Calming the Storm

30 Aug 2014

Improved therapy helps anxiety sufferers conquer life-altering thoughts

By Debra Melani

The pictures will always stay etched in Lori Flynn’s mind. Massive up-rooted trees, hurled like toothpicks by the river’s powerful force. Water churning up ground and sweeping across the highway toward her cabin two miles up the North St. Vrain canyon. The looks on people’s faces as they returned from a failed search for her neighbor, who died in last fall’s flood. But the Lyons yoga instructor will also always remember something else: her ability to endure the “horrifying” emotions without let-ting anxiety seize control. It’s a message area anxiety experts want to send to the 18 percent of Americans—which translates to 55,000 in Boulder County alone— affected by an anxiety disorder. Whether it’s with-standing a national disaster or calming everyday worries, professional help, along with personal resolve, can lead to a better life, they say. “Therapy, for me, was the most transitional thing in my life,” says Flynn, 39, sipping water at a local coffee shop after a yoga class. Flynn sought help for anxiety after fires destroyed two of her homes within 13 months of each other in California. Escaping both blazes with only her guitar and her dog, she returned to Colorado five years ago to be close to her family. And then she faced her true test, which, thanks largely to her therapy, she passed, Flynn says. Her advice to fellow anxiety sufferers? “I would definitely talk to a therapist.”

Life on Edge

Flynn was diagnosed with post-traumatic stress disorder after the fires and suspects she’s had generalized anxiety disorder since her teens, when her parents took her for counseling. (GAD and PTSD are two of five clinical anxiety disorders, each with its own, although often similar, symptoms and distinct treatment.) That visit led to a failed attempt with Prozac—“I didn’t like the way it made me feel”—and then years of trying to control her worried thoughts on her own, eventually slipping into substance abuse. “I spent most of my 20s self-medicating in a very toxic way,” says Flynn, who was displaced by the flood and now lives in Longmont. GAD sufferers often abuse substances to control the disorder’s main symptom of excessive worry, which goes far beyond the normal anxiety people feel, and is diagnosed when it has persisted for more than six months. With GAD, people worry needlessly, often not even knowing the cause of their angst. Often, family members don’t understand, saying things like “Why can’t you just relax?” says Boulder psychologist Cristina Scatigno. Research shows that both psychological and biological factors can contribute to clinical anxiety. GAD strikes women, who tend to internalize feelings, twice as often as men, and more than half of patients suffer concurrently from depression or another anxiety disorder. Researchers believe neuroticism, a tendency toward negative emotions, plays a role in developing GAD. “Also, people who are vulnerable to GAD tend to develop a sense early on in life that things are uncontrollable and are potentially dangerous,” says Joanna Arch, assistant professor in the Department of Psychology and Neuroscience at the University of Colorado Boulder. Some characteristics can signal an issue with anxiety, such as being particularly hard on oneself, says Joan Unruh, a Boulder addiction counselor who became an anxiety therapist after she noticed a strong connection between anxiety and substance abuse. She says many of her anxiety patients dwell on making mistakes, beat themselves up mentally when they do, and ignore all of their positive attributes. Obsessive behavior can be another sign of clinical anxiety. “For instance, some patients, after the flood, might become obsessed with checking the weather channel, thinking they can control and predict the future,” Scatigno says. For years after the fires, Flynn would convince herself that she had left the stove on or a candle burning every time she left her cabin. “I would always turn around to make sure my dog was OK, and I never did leave anything on.”

Going the Long Way

When avoidance of things that cause fear significantly affects someone’s life, they should seek help, says Arch, using as an example a patient who lived in Los Angeles and was terrified of freeway driving. Five days a week, this woman spent an extra two hours away from her family, commuting to work on back roads. Therapists help by teaching patients to discern fact from fiction, fear from intuition. “I was having a hard time figuring that out,” Flynn says. “Now I’m getting better at watching anxiety arise, acknowledging it as a temporary feeling, and letting it go. Or I’ll reduce it to: What is the uncertainty? Is it real?” Because anxiety has one of the highest rates of treatment success of any mental disorder, sufferers can find relief, whether partial or complete. “People really do get better, and it’s really exciting to see,” Scatigno says, adding that treatment has dramatically improved in recent years. Today’s therapy focuses less on dredging up the past and more on changing the behaviors that allow incessant worries to control people’s lives. “We teach them to face their fears and learn how to function more normally again,” Scatigno says. Cognitive Behavioral Therapy, which includes Exposure Therapy, has the broadest evidence base for GAD, and Arch says it lasts longer than medications. “It has a prophylactic effect. After the therapy ends, it continues to help people. But if you take medication and you stop the medication, which people often do, it no longer offers help.” Drug therapy is sometimes necessary in conjunction with behavioral therapy, and today there are a number of pharmaceutical options for anxiety disorders. Exposure Therapy, a highly effective component of CBT, is also often used, says Arch, who focuses much of her research on anxiety. “It deliberately and directly confronts the situations, the objects or the places that somebody fears,” Arch says, using her Los Angeles patient as an example. The two drove miles of freeway together as part of therapy, until the patient realized her fears were unfounded, and could quiet her anxiety.

'Stop the Misery'

Treatment success for anxiety can range from 55 percent to 85 percent, Arch says, depending partly on the patient’s willingness to work. For GAD, she says, it’s crucial to choose a therapist trained in CBT; there are many in the Boulder area. The Raimy Psychology Clinic on campus offers CBT on a sliding scale and is open to the public. Those who notice the signals and take charge by seeking treatment can profoundly influence their lives, Flynn and the therapists agree. The trick has been learning to slow down and live in the moment—a focus of yoga, Flynn says. She believes that both yoga and music have enhanced her therapy. “It’s not just their presence in my life; it’s their path,” she says, explaining that “putting herself out there” with her singing and songwriting is therapeutic. “Sometimes, just the fact that I’m doing gigs in front of people blows my mind.” Seeing people like Flynn re-engage in life is a therapist’s reward, because untreated anxiety is “a miserable place to be,” Unruh says. “You’re so negative. You’re not in the moment. You’re not really living.” Scatigno agrees, advising people to stop the misery. “You don’t need to suffer,” she says. “You can live the life that you want to live.” [divider] Debra Melani lives in Lyons, which she still loves despite the flood, writing freelance articles with a focus on health and wellness.

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