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Play detective with anxiety Feb. 3, 2003
Provided by: Sun Media
Mark Berber loves mnemonics, a system to improve your memory that comes from Mnemosyne, the Greek goddess of memory. I remember employing mnemonics (the first m is silent) in learning the letters of the treble clef in music: Every Good Boy Deserves Fudge. While we may use simple mnemonics to remember stuff such as the names of the great lakes (HOMES), doctors apparently use the device a lot to remember complicated lists of things like the six cranial bones: Old People From Texas Eat Spiders.

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But Berber's into behaviour, not bones, and at a recent seminar on anxiety disorders he used mnemonics to explain various anxiety disorders. Recognizing them for what they are is the first step in getting help. Everyone is anxious about something, he says: If you're driving on an icy road, it's normal to be anxious. Abnormal anxiety is a state of constant fear -- like fearing ice where there is none. Chronic anxiety stresses the heart and the immune system, he says: "It wears you down."

SIX TYPES OF ANXIETY

There's anxiety and then there's anxiety: In fact, psychiatrists recognize six different types: Social anxiety, phobias, post traumatic stress syndrome or PTSS, generalized anxiety disorders, panic attacks, and obsessive compulsive disorders or OCD. Anxieties tend to affect more women than men; panic attacks are extremely common. And the lifetime chance of having a phobia, which Berber says is extremely easy to fix, is about 11%.

To control your anxiety before it controls you, Berber says you need to play detective with yourself in order to discover the kind of anxiety you have. "Ask yourself, 'What am I worried about?' If you answer that correctly, you'll know which kind of disorder you have."

For example, people with a social anxiety fear being criticized and humiliated in front of others: They're terrified of public speaking, and in severe cases of using a public washroom. Phobias are obvious: They could be anything from snakes to sweaters, elevators to elephants. The fear in PTSS is that you'll re-experience the trauma, while someone with a generalized anxiety disorder or GAD fears everyday things such as their job or money.

Berber, a fan of media psychologist Dr. Phil, says that anxiety disorders can be disabling. People with social anxiety issues, for instance, can feel trapped in social situations and so avoid parties and end up leading isolated lives. Those with a generalized anxiety disorder are life's worriers. Berber can spot them through employing the mnemonic WATCHERS: They have Worry, Anxiety, Tension, a lack of Concentration, are Hyper-aroused, feel a loss of Energy, are Restless and suffer Sleep disorders. "This is not a trivial problem," says Berber.

People with panic disorders experience panic attacks that can produce sweaty palms, racing hearts and tight chests. Often, their doctors send them to cardiologists or other specialists thinking there may be something physically wrong with them. There are 13 sub-symptoms to this disorder which Berber remembers through the mnemonic STUDENTS FEAR C (the letters stand for everything from Sweating to Trembling, from FEAR of dying to Chills, Chest pain and Choking.)

OCD is an awful disease that has two components: The obsession (recurrent thoughts that keep crowding your consciousness: Did you turn off the stove?) And the compulsion (the tapping or constant washing of hands). OCD often begins in adolescence, says Berber who had one patient who spent three hours every day in the shower.

Besides offering an easy way to diagnose symptoms, Berber believes his approach demystifies the subject: "There's a lot of gobbledygook in psychiatry so we try to make the diagnosis as clear as we can." He believes that patients can quickly understand the root of their anxiety disorder, be it an inherited predisposition or a precipitating event.

Treatment of these disorders ranges from talk therapy to patient education and medications such as anti-depressants, he says. And they're important to get on top of because anxiety is found in 80% of people with depression.

COGNITIVE THERAPY

Therapy can be helpful to change the "negative self-talk" that is rampant in anxiety disorders, says Berber who explains that "if we think a certain way, we feel a certain way." This, he explains through the mnemonic BADMOODS which stands for Black and white thinking, "Awfulizing" situations, Discounting the positive, Maximizing the negative, Overgeneralizing, Overestimating the likelihood of something bad happening, Demanding too much of yourself, and full of Self-blame. If that's you, cognitive therapy can help.

Berber has accompanied patients on the elevator rides they feared, driven with highway phobics on the 401, and even prescribed lifestyle changes and eastern medicine. "I love breathing," he says, describing pranayama, a yoga technique that focuses on controlling the breath and which creates clarity and focus. "It can calm the whirlpools of the mind." That's BIBOS, for you mnemonics lovers: Breathe In, Breathe Out -- Slowly.
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