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Part 2: Anxiety Disorders Theories

Interview w/ Chris Edwards, Clinical Pysch.

Jasmine: What about medication, especially the benzodiazepine dependence issue?

Chris: In my practice, I see benzodiazepine dependence as being a problem in a substantial proportion of my clients. However, it could be that I see a biased population. That is, I am more likely to see people that develop troubles with medication. There are a group of panic disorder people who actually panic when they take a drug. You really need to look at a drug as a chemical and some people take tablets and don't have ill effects. Other people might take medication and that's like introducing a new chemical into the body and one of the things that people with panic disorder are scared of is sudden changes in bodily physical sensations. So for people that misinterpret the change due to the drug as meaning something bad, they are likely to panic more as a result of having taken it.

Jasmine: Everyone is so confused about the different theories about what is causing their Anxiety Disorder. Some say chemical imbalance, some behavioral, some childhood issues. What can people do to sort through this quagmire?

Chris: All of those things can cause panic disorder and the literature generally supports a conclusion that panic disorder develops within the context of a multiple of causal factors including biological variables. In other words, some people might have a medical condition which can bring on their panic attacks. Another person might have an injection. I've heard of people having gold injections and injections for other things which have brought on or precipitated panic. Cannabis is another substance that can change the biological nature of the individual for a time period and bring on a panic as well.

Jasmine: Mercury teeth fillings?

Chris: Well, I haven't heard of that one. There are a lot of biological causes for panic. Now the question is, is a biological cause really important? It seems like you can use cognitive therapy even when the disorder is caused by some chemical and still get a good result.

Another way a person might develop the disorder is as a result of learning influences within their family or perhaps some idiosyncratic thought. Another way a person may develop panic disorder is through stress. Say for example, a person is in a bad, or an abusive, relationship. They may develop panic disorder and it is unlikely to be resolved until they do something about that relationship. So there are a whole lot of causative factors. So it really doesn't make sense to talk about a single cause.

What people need to do is to go to somebody that has some experience in assessing these causes and have a behavioral and cognitive analysis done to determine what the cause is for them. That assessment might even require a medical assessment. We must remember, however, that many people do not need to know what caused the disorder to be successfully treated.

Jasmine: So, what about chemical imbalance?

Chris: All behaviors ranging from a brief thought through to playing tennis causes neuropsychological changes. People who are treated with CBT often show similar changes in brain chemical systems as those treated with medication. So, you can change behavior and you can change brain chemistry.

Jasmine: So, basically whatever the initial cause was for the Panic Disorder, it is still very possible to recover, regardless of what that cause was. Is that right?

Chris: I think so. You know, there are a lot of combinations in recovery, but for most people the promise for recovery and good management of panic attacks is very, very promising at this present time.

Jasmine: The big question everyone wants to know is how long does it take to recover? I know it is individual but what is your general opinion on this big question?

Chris: Some of the Cognitive Therapy sessions are down to around 3 and 4 sessions. However, in my own experience I've found between 6 and 13 sessions. Of course, not everybody can be guaranteed that kind of a result. It depends on a person's individual situation. Say, for example, a person who has been traumatized may have more than an Anxiety Disorder. The therapist may need to treat issues related to the trauma in order to successfully treat the panic.

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