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WHEN WORRY BECOMES AN ANXIETY DISORDER

By: Mozelle Forman, Lcsw



The young man walked into my office looking around furtively. “This place is messy,” he said.
I looked around the office to check out what he was seeing. “My wife would hate it.” He described his wife’s need for orderliness, her constant control of where he left his things, her anger and lashing out when he didn’t follow her instructions, and her inability to leave the house and attend social functions. He went on to explain that her obsessive need for order and cleanliness was taking a toll on their marriage.

When I met with his wife she described how she has been a “clean freak” since she was a teenager, when she was in a car accident that lead to three surgeries. She acknowledged that she is a nervous person, but except for having to check and recheck the locks on the doors at night and the gas on the stove, she thinks she’s fine.

The young couple who met with me later that week looked frazzled and tired, and wired to burst. I guided them gently into revealing the issue that brought them in. “She has to stop – every time we have company she gets nervous and puts demands on me to help her.
She’s always worried that the kids didn’t eat enough, that the carpool will be angryif we are late, and that she won’t meet her deadlines at work, and she’s always busy. It’s making me crazy.” She calmly looked at me and said, “I’m a working mother with two small children and no household help. Aren’t I normal?”

By nature, and for the sake of survival, human beings worry. Anxiety, though, must be looked at on a spectrum, because in this day and age of “busyness” we all worry. Anxiety about a test, a job interview, or travelling to a foreign place serves to keep one motivated, prepared, and safe. This type of anxiety is considered within the normal range. This is the type of anxiety experienced by the wife in the second scenario. Her anxiety is situational, and keeps her motivated and productive.

Severe anxiety that interferes with an individual’s work and home life, that paralyzes a person, preventing them from getting up to go to school, work, or the airport, is the kind experienced by the wife in the first scenario. This type of anxiety can be defined as an anxiety disorder, and will require evaluation by a qualified psychiatrist and may require medication. The good news is that anxiety, at any level, is very treatable (see sidebar).

The following are the best approaches to treating anxiety and are highly beneficial:

Cognitive Behavioral Therapy (CBT) – This is an effective treatment for anxiety disorders. It relies on the premise that our thoughts and beliefs about a situation cause anxiety – not the situation itself. The core principles of CBT are identifying negative or false beliefs and testing or restructuring them.

Stress and Relaxation Techniques –These techniques often combine breathing exercises and focused attention to calm the mind and body. They can be an important component in treating phobias or panic disorders.

Yoga –The combination of yoga’s physical postures, breathing exercises, and meditation have helped many people improve the management of their anxiety.

Exercise –Aerobic exercise can have a positive effect on your stress and anxiety. Check with your primary care doctor before beginning an exercise program.

In order to gauge where youor your loved ones fall on the spectrum, consider the following questions:

Are your worries causing you excessive suffering and interfering with daily life? Are they stopping you from going to work?

Are you having difficulty sleeping? Are you staying upnights because of your worries?

Are your worries irrational? For example, is a fear of spiders crippling you and keeping you from leaving the house?

Are you constantly clenching your jaw, balling your fists,
chewing your nails, or keeping yourself in a near constant
state of muscle tension?

Are you having gastrointestinal difficulties? Anxiety is often accompanied by tummy troubles.

Do you find yourself working yourself into a state of panic –
or even experiencing panic attacks?

If you answered yes to one or more of these questions, and your symptoms have been occurring for more than six months, it’s probably time to seek out the counsel of a qualified mental health professional. Your health insurance company or Sephardic Bikur Holim can give you a recommendation. While some worry is part of a healthy, normal life, suffering is unnecessary.