Tuesday, May 16, 2017

The Power of Anxiety: Leaning Into Discomfort

Whether on "The Spectrum" (autism spectrum) or not, I've been impressed lately with how powerful anxiety is.  Consider:


  • The typically developing middle school girl whose anxiety is so powerful, that despite wanting to go to school, her body spontaneously vomits due to the fear of being bullied.



  • The college student with high functioning autism who, despite very strong academic skills and competence, freezes during finals jeopardizing their academic standing.



  • The typically developing adult woman who has lived in a sexless, loveless marriage for 25 years who (despite financial means) is frozen when she wants to address the sadness of her marriage with her husband.



  • The person with high functioning who's asked by a co-worker why they always seem so nervous.
I don't know why suddenly I've become more aware of how powerful anxiety is, but it hit me recently that the anxiety people experience can be crippling.  I often say to folks experiencing these levels of impairment with anxiety (or depression) that there's no therapeutic benefit from going through such mood disturbances.  It doesn't make one stronger or a better person.  It's just torture without profit. Which is why I am a strong advocate of doing anything and everything possible to dampen these anxious responses.

I am a believer in the benefits of the cognitive approaches that have become so strongly put forth in Cognitive Behavior Therapy CBT and Dialectic Behavior Therapy DBT.  The only challenge is that the person has to show up and do the work, and in my experience, some do and some don't.  

I am a believer in the use of medications that have a decades long track record of success in reducing depression.  I'm NOT a fan of the addictive medications (benzodiazepines such as valium and xanax) that, while quite effective have a strong addictive potential.  The non-addictive medications (the class of SSRI's, selective serotonin re-uptake inhibitors being those with the best track record) have a strong track record of success in managing anxiety and depression.  The only challenge is that the person has to be committed to taking them daily and following up with a qualified medical professional and enduring the time - sometimes months - until a therapeutic level can be reached. They also might need to endure the time it takes for the sometimes needed medication changes.

And yes, I'm a fan of good old fashioned talk therapy.  I've heard over and over that despite the hesitation to discuss things that are upsetting, anxiety producing, depressing, that afterwords people (kids, adults, on and off the spectrum) feel better.  I still believe that people relieve their emotional pain by talking about it, as doing so reduces the pressure their emotions build up.  

So yes, anxiety is powerful, very very powerful.  And yet I continue to have faith in the power individuals have to change.  There's lots of ways to change and most of them involve leaning into what is uncomfortable.  It's hard, but it's do-able.