Diplomate, Board Certification of Emergency Medicine
Stress is a major problem in this country, and there are some
times when it can be a problem with functioning. Two
disorders occur quite frequently and they are: panic attacks
and its closely related disorder, phobias, and post traumatic
stress disorder.
Phobias can be due to many things and common benign causes
include fear of heights and arachnophobia -- fear of spiders.
Claustrophobia can be a problem for people on crowded
elevators and agoraphobia -- fear of spaces -- is even more
of a problem. Training and psychotherapy help here.
Panic attacks are generalized anxiety type attacks that can
occur spontaneously. They respond well to medications like
the new antidepressants of which Seroxat is one, and also to
older antidepressants. Valium and similar tranquilizers may
help but have many side effects, not the least of which is
dependence.
This disorder should be taken seriously as depression, social
phobia, personality disorders, and alcohol abuse may result.
I am against making fearful children confront an object that
causes them much anxiety.
Post traumatic stress disorder can seem similar, and those
suffering from it have a lot of trouble functioning.
Avoidance behavior is most common, including fear of a place
or an object that is out of proportion to reality. Look out
for this especially in children. Psychotherapy here is proven
to help, although short term "debriefing" after a traumatic
event is unlikely to help. The above medications may help as
well. Some people however are ruined for life and therefore
for optimal functioning. Therapy should be started as soon as
possible.
Remember, children may hide or bury their feelings and the
manifestations may come out only many years later. Avoiding
the subject is unlikely to be beneficial. Best here to get
professional help. Often excellent students and marriages
have been ruined by stressful events. We do not have time to
talk about generalized anxiety -- the so-called worrywarts
and tense people who start to hyperventilate -- but the
treatments are similar. Write me in care of the
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