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GAY PEOPLE'S CHRONICLE MAY 20, 1994

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PSYCHED OUT

Anxiety disorders

by Keith Oliver, PhD

Panic-anxiety attacks and agoraphobiawhat are they really? Anxiety disorders are one of the most common emotional disorders in our country today. A recent estimate is that one in five people suffer from an anxiety disorder. Anxiety disorders include such disorders as: panic disorder, agoraphobia, phobias, generalized anxiety, post-traumatic stress disorder, and obsessive compulsive disorder. Often the reason people seek medical attention is due to the symptoms of

an anxiety disorder. For the purpose of this article, the focus will be on anxiety, panic attacks and agoraphobia.

It has been estimated that there are over 13 million people in the U.S. who have agoraphobia. This condition is often misunderstood and though of as the fear of the "out of doors." Literally, agoraphobia means "the fear of open spaces or fear of the marketplace." Thus people usually assume that people with agoraphobia are house-bound. In actuality only about two percent of those with agoraphobia cannot leave their home. Therefore, a better definition is the "fear of fear and fearful feelings" which more closely describes the actual experience of those with agoraphobia.

People who have agoraphobia have at some point experienced a severe panic attack. A panic attack is characterized by such symptoms as: sweating, accelerated heart rate, dizziness or lightheadedness, feeling faint, increased respiration, dry mouth, tension in the stomach, tension in the neck or shoulders, trembling, difficulty swallowing, confusion, etc. As a result of these symptoms the individual may believe they are dying. Often the symptoms are associated with a place. The person has the urge to run as far away from the place as possible, to escape and find safety. As a result of this initial attack the person begins to fear additional

attacks, and becomes fearful of places or situations from which escape might be difficult. If and when another attack occurs, the fear of additional attacks increases. As a result of this fear the person begins to limit her or his activity to places and situations from which easy escape is perceived.

The fear of additional attacks and the fear of embarrassment cause the individual to attempt to control as many variables as possible. The person may begin to make excuses for not going places or insist on sitting only in the back row of the theater, or driving separately to ensure an escape vehicle. The person may begin to "self-medicate" with alcohol or other addictive substances and develop a dependence on these substances. These methods do not work and can lead to obvious other problems and complicate treatment.

Anxiety left untreated can lead to such medical problems as: increased risk of hypertension, ulcers, circulatory problems, stomach and intestinal problems, headaches, asthma, skin problems and cardiovascular concerns. In addition, quality of life is affected as well as the person's emotional well-being. Further, panic attacks and agoraphobia can seriously disrupt relationships, family life, career and the carrying out of daily living activities.

Anxiety disorders are treatable. Through treatment, many people have found relief and have been able to return to normal living. Treatment can involve counseling alone or a combination of counseling and medication. Medication alone usually only treats the symptoms and can therefore leave the disorder intact. In addition to formal treatment programs there are self-help programs and groups available for additional support. ✔

Dr. Oliver is a psychology post-doctoral intern with Mark Harris and Associates in Columbus.

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