We live in an age of anxiety - an era when demands, stresses, and responsibilities are overwhelming. In our hectic, fast-paced schedules, we are told today about what was due yesterday, and we have eight things to do simultaneously. We can either respond in knee-jerk fashion to everything thrown our way, or we can exercise some control over what we are able to do.
On days away from work, many people want to hibernate away from others with a sort of “couch potato” reaction. Our bodies learn to gear up for the stresses put on us by a “fight or flight” mechanism that stirs us up when danger threatens or calms us down when the heat is off. This is our automatic nervous system responding. Anxiety occurs when the switch is left on even though excessive outside demands are not being made. This may result in general anxiety, fears, or states of panic.
Look, for example, at the person who avoids going to shopping centers because he/she is afraid of becoming panicked - racing heartbeat, sweaty palms, paralyzing fear. This person is not afraid of the shopping center itself, but afraid of what he/she may feel. Take the achieving man who hates oral presentations at work because of the nervousness that comes over him. Or how about the person who has a real or potentially harmful mishap resulting from an automobile accident, air travel, or the like, and as a result, avoids carrying on with life in fuller ways, and instead becomes more reliant or dependent upon others to get places. These are real feelings that many experience.
Recent studies indicate that approximately 8.3% of the population or about 13.1 million people in the United States suffer from an anxiety disorder. It is estimated that over a lifetime 10-15% of women and 5-8% of men suffer from simple phobias. Approximately 10% of the population will experience a panic attack at some point in their lives. Only 23% of people with anxiety receive treatment for these difficulties.
Some authorities argue that anxiety disorders are more common than alcohol and drug problems. Substance abuse, of course, is very destructive in our society, but it needs to be mentioned that the use of alcohol and drugs is probably a major way of dealing with problems. People who experience excessive anxiety tend to be nice people who internalize their feelings, especially angry feelings. They also may be perfectionistic and like to have control over things, which is why panic is so frightening. They are very sensitive people. Prior to a first panic episode, an individual will have likely experienced a period of stress involving a personal loss or a major change in their lives.
The good news is that anxiety can be successfully treated. Many forms of therapy - individual, group, medication, social support, etc.- are available and are most effective with a combination of treatments. A primary role for the therapist in the treatment of anxiety is an educator as well as a practitioner of various treatment approaches. Education about the problem is critical to the patient’s understanding of what is happening to him/her. This enables a person to be effectively involved in his/her own treatment. The anxiety that interferes with one’s ability to function, go to work, go to school, and participate socially with others without undue withdrawal, flight out of panic, avoidance, or extreme discomfort needs to be and can be treated very well today.
Depression and anxiety are the two key emotions for which people seek help from the mental health community. It takes many disguised forms if we look only at appearances or overt behavior. Manifestations of depression may include:
• The child who doesn’t like school and may be covering an “anxiety” about not doing as well as others academically.
• The estranged spouse who has trouble sleeping, takes off (or puts on) weight, and can’t concentrate at work.
• The ambitious executive who drinks excessively, fears failure and questions his continuing competence in the face of change in the workplace.
• The perfectionistic adolescent who loses interest in school and worries that she is not living up to her parents’ expectations.
• The drug and alcohol users who numb their feelings in an attempt to relieve feelings of distress, worry, fear, pessimism and low self-esteem.
Depression is a disorder of mood and is characterized by severe or prolonged feelings of sadness. Depression is accompanied by sad feelings, changes in attitude or motivation, depressed thoughts - those that are negative, self-critical, blaming, helpless - and by physical symptoms of impaired appetite, sleep, weight, headaches, tension, etc. People in the age group 22-44 are at the highest risk of depression, and women are twice as likely as men to become depressed. It has been estimated that 35% of people who have a true clinical depression first see a doctor because they are suffering from some kind of physical pain. Whether the depression is constant and long-standing, cyclical in nature, or manifested in behavioral expressions, treatments are available.
Depression can take many forms. Often a transient, somewhat depressed period may occur when a couple separates or divorces. Individuals who are separated or divorced, for instance, are two and one-half times more likely to suffer a depressive episode than are individuals who are married. The stresses and symptoms seem to arise out of a particular event which changes the person’s life. One feeling of control or influence over the event (or lack thereof) will tell us whether the period of depression will be substantial or passing. This could be considered a depression related to a period of adjustment in one’s life.
Another type of depression manifests itself by a period of adjustment wherein symptoms have been present longer than six months and are interfering with how well the individual can continue to function at home, work or school. Concern and preoccupation about personal difficulties is usually accompanied by a lack of interest in work, recreation, or relationships. There may be changes in eating habits, sleeping patterns, lack of sexual desire, and loss of interest in previously rewarding activities.
Young married couples, or “young marrieds” as I like to refer to them, are no longer individuals living the “single life.” “Husband” and “wife” imply new roles. Each defines himself or herself as having a new role of being married. Consideration and care for another person must be taken into account.
Does one partner have the same style or preference in everything he/she does? Do they become a “we” to the world? When one is invited out by a friend, are both invited to go out? Is the old chauvinistic joke present that “his wife is married,” but he can do what he wants? A new orientation to the spouse must come about and be negotiated with the other.
Do they eat together, go to church together, visit respective families together, go out separately with friend, etc.? Attitudes about respective families of origin go through some transformation. They don’t belong to either family exclusively anymore after marriage. An adult relationship with family of origin is to be worked out so that both can have a couple status while maintaining a personal relationship with each family. Does the couple only visit with one family on holidays? Are accommodations made for both families? Change and adjustment is the name of the game.
There are ordinary and expected differences that arise when each partner has his own opinion or preference for something. Do these differences become conflicts or power struggles? A high level of cooperation, openness, willingness to discuss, and negotiate is the process that will succeed. What is each willing to do to make the relationship, and the demands placed on it, work?
Mel Kranzler, who has written extensively on marriages, suggests a solution that a young couple needs to become a “friendly teacher and receptive student to each other.” The couple goes through a learning process together, both learning to be a spouse, companion, cook, sexual partner, moviegoer, student, co-worker, etc. with each other. The success of a marriage depends upon two people knowing themselves first. Only then are they able to give cooperatively and with a willing spirit to focus on problems and solutions.
Another challenge to work on for young marrieds is learning how men and women are different. Each has different expectations of the marriage and view events from singular perspectives. Men usually want to think something through, and then talk about it. Often women do this in a continuous process of verbalizing and weighing issues. Men get frustrated with all the talk, but it is important for women to understand and experience the relationship their way. Viva La Difference! It takes work and a conscious effort on the part of men to appreciate this process.
Are differences in viewpoints perceived as signs of rejection or loss of love, or are they merely personal attitudes? Should a couple have identical outlooks in order to be close to each other? No, of course not! Similarities draw them together; differences help them to grow! My spouse is not an extension of myself in the world. “Xerox copies” we are not. To allow for and tolerate differences means having respect for the separateness of my spouse.
Within the first three to five years of marriage, a set of rules are agreed upon, not by conscious discussion, but by a kind of consensus in behavior during this time. They don’t quite sit down and put it in writing, although that may not be a bad idea. Their ongoing daily interactions result in working out a style of relating.
If these “agreements” are comfortable and work for the couple - great! If they don’t, then renegotiation needs to take place. And that will only happen if they communicate about what each needs and desires. Marriages go through a number of stages, just as individuals do.