What, Me Worry?

How has the “age of anxiety” shaped your life?

/ Author:  / Reviewed by: Joseph V. Madia, MD

Poet W.H. Auden dubbed the years following World War II the “age of anxiety.” Clearly he was on to something.

In 1962, 12 million people had been diagnosed with anxiety disorders, and by the year 2000, some 10 percent of the population was taking antidepressant medication, which is often prescribed for anxiety and its close friend, depression

Anxiety is a normal reaction to stress. Who hasn’t fretted over a test or felt panicked before a public-speaking engagement? But sometimes our fears and worries can overcome us and cause disruption of our routines, our lives. When this happens, it’s time to consult a mental health professional and/or your physician.

When anxiety rises to the level of a disorder, it usually falls in one of these five categories: Panic Disorder (PD), Post-Traumatic Stress Disorder (PTSD), Social Anxiety Disorder (SAD), Generalized Anxiety Disorder (GAD) or Obsessive-Compulsive Disorder (OCD).

Panic Disorder happens when unexpected and repeated episodes of intense fear, accompanied by physical symptoms occur. The physical symptoms can include heart palpitations, dizziness, chest pains and abdominal distress. Phobias can trigger these terrifying attacks. And no one is immune – regardless of race, gender or socioeconomic status. Remember Tony Soprano? Even (fictional) macho mob bosses fall prey to PD.

As one PD patient put it: “"For me, a panic attack is almost a violent experience.  … My heart pounds really hard. I feel like I can't get my breath, and there's an overwhelming feeling that things are crashing in on me.”

Post-Traumatic Stress Disorder often occurs as the result of a physical threat or violence. Many rape and assault victims, natural disaster survivors and combat veterans suffer with PTSD, a chronic anxiety with “triggers” that can disrupt sleeping and eating patterns, and compromise close relationships.

“I was raped when I was 25 years old,” said one PTSD patient. “I started having flashbacks [a common symptom]. They kind of came over me like a splash of water. I would be terrified. Suddenly, I was reliving the rape. Every instant was startling.”

Some people worry about everything, occasionally to the degree that it interferes with their livelihoods.  Generalized Anxiety Disorder, another chronic anxiety, is present when anxiety is continually provoked for little or no apparent reason. GAD sufferers sometimes worry about matters well beyond their control, such global warming and nuclear war.

Social Anxiety Disorder is a type of phobia (an intense, irrational fear of something that poses little or no actual danger) provoked by the presence of other people.

“In any social situation, I felt fear. I would be anxious before I even left the house, and it would escalate as I got closer to a college class, a party, or whatever. I would feel sick in my stomach. It almost felt like I had the flu,” said one SAD patient.

Obsessive-Compulsive Disorder follows a two-pronged path: Recurrent, unwanted thoughts (obsessions) become lodged in the minds of sufferers, and repetitive behaviors (compulsions) follow.  For example, fear of the house burning might prompt an OCD patient to check the stove burners a certain number of times or engage in some other routine or ritualistic behavior such as handwashing, counting or cleaning.  The rituals help pacify the obsession in the OCD patient’s mind, but only temporarily.

Antidepressants prescribed for anxiety usually include selective-serotonin reuptake inhibitors (SSRIs) like Prozac, which may take weeks to build effective levels in the bloodstream and curb anxieties. Zoloft and Lexapro are other commonly prescribed SSRIs.

Anti-anxiety medications (Xanex, Klonopin and Valium, among others) provide a more direct but potentially addictive means to control anxiety symptoms. These drugs, known as benzodiazepines, produce feelings of calm and relaxation but can cause side effects such as sleepiness, fogginess and a lack of coordination. Remember: The higher the dose, the greater the chance of side effects.

Beta-blockers like Tenormin and Inderal are medications that stem physical symptoms caused by anxiety, such as trembling, rapid pulse and sweating. These medicines do not address the emotional symptoms or feelings associated with anxiety.    

If any of these anxieties sound familiar, seek out help. There are plenty of effective treatment options available – from Prozac (Tony Soprano’s go-to medication) to cognitive-behavioral therapy. Usually a combination of the two proves most effective. Don’t let the “age of anxiety” claim you. 

Reviewed by: 
Review Date: 
November 12, 2010