Research

Panic Anxiety Education
Management Services

Panic Anxiety Disorder Treatment
Needs Research Project - Part 5
Jasmine Arthur-Jones

CONCLUSIONS

PRIMARY STATISTICAL DATA
Diagnosis. The primary diagnosis received by participants is across a broad spectrum. These are the diagnosis received by the participant from the Health Professional. As we would expect, the General Practitioner is the the main Health Professional that gives the diagnosis to the participant. General practitioners are the first Health Professionals that people will visit for assistance for their Anxiety Disorder. Many people received their diagnosis from multiple sources eg. from the general practitioner first and then a psychologist. Many people did not receive a diagnosis from a Health Professional, then they did their own research and discovered they had an Anxiety Disorder - then went back to the Health Professional to confirm the diagnosis. These participants were specific about how they received their diagnosis. It does, however, appear that people are being diagnosed earlier and more accurately than in previous years. The figures for how long it took to receive a diagnosis after first contact with a Health professional reflect this fact. Nearly 25% of participants received their diagnosis within one week of first contact. This is an improvement, probably due to increased education and awareness of Health Professionals. However, the majority of participants did not receive a diagnosis until after months, years. It is heartbreaking to see the figures for people who did not receive a diagnosis for years after first contact with a Health Professional.
Secondary Conditions. The data for the secondary conditions reflect the degree of disability created by the Anxiety Disorder. Only 9.6% of participants reported that they had not developed any of the secondary conditions. Agoraphobia and Major depression were the most frequent of the secondary conditions to develop as a result of the Anxiety Disorder. There was a high correlation between development of Agoraphobia and major depression as well as with suicidal thoughts. Nearly 32% reported that they had developed a Prescribed Drug dependence as a result of medication prescribed for their Anxiety Disorder.
In total, 444 (or 95% of those experiencing secondary conditions) responded that they felt that these secondary conditions had developed as a result of the Anxiety Disorder. This is an important point. These are secondary conditions, the primary cause is the Anxiety and/or panic attacks.
Employment data. Maintaining employment is a known difficulty for people who experience an Anxiety Disorder. 46% of participants reported that they had left their employment as a result of the Anxiety Disorder. Of these 17% of these participants received Social Security Benefits for a mean period of 31 months. Of the people who reported that they did not leave their employment, many of those reported that they had not been employed or were home carers.
Prescribed Minor Tranquilliser Data. Of all the data, the Prescribed Minor Tranquilliser data "speaks volumes" about the treatment options provided to people who experience an Anxiety Disorder. The total number of research participants who have used at least one Prescribed Minor Tranquilliser is 308 (or 59%). A total of 57 (or 11%) of the research participants are/have taken more than one Prescribed tranquilliser. A total of 15 (or 3%) of the research participants are/have taken more than two Prescribed tranquillisers. The mean time for taking the specific Minor Tranquillisers is not less than 19 months (and that is for Kalma). The mean time for taking a Minor Tranquilliser is 43 months (about 3.6 years).

These are definitely long-term figures. There must be a time when the Health Professional reviews the progress of the client and questions the effectiveness of the Medication prescribed. Surely, after a year of prescribing medication for the Anxiety Disorder, wouldn't investigating other or additional treatment options be in the clients best interest.
Not only do we need to educate the Health Professionals, we need to educate the clients with an Anxiety Disorder. It is also the clients responsibility to review the treatment options they have received and ask for other options if the current treatment is not effective in treating their Anxiety Disorder.
In fact, in the comments section of the Project, the majority of participants said that Prescribed medication should only be taken short- term. There is the awareness that the medication should be short- term, but the results reflect that medication is prescribed long- term.
Prescribed Antidepressants. Looking at the figures, the fact that 56% of participants have been prescribed Antidepressants for their Anxiety Disorder may be related to the high percentage of people who experience a secondary condition of Depression with their Anxiety Disorder. The other fact that contributes to this high figure is that there has been much publicity on the effectiveness of certain Antidepressants in treating panic attacks. Many General Practitioners and clients, hearing this often choose this form of treatment for the Anxiety Disorder. However, as a very high percentage of participants reported, this is just a mask over the problem, not the solution. The figures for the Antidepressant usage and average length of time people have been taking Antidepressants are certainly much better than the Tranquilliser figures. However, if we look at the totals for people using Antidepressants greater than 12 months, they are once again, very significant. It is also significant that many more participants are stilling taking these medications after 12 months compared to those who have stopped taking the Antidepressants.
The other significant figure was for participants that had taken more than one Antidepressant. This is not to say that the 11% of participants were taking more than one Antidepressant at any given time. Usually the participant had been taking one Antidepressant for a period of time and then were transferred over to another Antidepressant.
Multiple Medication usage. Table shows the degree to which prescribed medication is used as a treatment option for people experiencing an Anxiety Disorder. It is the easy option that is provided, but it is staggering to see the figures. The figure for the total number of participants that have tried prescribed medication as a treatment option for their Anxiety Disorder is 422 out of the 518 participants (or 81.47%). That is an incredible figure. 81.47% of the research participants had/have used either a Minor Tranquilliser or an Antidepressant or both or a multiple of each or both. Looking at Table 2 above you will see the primary figures for Tranquilliser and Antidepressant usage. Now look at the figure for 1 or more Tranquilliser and one or more Antidepressant - 35.5%. In fact, this figure shows a large percentage of participants that were using at least one Tranquilliser and Antidepressant at the same time. 9% of participants were using one or more Tranquillisers and at least 2 antidepressants. 7.7% were using one or more antidepressants and at least 2 Tranquillisers. As we go through to 2 or more of both and 3 or more of both, it makes you wonder (once again) the other treatment options offered to these people. Surely there has to be a review of treatment options.
Remember, any drug withdrawal must be done under medical supervision.
Treatment options tried by Participants. Once again, prescribed medication is the most tried treatment option used (81.5%) by the Anxiety Disorder participants. Other options tried predominantly by participants are counselling, hypnotherapy, psychotherapy, cognitive behaviour therapy and graded exposure. Most participants had tried self-treatment options. Many were trying multiple treatment options.
According the 518 participants, the following treatments offered by Health Professionals were considered :
Most effective : meditation, cognitive behaviour therapy, Anxiety Disorder Management Programs, and psychologist.
Somewhat effective : graded exposure, counselling, psychotherapy, psychiatrist.
Least effective : hypnotherapy, prescribed medication.
Rapid eye movement was tried used by 1 participant and so can't be assessed.
According the 518 participants, the following self- treatments were considered :
Most effective : self awareness/ working with thinking, Self, support groups, self help books, yoga/relaxation
Somewhat effective : homeopathy, naturopath, acupuncture
As can be seen in the above, Prescribed medication is the most used option provided to participants but was assessed as one of the least effective treatment options (81.5% tried prescribed medication but only 15.9% considered it effective treatment option). It is to remember that this was the result from the population that participated in the study. However, the %effectiveness of cognitive behaviour therapy (CBT) is similar to other studies looking at the effectiveness of CBT. Certainly, CBT is currently one of the most effective treatment options for people who have an Anxiety Disorder. The participants of this study concurred with that opinion. Also very successful is meditation and Anxiety Disorder Management Programs.
Many people use self-treatments with success. Many use these in conjunction with Health Professional treatment options. Simple self-techniques such as self-awareness/ working with thinking, working on self issues, and self help books are considered very effective.
Effectiveness in stopping panic attacks and/or Anxiety. Participants were asked to assess the effectiveness of different techniques in stopping panic attacks and/or Anxiety. Many people had not used cognitive methods (at that time) but according to the results were very aware of the mechanism of thoughts within the Anxiety Disorder. Participants considered that "changing thinking patterns" would be between "mainly and totally" effective in stopping panic attacks and/or Anxiety. Participants considered that "graded exposure" would be between "somewhat and mainly" effective in stopping panic attacks and/or Anxiety. It must be given that most of the participants were not aware of what graded exposure was and so responded with "not specified". As 81.5% of participants have/are used medication, they would be giving their "opinion" based on experience. Participants considered that "prescribed medication" was between "very little and somewhat" effective in stopping panic attacks and/or Anxiety.

Final synopsis. Reviewing the results, more awareness and education is required - not only with the Health Professionals but also within the general community. The results for the prescribed medication is only symptomatic of the lack of awareness and education on Anxiety Disorders and appropriate/ effective treatments for them. Continued education of Health Professionals should include
a) treatment needs of the consumer - including preferred options, treatments that are considered effective by consumers;
b) current research showing the most effective treatments for Anxiety Disorders and the effects of those treatments;
c) cognitive skills that can be used with their client; and
d) a referral list or links to organisations that can provide referral to appropriate Health Professionals.
Education and awareness is also vital within the general community. This will empower people to make informed decisions as to which treatment options will be best for their individual recovery. Many of the comments from the participants expressed the frustration of not having:
a) awareness and understanding about Anxiety Disorders - both in the general community and among friends and family
b) access to appropriate treatment for their Anxiety Disorder
c) access to a Health Professional that understands Anxiety Disorders that can provide effective treatment.
Most participants commented that they were aware that Prescribed medication was a short- term solution (for themselves). They also expressed their dilemma - they didn't want to have to take Prescribed medication but it was the only option offered to them (some were prescribed medication but were never given any understanding about the Anxiety Disorder - therefore there was much anger from participants). Again on the issue of prescribed medication, many participants felt that Anxiety and panic was actually compounded by having to take medication - fear of dependence on medication, not wanting to take the medication, the side-effects of taking the medication.

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