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Three faces of anxiety

By Norman Araiza

In my experience, working with alcoholic clients, once the drinking has stopped, symptoms of anxiety disorders may exhibit themselves and we learn that the drinking problem is secondary to the primary anxiety disorder. When recovery is limited to A.A. exclusively and does not include psychotherapy, often times this anxiety condition goes undiagnosed and relapses are common. Social activities may be limited to A.A. functions. This is not a criticism of Alcoholics Anonymous, of which I have great respect, but rather to point out that with alcoholism there may be other underlying reasons unrelated to the drinking that may be the root of the problem. If these underlying reasons remain undiscovered the quality of recovery and sobriety could be greatly impacted.

Symptoms of GAD include:
Excessive, ongoing worry and tension
An unrealistic view of problems
Restlessness or a feeling of being “edgy”
Muscle tension
Difficulty concentrating
The need to go to the bathroom frequently
Trouble falling or staying asleep
Being easily startled

“I thought I was going to die,” is a common refrain of clients having experienced what is known as “Panic Attack.” Panic attacks are horrifying experiences that can occur at any time, even during sleep, but thankfully lasting but a few minutes, though it may feel like hours. Clients describe them as being their most terrifying experiences. They tend to reoccur if untreated. When someone has had repeated attacks or feels severe anxiety about having another are said to have Panic disorder.

The symptom is strikingly different from other types of anxiety in that panic attacks are sudden, often unexpected, seemingly unprovoked, and are often disabling.

In emergency rooms and with primary care physicians, according to researchers, it is often misdiagnosed or minimalized. The patient is told there is “nothing to worry about…that it’s only in your head.” It is estimated that as much as 40 percent of panic disorder patients get the minimum standard of treatment. Contrary to the impression by the person suffering from an attack, Panic Attack is not organ threatening. However, if untreated, the quality of a person’s life may be seriously affected. Furthermore, attempts at avoidance or concealment of symptoms often lead to other social, occupational or family problems.

While the cause of Panic Attack is not fully understood, at least one theory states that the body’s normal fight/flight response to some threat gets triggered mal-adaptively and the reaction sets in. This condition does not spontaneously improve. It seems clear to me that Panic Attack appears to be the unconscious mind expressing itself in a most dramatic way, about some issue in the person’s life, now or in the past. It commands attention and if not heeded, serious life changing consequences may occur. Often associated with post-traumatic stress disorder, the episodes are unpredictable and may have nothing to do with the current environment.

My third example is someone suffering with Generalized Anxiety Disorder (GAD). GAD is characterized by excessive, exaggerated anxiety or worry about everyday life events. For some, anxiety begins in the first wakeful moment, like a mental bully that controls their life with worry, concern, and negative thinking. It’s as if they are in a state of crisis, all the time.

Part of the problem is that it is considered by some to be just part of their life, like a lifestyle. Anxiety is not a lifestyle. It’s a serious life-debilitating symptom that we create in our selves but over which if untreated, we have no control. Once we identify it we can learn to not create anxiety and in its place find harmony.

Anxiety is the most common of all psychological problems, occurring in roughly 20 percent of Americans. But living with anxiety is not normal, nor must it be tolerated. While anxiety is a psychological issue it usually has genetic and physiological components to it. So, it is not the fault of the individual. Thanks to modern medication and certain forms of psychotherapy directed at identifying the triggers, conditioning new responses and learning to control their thoughts, treatment is usually effective.

Norman Araiza M.A. is an American-trained psychotherapist enjoying a limited practice in San Miguel. He is available for consultation at 152-7842. email:

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