Anxiety and Fear The Mental Health After-Effects of a National Tragedy

Some of us will experience intense, prolonged feelings of anxiety and fear just from watching the Virginia Tech shooting on tv news

Following a nationally publicized traumatic incident like the shootings at Virginia Tech, it is common for those actually involved in the shooting, or those closest to them, to experience a wide range of emotions; from severe helplessness, hopelessness and horror, to anger, and for some, even guilt of having survived the ordeal. But even those of us who only experience the events as spectators from afar (through news reports) may be dismayed, confused or frightened by the emotions we experience.

Some spectators will experience some of the emotions listed above. Many may be bothered by symptoms of fearfulness or depression. Others may be confused that they are not experiencing any unusual emotions and may wonder why they are "unmoved by the incident."  Still others may experience anger or frustration at the "shooter"  or his family, the people in charge for not responding sooner, the laws regarding gun possession, the mental health system for failing to prevent the tragedy, or society itself for creating the conditions the shooter experienced. All of these thoughts and feelings, as well as a multitude of others not mentioned, are understandable. They appear on top of the underlying layer of thoughts of disbelief, frustration, fear, and of sadness and grief.

Who is susceptible to long-term fear from a tragic event?

For most of us, time will dampen and ultimately remove the most intense of these feelings, but for some people, the feelings of fear become prolonged. The most vulnerable amongst these long-term sufferers are those with pre-existing mental illness; especially those with one of the various anxiety disorders and those with substance abuse problems.

Anxiety is explained to be inappropriate or overdone feelings of fear, apprehension and worry. I explain to my patients that anxiety is best thought of as a severe case of the "what ifs."  What if this? What if that? What if, what if, what if??? It is an ongoing and unrealistic state of concern for future events.

If you're experiencing an anxiety disorder, you may find it difficult to control the worrisome thoughts and feelings, and the anxiety is accompanied by behavioral symptoms:

• restless, feeling keyed up or on edge, often with trouble getting restful sleep
• withdrawal and isolation

physiological symptoms:

• heart racing
• trouble breathing
• stomach problems

emotional symptoms:

• irritability,
• crying easily
• sadness
• fear of disease or death

To be a disorder, these symptoms must bother the person significantly (cause distress) and/or interfere with their ability to function on an everyday basis. There are a variety of anxiety disorders like phobias, obsessive compulsive disorder, generalized anxiety disorder, social anxiety disorder and post traumatic stress disorder, but the hallmark symptom of an anxiety disorder is inappropriate or overdone fear, worry and apprehension.

What if you have realistic fears?

For most people suffering from anxiety disorders, the underlying precipitating cause is unclear or unknown (except perhaps for PTSD where the stressor is clear and overwhelming). Despite being unaware of the cause, the person with an anxiety disorder continues to suffer from the fear and worry, although they realize it is overdone.

With a tragedy like to one at Virginia Tech, however, a person with a pre-existing anxiety disorder now has an obvious "reason"  to be anxious---after all, what happened at the university could happen anywhere, and to anyone---even to them. Although possible, a similar event is unlikely. Even though school shootings are covered "wall-to-wall"  by the media they are, thankfully, unusual and, in fact, rare events. After all, that's what makes them newsworthy.

Although it is understandable to experience worry and concern over such horrific tragedies, if the anxiety resulting from such concern is overwhelming, impairing or prolonged, it may indicate a need for the sufferer to get help.

So, how do you know if you have prolonged anxiety that is problematic?

If you begin to experience ongoing symptoms such as:

• Fearfulness that is uncontrollable and incapacitating
• Trouble with sleep impairing daytime functioning
• Withdrawal from usual activities
• Failure to take care of ones daily needs (like eating, resting,etc)
• Onset of depression
• Difficulty concentrating or functioning day to day
• Marked worsening of underlying emotional disorder
• Turning to non-prescribed chemicals or alcohol to control worry

Although these symptoms may not represent a true disorder, they can be the warning signs that alert you to the need for more help; especially if they are prolonged in duration.

Self-help techniques for coping with anxiety include:

1. Take a break from the news
2. Re-establish a regular day-to-day routine
3. Re-connect with a support system such as family or friends and talk to them about your thoughts, feelings and behavior
4. Pamper yourself with activities you enjoy
5. Engage in relaxation techniques (massage, meditation, yoga, exercise, positive self-talk and relaxation techniques)
6. Avoid self-medication (alcohol, drugs)
7. Begin to question your own irrational thoughts and feelings 8. Get good information from places like HealthyPlace.com

If these self-help activities do not significantly relieve your anxiety, a visit with a mental health professional might be in order.

Detailed information on Anxiety Disorders can be found here.

By Harry Croft, MD
Medical Director of HealthyPlace.com

back to: Dr. Harry Croft's News Index

http://www.healthyplace.com/news_2007/croft/croft_va_tech_shootings_anxiety.asp