Anxiety and Panic/September 2008
Failure to recognize these common disorders
perpetuates suffering and wastes resources.
The
brain—which controls the entire body with all its physical properties, needs,
yearnings, thoughts, and emotions—is the only repository of pain, both physical
and emotional. Without brain there is no pain. The stigmatizing term, Mental Illness, is a demeaning misnomer that modern science has
rejected and replaced with the non-stigmatizing, medically accurate term, Brain
Illness. There are two types of Brain Illnesses, the anatomical—such as brain tumors, strokes,
infections, seizures, dementias—which are visible or discoverable by tests and the
neurochemical—such as chronic fatigue, migraine, depression, anxiety, panic—which are caused by
invisible defects in brain chemistry and neuronal wiring.
Anxiety
and Panic disorders are genetic, neurochemical diseases of the Locus
Ceruleus, which is the alarm button of the
human brain. In a healthy brain,
the Locus Ceruleus adjusts the
amount of Adrenaline it discharges to
the gravity of the danger perceived.
If there is fire, flood, storm, aggression, etc. the Locus
Ceruleus reacts by discharging a
proportionately large amount of Adrenaline, a life-saving reaction that alarms the individual causing a
flight-or-fight response. However,
in a susceptible brain, the Locus Ceruleus discharges its Adrenaline
in disproportionately large amounts for minimally alarming situations—such as
exposure to new faces, places, situations, discomfors, or losses—and that's when Anxiety and Panic
become manifest. Indeed, Anxiety
and Panic are disorders of Adrenaline
excess and the clinical manifestations of Anxiety and Panic are mainly the
physical and emotional consequences of excessive brain Adrenaline.
The
spectrum of Anxiety can be visualized as a continuum from Good Anxiety at one
end to Bad Anxiety at the other.
Good Anxiety is necessary for an effective, stimulated life; a student
who is not anxious about a test may not prepare as hard, a driver who is not
vigilant may have more accidents, and a writer who does not carefully edit his
work may make excessive mistakes.
Consequently—unlike Bad Anxiety, which always diminishes performance and the
quality of life—Good Anxiety may be defined as that appropriate amount of brain
Adrenalin that enhances quality and performance.
Clinically,
Bad Anxiety is a great mimicker that wears different masks in different
individuals. Those who may seem
shy, avoidant, quiet, reclusive, reticent, and harbor great fear of public speaking may
actually suffer from Social Anxiety, which normally begins in childhood and is
the forerunner of Bad Anxiety and Panic Disorder. Adults who suffer from Bad Anxiety may complain of rapid
heart beats, shortness of breath, dizziness, insomnia, abdominal cramps,
diarrhea, urine urgency and frequency, hand and voice tremor, skin rashes,
fatigue, chest pain, body aches, flushing, poor concentration and memory,
irritability, etc. and may see many sub-specialists such as cardiologists,
pulmonologists, neurologists, gastroenterologists, dermatologists, urologists,
rheumatologists, etc. They may
become hypochondriacs, going from one sub-specialist to another and finding out
with consternation that treating their individual symptoms does not improve
their wellbeing. Undiagnosed
Bad Anxiety victims overuse medical services, lose faith in the medical profession,
visit charlatans and quacks, take excessive amounts of vitamins, minerals, and
herbs, become delusional, and live a life of alarmed frustration.
Panic Disorder victims are a lot worse off because on top of their daily Bad Anxiety,
they experience sudden attacks of panic, which make them feel like they are
chocking, dying, having a heart attack, going crazy, losing control, or having an oout-of-body experience. They often end up in emergency
departments and are frequently hospitalized but no diagnoses are made. Without proper treatment, they become
homebound, afraid to go anywhere or do anything for fear that whatever they do
may precipitate another Panic Attack.
The
treatment of the Bad Anxiety and Panic Disorder must begin with recognition. Undiagnosed, these conditions ruin
life’s quality and diminish performance.
Early diagnosis, which leads to early intervention, is the fastest road
to wellbeing. Too many Bad Anxiety
victims remain undiagnosed, however, because they mainly visit sub-specialists—doctors
who are trained to diagnose and treat diseases within their own small areas rather
than examine the whole patient and try to understand the entire human being. It is better to start
with a specialized generalist—such as a Family Medicine specialist or an Internal Medicine
specialist—and leave it to these specialists to refer the patient to a sub-specialist if
there is need. The fragmentation
of modern medicine into myriad small subspecialties has relegated a
secondary role to the primary care specialist and, because of that, too many
patients continue to needlessly suffer.