Understanding Anxiety Problems : Treatment

INVOLVING SELF-DOUBT, insecurity and fear, these problems often feel too powerful to deal with and it's not surprising that most people are desperately seeking something that will just take the problem away.
Doctors, scientists and drug companies have searched for this 'holy grail' for decades, the one pill or medication that will simply cure these problems. In doing so they proffer the 'medical model' to explain anxiety and depression problems. This model proposes that physical abnormalities explain the mental processes involved in these problems and, as such, any cure lies in 'correcting the thing' that has gone wrong, usually by medication.
This goes hand-in-hand with classification and treatment. Problems are defined, named, classified, listed, ordered,

placed in categories, placed in sub-categories in an attempt to
understand and control them. Strangely enough, exactly the same attempts to gain control are found in most forms of OCD. And while some argue that benefits of this system include a more accurate diagnosis and subsequent better treatment (which is debatable given such a lack of success) others argue that it is inaccurate, misleading and overlooks the bigger picture.

The medical model of anxiety-related problems ignores the incredible power of the mind and in doing so doesn't even come close to providing an answer. Indeed there is mounting evidence to show that beliefs about such things as genetics, physical brain differences and chemical imbalance are simply wrong. These are not responsible for these problems as it's often suggested and treatments based on these beliefs are actually trying to 'fix' the wrong thing.
More about this shortly, but first let's take a look at the range of anxiety medications available today.
(Medications as of 2014.)

Anxiety Medication

Currently there are four main types of medication used to treat anxiety problems and disorders.

1. Tranquilizers

Tranquilizers (anti-anxiety drugs) work by reducing brain activity and slowing down the central nervous system. This not only reduces anxiety but thoughts and feelings in general. This 'numbing' of feelings can be very calming but also habit- forming and long-term use should be avoided.

Benzodiazepines are the most common class of tranquilizers prescribed. They include:-

Ativan (lorazepam)
Klonopin (clonazepam)
Valium (diazepam) Xanax (alprazolam)

2.             Antidepressants (Depression medication)

Now that a link between anxiety and depression has been established certain antidepressants are becoming more widely used to alleviate anxiety. These medications can take up to 4-6 weeks to take effect and require long-term usage.

There are 3 main types of antidepressant used to treat anxiety: 

i.                Selective Serotonin Reuptake Inhibitors (SSRI's)
These work by reducing the depletion of the neurotransmitter Serotonin (thought to be connected to mood) in the brain.

Celexa (citalopram)
Lexapro (escitalopram)
Paxil (paroxetine)
Prozac (fluoxetine)
Zoloft (sertraline)

They include:-
SSRI's are often used to treat: panic disorder, GAD (generalized anxiety disorder) and OCD (obsessive compulsive disorder)

ii) Tricyclic Antidepressants (TCA's) 

Thought to be less habit-forming than the cyclics (                    eg.
benzodiazepines). Largely replaced by SSRI's they are still used for some problems such  as  panic disorder. Unlike benzodiazepines, tricyclics usually require only a daily single dose. TCA's include:-

Gamanil (lofepramine) Tofranil (imipramine)

One major disadvantage of the tricyclics is that they sometimes produce cardiac effects such as dizziness and palpitations, the very symptoms they are used to alleviate.

iii) Monoamine Oxidase Inhibitors (MAOI's)

eg. Nardil (phenelzine)

One of the oldest classes of antidepressants, this is often used
when others have not been effective. Possibly effective in relieving panic disorder and social phobia MAOI's can have very serious side effects (sudden increase in blood pressure) and people taking them often have to have a restrictive diet to protect from this.

3.             Azapirones
A newer treatment, there is only one medication available: Buspar (buspirone)

Buspirone is a milder tranquilizer. It works by regulating levels of Serotonin and Dopamine in the brain. Slower acting than the traditional anti-anxiety drugs, this medication has the advantage of not being as sedating or addictive as the older types of tranquilizer and having less withdrawal effects.

4.             Beta Blockers

Originally developed to treat heart problems by reducing stress on the heart, this class of drugs work by blocking the
adrenaline (produced when anxious) from acting on various
organs in the body. Common beta blockers prescribed are:- Inderal (propranolol)
Tenormin (atenolol)
Zebeta (bisoprolol)

Note that these drugs don't stop anxiety or adrenaline but stop
some of the effects of the adrenaline eg. a speeding heart.

It is important to realise that medication is not a cure for anxiety problems. Taking prescription drugs doesn't deal with the underlying cause of the problem and once the medication is stopped symptoms usually return with a vengeance. Also, many medications produce side effects, which may be as bad as or worse than the actual problem, and long-term usage can lead to addiction and withdrawal problems. The same is also true when taking medications for depression; they do not cure the underlying problem.
That said, medication does have a place in the treatment of anxiety problems. In some cases, good practice involves taking medication, short-term, to help alleviate symptoms alongside an appropriate therapy to help deal with any problematic thoughts, feelings and behaviours that exist.

Please Note:     sudden  withdrawal from certain medications can be
dangerous and under no circumstances, should anybody stop taking prescribed medication without fully qualified medical supervision.

Treating the Wrong Thing?

Current ideas about what causes anxiety and depression problems falls into three main areas: genetics, physical brain problems and chemical imbalance. 

Many treatments are based on these ideas. Yet there is
plenty of evidence to show that they are wrong, they are not the cause of these problems and looking for answers based on them cannot work.

Perhaps It’s in Our Genes?

Many anxiety disorders and depression problems can be seen to run in families, but it's too easy to see this as proof of genetics being the cause of these problems.
A depressed or anxiety-riddled parent may treat their child in such a way, and provide such a role model, that the child could develop emotional problems entirely through learning and conditioning.

Once the human genome was mapped (the entire DNA sequence that makes up humans) it was hoped to be able to identify and cure the genetic cause of almost everything. But that didn't happen. Whilst ground has been made identifying DNA mutations or variations that may be associated with a higher risk for certain diseases, the actual situation is a great deal more complex. The position of the genes in relation to others and interactions between them may exert as great an influence as the genes themselves. It's the structure as a whole, the system, not just its constituent parts that is important.
Anxiety and depression problems are the same, it is the whole system that counts: our mind and body and the environment they are in. Indeed there are numerous findings from gene research that suggest mental 'illnesses' do not occur because of a single gene.

Genetic information passed from our parents regarding
certain physical attributes (hair and eye colour, general size
etc.) may be fixed but the same cannot be said about our
behaviour. Information that is passed between a parent and child does not result in actual behaviours, but predispositions. Not fixed behaviours but ways of behaving we are susceptible to develop given the right stimulation. A parent cannot pass on fixed behaviours, for the environment the child is born into is unknown. The knowledge we inherit has to flexible to enable us to adapt and survive – reacting with extreme anxiety to unconditional love would not be adaptive.
We all come predisposed to learn language, but the main language we eventually learn to speak depends on where in the world we are born. Racehorses are bred to be good runners but they still have to be groomed and trained. Any genetic information that we receive from our parents can only be put into practice if the appropriate environment exists. DNA is our past not our future. In fact there is evidence to show that DNA (considered to be fixed and unchangeable) can actually change.
Experiments by Barbara McClintock in the 1950's showed vast changes in the DNA of plants occurring when they were stressed. A stressful environment actually resulted in whole sequences of DNA moving from one place to another, even inserting themselves into active genes. Not random behaviour, there was a method to their shifting and it was triggered by outside influences; changes in the environment such as extreme heat or drought that threatened the survival of the plant.
Initially ignored by her peers, McClintock received a Nobel Prize for her work, some thirty years later.

Genes were changing due to experience in plants. Imagine
what may be happening within the complexity of humans. Intuitively we would expect this to be the case. Life is about growing, learning and evolving. Genes shape our reaction to experiences and our reaction to experiences and learning must shape our genes. We need not be slaves to our genes!

Maybe It's Because Our Brain is Different?

PET (Positron Emission Tomography) brain scans of some people with severe anxiety disorders show increased activity and size in certain areas of the brain.
Often seen in people with obsessive compulsive disorder (brain scans of people with OCD show increased energy use in the orbital cortex of the brain, compared to those who don't have OCD) such evidence can lead to the conclusion that brain abnormalities (differences in the size and/or function of certain areas in the brain) may be responsible for these problems.
However, brain scans of violinists show the area of the brain devoted to his or her left fingers (the right primary motor cortex) to be 2 or 3 times larger than that of non- violinists. Constant use of these fingers in playing the violin have formed and embedded the associated pattern of neural connections in that part of the brain making it more active and larger.
It makes much more sense that the areas of increased size and activity in the brain are a result of continued behaviour, not the cause of the behaviour.

Or the Chemicals in Our Brain are Out of Balance?

Synapses, those connections between the neurons in our brain (around 10,000 for each neuron) are tiny spaces that are occupied by chemical messengers (called neurotransmitters) that carry information between neurons.
Serotonin and Dopamine are the two neurotransmitters regularly mentioned with regard to anxiety and depression problems. And chemical imbalance, usually referring to deficiencies in these two neurotransmitters, is often proffered as a reason for these problems. Well, anxiety and depression deplete the body of many resources including: vitamins, minerals, energy and, without doubt, also neurotransmitters.  Surely, any chemical imbalance is the result of these problems not the cause. Balancing chemicals in the brain through medication may alleviate some symptoms to a degree, but it never touches the root cause.

Current beliefs about mental illness, genetics, chemical imbalances, physical brain problems, and treatments based on these beliefs have failed millions of people looking for an answer to these problems. For they miss the real cause of the problem and never deal with it at all. They leave us struggling with symptoms, fighting in the dark, trying to deal with something when we don't even know what it is.
In viewing anxiety problems in terms of the brain and body and that something has gone wrong which needs fixing, the bigger picture is often overlooked. 
To deal with these problems successfully we need to understand the system as a whole – brain, mind, body, spirit and environment all interacting ... our whole being.