Overcoming Anxiety For Dummies, 2nd Edtion

by Smith, Laura L.

  Is it possible that anxiety causes me to have other symptoms, such as stress and depression?

  If I do get sick, is there anything I can do to cope?

  How do others cope with what I'm worried about?

  Is there any evidence that I'm more likely to get sick than other people?

  After completing the exercise, take another look at your answers. Decide for yourself whether your worry and anxiety keeps you safe. The following example of Arturo, a young man who worries excessively about getting sick from contaminated food, illustrates the cost/benefit analysis.

  Arturo doesn't eat in restaurants because he worries about getting food poisoning. He believes that processing food increases the risk of industrial contaminants, rodent droppings, bacteria, or viruses entering into the food supply. Thus, he only eats fresh produce that he buys at a local food co-op. He then takes special care to make sure that the food he buys is clean. Because of his strict diet, Arturo is slender and generally healthy.

  He spends more than three hours each day choosing and cleaning his food. Despite these precautions, he frets and worries. His peculiar habits keep other people from being close to him. His loneliness leads to depression. His primary-care doctor refers him to a psychologist who helps him develop the cost/benefit analysis shown in Table 16-1 regarding his concern about food contamination.

  Arturo sees that his over-concern about food has both costs and benefits. He begins to understand that he can't stay completely safe all the time. And if he does get sick, it's likely that his illness can be treated. Furthermore, he sees that some of his perceived "benefits" for his worry are illusions. Thus, he could eat healthy food, stay slim, and still get sick whether he worries or not. He decides to take a chance and eat at a vegetarian restaurant with his cousin.

  If you worry about your health, take Arturo's approach. Make lifestyle changes that matter and realize that excessive worries can, by themselves, make you sick. Seek professional help if your health concerns persist in spite of your best efforts.

  Tabulating Risks of the Modern World

  In the early 1900s, you were lucky to live to age 50. People died of contagious diseases like tuberculosis and influenza or infections caused by simple injuries. Heart disease, dementias, and cancers were less likely to be the cause of death only because people succumbed to infections before reaching old age.

  Now, most industrialized countries boast a life expectancy well into the 70s. People over 100 are the fastest-growing sector of the world population, with expectations that this segment will be over 6 million strong by mid-century. Today, heart diseases and cancer have replaced contagious diseases as the most likely cause of death. Yet, it seems that as people live longer, they don't appear to be living healthier. The skyrocketing costs of healthcare not only reflect improvement in care but also the fact that many more people have chronic diseases. In the following sections, we take a look at when it makes sense to keep tabs on diseases and epidemics and when you can safely ignore them.

  Examining the evolving realities of diseases and treatments

  Paradoxically, longer life spans and modern medicine give people more to worry about all the time. Even though people live longer, in a sense, they're getting sicker. There are several reasons for this increase. First, more years of life equal more wear and tear on the body. Many diseases become more frequent with age, such as cancer, arthritis, dementia, and hormonal disorders, so obviously, in an aging population, the risk for getting sick is greater.

  Second, so-called advances in technology and medicine allow doctors to find disorders they never looked for in the past, such as prostate cancer. Even though the vast majority of "sufferers" have relatively few symptoms and eventually die of other causes, we now worry about such cancer and often experience significant side effects from the treatment itself. Furthermore, we treat things we never used to see as problems. For example, what used to be considered normal aches and pains in the knee can now be seen on an MRI and diagnosed as osteoarthritis. Unfortunately, the surgical treatment of osteoarthritis has recently been found to be no better than a placebo — the treatment consisted of giving some patients a sham surgery (the patients thought they received surgery, but actually did not — the surgeons even cut open their knees and stitched them right back up).

  On the other hand, screening can prevent diseases from even occurring in the first place. For example, the dreaded colonoscopy can detect benign polyps before they become cancerous. Removing these polyps stops colon cancer before it has the chance to take hold. That's wonderful.

  Yet another interesting cost of medical advancement is the additional risk that some treatments carry. For example, acid reflux disease used to be called indigestion. Known to increase the risk of certain cancers, it's now vigorously treated with medication to reduce or eliminate stomach acid. However, stomach acid protects us against common bacteria such as salmonella. So people being treated for acid reflux may be at greater risk for food poisoning. Other medications such as antipsychotics (see Chapter 9) can help people with severe mental disorders but lead to weight gain and diabetes.

  Another example can be found in the treatment of osteoporosis. Osteoporosis is defined as significant loss of bone density that results in an increased risk of bone fractures. This disorder can be successfully treated with medication. However, a rare side effect of long-term use of these medications results in collapse of bones (the very problem the treatment is supposed to deter).

  Finally, definitions of disease have changed over time. Blood pressure is now considered high and treatable at lower levels than before; the cutoff for normal cholesterol has also dropped. The idea is to treat diseases early to prevent later problems. That can be a good idea, but what constitutes diseases sometimes gets out of hand, such as when normal sadness is defined as serious depression in need of medication.

  Consider another example: Minor loss of bone density was once thought to be a common and normal result of aging. But today medical providers have started treating a "new" condition called osteopenia — a milder loss of bone mass than osteoporosis. Treating this newly diagnosed "disease" has led to a huge increase in sales of the drugs originally developed for osteoporosis. Because this disorder is usually found among younger people, the long-term effects of treatment with medication are not yet known.

  Take the time to keep informed about the risks and benefits of treatments, and make modifications in your lifestyle as much as you can to stay healthy.

  Weighing local versus global health risks

  People who worry about their health sometimes focus on potential threats that are quite rare. Take some time and think about the risks of getting sick in your locality as compared to somewhere else in the world. For example, if you live in the United States or Canada, you're pretty unlikely to come down with malaria or typhoid fever. And if you live in a country where adequate care is available, getting sick is not necessarily a death sentence.

  On the other hand, millions of people throughout the world lack basic sanitation, clean water, medical care, and food. These conditions breed and spread infections. Diseases that have been eliminated by improved sanitation or vaccines can be deadly when medical care is insufficient. Poverty, famine, disease, and violence shorten life spans to the mid or even early 30s in some countries.

  Although your chances of getting the kind of diseases that regularly kill people in third-world countries are less than for those people who live in terrible conditions, people travel all over the world. And infectious diseases can catch a ride. The following example illustrates:

  Leroy travels to Indonesia. While there, he is bitten by a mosquito. He then travels to Paris for a short business trip. Sitting outside sipping wine at a French bistro, he is again bitten by a mosquito. That mosquito could infect someone in Paris with the tropical disease that Leroy carries. Leroy then returns to Chicago. Sitting outside on his deck on a hot summer evening, he gets bitten by another mosquito. That mosquito could possibly infect Leroy
's neighbor. A couple of weeks later, Leroy comes down with fever, chills, and a horrible headache. In severe pain, he goes to the hospital and is diagnosed with malaria.

  Leroy's story shows how diseases can spread. Although malaria is quite rare in most of the western industrialized world, between 350 to 500 million cases occur in Africa, Asia, the Middle East, and Central and South America. About a million people die from it each year, mainly young children in certain regions of Africa. Most people who get sick in the United States are people who travel to those regions. Fortunately, inexpensive medications that prevent malaria can be obtained before traveling to places where malaria is present.

  So it's a good idea to take reasonable precautions when traveling. Reasonable precautions include making sure that you're up-to-date on vaccinations and checking with your medical provider if you're traveling out of the country.

  Wear mosquito repellent when you're outdoors during a time that you might become infected by mosquito-borne diseases such as the West Nile virus, because this virus can occur almost anywhere on the planet.

  The U.S. Center for Disease Control (CDC) maintains a Web site that includes up-to-date information about infectious diseases throughout the world. You can click on any country and find out whether there are any travel restrictions or warnings. Go to http://wwwnc.cdc.gov/travel.

  Watching out for exaggerated claims

  People pay attention to unexpected events. So when something predictable happens, it's less likely to be a focus of media scrutiny. For example, when an 88-year-old woman dies of a stroke in her sleep — unless she was rich or famous — there may be just a short obituary in the local paper. However, when a 3-year-old dies of a new type of flu that's spreading around the world, that's news. People talk about what's in the news and the media goes to great lengths to bring you complete coverage of the story, so your awareness of an event like a toddler's death from a new disease is heightened. As your awareness goes up, your anxiety likely does too.

  We're not saying that the concerns about H1N1 flu (also known as swine flu) aren't legitimate, but the probability of dying from heart disease or an auto accident are much greater than dying of all but the most catastrophic of pandemics.

  Taking an Inventory of Your Personal Health

  Accidents happen, and people get sick. And eventually, as far as we know, everyone dies. Whatever your own personal beliefs are about what happens after death, most people don't look forward to dying. Some believe that people have a certain amount of time on this planet and what they do with their day-to-day lives doesn't much matter. But how you live your life greatly affects your health and comfort, no matter what happens in the end, whereas worry never kept anyone healthy. So we recommend that you take a careful look at your lifestyle and your known family health risks, take whatever steps you can to minimize those risks, and then make the best you can out of each and every day.

  So far, no one has been able to predict the future. Live each day fully and to the best of your ability. Worry and regret do not lead to better health.

  Checking out your lifestyle

  In Chapter 10, we highlight some of the lifestyle changes that you might consider to improve your health and, hopefully, reduce your anxiety. Here we zero in on some of the health risks that may add to your worries. Many studies have looked at the factors that have the greatest impact on leading a long and healthy life. These studies follow people for decades and keep track of their health and habits. According to reports, more than a third to almost 90 percent of heart disease, cancer, diabetes, and stroke are caused by one or more of the following lifestyle choices:

  Smoking: If you don't smoke, don't start. If you've already started, quit. If people around you smoke, insist that they smoke outside. Secondhand smoke can hurt your health and the health of children. Make this a priority; get all the help you need.

  Weight: If you're overweight, face the fact. Excess weight can — and eventually will — make you sick. There are hundreds of free Web sites that can help you determine your body mass index. If you carry that extra weight around your belly, you're at higher risk for diabetes and heart attacks than if you carry it in your hips. Join a weight-loss group; talk to your doctor.

  Poor diet: Eat more fruits and vegetables and less saturated fat. Be aware that fiber keeps you full and keeps your digestive tract healthy.

  Lack of exercise: Get moving. Some exercise is better than no exercise, but exercising every day is best. Walk around briskly and get your heart pumping, dance, run, go to the gym. Weight-bearing exercise such as walking, running, or weight-lifting improves stamina, strength, and bone density.

  High blood pressure: Check your blood pressure. If you have high blood pressure, take medication and change your lifestyle to lower your risks.

  Sun exposure: Wear sunscreen if you're outside for a long time, especially in the middle of the day. Don't get sunburned.

  Inadequate medical care: Go to your doctor for regular checkups and talk to your doctor about any concerns that you have. Many diseases are treatable when caught early through screening tests.

  Accepting your genetic risks

  Although lifestyle changes can cut down most people's risk of getting sick, certain people have genetic predispositions that can't be overcome with good habits. For example, your family may have a high rate of cancer, heart disease, or diabetes. In such a case, your chances of getting sick are probably elevated, despite preventive care and good lifestyle choices. If that's the case, take the precautions that make sense, talk to your doctor, and learn as much as you can about the condition.

  Designing a Health Action Plan

  After you've looked carefully at your lifestyle and taken into account your genetic risks, decide what steps you can take to improve your chances of having a long, healthy life. Don't try and tackle everything at once; at first, just write down one or two small, achievable goals. The following examples can guide you:

  If you're inactive, don't plan on running the next marathon; start by walking 15 minutes a day, most days a week.

  If you have a family history of high cholesterol, get a referral to a dietician to talk about ways to improve your diet.

  Buy sunscreen and wear it every day. Daily use of sunscreen has the added benefit of keeping your skin looking young.

  Floss your teeth; it does more for your health than you think!

  Keep on trying to quit smoking. It may take lots of effort, but millions of people eventually do quit; you can too.

  Add one more serving of fruits and vegetables to your diet.

  Don't put off medical screening tests — especially mammograms and colonoscopies.

  If you do get sick, be hopeful and optimistic.

  Stay connected with friends and family.

  Accept the fact that life and death are part of this world.

  When you've accomplished one or two goals, add a new one. Keep the process going until you've really improved your health; your anxiety will decrease as your body feels better.

  Chapter 17: Keeping Out of Danger

  In This Chapter

  Figuring out how dangerous your world is

  Staying as safe as you can

  Dealing with scary events

  Letting go of worries

  Unexpected events frighten most people from time to time. Have you ever been in an airplane when turbulence caused a sudden dip of the plane as well as your stomach? Or watched in slow motion as another car careened across the road sliding in your direction? How about noticing someone wearing dark clothing, who's nervously glancing around, sweating, and carrying a large bag at a ticket counter? Do you get a bit jumpy in a strange city in the dark, not sure which way to go, with no one around, when a group of quiet young men suddenly appear on the corner? Boo. Sorry if we scared you.

  This chapter is about true feelings of stark terror and the emotional aftermath of being terrified. First, we take a look at your personal risks — just how safe you are and how you can improve your odds. T
hen we discuss methods you can use to prepare or help yourself in the event that something terrifying happens to you. Finally, we talk about acceptance, a path to calmness and serenity in the face of an uncertain world.

  Evaluating Your Actual, Personal Risks

  Chapter 15 discusses the fact that the risk of experiencing natural disasters is quite low for most people. But lots of people worry about them nonetheless. Interestingly, the same can be said about risks of terrorism. Billions of dollars are justifiably spent battling terrorist activities, and according to a 2005 report in Globalization and Health, you're 5,700 times more likely to die from tobacco use than an attack of terrorism. Similarly, the journal Injury Prevention noted in 2005 that you're 390 times more likely to die from a motor vehicle accident than from terrorism.