Fear, Anxiety and Things That Go Bump in the Night
By Ronnie Biemans, Dec 16 2016 05:59PM
“The only thing we have to fear is fear itself – nameless, unreasoning, unjustified, terror which paralyzes needed efforts to convert retreat into advance.”
- Franklin D. Roosevelt (First Inaugural Address, March 4, 1933)
“Fear is a tyrant and a despot, more terrible than the rack, more potent than the snake.”
- Edgar Wallace (The Clue of the Twisted Candle)
Zombies gone mad, horror and slasher films, natural disasters, terrorist attacks ---what’s not to fear? All of us experience the emotions of fear and anxiety at one time or another. For some, however, fearfulness is ever-present and anxiety is disabling.
What is the difference between fear and anxiety? Fear is an unpleasant emotion caused by the belief that someone or something is dangerous, likely to cause pain, or a threat. Anxiety is a feeling of worry, nervousness, or unease, typically about an imminent event or something with an uncertain outcome. Sometimes anxiety is persistent fear in the absence of threat. Anxiety, the disorder, is characterized by a state of excessive uneasiness and apprehension. Some forms are typified by compulsive thoughts and behavior or panic attacks.
According to the Journal of the American Medical Association, clinical anxiety is the most common disorder in many countries. Epidemiological data tell us that one in four people will be stricken by debilitating anxiety at some point in their lives.
The National Institute of Mental Health states that 40 million Americans, ages 18 and older, about 18 percent of the population, are affected by anxiety disorders. Interestingly, despite its prevalence, the recognition of anxiety as a disorder is fairly recent. According to Scott Stossel in his recently published book My Age of Anxiety, “As recently as 30 years ago anxiety disorder did not exist as a clinical category. Only in 1980 - after new drugs designed to treat anxiety had been developed and brought to market - were the anxiety disorders finally introduced into the third edition of the Diagnostic and Statistical Manual of Mental Disorders - that is the discovery of anti-anxiety drugs drove the creation of anxiety as a disorder.” At around the same time, research by Joseph LeDoux, author of The Emotional Brain, pointed to a tiny organ at the base of the brain, called the amygdala, as the primary structure responsible for the arousal and management of anxiety, fear response, and related behaviors. Research over the past 30 years has revealed the brain structures that are involved and also that neurotransmitters such as serotonin, norepinephrine, and dopamine can reduce or increase anxiety. Numerous studies show that there is a very strong genetic component to developing anxiety disorder and scientists are close to identifying the genes that are responsible. As we become better informed we will be better able to find the linkages between genetics, biology, and environmental factors; differentiate between anxiety the emotion and anxiety the disorder; and develop more strategic and effective intervention to bring relief to countless sufferers.
Despite these advances, there continues to be disagreement about the most effective treatment for anxiety. At the crux of it is a century-old debate. Is anxiety disorder a medical issue to be addressed with medication or is it a psychological or philosophical struggle? Is it related to childhood trauma or deeply rooted attachment issues? Scott Stossel sums is up nicely for us, “The truth is that anxiety is at once a function of biology and philosophy, body and mind, instinct and reason, personality and culture. Even as anxiety is experienced at a spiritual and psychological level, it is scientifically measurable at the molecular level and the physiological. It is produced by nature and it is produced by nurture. It’s a psychological phenomenon and a sociological phenomenon. In computer terms it is both a hardware problem (I’m wired badly) and a software problem (I run faulty logic programs that make my anxious thoughts).” Anxiety disorder is complex and multifaceted. We don’t have all the answers but we do know more and there is reason to have hope.
Reason for Hope
Destigmatization and Treatment Options
In the United States, the stigma of mental illness and anxiety is beginning to lessen as more individuals come forward and acknowledge their own personal struggles. Contributing to the destigmatization are three journalists who have chosen to come “out of the closet” One is , Scott Stossel, editor of The Atlantic , whose book, Age of Anxiety, inspired me to write this article. The book recounts his personal struggles with anxiety and explores in considerable detail the history of the efforts by scientists, philosophers, physicians, and therapists to understand the condition. Daniel Smith’s 2012 memoir, Monkey Mind, shone a light on the intense and very real suffering encountered by those with anxiety disorder and did so with humor and compassion. Most recently is Dan Harris, the current poster boy for mindfulness meditation, whose live, on-air broadcast panic attack before a national television audience, brought him to his knees and to the meditation cushion. His book 10 % Happier, touts mindfulness meditation practice as his saving grace. Many of today’s best therapy approaches for anxiety and other mental disorders include mindfulness practice and teachings as an essential component.
How much should anyone suffer and for how long before seeking relief through medication and/or therapy? With suffering can come the inspiration and commitment necessary to find what works. Perhaps Daniel Smith says it best, at a point when he has finally found some relief from his lifelong struggles: “I didn’t realize that there is no cure for anxiety, just perpetual treatment. I didn’t yet realize that a quarter century of anxiety had gouged deep, packed-earth ruts in my brain, and that the only way to stop my thoughts from falling back into those ruts was to dig new tracks and keep digging them, forever. I didn’t yet realize that the only nonnegotiable approach to the anxious life is discipline.”
Suggestions for Those Struggling with Anxiety
• Seek help from a therapist or physician who is capable, well trained in evidence- based best practices, and who is willing to work with you to find the solutions that work best for you. Therapy should be matched to the specific type of anxiety disorder and the unique needs of each individual. Moving forward as an informed and proactive consumer is key.
• Be in it for the long haul. Managing anxiety takes time and tenacity. Make the commitment.
• Explore a variety of self-calming strategies and practice them. Breathing techniques are extremely useful as is meditation and yoga practice. Check out the following websites for some ideas:
• Seek support from those you trust and who are good listeners. Social supports are important. Friends are essential.
• Consider medication as a tool to assist in managing symptoms. Exercise caution and be well informed, as all medications have side effects, some are addictive, and all medication should be carefully managed. A good source of preliminary information is the National Institute of Mental Health’s website. The Anxiety and Depression Association is another excellent resource for further understanding of the medications commonly used The ADAA also provides information on evidence-based therapy methods that are commonly used to address anxiety disorders http://www.adaa.org/finding-help/treatment/therapy.
• Have courage.
“People are not disturbed by things but by the view they take of them.” - Epictetus
“There are more things to alarm us than to harm us, and we suffer more in apprehension than in reality.” - Seneca
About the Author:
Informed by over 25 years of professional training and work experience as well as her many years of meditation and yoga practice, Ronnie Biemans, M.A., L.C.P.C., is guided by a core philosophy to focus on strengths, not deficits or pathology. By discovering, restoring and optimizing each person’s unique ability to thrive and meet the demands, of today’s fast-paced, stressful world, those who have encountered physical and emotional health challenges can discover ways to improve their lives and well being. Operating from her home office and in other community settings, Ronnie provides guidance and support to individuals, families and groups seeking to live healthy, balanced lives.