Nikki 's Reviews > Anxiety: A Very Short Introduction

Anxiety by Daniel Freeman
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really liked it
bookshelves: health, science-fact, non-fiction

I pretty certainly have generalised anxiety disorder (GAD). I score 19/21 on the GAD 7 test, even medicated. According to this book's tests, I get 80/80 on the Penn State worry questionnaire, indicating GAD; 39/72 on their OCD test, which indicates OCD as well; 46/88 for a single traumatic event on their PTSD test, where 30 and above indicates probable PTSD.

So that probably tells you why I read this. Another person with GAD recommended it to me: it explores the physiological/genetic/environmental/sociological understanding of GAD, more or less from an outsider's point of view, thereby offering a reasonably academic and detached perspective. For me, this is helpful. I got really sucked in to wondering about the techniques for treating anxiety disorders, trying to apply the conclusions to things I'm familiar with...

For example, people with GAD will often try to avoid the situations that make them feel anxious, but that only enhances their fear of those situations because they never actually experience them to find out that they can live through them, that it wasn't so bad after all. People in fandom often (though not always, and not exclusively in fandom) provide "trigger warnings", enabling people to avoid things that commonly cause people anxiety and distress. E.g. warning for discussion of rape. One my friends usually warn me of in advance is cancer, or bugs. Anyway, so is that actually causing further harm, in the long run, by unduly insulating the person? I always used to think that it would cause more harm for someone to be triggered, not be in any way helpful, but this book suggests -- the research suggests -- that actually, avoidance of triggers makes them worse.

Still, I know first-hand that triggers really can be distressing, can cause harm of their own on top of the existing fear. So I remain pro-trigger warnings: they're a valuable way for people to ensure that they don't encounter something distressing without support and the choice to do so. ERP therapy is valuable not because of the exposure to the trigger alone, but because it is done in a controlled environment by someone who knows what they're doing, and by the patient's choice, it's different to just saying "you've got to man up and face your fears".

Anyway, I think it's helpful, speaking as a person with anxiety, for understanding what's happening to me and why. I think it would also be helpful for people who don't understand what anxiety is, who might be inclined to dismiss it as "all in the mind", but reluctant to actually do so. It identifies a lot of causes and contributing factors, and makes reference to a lot of studies. Additionally, for those who have some form of anxiety but aren't sure whether it qualifies as a disorder, there's several different tests in the back for evaluating how likely it is that your anxiety is severe enough to be considered a disorder.

It's a basic book, of course, probably not useful to anyone with degrees in psychology or even just plain medicine. But I found it both interesting and helpful.
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Reading Progress

April 12, 2013 – Shelved
April 14, 2013 – Started Reading
April 14, 2013 – Finished Reading

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message 1: by [deleted user] (new)

Assuming I did it right, I scored 14/21 on the GAD-7 test, and my doc has me on about 9 different dietary supplements rather than medicine, at least four of which to help with anxiety. So yeah, I am also very interested in this book now.

I'll probably also walk away from this pro-trigger warnings regardless. As much as I'd love to make my emetophobia disappear forever, it's the surprise--the lack of control--behind sudden vomiting that sets me over the edge. I can appreciate the point of view that, by avoiding it (which I do by avoiding parties that involve alcohol, avoiding bars, avoiding food that upsets my stomach, avoiding sick people, having my MP3 player on and my eyes averted away from people in public spaces as much as humanly possible, etc.) I am only hurting myself. I know I am, but at the same time I have to be calm and rational as much as possible, especially at my job, so I've not quite figured out how to balance that and gradual desensitization yet.

Not to mention vomit is not the only thing that makes me anxious. It's my only phobia. Battling it just isn't a priority right now, though, especially since I've not even come close to succumbing to agoraphobia, which is common among people with emetophobia, so mine's probably a relatively minor case. Anyway, until I'm ready to "face my fears" I do appreciate trigger warnings in the mean time, and people that don't use words such as "this is making me nauseous" in response to something gross, when that something gross actually isn't making them nauseous. I only really expect my closest friends to know this about me and accommodate, though.


Nikki Yeah, that'd put you in the moderate bracket for GAD. Dietary changes didn't help me at all; I'm following the course of treatment recommended in a recent conference in Nice: an SSRI antidepressant, an anti-convulsant, and hopefully psychotherapy.

To me, trigger warnings remain useful because you can't dictate the rate at which someone else recovers. Nobody can decide what's best for another person -- even a doctor ultimately defers to the patient in terms of what treatment is necessary.


message 3: by [deleted user] (new)

I think dietary changes helped me because I had food allergies that I wasn't aware of until this year (eheh... ) and my Vitamin D and B12 crazy low thanks to working grave shift. My TSH hormone was high, so I was showing signs of developing hypothyroidism. Anxiety and depression are symptoms of that. So yeah, in my case I needed the boost of dietary supplements. My quality of life now has improved drastically since, but sometimes I wonder if I should have some medication as needed for occasional days where it's just too much. Quitting grave shift would also help, except I need a job, so that's not really an option at the moment.

And you're exactly right. There's no one size fits all road to recovery in these matters. In my opinion it's just more respectful, and easier, to consider everyone's comfort zone rather than argue against it.


Nikki For an occasional one, I'd recommend a beta blocker. Propranolol worked well for me. It tended to 'reset' things so that my anxiety went back down to a reasonable level.

Yup. It's not anyone else's business but the person concerned and their physician, after all.


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