug. So if you don't have diabetes, protect yourself by overcoming anxiety, and if you do have diabetes, know that calm thoughts may help you control the disease.

  Mimicking Anxiety: Drugs, Diet, and Diseases

  As common as anxiety disorders are, believing that you're suffering from anxiety when you're not is all too easy. Prescription drugs may have a variety of side effects, some of which mimic some of the symptoms of anxiety. Sometimes what you eat or drink can make you feel anxious. Various medical conditions also produce symptoms that imitate the signs of anxiety. We look at these anxiety imitators in the following sections.

  Exploring anxiety-mimicking drugs

  The pharmaceutical industry reports on the most widely prescribed categories of medications every year. To show you how easily medication side effects can resemble the symptoms of anxiety, we list ten of the most widely prescribed types of drugs and their anxiety-mimicking side effects in Table 3-1. These medications have many other side effects that we don't list here.

  Interesting, isn't it? Even medications for the treatment of anxiety can produce anxiety-like side effects. Of course, most people don't experience such side effects with these medications, but they do occur. If you're taking one or more of these drugs and feel anxious, check with your doctor.

  Angst from over the counter

  One of the most common ingredients in over-the-counter cold medications is pseudoephedrine, a popular and effective decongestant that stimulates the body somewhat like adrenaline. I, Dr. Charles Elliott, specialize in the treatment of panic and anxiety disorders. A few years ago, I had a bad cold and cough for longer than usual. I treated it with the strongest over-the-counter medications that I could find. Not only that, I took a little more than the label called for during the day so I could see clients without coughing through sessions. One day, I noticed an unusually rapid heartbeat and considerable tightness in breathing. I wondered if I was having a panic attack. It didn't seem possible, but the symptoms stared me in the face. Could I possibly have caught a panic disorder from my clients?

  Not exactly. I realized that perhaps I'd taken more than just a little too much of the cold medication containing pseudoephedrine. I stopped taking the medication, and the symptoms disappeared, never to return.

  So, be careful with over-the-counter medications. Read the directions carefully. Don't try to be your own doctor like I did!

  In addition, various over-the-counter medications sometimes have anxiety-mimicking side effects. These include cold remedies, bronchodilators (for asthma), and decongestants. Also, many types of aspirin contain caffeine, which can produce symptoms of anxiety if consumed excessively. These medications can cause restlessness, heart palpitations, tension, shortness of breath, and irritability.

  Ingesting anxiety from your diet

  Stress and anxiety often provoke people to binge on unhealthy foods and substances, which may lead to increased anxiety over the long run. In Chapter 10, we discuss foods that may help you calm your moods and alleviate your anxiety. Here we tell you how to avoid foods or drinks that may worsen problems with anxiety.

  Notice whether you have special sensitivities to certain types of food. Whenever you feel out of sorts or especially anxious for no particular reason, ask yourself what you've eaten in the past couple hours. Take notes for a few weeks. Although food sensitivities aren't generally a major cause of anxiety, some people have adverse reactions to certain foods, such as nuts, wheat, dairy, shellfish, or soy. If your notes say that's true for you, avoid these foods!

  The chicken or the egg: Irritable bowel syndrome

  Irritable bowel syndrome (IBS) is a common condition that involves a variety of related problems, usually including cramps or pain in the abdomen, diarrhea, and/or constipation. These occur in people with no known physical problems in their digestive systems. For many years, doctors told most of their patients that irritable bowel syndrome was caused by stress, worry, and anxiety.

  In 1999, Catherine Woodman, MD, and colleagues discovered a mutated gene in patients with IBS more often than in those without it. Interestingly, that same rogue gene also occurs more often in those with panic disorders. Other possible physical causes of IBS may have to do with poor communication between muscles and nerves in the colon.

  Various medications have been found to decrease some of the worst symptoms of IBS. In addition, psychotherapy that teaches relaxation techniques, biofeedback, and techniques for coping with anxiety and stress also improves IBS symptoms. So at this point, no one really knows to what extent IBS is caused by physical causes, anxiety, or stress. It's more likely, however, that the mind and body interact in important ways that can't always be separated.

  Limit or avoid alcohol, which can make you feel tense in the long run. Alcohol may relax you in small quantities, so many people try to self-medicate by imbibing. However, people with anxiety disorders easily become addicted to it. Furthermore, in excess, alcohol can lead to a variety of anxiety-like symptoms. For example, after a night of heavy drinking, alcohol can leave you feeling more anxious because it clears the system quickly and the body craves more. That craving can lead to addiction over time.

  Caffeine can also spell trouble. Some people seem to thrive on triple espressos, but others find themselves up all night with the jitters. Caffeine lurks in most energy drinks as well as chocolate, so be careful if you're sensitive to the effects of caffeine.

  Speaking of energy drinks, these sometimes contain unusually large quantities of not only caffeine but also other stimulants. You'll see herbal stimulants such as taurine, guarana (loaded with caffeine), ginseng, and ginkgo biloba, among others. Reported adverse effects include nervousness, sleeplessness, abnormal heart rhythms, and seizures. If you have excessive anxiety, you don't want to be chugging down these concoctions.

  Finally, lots of people get nervous after eating too much sugar. Watch kids at birthday parties or Halloween. Adults can have the same reaction. Furthermore, sugar is bad for your body in a variety of ways, such as spiking blood g
lucose levels and contributing to metabolic syndrome (a condition that often leads to high blood pressure and diabetes).

  Investigating medical anxiety imposters

  More than a few types of diseases and medical conditions can create anxiety-like symptoms. That's why we strongly recommend that you visit your doctor, especially if you're experiencing significant anxiety for the first time. Your doctor can help you sort out whether you have a physical problem, a reaction to a medication, an emotionally based anxiety problem, or some combination of these. Table 3-2 lists some medical conditions that produce anxiety symptoms.

  Getting sick can cause anxiety, too. For example, if you receive a serious diagnosis of heart disease, cancer, or a chronic progressive disorder, you may develop anxiety about dealing with the consequences of what you've been told. The techniques we give you for dealing with anxiety throughout this book can help you manage this type of anxiety as well.

  Chapter 4: Clearing the Roadblocks to Change

  In This Chapter

  Finding out where your anxiety comes from

  Looking at resistance

  Watching worries ebb and flow

  Getting the right help

  The odds are that if you're reading this book, you want to do something about your own anxiety or help someone you love. If so, you should know that sometimes people start on the path to change with the best intentions, but as they move along, they suddenly encounter icy conditions, lose traction, spin their wheels, and slide off the road.

  This chapter gives you ways to throw salt and sand on the ice and keep moving forward. First, we explain where anxiety comes from. When you understand the origins of anxiety, you can move from self-blame to self-acceptance, thus allowing yourself to direct your energy away from self-abuse and toward more productive activities. Next, we show you the other big barriers that block the way to change. We give you effective strategies to keep you safely on the road to overcoming anxiety. And finally, if you need some outside support, we give you suggestions on how to find professional help.

  Digging Out the Roots of Anxiety

  Anxiety doesn't come out of nowhere; rather, it typically stems from some combination of three major contributing factors. The primary villains underlying anxiety are

  Genetics: Your biological inheritance

  Parenting: The way that you were raised

  Trauma: Horrific events that sometimes happen

  Studies show that of those people who experience an unanticipated trauma, only a minority end up with severe anxiety. That's because anxiety stems from a combination of causes — perhaps genes and trauma, trauma and parenting, or even all three factors may gang up to induce anxiety. Some people seem almost immune to developing anxiety, yet it's possible that life could deal them a blow that challenges their coping abilities in a way they couldn't expect. In the story that follows, Bonnie shows how someone can show resilience for many years yet be tipped over the edge by a single traumatic event.

  Bonnie manages to grow up in a drug war zone without developing terribly distressing symptoms. One night, bullets whiz through her bedroom window and one pierces her abdomen. She shows surprising resilience during her recovery. Surely, she must have some robust anti-anxiety genes and perhaps some pretty good parents in order to successfully endure such an experience. However, when she is raped at the age of 16, she develops post-traumatic stress disorder (PTSD; see Chapter 2 for more information). Bonnie has sustained one trauma too many.

  Thus, as Bonnie's example illustrates, you can never know for certain the exact cause of anyone's anxiety with absolute certainty. However, if you examine someone's childhood relationship with her parents, family history, and the various events in her life (such as accidents, war, disease, and so on), you can generally come up with good ideas as to why anxiety now causes problems. If you have anxiety, think about which of the causes of anxiety have contributed to your troubles.

  What difference does it make where your anxiety comes from? Overcoming anxiety doesn't absolutely require knowledge of where it originated. The remedies change little whether you were born with anxiety or acquired it much later in your life.

  The benefit of identifying the source of your anxiety lies in helping you realize anxiety isn't something you brought on yourself. Anxiety develops for a number of good, solid reasons, which we elaborate on in the following sections. The blame doesn't belong with the person who has anxiety.

  Guilt and self-blame only sap you of energy. They drain resources and keep your focus away from the effort required for challenging anxiety. By contrast, self-forgiveness and self-acceptance energize and even motivate your efforts (we cover these ideas later in the chapter).

  It's in my genes!

  If you suffer from excessive worries and tension, look at the rest of your family. Of those who have an anxiety disorder, typically about a quarter of their relatives suffer along with them. So your Uncle Ralph may not struggle with anxiety, but Aunt Melinda or your sister Charlene just might.

  Maybe you're able to make the argument that Uncle Ralph, Aunt Melinda, and your sister Charlene all had to live with Grandma, who'd make anyone anxious. In other words, they lived in an anxiety-inducing environment. Maybe it has nothing to do with their genes.

  Various researchers have studied siblings and twins who live together to verify that genes do play an important role as to how people experience and cope with anxiety. As predicted, identical twins were far more similar to each other in terms of anxiety than fraternal twins or other siblings. But even if you're born with a genetic predisposition toward anxiety, other factors — such as environment, peers, and how your parents raised you — enter into the mix.

  It's how I was raised!

  Blaming parents for almost anything that ails you is easy. Parents usually do the best they can. Raising children poses a formidable task. So in most cases, parents don't deserve as much blame as they receive. However, they do hold responsibility for the way that you were brought up to the extent that it may have contributed to your woes.

  Three parenting styles appear to foster anxiety in children:

  Over-protectors: These parents shield their kids from every imaginable stress or harm. If their kids stumble, they swoop them up before they even hit the ground. When their kids get upset, they fix the problem. Not surprisingly, their kids fail to find out how to tolerate fear, anxiety, or frustration.

  Over-controllers: These parents micro-manage all their children's activities. They direct every detail from how they should play to what they should wear to how they solve arithmetic problems. They discourage independence and fertilize dependency and anxiety.

  Inconsistent responders: The parents in this group provide their kids with erratic rules and limits. One day, they respond with understanding when their kids have trouble with their homework; the next day, they explode when their kids ask for help. These kids fail to discover the connection between their own efforts and a predictable outcome. Therefore, they feel that they have little control over what happens in life. It's no wonder that they feel anxious.

  If you recognize your own parenting style in any of these descriptions and worry that your behavior may be affecting your child, flip to Chapter 20 to see how you can help your child overcome her anxiety.

  It's the world's fault!

  The world today moves at a faster pace than ever, and the workweek has gradually inched upward rather than the other way around. Modern life is filled with both complexity and danger. Perhaps that's why mental-health workers see more people with anxiety-related problems than ever before. Four specific types of events can trigger a problem with anxiety, even in someone who has never suffered from it much before:

  Unanticipated threats: Predictability and stability counteract anxiety; uncertainty and chaos fuel it. For example, Calvin works long hours to make a decent living. Nevertheless, he lives from paycheck to paycheck with little left for savings. A freak slip on an icy patch of sidewalk disables him for six weeks, and he has
insufficient sick leave to cover his absence. He now worries obsessively over his ability to pay bills. Even when he returns to work, he worries more than ever about the next financial booby trap that awaits him.

  Escalating demands: Having too much responsibility piled on your plate can make you anxious. Jake initially thinks that nothing is better than a promotion when his supervisor hands him a once-in-a-lifetime opportunity to direct the new high-risk research and development division at work. Jake never expected such a lofty position or the doubling of his salary this early in his career. Of course, new duties, expectations, and responsibilities come along for the ride. Jake now begins to fret and worry. What if he fails to meet the challenge? Anxiety starts taking over his life.