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The Weight of Worry

They can come in all shapes and sizes and do not discriminate about who they affect. MiNDFOOD looks at the real, often devastating, consequences anxiety disorders can have and the latest clinical studies into the best ways to manage them.

The Weight of Worry

My anxiety is a wild beast,” journalist Elisa Black says in her new book. “It has destroyed relationships, clawed at my insides until I was sick, left me cowering under blankets, plagued me with panic attacks and tipped me into postnatal depression following the birth of my son. “My anxiety is that tightness in my chest, the wild scrabbling of whatever is masquerading as my heart. My anxiety is the constant worry, the fixating, the obsessing over things I cannot control: sickness, death, oblivion. “My anxiety is my upset stomach … My anxiety says I can’t do this, any of this. My anxiety says life is scary and dangerous and fraught and unpleasant. “For 20 years I have sought a cure and for much of that I haven’t even know what I was fighting, haven’t understood why I felt the way I did, why I couldn’t cope with things others found everyday-normal.” Black is not alone in this.

Anxiety is highly prevalent throughout both Australia and New Zealand. Anxiety disorders are the most common mental disorders in Australia, with one in seven people reportedly having had an anxiety disorder in the past 12 months. In the 2011/2012 New Zealand Health Survey, 14 per cent of New Zealand adults (more than half a million people) were said to have been diagnosed with depression at some time in their lives, and six per cent (more than 200,000 people) with anxiety disorders. Generalised anxiety disorder is much more than the normal anxiety people experience from day-to-day. It is chronic and exaggerated worry and tension, even though nothing appears to elicit it. “Having this disorder means always anticipating disaster, often worrying excessively about health, money, family, or work,” the Anxiety New Zealand Trust says. Black first wrote an article about her lifelong struggle with anxiety in 2015, and it has since been read by hundreds of thousands of people, which led to her writing The Anxiety Book.

In the book,  she uses the stages of her life, and the anxiety she experienced, to try to relate to other people’s struggles. The daily struggle Brigid Furness, who works at primary mental health provider Raeburn House, says it is those everyday parts of life with which people with anxiety struggle – their anxiety exacerbating normal worry into something that is out of control. “It could be, for example, about driving in general, or driving at night or to an area that is not familiar to them,” Furness says. “Practical things like whether there will be parking or not can cause anxiety. A lot of anxiety stems from family break-ups or relationship break-ups or financial pressures. “It is the high demands on people.

A lot of people struggle with self-esteem and confidence and it is a competitive world. There are a lot of shifts in the way society is working.” Julia Rucklidge, Professor of Clinical Psychology at the University of Canterbury, says there is a huge range of existing anxiety disorders. “We all experience anxiety. It is
a natural part of survival and fight-flight response. But there is a difference between that and a diagnosable anxiety disorder.” Rucklidge has been researching alternatives to the existing anxiety treatments. Currently, there are two main types of treatment: medication and cognitive behavioural therapy. Rucklidge says many people will be prescribed antidepressants to treat anxiety, “just because there is such an overlap between the two disorders”. Cognitive behavioural therapy, Rucklidge says, is “being taught relaxation techniques and mindfulness and how to challenge your thoughts to curb the ‘worry thoughts’ and their impact on your life”.

Sufferers might be put into a situation in order to demonstrate and learn techniques to manage anxiety. Rucklidge says she is investigating alternative treatments, including using vitamin and mineral supplements, because “despite evidence-based treatments being out there, there are still people who will continue to struggle with mental illness”. She has taken the approach that there are people who need more nutrients in order to function optimally. A clinical trial “showed a really effective way forward”. Rucklidge says she randomly selected three groups: one were given vitamins, one were given vitamins and minerals at a low dose, and another received vitamins and minerals at a high dose. There was also a non-randomised control group. After one month of treatment, each of three treated groups showed “large drops in their anxiety”. “People reported they felt much calmer when taking the minerals and vitamins combination. It does seem to have a positive effect.” Rucklidge says more research is needed. “When you are doing something that challenges conventional thinking, you need to spend a large amount of time collecting data.”

There is also ongoing extensive international research. In an animal research report in the journal Nature, scientists identified a specific region of the brain that helps regulate behaviours and physiological changes associated with anxiety. Cells in this area differentiate between safe and potentially threatening environments and work to suppress anxiety when conditions seem safe. Better understanding of how the brain regulates fear and anxiety is likely to help researchers develop more effective treatments for anxiety disorders.

Types of anxiety

There are many different anxiety-related conditions and no two experience will be the same. According to the Anxiety New Zealand Trust, conditions include: • Agoraphobia – where panic attacks or anxiety are followed by an avoidance of the places where those attacks occur.
• Body dysmorphic disorder – where a part of a person’s physical appearance provokes intense anxiety and negative thoughts.
• Panic attacks – a sufferer may feel out of control and suffer physical symptoms including a pounding heart, sweating and, potentially, shaking.
• Generalised anxiety disorder – chronic and exaggerated worry about often everyday tasks.
• Obsessive compulsive disorder – where people become trapped in a pattern of repetitive behaviours that are senseless and damaging.
• Post-traumatic stress – distress following exposure to a traumatic event.
• Social phobia – an intense fear of social situations where the person feels that they will act in a way that will be humiliating or embarrassing.
• Trichotillomania – the compulsive urge to pull hair.
• Compulsive hoarding – hoarding that is undertaken secretly and can lead to distress and dysfunction.

Where to get help

• BeyondBlue: 1300 22 46 36. A hotline is operated 24 hours a day, seven days a week. It’s a completely confidential service. On beyondblue.org.au you can also talk to trained professionals from 3pm until midnight.

• Your GP can also help and refer you to other services if needed.

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