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Jun 11, - Anxiety disorders are among the most common mental health problems and have been What can help this panic stricken demography?
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• This is what anxiety feels like to me
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I did this enough times that I shocked Dr. The exercise was star-crossed from the beginning. Then it turned out that the upstairs lab was booked, so the exposure would have to take place in a small public restroom in the basement.

I was constantly on the verge of backing out. What follows is an edited excerpt drawn from the dispassionate-as-possible account I wrote up afterward, on Dr. Writing an account of a traumatic event is a commonly prescribed way of trying to forestall post-traumatic stress disorder after a harrowing experience.

As we waited for the nausea to hit, she asked me to state my anxiety level on a scale of one to By now I was starting to feel a little nauseated. Suddenly I was struck by heaving and I turned to the toilet. I retched twice—but nothing was coming up. I knelt on the floor and waited, still hoping the event would come quickly and then be over. The monitor on my finger felt like an encumbrance, so I took it off.

After a time, I heaved again, my diaphragm convulsing. I was now desperate for this to be over. The nausea began coming in intense waves, crashing over me and then receding. I kept feeling like I was going to vomit, but then I would heave noisily and nothing would come up.

Several times I could actually feel my stomach convulse. But I would heave and … nothing would happen. My sense of time at this point gets blurry. During each bout of retching, I would begin perspiring profusely, and once the nausea passed, I would be dripping with sweat. I felt faint, and I worried that I would pass out and vomit and aspirate and die. When I mentioned feeling light-headed, Nurse R.

But I thought she and Dr.

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This increased my anxiety—because if they were worried, then I should really be scared, I thought. On the other hand, at some level I wanted to pass out, even if that meant dying. After about 40 minutes and several more bouts of retching, Dr. But I feared a second dose would subject me to worse nausea for a longer period of time.

I worried that I might just keep dry heaving for hours or days. At some point, I switched from hoping that I would vomit quickly and be done with the ordeal to thinking that maybe I could fight the ipecac and simply wait for the nausea to wear off. I was exhausted, horribly nauseated, and utterly miserable. In between bouts of retching, I lay on the bathroom tiles, shaking. A long period passed. I could feel my stomach turning over, and I thought for sure that this time something would happen. I choked down some secondary waves, and then the nausea eased significantly.

This was the point when I began to feel hopeful that I would manage to escape the ordeal without throwing up. We talked briefly in her office, and then I left. Driving home, I became extremely anxious that I would vomit and crash. I waited at red lights in terror. When I got home, I crawled into bed and slept for several hours. I felt better when I woke up; the nausea was gone.

But that night I had recurring nightmares of retching in the bathroom in the basement of the center. The next morning I managed to get to work for a meeting—but then panic surged and I had to go home. For the next several days, I was too anxious to leave the house. She clearly felt bad about having subjected me to such a horrible experience. Though I was traumatized, her sense of guilt was so palpable that I felt sympathetic toward her. At the end of the account I composed at her request, which was accurate as far as it went, I masked the emotional reality of what I thought which was that the exposure had been an abject disaster and that Nurse R.

I wish that I had vomited quickly.

But the whole experience was traumatic, and my general anxiety levels—and my phobia of vomiting—are more intense than they were before the exposure. I also, however, recognize that, based on this experience in resisting the effects of the ipecac, my power to prevent myself from vomiting is quite strong. Stronger, it seems, than Dr. I confess I took some perverse pleasure from the irony here—the ipecac I took made someone else vomit—but mainly I felt traumatized.

I continued seeing Dr. We both knew it was over. Is pathological anxiety a medical illness, as Hippocrates and Aristotle and many modern psychopharmacologists would have it? Or is it a philosophical problem, as Plato and Spinoza and the cognitive-behavioral therapists would have it? Is it a psychological problem, a product of childhood trauma and sexual inhibition, as Freud and his acolytes once had it? Or, finally, is it—as W. Auden and David Riesman and Erich Fromm and Albert Camus and scores of modern commentators have declared—a cultural condition, a function of the times we live in and the structure of our society?

The truth is that anxiety is at once a function of biology and philosophy, body and mind, instinct and reason, personality and culture. Even as anxiety is experienced at a spiritual and psychological level, it is scientifically measurable at the molecular level and the physiological level. It is produced by nature and it is produced by nurture. The origins of a temperament are many-faceted; emotional dispositions that seem to have a simple, single source—a bad gene, say, or a childhood trauma—may not.

My great-grandfather Chester Hanford, for many years the dean of Harvard College, was in the late s admitted to McLean Hospital, the famous mental institution in Belmont, Massachusetts, suffering from acute anxiety. The last 30 years of his life were often agonizing. Though medication and electroshock treatments would occasionally bring about remissions in his suffering, such respites were temporary, and in his darkest moments, in the s, he was reduced to moaning in a fetal ball in his bedroom.

Perhaps wearied by the responsibility of caring for him, his wife, my great-grandmother, a formidable and brilliant woman, died from an overdose of scotch and sleeping pills in , a few months before I was born. She assiduously avoids heights glass elevators, chairlifts , and tends to avoid public speaking when she has to talk publicly, she takes beta-blockers in advance and risk taking of most kinds.

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Like me, she is mortally terrified of vomiting and has not done so since As a young woman, she suffered from panic attacks. Today, my mother and father, now divorced 15 years, disagree about the severity of the paranoia: my mother says it was negligible—and that, moreover, there really was a serial killer afoot at the time, a fact that research confirms. My only sibling, a younger sister who is a successful cartoonist and editor, struggles with anxiety that is different from mine but nonetheless intense.

But these facts, by themselves, are not dispositive.

‘My neighbour avoids me ... I was very unhappy’: your tales of urban loneliness

In the s, my great-grandparents had a young child who died of an infection. This was devastating to them.

Perhaps my mother, in turn, was made anxious by the fussy ministrations of her worrywart mother; the psychological term for this is modeling. Both my mother and father were well intentioned and loving, but between them, they combined overprotection and anger in a way that may have been particularly toxic for a child with an innately nervous temperament.

On many occasions, my screaming bouts of nighttime panic would awaken the whole family, and my father would lie patiently with me, trying to calm me down enough to sleep. But sometimes, exhausted and frustrated, he would lash out at me physically. My mother dressed me until I was 9 or 10 years old; after that, she picked out my clothes for me every night until I was about She ran my baths until I was in high school. Any time my sister and I were home while my parents were at work, we had the company of a babysitter.

By the time I was a young teenager, this was getting a bit weird—as I realized the day I discovered, to our mutual discomfort, that the babysitter was my age My mother did all of this out of genuine love and anxious concern.

And I welcomed the excess of solicitude: it kept me swaddled in a comforting dependency. But our relationship helped deprive me of autonomy and a sense of self-efficacy. Research suggests that mothers who suffer stress while pregnant are more likely to produce anxious children.

Thomas Hobbes, the political philosopher, was born prematurely when his mother, terrified by a rumor that the Spanish armada was advancing toward English shores, went into labor in April My sister and I were raised in the Episcopal Church, our Jewish background hidden from us until I was in high school. My father, for his part, has had a lifelong fascination with World War II, and specifically with the Nazis; he watched the —74 television series The World at War again and again.

In my memory, that program, with its stentorian music accompanying the Nazi advance on Paris, is the running soundtrack to my early childhood.