Launch of the NIMH Anxiety Disorders Education Program

Update on October 22 Launch

More than 19 million Americans suffer from anxiety disorders. They are tormented by panic attacks, obsessive thoughts, flashbacks, nightmares, or countless frightening physical symptoms. On October 22, 1996, the National Institute of Mental Health (NIMH) launched the Anxiety Disorders Education Program to help people recognize and find treatment for obsessive-compulsive disorder, panic disorder, post-traumatic stress disorder, phobias, and generalized anxiety disorder. At a press conference introducing the new program, NIMH Director Steven E. Hyman, M.D. and a panel of experts discussed the tremendous advances that have emerged through brain and behavioral research.

"Anxiety disorders are real, identifiable brain diseases," Hyman said. "Current research is leading us to understand that anxiety disorders arise from a combination of genetic vulnerability with an environmental second hit.' In addition, we are beginning to understand the specific circuits in the brain that are malfunctioning in post-traumatic stress disorder, obsessive-compulsive disorder, and perhaps panic disorder. Through this research, we will be able to develop new and better therapies."

Susan Swedo, M.D., Acting Scientific Director of the Intramural Research Program at NIMH said her research on obsessive-compulsive disorder (OCD) has not only led to discoveries about the causes and prevalence of OCD, but it has also demonstrated the effectiveness of new treatments. Dr. Swedo said research has shown that 75 to 80 percent of patients are dramatically helped by medicines that normalize the brain's use of the chemical serotonin. "But what is most fascinating," Swedo said, "is that we're seeing exactly the same normalization happening with behavioral treatments."

Another panelist, Patricia Resick, Ph.D., professor of psychology at the University of Missouri in St. Louis, said research has shown that these behavioral therapies not only achieve excellent results, but achieve those results fairly quickly. Dr. Resick, principal investigator on two NIMH grants to study rape-induced post-traumatic stress disorder (PTSD), said that through her research she has found that for most patients, the majority of PTSD symptoms can be alleviated in twelve behavioral therapy sessions. "The bad news is we don't have people coming into treatment soon enough," Resick said. "The average is eight years after the [traumatic] event. Because of the stigma society places on people with mental illnesses, many people wait for years after the onset of troubling symptoms before they seek help."

Two panelists shared their experiences of living with and ultimately finding effective treatment for their anxiety disorders. Connie Foster, Executive Director of the advocacy group Awareness Project, Inc., battled with OCD for 35 years before being diagnosed. Now she helps other people living with mental illness gather the courage to seek treatment. "The sad truth," she said, "is that even on the very threshold of the 21st century, the world is still rampant with stigmas, myths, and misconceptions regarding OCD and like illnesses."

Athena Chappell sought treatment for PTSD symptoms more than twelve years after being raped. At the press conference, she emphasized the positive effects that treatment has had in her life. "I learned I had a treatable disorder and I was filled with hope," Chappell said. "My optimism was well placed. When I successfully completed the treatment program, I was impressed with how much I had learned and how much better I felt."

Jack Maser, Ph.D., Chief of the Anxiety and Somatoform Disorders Research Program at NIMH and an expert in the comorbidity of mental disorders, said that recognition and treatment for anxiety disorders can often be complicated by the existence of more than one disorder in a patient. "Persons with anxiety disorders often tend to be depressed, and many are abusing or dependent upon alcohol or other chemical substances. Each additional disorder may increase the difficulty of treatment." Dr. Maser said that research conducted by NIMH is translated into information and tools to help medical and mental health professionals diagnose and treat anxiety disorders and other mental illnesses.

The issue of co-occurring disorders can become particularly complex in the primary care medical setting. Steven Hahn, M.D., Associate Professor of Medicine at Albert Einstein College of Medicine in New York, discussed findings from the PRIME-MD study in which he and other investigators looked at the diagnosis of mental disorders by primary care physicians. "The majority of patients with mental disorders who seek treatment do so in the primary care setting, not the mental health setting," Hahn said. "When mental disorders are not detected by primary care providers, odds are that the disorder will go undiagnosed and untreated.

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