Fear: As Natural As Anything

fanayDizziness, a racing heartbeat, a feeling of being nearly paralyzed-these are some of the terrifying symptoms that an anxiety disorder can cause. How two women triumphed over this baffling condition.

Anxiety is actually a healthy emotion. Without it, we couldn’t anticipate danger and prod ourselves into action. But abnormal anxiety is of no use at all. It sets off false alarms in our minds, dramatically exaggerating perceived dangers and provoking terror and dread that interfere with daily life. An anxiety disorder can also be humiliating, according to Robert DuPont, M.D., coauthor of The Anxiety Cure, because sufferers know it’s irrational yet cannot control their obsessive thoughts and physical symptoms. “It is like putting your hand into a pocketful of fishhooks,” says Dr. DuPont. “The more you struggle, the more hooked you get.”

More than 17 percent of Americans aged 15 to 54 experience an anxiety disorder in a given year, according to a national survey conducted by Ronald Kessler, Ph.D., professor of health-care policy at Harvard Medical School. Largely because of the shame attached to mental illness, fewer than one quarter of these people seek help. On these pages, two women break the silence surrounding this common mental-health problem and describe how they suffered for years before receiving effective treatment.

Tricia Hindermann, 28, ARLINGTON, VA

A woman who clearly loves life, Tricia Hindermann describes herself as “energetic and up.” And yet, she has long known she has “more of an anxious nature” than most people. Panicky sensations first bothered her in college, then subsided after she graduated. Three years ago, she met the man she was to marry and began working at a marketing company. “It was a stressful job,” says Hindermann, “and little things became big things. Going outside to get coffee, I’d feel dizzy and very weak. I’d think: What’s wrong? What’s happening? I’m too young to feel this way. “She went to a psychiatrist who prescribed an antianxiety drug, but it didn’t make her feel any better, so she stopped taking it.

Hindermann left that job and took another, but eventually quit to plan her wedding and start a business selling advertising art on the Internet. Her marriage and business were going well, she says, when the panicky feelings suddenly intensified. One night Hindermann awoke terrified: She was panting, her heart racing, her face numb. She made her husband take her to the emergency room, where she learned there was nothing physically wrong with her. Her symptoms were caused by a panic attack, and she was told she needed to consult a doctor.

Because of her unsuccessful previous experience with antianxiety medication, Hindermann was distrustful of doctors and skeptical about what they could do. She decided to handle her problem alone. However, as she spent more time working at home, she began to experience nearly constant anxiety. “All the time I had a racing heart, dizziness, uneasiness. I couldn’t take a deep breath and relax, and I was worried about panic attacks, which I was having every couple of days. My mind was always taken up with Here I am by myself. What if I can’t get help?”

These feelings were beginning to intrude on all aspects of her life. “At parties I might look okay, but always in the back of my mind was What if it happens? I’d be too tired or edgy to enjoy myself. My husband and I would go out running, and I’d feel my heart race and I’d think, You’re going to fall over and die, and I’d have to stop.” She felt sick and stressed out all the time.

Not knowing where to turn, Hindermann went on the Internet, typed in the word anxiety, and found the Ross Center for Anxiety and Related Disorders, right in Washington, DC. Jerilyn Ross, a psychotherapist and clinical social worker, is one of the country’s leading anxiety-disorder experts. A recovered phobic (her fear: high floors), Ross helped pioneer and popularize the use of goal-oriented cognitive/behavioral therapy for this problem; she encourages patients to change their thinking about anxiety, distract themselves from their panicky feelings, and practice self-acceptance.

After reviewing Hindermann’s history and talking to her, Ross suggested individual sessions with one of the center’s psychotherapists. Ross also advised her to talk to a psychiatrist who could prescribe medication.

Hindermann balked. “I’m a very healthy person,” she says now. “I thought of medicine as poison that would hurt me.” Instead Hindermann focused on her regular sessions with the therapist, learning that the constant “what ifs?” she asked herself only increased her anxiety. She practiced ways to interrupt that pattern (if thinking. Seeing a therapist definitely helped, but her life was still dominated by panic attacks and worry about them.

Finally, last July, tired of feeling the way she did, Hindermann reconsidered medication. The psychiatrist explained that medications were not a cure-all, nor was taking them an admission of failure or weakness. A very low dose of a widely used antidepressant, Zoloft, would simply give her relief and allow her to make progress in her therapy. He also recommended Inderal, a beta-blocker, to regulate her heartbeat. “That sounded good,” says Hindermann, “because I was still so anxious about my heart beating too fast.”

She started with low dosages, so she could see how her body would react. After two weeks, her panic attacks were gone. By September, her energy had returned, and she felt motivated to rake a part-time job and to move forward with her Interact business. She continues to see her therapist every couple of weeks. She runs and hikes with her husband and can once again enjoy her social life.

Hindermann has no illusions about her anxiety disorder. “It will always be them,” she says, “but I’m learning to live with it. I’m not always thinking, What could happen to me? I have time for real things. I can go to the store, walk my dog, sit at home and watch a video, and be content. I feel like I’ve gotten my life back.”

RELATED ARTICLE: Elaine Geffken, 39, ANDOVER, MA

Today, Elaine Geffken, a busy mother of three, is active in her community and happily taking care of her husband and family. Not that unusual, perhaps, yet for Geffken, this life feels miraculous. For more than tea years she suffered from a debilitating anxiety that threatened her career, her sense of identity, and the family life she so clearly treasures.

“It wasn’t any one thing; anxiety slowly crept in,” she says. In her mid-20s, as a recent MBA graduate, she started working at a bank in Pennsylvania. “There were few women who held managerial positions,” she says. “Some male bankers and customers would say very demeaning things, and I let it get to me.”

When she moved to Massachusetts with her husband in 1984, Geffken took a job at a government contracting firm. It was at this point, she says, that she really started to doubt herself. Often, she would find herself in business meetings scarcely able to speak: “There’d be twenty people in a closed room all looking at me, waiting for an answer. I’d go tense; I’d feel trapped.” Each morning when she got out of her car and headed for her office door, anxiety would engulf her: What is it going to he today? she would wonder.

Geffken left that job for one in a smaller company, but anxiety dogged her. “I couldn’t get up and give presentations. I was having panic attacks in meetings.” Geffken’s husband was sympathetic, but, she says, “I felt very alone. I couldn’t understand myself what was happening and couldn’t communicate it to anybody.”

When another firm bought the company she worked for, Geffken decided it was time to do what she and her husband had always planned: have a baby. “I was relieved; I thought, Okay, I won’t be working, I won’t be anxious.” She became pregnant right away and felt calm–except when she and her husband would meet people at a restaurant or a dinner party. “It was the tables,” she says ruefully. “My husband and I kid about it now. But tables reminded me of meeting rooms, and I’d get very anxious.”

As a new mother, Geffken found more ways to doubt herself. “My confidence was really dwindling. The anxiety was there all the time, affecting how I related to zither people.” Her second and third child arrived; soon, the older two were off to school, and Geffken’s sense of isolation increased.

Then, in 1998, Geffken had a panic attack while driving alone on the highway at night. “This was really frightening–you’re going sixty miles per hour, and you can’t breathe, you can’t see.” From then on, she became anxious about driving along that stretch of highway. “I thought, This is totally loony. How can I be a mother of three kids and not drive?” She felt herself starting to sink into a depression.

With a perfectionist personality, Geffken explains “It was really hard for me to say, even to my husband, `I have a problem. I need to get help.’ But finally, I did.” In the fall of 1998, Geffken went to the Andover Center for Anxiety Disorders, run by psychiatrist Jorge H. DeNapoli, M.D. In the waking room, she read a fact sheet explaining anxiety and panic disorder. “It was like, Oh, my gosh! This is me!” Geffken had found a place where she didn’t have to hide her problems. She went to the center for group therapy for ten weeks. “Probably the most important thing for me,” she says, “was understanding that I wasn’t alone. My attitude was different there. I could sit and say, `So what if I have a panic attack. Nobody here is going to care.'”

Like many other anxiety-disorder sufferers, Geffken worried about taking medication. Yet, as she came to understand how anxiety had made her nervous system highly reactive, she followed Dr. DeNapoli’s suggestion to take the antianxiety drag Klonopin. She met regularly with a therapist and learned how to cope with her physical symptoms and irrational thoughts. “I’d notice my heart racing, and I’d think, So what! Your heart’s supposed to be beating; if it doesn’t, you die. `So what!’ became my favorite phrase!”

With her therapist, Geffken set goals: “To make more time for myself. To laugh at myself, accept that I’m not perfect and that no one is. To be willing to try new things even if they bring about failure.” Looking back over the past year, Geffken sees how far she has come. “When I went to the center, I was feeling very bad about myself: Now I’m teaching Sunday school, helping my husband with Cub Scouts, running community fired-misers. I’m in my kids’ classrooms two or three times a week. It’s such a liberation that I can do these things and do them comfortably.”

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