According to the Anxiety and Depression Association of America, anxiety disorders are the most common mental illness in the United States, affecting 40 million adults. That’s 18 percent of the population. This means that even if we don’t directly experience high anxiety ourselves, at some point most of us will know someone we care about who is dealing with an anxiety disorder.
In On Edge, author Andrea Petersen details her own personal journey through anxiety, including thorough scientific research as well as hilarious anecdotes to help readers really understand anxiety disorders. We sat down with her to talk about the science behind anxiety and her experience.
Books for Better Living (BBL): In On Edge, you talk about how it took you a while to get diagnosed, and how you had to go through a battery of tests. Sometimes, though, people get this diagnosis and rail against it. What would you suggest for anyone who gets or is afraid of an anxiety diagnosis?
Petersen: Anyone who’s having strange physical symptoms should go to their primary-care doctor. It makes sense that if your heart’s racing or something similar, you want to make sure that it isn’t something else because there are certain physical illnesses that can mimic some of the symptoms of anxiety.
Some people have a hard time believing that their symptoms can be something psychological because I think the misconception is that anxiety is all cognitive, it’s all worrying, it’s all having catastrophic thoughts. But in reality, it’s often a whole-body experience.
BBL: You talk about the mind-body connection being heightened in people who suffer from anxiety in On Edge. Are there any tools a person suffering from anxiety can use to figure out when to trust that mind-body connection and when to say “This could be a manifestation of my anxiety, so I should work from that”?
Petersen: I have strategies that Dr. G—my wonderful primary doctor—and I have agreed on that help me handle these mystery symptoms that I often get. Because I still do get strange aches and pains; we all do. The one erroneous conception that a lot of anxious people have is that good health is symptom free, and that’s just not true. The body is changing all the time.
When I have a new symptom or experience one more pronounced, I redouble my efforts to tackle my anxiety, whether it’s making sure I’m doing yoga every day or trying to reduce my obligations. Also, I take Klonopin as needed, which is a benzodiazepine. There are some doctors who are skittish about prescribing these because there is the danger of addiction and abuse. What Dr. G may have me do is take Klonopin every day for three days and see if that affects the symptom. A couple weeks later, if the symptom is still there, I’ll go back to her. Then maybe she’ll pursue further testing or will send me to a specialist.
Having a relationship with a primary-care doctor is really important—having someone who can help you navigate the medical system and your noisy body.
BBL: You mentioned some doctors don’t like to prescribe benzodiazepines. Do you have anything to say to people who have similar fears about taking them or critics who think anxiety sufferers shouldn’t take medications?
Petersen: There’s a lot of evidence that shows that selective serotonin reuptake inhibitors (SSRIs) are at least modestly helpful for anxiety disorders. I resisted taking medication for years. I was so afraid of the idea—I felt so out of control and so fragile that the idea of monkeying with my neurotransmitters was scary.
There are several studies that show medication is not much better than a placebo, but what it does seem to be good at is preventing relapse. But a third of people with anxiety disorders do not get relief from SSRIs, so that’s why it’s exciting there are new medications on the horizon.
BBL: So anxiety can manifest in many different ways and there are many different types of treatment, but it is not all going to work the same for everybody?
Petersen: Yes, there are certain treatments, though, that have really solid bodies of research behind them. The two major ones are SSRI treatments and cognitive behavioral therapy (CBT). Also, acceptance and commitment therapy (ACT) has a good body of evidence behind it and incorporates a lot of mindfulness techniques.
There’re tons of things that claim to work for anxiety, and there’s probably anecdotal evidence for all of them. But as a journalist, I’ve really looked through the scientific evidence and asked: What backs this up? And the thing is some of the treatments that people have been using for a long time—like meditation and yoga—really do have a lot of science behind them now.
BBL: What would you say to anyone reading this who has a loved one dealing with anxiety?
Petersen: First of all, if people could understand the difference between everyday anxiety and an anxiety disorder—an anxiety disorder is impairing, and you cannot just sort of talk your way out of it or “just relax.” Encouraging people to get appropriate treatment is really helpful, and just being supportive. Also, I think people still believe—and I think this can be true of mental illness in general—that having an anxiety disorder is a moral failing, that it’s somehow a weakness. It’s not. It’s an illness like any other illness, and this one happens to affect the brain.
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