Jerilyn Ross - One less thing to worry about: uncommon wisdom for coping with common anxieties

IN DEFENSE OF ANXIETY

F or nearly thirty years I have worked with patients, medical doctors, researchers, psychologists, social workers, legislators, journalists, and media figures to raise awareness of and educate people about the causes, impact, and treatment of anxiety disorders. I have also worked to help people understand the difference between the normal anxiety, stress, and tension we all feel from time to time and the chronic, intense, irrational anxiety experienced by people suffering from an anxiety disorder.

And I'm the right person for the job: when I was in my early twenties, I was stricken with an inexplicable and paralyzing fear of heights while dancing on a mountaintop veranda high above the glistening lights of Salzburg in Austria. Little did I know that this relatively common but life-altering event would inspire my life's work. Triumphing over that irrational yet real and crippling fear, which dictated where I could live, which friends I could visit, and whom I could work for (I was living in Manhattan and unable to go above the tenth floor), marked the beginning of my professional relationship with anxiety.

When I set about writing my first book, Triumph Over Fear, very little had been published about anxiety disorders, so my goal was to create a resource that would tell people what to expect when they weren't anticipating a panic attack but inexplicably found themselves having one anyway. That book explored the outward manifestations and inner experience of anxiety disorders, focusing on panic disorder, phobias, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and generalized anxiety disorder (GAD) and featured a step-by-step program to help people cope with these disorders and offer hope that the day might come when irrational, inexplicable anxiety no longer ruled their lives.

Since then, research into the causes and diagnosis of anxiety disorders, vast strides in their treatment, and programs to educate both health professionals and the public about them have brought these medical conditions out into the light of day, where we can get a good look at them. People have become more willing to talk about anxiety disorders and reach out for help. Famous athletes and entertainers routinely go on television and talk about their struggles with panic disorder and social phobia; fifteen years ago, this would have been unthinkable. Even the armed forces are more forthcoming: as I write this, a breaking story in The New York Times has reported a substantial increase in the number of servicemen and -women diagnosed with PTSDnearly forty thousand cases since 2003. In a laudable display of candor, Pentagon officials said that these cases represent only those tracked by the military and estimate that many more of their people suffer from the disorder, citing embarrassment or fear of career damage as a reason for why more of them don't seek treatment. The officials said they were encouraging service members to seek help, even if they preferred to work with private therapists and not report the problem to the military. This is all to the good: anxiety disorders are medical illnesses, not signs of weakness or character flaws, as people used to believe.

Nor do anxiety disorders develop from ordinary, everyday anxiety, as people also once believed. You are not going to develop a height phobia, for example, because you feel dizzy and get butterflies in your stomach when you gaze down from the fortieth-floor balcony at your in-laws' apartment; nor will you develop obsessive-compulsive disorder because, as a nurse, you make a point of washing your hands frequently throughout the day. Anxiety disorders are not inevitable outgrowths of everyday anxiety any more than measles is the outgrowth of a heat rash: some of the symptoms may be similar, but their underlying causes are different. Likewise, the fact that you manifest some behaviors associated with an anxiety disorder does not mean that you have one, nor that you will develop one. What it may mean is that you are experiencing enough anxiety to adversely affect some of your thoughts and behaviors, which in turn may be making you less comfortable in your skin than you would like to be. If this is the case, you are wise to address your anxiety, however accustomed you may have become to living with it.

The science of anxiety and anxiety disorders is still relatively new. Even as I write about the latest research, scrupulously checking references, some of what I cite is being challenged, debated, and, in some cases, refuted in a laboratory, at a medical conference, or in a professional journal somewhere in the world. This is both the glory and the challenge of writing about a subject that is so vast, complex, and often controversial yet has implications that affect us so profoundly. Add to this the fact that, although we are making progress, there is still a dearth of information about the mechanism of anxiety in womeneven though, when it comes to having anxiety disorders, we outnumber men two to one.