Depression, Agoraphobia, Alcohol & Drug Abuse, Suicide – secondary conditions of Anxiety Disorders

Depression

Depression is one of the most common secondary conditions arising from an untreated or ineffectively treated anxiety disorder. Sometimes it’s the resulting depression that becomes the primary diagnosis, while the underlying anxiety disorder goes either untreated or unrecognised.

The symptoms of depression include:

• a sense of being overwhelmed
• loss of hope for the future
• irritability
• fatigue
• changes in appetite
• change in sleeping patterns
• poor concentration
• reduction of sexual interest or desire
• suicidal thoughts

Through an inability to control panic attacks and/or anxiety, a person can experience an overwhelming sense of helplessness and despair. They can feel guilty and ashamed about the effect their anxiety is having on their family. Things they were once able to do without a second thought have become a focus of fear and dread. A dependence on partners to shoulder more of the burden in taking care of the family and daily tasks develops into a sense of worthlessness.

Depression can become very disabling. The sufferer lacks motivation and energy, loses interest in every-day activities and often experiences disturbed sleeping patterns. In extreme cases, the person is unable to care appropriately for themselves or their family. Depression also means the sufferer is much less likely to manage their anxiety disorder.

Many people with an undiagnosed anxiety disorder will develop depression. While shame and guilt will sometimes prevent a person with an anxiety disorder from getting help, it’s the further disabling effects of depression which forces them to seek treatment.

In recent times it has become more ‘socially acceptable’ to admit to being depressed. It is hoped that in the not-so-distant future much of the stigma associated with anxiety disorders will also be removed

Agoraphobia

Agoraphobia, once interpreted as a ‘fear of the market place or open spaces’ is now recognised as avoidance behaviour due to fear of having anxiety symptoms or a panic attack. Avoidance is the most common practice used to prevent the re-experiencing of distressing symptoms. While avoidance may bring short-term benefits, it can lead to the development of Agoraphobia, as a secondary condition to the anxiety disorder.

When the first attack occurs, most people are caught completely by surprise. Immediately they try to make sense of why it happened. The logical conclusion (although incorrect) is to believe there was something about where they were or what they were doing that was the cause. The natural instinct is to avoid placing oneself in the same or similar situations in the hope of preventing the return of the distressing symptoms. It’s only with a better understanding of anxiety that a person understands the attacks/symptom is connected to their anxiety level and that where they were at the time may only be coincidental.

The degree to which people use avoidance varies greatly depending on the progression of their anxiety disorder and the nature of the perceived triggers. Avoidance, while bringing short-term relief, does not address the original cause for the attack, high levels of anxiety. This is the flaw in using this type of control. As the person experiences symptoms in additional situations, these too must be placed on an ever-increasing list of places to avoid. In a worst-case-scenario, the person will become housebound and unable to leave the relative safety of their home.

Some people are able to avoid a selected few situations without it interfering with their lives to any great degree. They may even be able to hide the avoidance behaviour from others. However, this can become more and more difficult as life circumstances change e.g. an employee who had her first attack in an elevator would find life more difficult if her boss moved his business into the upper level of an office tower.

Alcohol & Drug Abuse

Alcohol has long been used to ‘settle the nerves’. Alcohol is easily accessible and socially acceptable. It’s for these reasons that people with an anxiety disorder can fall into the trap of using alcohol to self-medicate. It can start out quite innocently with just a drink here and there, but over time it can become a habit leading to abuse. The destructive effects of alcohol abuse are well-known, i.e. loss of employment, family breakdown and poor physical health in the long-term. Despite all this, it seems more socially acceptable to admit to an alcohol problem than an anxiety disorder.

Medication is often the first treatment people with an anxiety disorder will be offered. Although medication can have a calming effect, it does not take away all sensations of anxiety and people will sometimes increase the dosage themselves. This is very dangerous and can lead to over-dosing with a risk of death.

Illegal drugs are more available than ever before. Some people will choose this type of self-medication. There are many inherent dangers in this practice. Not only does it lead to an association with a particular lifestyle, it too can lead to death.

Marijuana is now well documented as triggering paranoid and/or panic episodes in those who have a predisposition. The difficulty is, no-one knows whether they may fit into this category until it’s too late.

Suicide

As part of the disorder many people will feel a sense of helplessness and deep depression. At times they can hate themselves and feel they are a drain on family and friends. Usually these thoughts are fleeting and never acted upon, but occasionally they persist.

It’s a tragic fact that some people will attempt or carry out a suicide in order to put an end to the suffering they experience. Most often those who make this decision have not been able to access the types of treatments which bring about recovery. Most often they have been depressed for a considerable period of time. If you are having these thoughts, you should speak to your doctor immediately.