by Marcelle Pick, OB/GYN NP
Many women operate in an ever-present state of low anxiety or worry, also called generalized anxiety that may blossom into episodes of full-blown panic attacks, phobia or anxiety disorders during times of psychological stress or biological change — like menopause.
A majority of my patients with chronic anxiety are so accustomed to living with it - often since childhood — that they don’t even mention it until I ask or until they begin perimenopause and their anxiety symptoms worsen.
Anxiety and worry are knots of both emotions and physiology feelings. Most psychologists look at anxiety as purely emotional: the outward sign of repressed negative feelings and inner conflict. But over 30 years of scientific research into severe anxiety disorders and panic attacks has established that all anxiety has a real, physiological cause that is just as important to treat — especially for relief of anxiety related to hormonal imbalance.
This is good news. It means that anxiety symptoms that were once dismissed as character flaws (think of the terms “worry wart”, “head case” and “control freak”) are not feelings you just have to live with or medicate when they get too severe for you to function. There’s a lot more to the story — and a lot that you can do to get that monkey of anxiety off your back.
What is anxiety?
Everyone experiences anxiety or feels panicky from time to time: the shaky knees and thudding heart, the shortness of breath, and the mind going a million miles per minute. Part of what keeps us alive is our ability to feel fear. In fact, we are made with a kind of built-in alarm system that brings the full weight of our mental and physical prowess to bear in the face of danger — the “fight or flight” response.
The limbic system, the parts of the brain responsible for orchestrating our emotions, including the fight or flight response, relies on a complicated interplay between neurotransmitters and hormones to fuel the body and mind to deal with a perceived enemy.
What’s not natural is to feel afraid and upset most of the time without any tangible cause. Like our immune response, our fight or flight response is meant to click into action in the face of danger and then rest. But in our day and age, too many of us never get to relax: our minds are perpetually on high alert with the accompanying physical response.
It’s no exaggeration to say there is an epidemic of anxiety. Over 19 million American adults and millions of children have anxiety disorders ranging from mild to severe. And the statistics only count the people reporting their anxiety symptoms to doctors. I know from my practice that there are many more on the mild to moderate scale who feel reluctant or even ashamed to admit their anxiety.
Our culture tells us that feelings of fear, vulnerability, and even shyness are signs of weakness — which makes anxiety the fault of the victim. Women are taught from childhood to “grin and bear it.” The people who accuse us of medicalizing anxiety are not being helpful. The truth is that telling women to suffer through anxiety is just as terrible as telling them that drugs are the only remedy for anxiety and panic attacks. Neither is correct.
Let’s start by looking at the major types and symptoms of anxiety and then examine the real roots of anxiety. That’s where we’ll find solutions.
Severe anxiety disorders
Severe panic and anxiety disorders like obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), social phobias, and stress disorders affect only a small minority of anxiety sufferers.
Severe anxiety disorders are highly treatable but require medical diagnosis. If you think you may be experiencing any of these disorders, contact your healthcare practitioner right away. Different approaches that include drugs and cognitive-behavioral therapies (such as exposure therapy) are proving to be very successful.
One hot topic of study is the connection between anxiety disorders and genetics, because anxiety disorders clearly run in families. At Women to Women, we think genes are a factor in some anxiety disorders, but generally not the most important factor. More often than not, anxious women grew up in anxious households. Anxiety is usually a learned behavior that can be unlearned — even when it’s severe. We’ll return to this topic after we explore generalized anxiety disorder, which affects many more women than the severe anxiety disorders.