Thursday, February 5, 2015

Damn Right, You Are Anxious


by Joan R. Shepherd, FNP

Prior to beginning an Accelerated Detox, we ask patients to rate their anxiety and depression on a scale from 1-10.  The depression varies, but I don’t think I’ve ever seen anyone weigh in with an anxiety score less than 5—and that’s a low one.

When people make the decision to stop using opiates, benzo's or booze, it’s scary. Likely they’ve tried to stop in the past. They know the physical realities of withdrawals, or they’ve suffered the humbling self defeat of relapse. Alcohol and other drugs that are used to reduce anxious discomfort will provide some anxiety relief in the short run, but cause bigger problems in the long run.

It is possible that, in addition to having a diagnosis of addiction to a substance, a patient has the co-morbidity of one of the many flavors of anxiety: Post-traumatic Stress Disorder (PTSD), Generalized Anxiety Disorder (GAD), Obsessive-Compulsive Disorder (OCD), or Social Anxiety to name a few.

While an Accelerated Detox is not going to ‘fix’ those conditions, it will certainly help to take the physical component of the addiction piece off the table, creating more opportunity for a person to deal squarely with their particular issue.

If you’re anxiety is mostly part of your Post-Acute-Withdrawal-Symptoms (PAWS) package, you’re likely to be feeling better within a couple months. If your anxiety persists, it may be helpful for you to know a little more about this condition.
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For one, you are not alone. People with anxiety disorders are everywhere and affect up to 30 percent of the general population at some point in their lifetimes. Number two; anxiety disorders tend to be chronic, so it’s important to get help. Number three, anxiety and fear are different, and both can be useful.

Fear is an intensely felt alarm response that we all need to survive. It is a present-oriented state that alerts us to nearby dangers and prepares our body to deal with them. We’ve all heard about the fight/flight/freeze response.
 
Anxiety, on the other hand, is a future oriented state. People describe an anxious apprehension or a sense of foreboding; the physical response is not as intense as a fear response, but it can linger much longer. For some people days, weeks or even years.

Here’s an example. You are in the woods and you see a bear (a big mean one coming at you). That should evoke a fear response. Thinking about the possibility of seeing a bear as you plan for a hiking trip, can evoke an anxiety response. Generally, anxiety tends to be fueled more by what your mind says than by real sources of danger or threat.

Clearly both fear and anxiety can perform a useful function. Fear will get you running away from that bear, anxiety will propel you to buy some bear spray before you hike in grizzly territory.

People get into trouble when anxiety and fear go beyond serving a useful purpose. Dr.’s Forsyth and Eifert state in “The Mindfulness & Acceptance Workbook for Anxiety

“People with anxiety disorders struggle with, avoid, and run away from their fear and anxiety. This tendency defines the actions of just about every person with an anxiety disorder. And, struggle turns out to be the most important toxic element that constricts lives and transforms anxiety from being a normal human experience into a life-shattering problem.”
 
Research suggests that figuring out exactly which "official anxiety" diagnosis you have seems to be far less important that understanding, as specifically as possible, what triggers your personal anxiety response and is keeping you stuck. In future blog articles, I will suggest some strategies that people have found particularly helpful in dealing with their anxieties.


In the meantime, if we can help you with taking the opiates, booze or benzo's off the table, give us a call.

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