More Than Nerves - Anxiety and Social Phobia in the Real World
By Rob Fischer, Ph.D.

As one of the more than 19 million people in the United States who suffer from an anxiety disorder, I can give a first-hand account of a condition that is, at best, poorly understood.

During the summer before my senior year in college, my mother died of lung cancer at the age of 57. As a rather private person, I dealt with this loss as I had most of my problems throughout adolescence: I repressed my grief and kept moving. I avoided talking about my mother's death and I continued my college work and social schedule as if nothing had happened. Some six months later, my repressed feelings showed physical manifestation. I developed ulcer-like symptoms that defied the abilities of professionals at campus student health to treat effectively. In addition to this "stomach pain," I developed a fear of being in group settings, particularly dining out. I came to fear the debacle of being nauseated in public and having to leave in a panic. The more I tried to force myself to stay, the greater the anxiety level and the perceived pain became. Frequently, I delayed eating until I could be in a safe environment. The result over time was a substantial weight loss, at one point taking me to a waifish 155 pounds on my 6'2" frame. After seeking additional professional help, first from a physician and then a clinical psychologist, I was diagnosed with generalized panic disorder with agoraphobia. Although this diagnosis troubled me greatly, it also provided a name for my condition. This confirmed for me that my phobia was real and that I was not alone in the symptoms I experienced.

With the ebb and flow of time, I had recurring bouts with my problem. I found it the most ironic of disorders - here I was, someone who had enjoyed groups and events, with a promising career involving frequent interpersonal interaction ahead of me, hamstrung with a phobia that caused me to detest groups, particularly functions involving a meal. I tried to deal with the situation proactively through talk therapy and some prescribed medication and, at times, out of frustration, through self-medication using alcohol. All the while, two internal voices coached me about the problem in. One voice offered comfort and tried to lessen the embarrassment of having to leave a social situation. The other derided me, minimized my feelings, and encouraged me to simply "suck it up." Each voice had a turn in being the more persuasive.

Now, over ten years later, there are but a few lasting remnants of my earlier phobia and anxiety. I still prefer to avoid crowded situations, though nothing like the aversion I previously experienced. I feel a small twinge of anxiety in restaurants as well as airport terminals and malls. I now recognize my symptoms earlier, before an episode occurs, and can take action to lessen the feelings of anxiety. In all, this condition that used to control much of my life has become a minor concern, but still a lasting reminder of earlier times. Much like a cancer patient in remission, I am forever watching for any signs of reemergence of the disease, especially around times of significant change, loss, or stress. I never claim to have beaten the anxiety disorder, rather, I seek to manage it through behavioral and cognitive strategies that work for me.

If you have experienced any of the symptoms I have described, I encourage you to openly talk about your feelings with those close to you and seek professional help immediately. If you worry, as I did, that medication could lead to a long-term dependence on a chemical solution to your disorder, this concern should not keep you from talking to your physician or counselor. Medication, if effective, can provide an anxiety-free window of opportunity in which you can work to address the issues underlying your disorder. If you know someone who experiences an anxiety disorder, I ask that you learn about the disease and provide support to this person, always in the most uncritical manner possible. Be aware that the disease rarely takes a linear path; it is likely that successes in certain situations will be followed by difficulties in others. Learn, along with your loved ones, to take a long view of the road to recovery and avoid unreasonable expectations for a quick cure. Anxiety disorders are manageable for the vast majority of those who suffer from them, but professional care and personal strategies are both imperatives for success.