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Imagine a trip to the grocery store where your biggest worry isn't finding good food at affordable prices, but the fear that your heart will start pounding, that you won't be able to catch your breath, and that you might feel like you're going to die. For the millions of women with anxiety disorders, fears like these are real and debilitating. Luckily, they are also treatable.
Nearly twice as many women as men suffer from certain forms of anxiety disorders. "There are a number of theories as to why anxiety disorders are more prevalent in women. Hormonal changes may sensitize women more to stress and anxiety than men. And women have many demands placed on them, and they often suppress their own needs, which creates a lot of stress and anxiety," says Elizabeth Carll, PhD, stress and trauma specialist in private practice in Long Island, New York, and past president of the media division of the American Psychological Association.
Anxiety is a normal human response to stress that everyone experiences from time to time. "The difference between experiencing anxiety and having an anxiety disorder is that with an anxiety disorder symptoms don't go away, they persist," Dr. Carll says. Anxiety disorders can develop at any age; they can occur even in young children.
The exact cause of anxiety disorders is not known, but researchers have several theories including a biological tendency toward anxiety, genetic factors (20 to 25 percent of people with anxiety disorders have a relative with a similar disorder), stressful events, and other illnesses or medications.
When anxiety disorders occur, treatment is important. "Untreated anxiety can have a devastating affect on a woman's life and, in addition, depression may develop from the ongoing feelings about being unable to cope, so it's important to diagnose and treat anxiety disorders as soon as possible," says Dr. Carll.
From fear of a crowded party or fear of leaving the house to recurring nightmares about a traumatic event, anxiety disorders may take different forms. Here are some of the most common:
Generalized anxiety disorder: If you've been worried, anxious, and expecting a catastrophe to happen for at least six months, and you can't attribute the anxiety to any one thing, you may be suffering from generalized anxiety disorder (GAD). One of the most common of the anxiety disorders, GAD affects an estimated four million Americans.
Panic attacks: While GAD is a constant underlying state of anxiety, panic attacks strike without warning and usually last only a few minutes. A person who experiences panic attacks is forced to deal with a pounding heart, shortness of breath, and faintness. "And people may associate the panic attack with the place they were when they had it," says Dr. Carll. "For instance, if you had your first panic attack in a restaurant having dinner you may start to associate restaurants with being anxiety-provoking and start avoiding restaurants. But in reality the attacks are typically biological and not related to anything in the environment," she says.
Panic disorder: When panic attacks occur frequently and cause constant worry, the condition is defined as panic disorder. Panic disorder strikes an estimated 2.4 million people a year and usually develops between the late teens and early adulthood. People with panic disorder may also suffer from substance abuse and agoraphobia (fear of public places).
Social anxiety disorder: Everyone feels nervous and anxious in social situations from time to time. But for people who have social anxiety disorder (SAD), the normal feelings of nervousness become extreme; they experience an intense fear of being observed and criticized in a social situation. "If you have social phobia to the point that you don't want to go to parties or socialize and you avoid doing a variety of things, that's problematic," Dr. Carll says. Social phobia usually begins in the mid-teens, although it can occur in children, and may be accompanied by substance abuse, depression, and agoraphobia.
Obsessive-compulsive disorder: A severe anxiety disorder, obsessive-compulsive disorder (OCD) causes the sufferer to have recurrent and persistent impulses and unwanted thoughts. To control these thoughts, the person performs certain actions, such as repeated hand washing, re-checking the position or whereabouts of objects in their house, or silently repeating words. More than half of sufferers experience the obsessions without the compulsions. OCD is one anxiety disorder that occurs equally as often in men as in women, and it affects 3.3 million Americans a year.
Post-traumatic stress disorder: The most severe of the anxiety disorders, post-traumatic stress disorder (PTSD) follows exposure to a traumatic event, such as rape, childhood abuse, natural disasters, life-threatening accidents, and war-related or other violence. "PTSD is caused by an external event and can also affect people who have observed a traumatic event. For most people who experience trauma, the anxiety subsides, but PTSD is diagnosed if the anxiety symptoms persist for more than a month. These symptoms may last for months or years," explains Dr. Carll. Symptoms of PTSD include re-experiencing the traumatic event (with flashbacks, for example), feeling emotionally numb, and increased arousal (such as feeling on edge, being easily startled, and having sleeping difficulties).
There are things you can do to prevent stress-related anxiety from becoming overwhelming. A healthy lifestyle with adequate sleep, proper nutrition, and regular exercise is a good start. Eliminating caffeine may also help. Also try the following:
If your anxiety doesn't improve within a month, discuss your symptoms with your healthcare professional. "Anxiety disorders tend to mimic symptoms of other conditions, such as heart attack or stomach problems, so it's important to rule out medical conditions first," Dr. Carll says.
While taking this step, it might also help to keep in mind that anxiety disorders are one of the most common mental health conditions and millions of women are feeling just as you do.Treating Anxiety Disorders
After other medical conditions have been ruled out as the potential cause of your symptoms, your healthcare professional should refer to you a psychologist or psychiatrist, depending on your symptoms. "Treatment typically includes cognitive and behavioral therapy, usually a combination of both," says Dr. Carll. Try to find a professional who specializes in a variety of treatments. "In extreme cases of anxiety, phobia, panic attack, PTSD, or OCD, medication may be recommended with therapy. Medication helps reduce the anxiety, enabling the person to use and benefit from anxiety-reducing strategies introduced in therapy. "
Medications used to treat anxiety disorders include selective serotonin reuptake inhibitors (SSRIs), which are usually the first choice in medication treatment options, tricyclic antidepressants, monoamine oxidase inhibitors (MAOIs), beta-blockers, and benzodiazepines, used on a short-term basis.
Therapy options for treating anxiety include behavior therapy and cognitive behavioral therapy (CBT). Behavior therapy involves a variety of techniques. Exposure and desensitization strategies are used to reduce unwanted behavior (fear and avoidance of social gatherings, for example) and increase desired reactions (such as feeling more comfortable in social settings and getting together with friends). CBT, a combination of behavioral and cognitive therapies, teaches people the skills to view and react to anxiety-provoking situations differently.For More Information
Information on anxiety disorders is available from a variety of sources. For more information, check out the following Web sites: