General News — 04 March 2014

For as long as she can remember, Amy Shortt’s  life has been overshadowed by her anxieties.

These aren’t the little fears or niggles that  bother us  all from time to time; Amy lives with an almost permanent sense of  dread that something awful is going to happen.

‘It hangs over me all the  time,’ she says.  ‘I worry about going out, what will happen as I drive  to work and about what  I’ve done during the day. While I try to laugh  with work colleagues, inside I’m  in pieces worrying about what might  happen next.’

At times her fear is so intense that she  feels dizzy  and her palms become sweaty. Every few weeks or so she also suffers  from panic attacks, when her heart starts to race and she fights for  breath.

‘It can happen anywhere,’ she says. ‘The  first time I was with Mum watching TV when I was suddenly overcome by this  overwhelming sense of dread. I  felt as if I was going to die.’

Amy – a funny, intelligent  29-year-old who  is a support worker for young people – felt too ashamed  to ask for help and for  years has hidden the condition from all but her  close family and boyfriend.  ‘Even some of my best friends don’t know,’  she says.

Last year, she finally decided to see a GP.  ‘It took me  ages to pluck up the courage. I began by saying: “I have been  feeling  really anxious – I get sweaty, nervous and dizzy.” Anxiety

‘Before I could  say any more, she got up,  shone a light in my ear and told me: “You’ve  got a virus.” She told me to rest,  and to come back if I didn’t feel   any better.

‘I was stunned. All I could manage to say  was: “I don’t  think it is that.” I left feeling even more anxious than when I  went  in.’

Amy moved to another GP, but it was months  before she could  face going to see them. When she finally did, the GP diagnosed  anxiety  disorder and started the process of trying to find the right treatment  for her.

As countless people like Amy have found,  getting a diagnosis can be difficult. Indeed, such is the concern about this  that last  month the National Institute for Health and Care Excellence (NICE)  issued new standards to improve on the ‘poor’ recognition of anxiety  disorders.

And even when sufferers are diagnosed, often  they don’t get the right treatment.

Anxiety – the medical term is generalised  anxiety disorder – means someone  feels unusually and inappropriately anxious on  a virtually daily basis.  It is a common problem, with 5 per cent of the UK  population – some  three million people – affected, according to the mental  health charity  MIND.

David Clark, a professor of clinical  psychology at Oxford  University, explains: ‘Anxiety is a natural response. If  you see a lion, your body will respond. Your heart rate will increase, for  example, in  preparation to run.

‘For people with anxiety, the response is  real  but there is nothing real to trigger it. It ruins lives. People feel  unable to go out and live life, even enjoy their children, because of  their  anxiety.’

The causes are unknown.

‘Research has shown that it is not based on a  major chemical imbalance – it is just that there  is a difference in the way  these people think,’ says Professor Clark.

Those with generalised anxiety tend to have  one or more types of anxiety.  These include social anxiety disorder, about  mixing with people;  post-traumatic stress syndrome, which starts after a  traumatic event  such as an accident; obsessive compulsive disorder, feeling  overwhelmed  by obsessive thoughts or compulsive behaviour; and panic disorder,  characterised by sudden attacks of panic when you think you’re severely  ill or  going to die.

‘One-third of people will have the odd panic  attack because of, for example, too much caffeine,’ says Professor Clark.

Caffeine and other foods, or stress, can  affect the nervous system, causing palpitations that trigger a panic attack.

Around 6 per cent of the population go on to  have repeated panic attacks. This seems to hinge on if they think the worst  about their first attack.

Living with any anxiety disorder can also  have ramifications for your general  health. Beth Murphy, head of  information at MIND, explains: ‘If you feel anxious all the time, this can lead  to conditions such as irritable  bowel syndrome and headaches. It can also  interfere with sleep.’

Some people become so anxious they end up in  hospital. Last year, 8,720 were treated in hospital for anxiety – the majority  of them women over 60.  ‘Women in this age group can feel squeezed: they have a  lot to deal  with, caring for elderly parents and children, and it can take its  toll,’ says Beth Murphy.

‘For someone to be admitted to hospital  with  anxiety, it needs to be quite serious. They will be feeling  suicidal, or so  anxious that they just can’t function.

‘The statistics are alarming and suggest a  failure in the services available to people suffering  with anxiety.’

Diagnosis is clearly an issue. ‘Some GPs are  really good at picking it up, but we do hear from people who wait a long time  for a diagnosis,’ she adds.

‘This can be because they’re worried about  talking about mental health, so  focus on physical symptoms, such as a racing  heart. This might lead a GP to check for heart problems, rather than talking  about the wider  issues.

‘It’s unfortunate, though, as it can take a  lot of courage for these people to ask for help.’

Even with the correct diagnosis, sufferers  are often offered drugs rather  than psychological intervention, such as  cognitive behavioural therapy  (CBT) – a form of talking therapy that aims to  change how people view   certain situations. This has been found to be more  effective  than  medication.

Professor Clark says: ‘If you look at social  anxiety, for example, 80 per cent recover with therapy (normally ten to 20  sessions), whereas medication helps only 40-50 per cent of people and  the  recurrence rate is higher.’  Medication also carries the risk of  side-effects. Amy tried it, with disastrous results.

‘My GP said she could sign me off work, put  me on medication, or get me counselling. I  feared time off work would make me  worse, and I wanted a quick fix, so I agreed to try medication.’

Amy was prescribed the antidepressant  citalopram.

‘It made me feel zombie-like,’ she says. ‘I  couldn’t concentrate at work, and felt really highly strung. I had to come off  it.’

She was then prescribed sertraline, which is  used for panic disorder or social anxiety, but this hasn’t helped either.

When Amy feels strong enough, she hopes to  try CBT – but she may face a  delay getting it. One in ten people waits more  than a year to get access to talking therapy, says Beth Murphy.

Therapy did help 20-year-old  Molly Woodham,  who has suffered anxiety since she was 14, though the  effects have not, in her  case, been long-lasting.

She suffers so badly that she’s too afraid to  leave the house she shares with her boyfriend in Stowmarket, Suffolk.

‘I look out of the window on a sunny day and  I long to go out – but my anxiety about what might happen overrides that.

‘It’s as if you’re in a battle with your own  mind. It’s not a mild feeling  that something bad will happen, it’s a terrifying  fear.’

Her first  attack was on a bus with her  mother and sister. ‘Out of the blue I had a panic attack. My heart was racing, I  had sweaty palms and felt as if I  couldn’t breathe.

‘I ran down to the driver and asked him to  stop – I felt if I didn’t have more air, I would die.’

Her GP diagnosed anxiety and handed Molly and  her mother a leaflet about the condition.

‘And that was that,’ says Molly. ‘I felt as  if I was doomed.’

She gave up her dreams of going to university  to become a teacher as she  had to leave school. ‘I would be in class and my  heart would start  racing.’

She’s since had four courses of CBT which  initially left  her feeling ‘incredible’ – so much so that after one she managed  to get a job and met her boyfriend.

But over the past six months the effects have  worn off.

Like Molly, Amy fears she will never be free  of her anxieties. ‘I just want some peace,’ she says.

This article first appeared on ‘Daily Mail’ on 3 March 2014.


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