Dystonia and Anxiety

Like depression, anxiety commonly affects people with dystonia.

The great majority of anxiety patients can be treated effectively. Response times vary, but full recovery is possible. Taking control of your life, asserting control, and putting anxiety into perspective can give you a tremendous sense of accomplishment and self-satisfaction.

What is Anxiety?
Anxiety is the apprehension, uncertainty, and fear a person feels when he/she is anticipating a threatening event or situation, whether the threat is real or imagined. Having dystonia can certainly be anxiety-provoking, but sometimes anxiety escalates to such a degree that familiar and everyday activities become intolerable. If anxiety overwhelms an individual's ability to function, an anxiety disorder may be present. Individuals with dystonia should be aware of their anxiety and seek professional treatment before their emotional discomfort feels unbearable.

What is an Anxiety Disorder?
An anxiety disorder is a psychiatric condition in which:

  •     Normal apprehension (such as driving at night in a strange neighborhood) is heightened to the point of panic or terror
  •     Fear strikes suddenly when no threat is present, even in a familiar and physically safe environment.

Such feelings of terror are inexplicable and not appropriate to the environment. The attempt to avoid fear begins to take over one's life. Most but not all anxiety disorders have a gradual onset and begin in adolescence or early adulthood.

The anxiety disorders that most often affect people with dystonia are:

  •     Social anxiety disorder:a less disruptive condition in which fear arises when the patient will be visible to other people or must play a socially active role such as proposing a toast or making a speech.
     
  •     Panic attacks:the sudden onset of intense anxiety, characterized by feelings of intense fear and apprehension and accompanied by palpitations, shortness of breath, sweating, and trembling. Panic attacks are usually accompanied by phobic avoidance, anticipatory anxiety, and worrying in some detail about the consequences of the panic attack.

Other anxiety disorders include:

  •     Specific phobias
  •     Generalized anxiety disorder
  •     Obsessive-compulsive disorder
  •     Posttraumatic stress disorder
  •     Agoraphobia

The Relationship between Dystonia and Anxiety Disorders
While some men and women are genetically predisposed towards anxiety, others may develop such disorders in response to the dramatic life changes that living with dystonia can impose. Confidence may be reduced or extinguished, especially if dystonia patients have to simultaneously grapple with disability and job loss, marital problems, or chronic pain.

Feeling worried and stressed does not necessarily mean that you have a clinical anxiety disorder, but chronic anxiety can often be a precursor to a more serious psychological condition. Signs of an anxiety disorder may include:

  •     Anxiety that is excessive, unreasonable, or without an obvious cause
  •     Anxiety that interferes with daily functioning and familiar activities
  •     Physical sensations such as pounding heart, sweating, nausea, jumpiness, trembling, a smothering feeling

Treating Anxiety
Reassurance and recovery often begin with a physical examination by your doctor because some physical conditions can cause symptoms that mimic panic.

Treatments for anxiety disorders include:

  •     Medication: Short-term or long-term treatment with anti-anxiety drugs (such as benzodiazapines), antidepressant drugs (serotonin reuptake inhibitors or tricyclic antidepressants), or beta-blockers
     
  •     Stress Reduction Techniques: Breathing re-training, exercise, guided meditation, deep muscle relaxation
     
  •     Cognitive Therapy: Learning to separate realistic from unrealistic thoughts under the direction of a therapist and reclaiming control over emotional states
     
  •     Behavior Therapy: Learning to handle fear-inducing situations through controlled progressive exposure
     
  •     Cognitive-Behavioral Therapy: A combination of the two therapies which aims to give the patient lifetime skills for coping with anxiety
     
  •     Supportive Psychotherapy: Short-term 'talk therapy' that gives the individual opportunities to process and understand the anxiety disorder and how to recover

Depression may also exist with anxiety, either simultaneously or as a result of having an anxiety disorder, and it should be treated at the same time.

Information provided by Jennifer Pader, MDiv, STM, a psychotherapist who works in New York City.   

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