arch 2007 Columnshttp://www.lightconnectiononline.com/colums.html1 of 53/30/2007 9:15 AM
Treating Anxiety Treating Anxiety Treating Anxiety Treating Anxiety
By David Gersten, M.D.
Anxiety, worry, fear, and panic affect millions of Americans. Some of us are “professionalworriers” and some of us have a full-blown disorder, such as “panic disorder with agoraphobia.” Apanic attack is an overwhelming mental and physical experience in which one feels a sense ofimpending doom. Your heart pounds and races; it's hard to catch your breath; you think you'regoing to die and are pretty sure you're losing your mind. Panic disorder, if not identified andtreated, can cripple a person's life. There are a host of anxiety disorders, including anxiety causedby an “existential crisis,” a time when one has lost one's bearings, one's sense of purpose andconnectedness. It is important to explore all issues related to anxiety and panic before going forthe quick fix, whether that is a medication or a vitamin.
How you deal with anxiety and panic reflects how you and your doctor conceptualize what youare struggling with. If your doctor believes that the problem is 100% biological, driven by problemswith brain chemistry, then your only treatment will come from approaches that improve brainchemistry.Regarding panic disorder, biological (medication) treatments were fairly well understood morethan 30 years ago, and included these components.1. Anti-depressants, like Elavil and Tofranil (early medications that raised brainnorepinephrine levels) were (and are) used to help stop panic attacks.2. While the effects of anti-depressant medication are waiting to kick in (about 2 weeks),minor tranquilizers (benzodiazepines), such as Valium, Xanax, Klonopin, and Ativan are used todecrease “anticipatory anxiety.” That's the anxiety a person feels in between panic attacks . . .when they are fearfully waiting for the next attack, which cannot be predicted. Largely for politicalreasons, minor tranquilizers fell into great disrepute, and so they are monitored quite closely bygovernmental agencies. The fact is that it is nearly impossible to commit suicide by overdosing onthis group of medications. On the other hand, the new generations of anti-depressants likeProzac, Paxil, Zoloft, Effexor, and Wellbutrin, are prescribed as if they are totally harmless. Theseare drugs that will kill you if you overdose. And if you increase them too quickly or suddenly stopthem, you may require psychiatric hospitalization.Why the stigma over benzodiazepines? They can and do cause tolerance, meaning that, ifyou take them every day, their effectiveness will drop from 100% to 75% to 50%, and you willrequire higher doses. For this reason, it is important, when using these medications, to “hold theline,” avoid increasing dosage, and avoid daily usage. Because people who are serious drugabusers have, among other drugs, abused benzodiazepines, this class of drugs began to belooked at as dangerous and evil in the mid-1980's.While many people prefer non-medical treatments, anti-depressant medications have a long,successful history of alleviating panic attacks, and should not be dismissed as a possible part ofthe solution.The anxiety experienced in between panic attacks, “anticipatory anxiety,” is qualitatively notdifferent from the anxiety of Generalized Anxiety Disorder, Social Anxiety Disorder, and otheranxieties with no name. Therefore, for virtually all forms of anxiety disorders, there are a numberof approaches that are universal. I do want to note that the pharmaceutical industry's attempt toportray SSRI anti-depressants as being helpful for most anxiety disorders is, in my opinion, adangerous marketing strategy. (Actually, it's a great marketing strategy, but dangerous, incorrectinformation). When I read on one web site that, “SSRI medications are a new class of anti-anxietydrugs,” I was concerned about how successful the drug companies have been in turning theiranti-depressant medications into broad-spectrum anti-anxiety drugs. The fact is that, for manypeople, SSRI's “cause” a great deal of anxiety, rather than curing it. However, they can be usefulfor panic attacks.
Mind-Body Approaches For Healing Anxiety
1. First, determine if you are dealing with an existential crisis. Medication, or powerfulnutritional supplements, will not fill the void of a life in search of meaning.2. Explore, perhaps with professional help, any immediate causes of conflict. Extreme conflictcan precipitate panic and anxiety. Trouble shoot to see if there are practical ways to resolve theconflict in the “real world.” If not, then it is important to use hypnosis or guided mental imagery toquickly get down to core causes of unresolved conflict. You cannot “think your way” out of conflict,since the runaway, ruminating mind causes a great deal of conflict and is not capable of resolvingconflict or decreasing anxiety.