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Trauma and Anxiety Disorders – The Link

Updated: Sep 7, 2022

Abuse by a parent, intimate partner, or stranger can lead to long-term anxiety due to the trauma experienced by the victim. Phobias such as a fear of heights, loud sounds, and social gatherings can all result from earlier traumas. According to the National Institute of Mental Health (NIMH), around 31 percent of all people in the US will experience an anxiety disorder during their lifetimes. Although fear is a sensible response to a real threat, anxiety is fear that is increased to a level beyond any actual threat and/or persists on a long-term basis when no threat exists. The following describes different types of anxiety disorders, and some ways to cope with persistent feelings of anxiety. How mental health counseling can help people with persistent anxiety is also described below.

What is Post-Traumatic Stress Disorder (PTSD)?

Military veterans, survivors of domestic abuse, and people living in locales with high rates of neighborhood violence are all at increased risk of developing Post-Traumatic Stress Disorder (PTSD). In people suffering from PTSD, intense, disturbing thoughts and feelings related to the traumatic event last long after the traumatic event has ended (per the American Psychiatric Association). Three symptoms of PTSD in people who have experienced an earlier trauma are:

  • Unwanted memories, “flash backs”, and nightmares of the traumatic event that cause distress (inclusive of insomnia resulting from nightmares of the traumatic event).

  • Activities aimed at avoiding memories and reminders of the traumatic event, such as avoiding social interactions that were not formerly avoided before the trauma.

  • Changes in emotional reactivity, such as increased difficulty in concentrating, more frequent angry outbursts, and/or being easily startled.

The primary mental health intervention for PTSD is Cognitive Behavior Therapy (CBT). This is short-term therapy that is aimed specifically at changing negative thought patterns and it is goal-oriented. Rather than helping the client to examine what led up to current mental health issues, Cognitive Behavior Therapy is focused on reducing the symptoms of PTSD. Therefore, Cognitive Behavior Therapy often involves learning and practicing relaxation techniques. According to an article in 2018 in Counselling and Psychotherapy Research reviewing other research studies, Cognitive Behavior Therapy is an effective therapeutic approach for the treatment of PTSD.

Understanding Eating Disorders

An eating disorder called anorexia often occurs in people who have experienced an earlier trauma. Despite being severely-underweight, people with anorexia incorrectly perceive themselves as very overweight – so want to continue to lose weight. An article in 2019 in the Journal of Child Psychology and Psychiatry reported that more than 50 percent of people living with eating disorders also have an anxiety disorder. This research article also noted that anxiety disorders in childhood were predictive of an eating disorder developing during adolescence. Bulimia nervosa (self-induced vomiting) and binge-eating are two other eating disorders, and eating disorders affect nearly 5 percent of adults in the US.

Obsessive Compulsive Disorder (OCD)

People living with Obsessive Compulsive Disorder (OCD) have recurring, unwanted thoughts, ideas or sensations (termed obsessions) that make them feel driven to do something repetitively (termed compulsions). Along with Bipolar Disorder and Schizophrenia, OCD is considered a major mental illness. Anxiety is often the root of the original obsessive (and compulsive) behavior. (In children and adolescents, symptoms of an anxiety disorder are often pulling out hair, facial twitches, and/or an eating disorder.) The problem for people with OCD is that it can negatively impact the ability to function at school or work.

The following are four common ways that OCD symptoms are experienced by people afflicted with this mental health disorder:

  1. Repeated self-injury to relieve anxiety (such as repeated cutting of own skin with a razor blade or knife).

  2. Excessive fear of germs manifesting as continuous hand-washing and fear of touching anything or anybody.

  3. Excessive fear of leaving the apartment or home (or entering any outside space), resulting in an inability to attend school, hold a job, or perform normal daily routines.

  4. Compulsive organizing of items in the home in an orderly and symmetrical way for no purpose (such as needing to keep all used plastic bottles in the house rather than recycling them, and also stacked on top of each other in a specific position throughout a particular room in the house).

Mental health counseling or therapy is often advised for people with OCD, and a specific form of Cognitive Behavior Therapy – called Exposure and Response Prevention (ERP) – is utilized. In this type of Cognitive Behavior Therapy, a very small exposure to whatever is causing the anxiety is initially utilized to begin the process of de-sensitization to whatever is causing the anxiety. That exposure is gradually increased over time, as the person afflicted with OCD becomes less compulsively-responsive to the exposure (such as by compulsively pulling out hair).

Medications are often used by people with OCD in addition to mental health therapy. Serotonin-Uptake Inhibitors (SRIs) are the class of medications most often prescribed for the treatment of OCD. According to the International OCD Foundation, seven out of every 10 people with OCD will benefit from medication or Exposure and Response Prevention (ERP) therapy.

Generalized Anxiety Disorder (GAD)

Excessive anxiety or worry lasting at least six months – and accompanied by at least three specific physical or mental health symptoms (but not meeting the criteria for any other anxiety disorder) – is classified in the American Psychiatric Association’s DSM-5 as Generalized Anxiety Disorder (GAD). Drinking alcoholic beverages is often a way that people with this common anxiety disorder self-treat their anxiety, but this can easily lead to an alcohol abuse problem. Besides mental health counseling or therapy, daily meditation and other relaxation techniques are often recommended to reduce symptoms.

Both a disinterest in eating anything and over-eating are linked to this type of anxiety disorder, so people with Generalized Anxiety Disorder (GAD) are at high risk for developing an eating disorder. Meanwhile, persistent anxiety is linked to an increased risk for heart disease (resulting from chronic high blood pressure). The percent of the adult population in the US with an anxiety disorder such as GAD increased significantly due to the Covid-19 pandemic – along with the gap between people living with depression or anxiety getting mental health therapy and those with mental health disorders not getting mental health therapy (per the Centers for Disease Control).

The GAD-7 as a Diagnostic Tool

The GAD-7 is a self-administered questionnaire that is used to diagnose the severity of Generalized Anxiety Disorder (GAD). It is a seven-item questionnaire that involves scaled answers. Study finding published in the Archives of Internal Medicine showed that the GAD-7 is a valid and efficient tool for both screening for GAD and assessing its severity.

Relaxation Techniques and Anxiety Disorders

Meditation, biofeedback, and Kundalini yoga (which involves controlled breathing) are three different types of relaxation techniques that can be useful to reduce anxiety in people with (and without) a diagnosed anxiety disorder. Likewise, a daily exercise regimen (such as jogging or swimming) can relieve anxiety in many people.

One of the reasons that utilizing relaxation techniques – besides mental health counselling or therapy – is a good idea for people with an anxiety disorder is that it calms the brain. In turn, this helps to lower the release of cortisol (a stress hormone) in the bloodstream that is associated with the increased heart and respiration rate linked to anxiety.

Since anxiety can interfere with getting high quality sleep – and poor sleep is associated with increased irritability and worsened concentration – the ability of relaxation techniques to improve sleep can likewise be helpful to people suffering from anxiety disorders.

The Use of Mental Health Counselling or Therapy for Anxiety

Anxiety can also lead to or worsen other areas, such as:

* Depression (which often occurs with an anxiety disorder) or other mental health disorders

* Substance misuse

* Trouble sleeping (insomnia)

* Digestive or bowel problems

* Headaches and chronic pain

*Social Isolation

Terri Watkins, MA, LPC, CCTP is a licensed professional counselor who works with adults, teens, and couples. Terri provides therapy for anxiety, depression and other difficult life events. She's a caring professional who listens without judgment or expectations, and helps you to access your skills and gain insight into your situation. Sessions can be held in person or via telehealth. Tired of anxiety? Try Inner Me Psychotherapy! Free consultations!

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