Sunday, May 23, 2010

Anxiety disorders

When I tell people that Big Guy has an anxiety disorder, they're often not quite sure what I mean. As mental health issues go it sounds pretty innocuous, kind of like a fancy way of saying someone worries too much. That's not it at all.

Try this: think back to the time in your life you were most anxious. Find that memory and hold it in your mind. Consider how easily irritated you were then. How jumpy did it make you? How prone to misinterpreting or overreacting to events? How rational in thinking through minor challenges? You were certainly not at your best, and chances are you remember that time as being a nightmare of erratic, debilitating feelings. Big Guy's anxiety disorder means he feels a high degree of anxiety all the time. He lives with it the way some people live with chronic pain. His baseline is probably close to my high water mark.

Clinically speaking, anxiety differs from fear because it's not a response to an external stimulus. Functionally, however, the two feelings are close cousins. Fear, embarrassment, disappointment, and other strong feelings cause surges in adrenaline which (in most of us) drop after the immediate situation has passed. With an anxiety disorder some portion of the instinctual fight-or-flight reaction seems to get stuck in a loop. If you're a worrier, you have some idea of what this feels like: it's that can't-shake-it feeling you get at 10pm when your brain just won't let go of a problem. Ramp up the intensity and take away the known cause, and you've got what we call anxiety.

The term anxiety disorder is a catch-all for a variety of things: phobias, social anxiety, OCD, PTSD, and panic attacks. Many anxiety disorders are readily treatable with cognitive behavioral therapy (CBT). CBT combines cognitive exercises -- which teach different thinking patterns -- with new behavioral patterns that help to alleviate the tension and adrenaline rush of anxiety. There's a nice variety of the latter in Your Anxious Child by John Dacey and Lisa Fiore. Like the relaxation practices or I've been teaching Little Guy or the kids' books on What to Do When..., the behavioral stuff takes consistent practice to be effective. But it really helps.

Big Guy has what's called Generalized Anxiety Disorder (GAD), which sounds pretty tepid until you realize that generalized doesn't mean vague, but pervasive. It permeates someone's being in a way that's hard to root out. We keep rooting.

1 comment:

  1. Hello, I was referred to your blog by Magpie after she read about my struggles with my son and GAD. It's just so difficult, isn't it? I find it difficult to deal with the mental health system and what I would describe as a detached child psych, and feel like my son isn't getting the care he deserves. Layman certainly cannot understand what it means to have GAD, and chalk it up to "nervousness", not the true fight or flight stimulus that we would have when our lives were in danger. Imagine living like that? Does Big Guy have academic issues? My son has issues with executive functioning and working memory.