Understanding Anxiety and Panic Disorders
Gerald Lewis, Ph.D.

Millions of people experience anxiety disorders, a common yet often misunderstood medical problem. Luckily, anxiety, and in its extreme form panic, are disorders for which there is treatment that can diminish the symptoms dramatically.

Most of us understand that in certain situations, feeling anxious is a normal reaction. We may be nervous about a test, a performance, a confrontation, a date, an interview or any number of circumstances. The manifestations of anxiety run the gamut, but most people describe variations of: muscle tension, difficulty concentrating, feeling nervous and agitated, difficulty breathing, feeling sweaty, light headedness.

As mentioned, while many people experience these symptoms occasionally, an individual with an anxiety disorder feels this way much of the time. In addition, the severity of the symptoms may reach a level that it interferes with daily activities such as work, school or social relationships. A panic disorder is an intense spiking of these symptoms with a variety of other symptoms such as chest pain, shortness of breath, racing thoughts, and severe physical and emotional discomfort. A person experiencing a panic attack may feel that they are "having a heart attack" or "going crazy." Others report that they must immediately leave the situation and retreat to a safe place.

Many people think of anxiety and panic disorders as psychological problems. However, recently, they have begun to be viewed as a medical problem with psychological (and physical) symptoms. One way to conceptualize these disorders is to use the analogy of an allergy. Put quite simply, our brain (and body) operates as a big filtering system, keeping harmful matter from infiltrating our system. For some reason, some of us may have a sensitivity to certain substances or situations. It may be dust, cat dander, pollen, or some food. These individuals' "filtering system" may be a little faulty and are unable to block these substances or situations from entering their bodies (actually their brain) and thus they are vulnerable to the discomfort of their allergic reactions. Medication is available to treat the symptoms, but not the disorder. In a similar way, some people may have an impaired filtering system for other types of "substances or situations." People with panic disorders often have an accompanying phobic reaction to certain situations that may trigger their "allergy." Claustrophobia a fear of being trapped or enclosed; hydrophobia-fear of water; agoraphobia- fear of being in large, chaotic, busy social situations such as malls, stores, concerts, etc. are a few of the most common. Certainly there are others such as fear of heights, flying, spiders, dogs. People suffering from anxiety and panic may develop a variety of methods to avoid these situations. When it cannot be avoided, they may have an anticipatory reaction just thinking about the upcoming event.

It used to be thought that these were people with psychological problems and that the source of the fear was symbolic of underlying issues. Now, most mental health professionals view these as analogous to allergies and treatment focuses around a more problem centered approach to helping the person feel more comfortable and less symptomatic. It should be noted, that some people may develop anxiety and panic disorder as a symptom of a true emotional condition. Often, people who have experienced trauma, neglect or serious crises may develop a psychologically derived anxiety problem with a specific phobic component. In other cases, people with a variety of medical problems may have a concurrent anxiety disorder. An example of this is Irritable Bowel Syndrome where the individual becomes anxious when not in close proximity to a bathroom.

Regardless of the etiology, people with anxiety and panic disorders often feel some shame or embarrassment. They may try to hide the problem from themselves as well as others. They may try to "self medicate" with alcohol, drugs, or food. These "treatments" may "help" but often lead to significant problems of their own. The good news is that anxiety and panic may be treated with a great deal of success through talk therapy that takes a "problem-centered" focus, relaxation.