Types of Anxiety and How Medications Help
By Mark Ragins, MD
I’ve heard that Eskimos have 47 words for different types of snow because it’s important for them to be able to differentiate between them. I think we need at least a dozen words for different types of anxiety. We use the same word to mean so many different things.
For starters, some of us experience anxiety mostly in our bodies (for example with a tight chest, rapid heartbeat, short of breath, lightheaded, sweating, shaking, biting our nails, pulling out our hair, or reliving traumatic body memories) and some of us experience anxiety mostly in our minds (for example worrying what other people are thinking about us, going over old mistakes or imagined mistakes over and over, anticipating lots of bad things trying to avoid anything bad from happening, catastrophizing over possible future mistakes or failures). Often the two sides, mind and body, interact making things worse (for example, thinking other people are going to laugh at us can make us stutter when we try to speak, or noticing a rapidly beating heart can make us think we’re having a heart attack). We have some medications, like Inderal and clonidine, that decrease our body’s response to adrenaline and calm down our body as a result and some medications, like the SSRIs, that decrease negative thinking and ruminations and calm down our minds. I often ask people, “Do you start thinking anxious thoughts and then your body reacts to the fear you’re generating, or does your body start reacting to some outside trigger or memory and then you start worrying about what’s going on?” to try to figure out which side of their anxious vicious cycle to try to block first.
