Anxiety can be a debilitating mental illness that keeps individuals from enjoying life or even
Photo courtesy of Jonathan Miller
going about daily tasks. When people suffer from anxiety, it can be difficult for them to know where to start in identifying and seeking help. Healthy New Albany Magazine talked to New Albany-based counselor Jonathan Miller to learn more about this illness.
Healthy New Albany Magazine: What are some short- and long-term physical effects that anxiety can have on a person’s body?
Jonathan Miller: The first thing that happens is the body gets ready to fight or run. It’s the same fight-or-flight reaction we used to hear about on the Discovery Channel. Automatically, the survival areas of our brain speed up our breathing to get oxygen into the bloodstream, increase our heart rate to get that oxygen around to the muscles and tense the muscles to get ready for action. In our frontal cortex – the logical, thinking part of our brain – we know rambunctious kids or a stack of bills is nothing to get agitated about. The brain’s limbic system, which handles emotions, perceptions of danger and our level of physical arousal, only sees a threat.
Long-term, high levels of anxiety can wear us down. The brain uses hormones such as adrenaline, cortisol and norepinenephrine to get the body ready for action. Researchers have found elevated cortisol levels may lead to memory deficits and learning trouble over time. We’ve all watched two-term presidents turn gray with the job; there’s evidence high cortisol levels age us more quickly.
HNA: How can talking with a counselor or therapist help a person deal with anxiety?
JM: Anxiety is the most treatable condition in mental health. A therapist can help patients check the automatic thoughts that can stress them out. These always feel true, but that doesn’t make them helpful. Through cognitive restructuring, people can work out different thoughts – ones that are realistic but still helpful – and practice those until they’re in the habit of thinking that way naturally.
For phobias, compulsions and anxiety in specific situations, exposure therapies are often helpful. A therapist can help a person set up a “stepladder” of situations that cause that anxiety. They’ll help patients stay in each situation long enough for their nerves to learn it’s not actually dangerous. Once that situation doesn’t bother patients anymore, they’ll be ready to move up to one that’s a little more intense.
There’s another therapy called Eye Movement Desensitization and Restructuring that helps people who have been through trauma. The research suggests it helps the brain process those memories more quickly. EMDR often helps people treat the trauma symptoms without going through the memory in a lot of detail.
HNA: What are some guidelines to figure out when it is a good idea to seek medication to alleviate symptoms of anxiety, and how is dosage determined?
JM: First, remember anxiety is an ordinary, healthy emotion that everyone has. If people get stressed over deadlines, edgy before they give a presentation or shy when they first walk into a party, that means they’re normal.
If anxiety causes problems in someone’s life, he or she has an anxiety problem. People should consider getting treatment if their nerves interfere with work, school or relationships. Medication can be right in a crisis, or to give short-term relief while a patient treats the problem in therapy.
Doctors calculate dosages based on a patient’s weight and research findings. Since everyone’s body chemistry is different, it can take a few appointments to find the right medication and dose.
HNA: What are some options other than medication for dealing with anxiety?
JM: We stress our bodies with poor diet and lack of exercise. If people aren’t eating right or working out regularly, good habits can do a lot to cool down agitation.
Daily relaxation practice is the cornerstone of treating anxiety. When people relax themselves completely each morning and keep it up day after day, their baseline anxiety levels start to come down. That’s why yoga instructors are often so serene: The benefits of a daily routine add up over time.
The important part is that people relax themselves with the kind of relaxation exercises found online. Yoga, meditation and mindfulness practice are also effective. Hot baths, walks in the park and recordings of nature sounds are all soothing, but they don’t have the same long-term effect as relaxation exercises. Also, “relaxation” isn’t the same as “hobby.” When someone tells me they play video games to relax, I’ll ask, “How often do you wind up cursing at the game?”
HNA: Can anxiety issues manifest themselves in different ways as a person ages?
JM: Children often show anxiety differently from adults. They’ll have headaches, stomachaches or diarrhea. Sometimes they’ll refuse to speak or get overwhelmed by separation anxiety.
Grown-ups with good memories know childhood isn’t the carefree time of life we see on TV. Even young children can worry excessively. If you ask a third-grade teacher, he or she could probably tell you about a former student terrified he or she wouldn’t get into a good college.
About Jonathan Miller
Jonathan Miller is a licensed professional clinical counselor working in New Albany. He’s provided therapy in group practices and community mental health since 1998, relying on evidence-based practices such as cognitive behavioral therapy, dialectical behavioral therapy and exposure therapy. He treats adults for depression, anxiety, trauma, anger, grief and personality disorders. More information can be found at his website, www.millercounselingllc.com.
Sarah Sole is an editor. Feedback welcome at ssole@cityscenemediagroup.com.
