The Sunday Leader

Anxiety Disorders — A Psychological Approach

By Dr. Marcel de Roos – (Psychologist PhD)

Anxiety is a feeling that occurs when there is fear of imminent danger. When there is no real cause for this fear and the person experiences social or professional problems because of it, we speak of a disorder. In psychiatry, anxiety disorders have the highest prevalence among all diseases. Some well known anxiety disorders are:
-    Generalised anxiety disorder. A long-lasting chronic anxiety which is difficult to control. The patient suffers from concern and fear where the frequency, intensity and duration of the worries are in no proportion to their real source. It is the most common anxiety disorder, especially with older people.

-    Social anxiety disorder. People who suffer from this type of anxiety have a fear of speaking in public, going to parties, attending meetings and so on. As a result of the huge fear of rejection and criticism they can get isolated. There is no gender difference in the prevalence of social phobia.

-    Obsessive–Compulsive Disorder (OCD). The name of this disorder stems from obsessive thoughts and compulsive movements. The thoughts can’t be controlled but the person is aware of them (unlike delusions). The movements (or rituals) are repetitive and are used to neutralise the anxiety which is incited by the obsessive thoughts. Examples are repetitive hand washing, aversion to odd numbers, opening a door a certain number of times before one enters a room.

-    Agoraphobia. If you have this kind of fear, then you are likely to avoid crowded places such as city squares, shopping malls and movie theatres. Generally speaking agoraphobia is the fear to leave a safe and comfortable environment. In severe cases people might only feel safe at home.

For treatment the preferred method is psychotherapy. In some selected cases (like panic attacks) this can be combined with (short term) medication. In Sri Lanka, possibly because of a lack of psychologists, as a rule medication seems to be the only available option. This said, medication only suppresses the emotions and doesn’t solve anything. Besides that, there is danger of dependency and possible side-effects. Psychotherapy looks for causes and real solutions; it is not a quick and superficial fix.

As always it is essential to see the patient in whole. Listen to his story, not only to the symptoms.

Each person is different. In my professional experience, people with an anxiety disorder have reasons to feel anxious. Usually the fear is the expression of a complex hurtful past and often combined with depression. It is about feelings of anxiety, and how to overcome them. In therapy the essence should be to look for the tale behind the anxiety.

Each fear tells an enciphered but real story. You’re suffering from your survival mechanism that points you to the wrong path by directing your attention to the present, instead of your past where the cause of the danger lies. In therapy you’ll be learning to face your original feelings and the hurt that accompanies them. Anxiety is like a lady clad in bright red. Don’t send her away out of fear of the colour but try to listen to her story. Only then it is possible to find emotional balance.

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