High Anxiety

By Brown, Norman | St Louis Post-Dispatch (MO), June 5, 1994 | Go to article overview

High Anxiety


Brown, Norman, St Louis Post-Dispatch (MO)


Physicians are seeing an unprecedented number of patients with anxiety disorders - so many, in fact, that the tranquilizer Xanax (alprazolam) has become the fifth most commonly prescribed drug in the country, far ahead of any antibiotic or birth control pill. But limited research into this twin of the "fight-or-flight" response has left diagnosis fuzzy and treatment options unclear.

Are we entering the Age of Anxiety (after depression in the 1980s and schizophrenia in the '70s)? It's not certain whether more of us suffer from anxiety, or that "we may just be less tolerant of feeling uneasy," says DR. Brian Doyle, a psychiatrist at Georgetown University. That makes it important to know about therapies for anxiety attacks.

If you've ever felt overwhelmed by job pressures and been tempted to call in sick, you're not alone. The National Institute of Mental Health (NIMH) estimates that 24 million people suffer from anxiety disorders. The cost (nearly $50 billion in 1990) lies not in treatment, but in areas like absenteeism and lost productivity.

If the anxiety goes undetected, patients may undergo costly diagnostic procedures and be put on medical regimens doomed to failure. Yet evidence is mounting that short-term therapy using medications and/or a blend of behavioral and cognitive techniques are both effective and increasingly available.

Anxiety sufferers seek treatment less often than people with other mental disorders, except for anxiety sufferers with panic attacks.

"When a person feels like he's going to die, that sends him to the doctor," says Dr. Frederick Goodwin, NIMH director.

When there is no obvious emotional reason for anxiety, you chould suspect a physical problem, says Dr. Jack Gorman, author of "The Essential Guide to Psychiatric Drugs" (St. Martin's Press, 1992). In these cases, a complete medical workup can help your doctor diagnose the problem.

Brief therapy or medications will help most people with general anxiety disorders, at far less cost than long-term treatment, according to a report this past year by the Institute for Behavior and Health in Rockville, Md.

Dr. Robert DuPont. lead author of the reprot, explains that anxiety disorders often go untreated or masquerade as physical symptom such as back pain or indigestion. "They're easy to trivialize," he says, "but are more common than depression or alcoholism."

If the anxiety goes undetected, patients may undergo costly diagnostic procedures and be put on medical regiments doomed to failure. Yet evidence is mounting that short-term therapy using medications and/or a blend of behavioral and cognitive techniques are both effective and increasingly available. When anxiety symptoms are severe and cannot be controlled through behavioral techniques alone, doctors may be able to prescribe effective medications for your condition. The options will depend on the type and cause of the anxiety:

* General anxiety or excessive worry can frequently be relieved with benzodiazepine tranquilizers (Xanax, Valium, Atrivan).

* Social phobias and performance anxiety often can be controlled with beta-blockers such as Inderal (propranolol). …

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