By Joseph Hart, Experience Life
Jenny Arthur was living at a pretty hectic pace. Working two jobs while pursuing a graduate degree had her stressed and rushing most of the time. Surprisingly, though, it was a relaxing weekend away that sent her into a tailspin. Arthur, then 30, had gone to Madison, Wis., to visit a friend, and the two spent the weekend visiting the farmers’ market, taking in films, wandering around the city, talking and drinking coffee- lots of it.
On the drive toward home, where all of her projects were waiting, Arthur started to feel strange. “My range of vision started getting narrower and narrower. My heart was racing, and I felt like I couldn’t breathe,” she recalls. “I had no idea what was happening to me.” She pulled off the freeway and called a friend who drove out and brought her to the nearest urgent-care clinic. “The doctor told me, “You’ll be fine. You’ve just had a panic attack.”
Arthur, now 42 and an event planner in Minneapolis, is one of 40 million Americans who have been derailed by what psychiatrists call anxiety disorders. It’s a broad medical diagnosis that includes several distinct categories:
Obsessive-compulsive disorder, which consists of intrusive thoughts (obsessions) combined with repetitive behaviors (compulsions), such as excessive hand washing, that the sufferer performs to avoid the obsessive thoughts.
Panic disorder refers to recurring episodes of intense physical fear, without an obvious or immediate source of fear. These episodes, also called anxiety attacks, are commonly characterized by heart palpitations and may be accompanied by chest pains. It might also be difficult to breathe, and you may feel like you are choking (symptoms that can make the situation even more frightening and further ratchet up anxiety).
Posttraumatic stress disorder (PTSD) follows a severe traumatic event that threatens actual harm.
Social anxiety disorder describes the condition of people who suffer overwhelming anxiety when faced with everyday social interactions.
Generalized anxiety disorder is a catchall category that describes any chronic anxiety or exaggerated worry that lacks an obvious cause.
While these diagnoses, symptoms and distinctions sound clear-cut on paper, in practice they are anything but. In part, this is because separating the typical from the pathological isn’t always easy. The human brain, it seems, is hardwired to worry even under the best of conditions.
“Because we humans have prefrontal lobes, we can anticipate the future and make up a scenario that is harmful to us,” says Melissa Blacker, MA, a psychotherapist and associate director of the Stress Reduction Clinic at the University of Massachusetts Medical School’s Center for Mindfulness.
Some degree of anxiety and fear are normal responses to life. “Healthy anxiety is part of our fight-or-flight response system,” says Jonathan Abramowitz, PhD, director of the Anxiety and Stress Disorder Clinic at the University of North Carolina, Chapel Hill. “As a basic emotion, it is helpful. In fact, we would all be dead without it, because it protects us from harm.”
So where does a healthy emotional response to stress leave off and an anxiety disorder begin? “Anxiety is a response to the perception of threat,” Abramowitz explains. “When we’re talking about a real danger, that’s healthy stress and anxiety, but when the perception of threat is based on either a misinterpretation of the severity of the threat or the likelihood of harm, then we’re talking about a disorder.”
It can be hard, though, to objectively differentiate between a real threat and misinterpretation.
To further complicate the picture, the science guiding the treatment of anxiety disorders has been anything but clear-cut, opening the door for pharmaceutical companies to encourage consumers to self-diagnose and to seek out advertised products that may or may not be particularly effective in treating the disorders in question.
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