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The twin effects of anxiety and fear
"Our fear is keeping the drug industry booming," so stated the Reverend Dr Robert Thompson, Suffragan Bishop of Kingston in a recent sermon. In a thought-provoking discourse, the bishop spoke about the booming sales of anti-anxiety drugs, sleep disorders and the necessity for us as God's creations to confront our fears from a spiritual perspective.
The Bishop is correct on two counts - spiritually and medically. Mark Henderson, a pharmacist practising in Jamaica, noted that in this country "sales of anti-anxiety drugs are increasing. In fact, Xanax® is a mainstay. Most general practitioners write prescriptions for this drug. (Xanax ® is an anti-anxiety drug, its generic name is alprazolam).
HD Hopwood, distributors of Xanax® stated that in recent years there has been an increase in sales of the drug. They were, however, unable to give specific figures. A pharmacist who wishes to remain anonymous, agreed with Henderson and pointed out that she had been noticing more prescriptions for anti-anxiety drugs written for persons under the age of 20.
We wonder why?
Stedman's Medical Dictionary describes anxiety as apprehension of danger and dread accompanied by restlessness, tension, tachycardia (fast beating of the heart) and dyspnea (shortness of breath) unattached to a clearly identifiable stimulus.
Anxiety is actually normal. It puts one on alert and can actually keep one out of harm's way. It is when anxiety becomes excessive and begins to interfere with normal functioning that it becomes a problem.
Anxiety disorders include panic disorder, agoraphobia, specific phobia, social phobia, generalised anxiety disorder, obsessive-compulsive disorder, and acute and post-traumatic stress disorder. Shared features of these disorders are prominent physical symptoms, panic attacks, anticipatory worry or fear, and avoidance or compulsive rituals. Persistent nagging health concerns are common and frequently cause patients with these disorders to seek medical treatment, where their anxiety disorders may go unrecognised.
Insomnia, sleep disorders, palpitations, difficulty breathing, chest pain or pressure, headaches, nausea, diarrhoea, stomach aches, dizziness, tingling sensations or numbness in parts of the body, hot/cold sensations and ill feelings in general are all symptoms of anxiety.
Fear and anxiety exist on a continuum. Rooted in the same physiology, they can have similar consequences. To understand anxiety, one has to examine the anatomy of fear.
Fear comes in many forms - from the seemingly trivial aversion to lizards to the pervasive fear of crime and violence that is gripping many Jamaicans. In the United States and Britain, persons worry about another 9/11-style attack. Just last week, the world watched in fascination and with fear as a plot to blow up airplanes flying between Britain and the United States was uncovered. Drs Afton Hassett and Leonard Sigal of New Jersey's Robert Wood Johnson Medical School wrote in 2003 that we are "living in a chronic heightened state of alertness and helplessness" prompted by a "poorly defined danger that could strike at any time in any form without warning".
Geoffrey Cowley and Claudia Kalb, in an article entitled Our Bodies, Our Fears published in the March 3, 2003 edition of Newsweek, stated that when fear grips the body it sets in motion a sequence of events that, repeated often enough over the long term, can have serious health implications. We need to acknowledge that the psychological state of fear is capable of affecting us biologically.
These effects are numerous and range from sleep disorders to immune dysfunction. Fear is capable of exacerbating many conditions including hypertension, diabetes mellitus, peptic ulcer disease, hair loss and acne.
When the body is faced with fear, it sets in motion a series of events that if repeated over the long term can gravely impact health. The fear response begins when the amygdale (part of the brain located near the centre) jolts the nearby hypothalamus into producing corticotrophin-releasing hormone. This causes the pituitary (also located in the brain) and the adrenals (located on top of the kidneys) to flood the bloodstream with the stress hormones adrenaline, noradrenaline and cortisol.
These hormones are able to shut down non-emergency functions of the body such as immunity and digestion and direct the body's resources to fleeing or fighting. So the heart begins to beat faster, the lungs pump more air and the muscles get a good load of glucose.
This fear response comes at a cost to the body. Harvard neurologist Martin Samuels observed that "norepinephrine is toxic to tissues - probably all tissues, but in particular the heart". In fact Israel recorded nearly 100 deaths during Saddam Hussein's 1991 scud missile attacks. These deaths were not bomb-related but were caused by heart attacks presumably triggered by fear and stress.
Acute fear is not the only type that can cause harm. Prolonged stress has physiological consequences. Constant low-grade levels of adrenaline may cause subtle damage to the heart, increasing the long-term risk of cardiovascular disease. Continuous exposure to cortisol can disrupt the immune system leaving persons under stress more vulnerable to diseases such as infections and cancer. Research on animals and humans discovered that prolonged stress shrinks the hippocampus, a brain structure that is critical to memory.
Prolonged stress can have numerous subtle effects such as neck and back pain, disorientation, headaches and insomnia.