Support for Anxiety
Sufferers
Illnesses happen to individuals, but one person's disease can
take a toll on everyone in the patient's life. If one member of
the family becomes sick, the routine of the entire household can be
disrupted. If the illness is short-lived, the family can return to
its normal activities quickly and without lasting impact. But a
chronic illness or one that is disabling permanently may affect the
way family members interact with one another and with the world.
Anxiety disorders can be as disruptive as physical ailments,
sometimes more so. Many normal family activities may become
difficult or impossible. Economic loss may occur if the anxiety
disorder limits a person's ability to work. Anxiety disorders may
exact a significant emotional toll on all members of the family
because the individual with the disorder may be reluctant to
participate in typical social activities.
Relationships can be further complicated by the failure of
family members to honestly confront the existence of an anxiety
disorder. Individuals with a phobia or obsessive-compulsive
disorder (OCD) may be too ashamed or embarrassed to ask for
help. They may try to hide their anxieties and, at the same time,
expect members of the household to be sensitive to their needs and
concerns.
The family can play a major supporting role in combating one
member's anxiety disorder. Although ultimate responsibility lies
with the patient, family members can help by taking part in the treatment
program. With training they can accompany the patient into
anxiety-producing situations, offer support and encouragement, and
create an environment that promotes healing. Family members should:
- recognize and praise small accomplishments
- modify expectations during stressful periods
- measure progress on the basis of individual improvement, not
against some absolute standard
- be flexible and try to maintain a normal routine
Family members often can play an active role in anxiety
disorder treatment. The precise nature of the assistance will
vary depending on the disorder and the family member's relationship
with the patient. In addition to providing psychological therapy and
medication, mental health
professionals increasingly are recommending treatment programs that
include family members. As a rule, the more severe the disorder the
more likely that family and/or marital issues will need to be
addressed by the therapy program.
In one common approach to family therapy, mental health
professionals enlist a spouse or other family member as a
co-therapist. Making the family member part of the treatment
team tends to reduce the possibility of tension concerning the
therapy program. Reading educational materials also promotes
understanding.
Helping The Patient With Homework
Family members can play an extremely valuable and supportive
role by assisting the patient in "homework" that has been
agreed upon in consultation with the therapist. Most typically,
at-home assignments for patients with phobias involve controlled
exposure to situations that trigger anxiety. Exposure therapy works
by gradually bringing patients into contact with a feared object or
situation to teach them that they can face their anxieties without
harm.
Achievement and progress, no matter how small, should be
acknowledged. The patient, using anxiety reduction techniques
taught by the therapist, should be encouraged to remain in the
situation even when anxiety increases. But the patient should not be
forced or humiliated into staying.
All goals and rewards should be clearly spelled out and agreed
upon before the home practice sessions get underway.
Families and patients must recognize that the recovery process
can itself become a source of tension by changing existing
relationships. Patients' emotional needs may change during
treatment. They may become more assertive or independent. Working
through such changes will require patience and understanding by all
members of the family, but they should ultimately lead to more
stable and more satisfactory lives for all.
Special Concerns of Older Patients
Diagnosis of an anxiety disorder can be difficult at any age,
but particularly in the elderly patient. Many of the signs of an
anxiety disorder are identical to the symptoms of illnesses common
in older people. And some anxiety disorder symptoms may also mimic
side effects of medication. Compounding this is the fact that, for a
variety of reasons, older people tend to avoid treatment by mental
health professionals.
Mental health specialists report success in treating elderly
patients.
Medications have proven
effective in reducing or eliminating many of the symptoms of anxiety
disorders and tend to be many therapists' treatment of choice for
the elderly. But there are several unique considerations that must
be weighed when prescribing drugs for older patients.
For example, metabolism, liver and kidney function, and the
working of the central nervous system decline with age. Physicians
also must take into account the patient's ability to remember to
take medication, and other drugs they may be taking. Some doctors
insist that another member of the household take responsibility for
monitoring the elderly patient's adherence to the medication
schedule and any adverse reaction to the drug.
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