Psycho-Social and Biological Approaches to Treating Anxiety - Research Paper Example

PSYCHO-SOCIAL AND BIOLOGICAL APPROACHES TO UNDERSTANDING AND TREATING ANXIETY DISORDERS IN ADULTS Introduction Earlier studies have shown that a great number of American adults are suffering from brain, mental disturbances, and behavior problems. The National Institute of Mental Health as cited by Kessler (2005) estimated that one out of 10 American children suffers from mental illness and 26.2 percent of Americans aging from 18 and older also suffer from mental disorder. With such great a number of mentally ill, there is the need for the government to prioritize and provide them health care and services. And yet in spite of the fact that the Department of Health and Services (1999) have long identified the problem, the need, lack of facilities, resources, and services remain as a problem in the health sector and the whole American society. Something must be done to improve the condition of the neglected mentally ill adults. There must be alternative ways to serve these unfortunate members of the society who most of the time, do not wish to stay in mental institutions of mental facilities and centers. It is the purpose of this paper then to dig into different psycho-social and psychological approaches that could be utilized in treating the mentally disturbed patients or family members. For better understanding, this paper also aims to provide a comprehensive definition of what anxiety disturbance on adult means. Anxiety Disturbance in Adults Anxiety disturbance comes in different types. Starcevic (2004) enumerated several types of adult anxiety disorders such as (1) panic disorder, (2) generalized anxiety disorder, (3) social anxiety disorder, (4) specific phobias, (5) obsessive-compulsive disorder, and (6) posttraumatic stress disorder. It is important to define and describe these types of disorders in order to understand the differences of such disorders. Panic Disorder. This disorder can occur because of biologic or environmental cause and this occur as twice more on women than in men. Katon (2006) stated that this is caused by an abnormally sensitive fear network that includes the prefrontal cortex, insula, thalamus, amygdala and projections from the amygdala to the locus ceruleus, hypothalamus, periaqueductal gray substance, and parabrachial nucleus. Generalized anxiety disorder. This is described as the worry associated with three or more of the following six symptoms that could persist for days to about six months. (1) restless; (2) feeling of fatigue; (3) difficulty in concentrating ; (4) irritability (5) muscle tension; and (6) difficulty in falling or staying asleep. Social Anxiety Disorder. Book and Randal (2008) defines this disorder as excessive fear from social situations, such as eating or speaking in public. According to the authors this kind of disorder affects 2 to 13 percent of the American population. It is also pointed out that about one-fifth of patients who are diagnosed for social anxiety disorder also suffer from an alcohol use disorder. Specific Phobias. Medical Dictionaries would define phobia as a sort of fear beyond reason that can cause anxiety, avoidance, and panic. There are specific fears or phobia. Some symptoms indicative of phobia can be the extreme feeling of horror, dread, fear. A person who has a phobia may be also known when fear is so grave and suffers from shortness of breath, rapid heartbeat, and displays extreme discomfort and may tremble or shake and very much desirous to escape from the situation. There are several types of specific phobia: (1) animal type – fear of animals; (2) natural environment type – fear of heights, storms, or water; (3) blood-injection-injury type; (4) situational type such as fear of situation such driving; flying; enclosed places; and (5) other type such as fear of choking after eating (Antony, Craske, & Barlow, 1995). Obsessive-Compulsive Disorder. The American Medical Association (2004) defines this disorder as the anxiety disorder that occurs during adolescence or early adulthood although there are cases where it may begin in childhood. It is described to be characterized by the presence of an obsession and compulsion that results to distress. Post-traumatic Stress Disorder. The National Institute of Mental Health (2008) defines the illness as an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened such events as violent personal assaults, natural or human-caused disasters, accidents, or military combat. Psycho-Social and Psychological Approaches in Treating Anxiety Disorders Psycho-social approaches are effective strategies that assume mental anxiety to have resulted from mental, behavioral, and social factors that includes conflict, trauma, personal experiences, and environmental conditions. These approaches deal with the patients by understanding the hereditary and the environment where they are currently situated. Treating the mentally disturbed patients with such approaches means that the social and physical condition of the patients must be investigated. It is important for the mental health center to gather information that must have brought disturbing impact on the patients. The mental health care center must have ample understanding of the relationship, the employment history, health condition, economic and living condition, as well as the support system of the patients. Psycho-social approaches are found effective because they allow more freedom to the patients. They put value on the right to self-determination. Patients are given the right to make decisions as these approaches aim to provide the patients the opportunity to have self-fulfillment and to maximize their potentials in achieving their dreams and aspirations in life. Tyrer and Steingberg (2003 as cited by Shulamit and Williams, 2005) presented three principles that serve as framework in psychosocial approaches. The principle are as follows: (1) that mental disorders are often triggered by significant events in life that appear to be independents; (2) that social forces linked to class, occupational status, and social roles are precipitants of mental disorder, and (3) the society has a great bearing on people who have mental disorders. With these principles in mind it is important therefore to look at every aspect in the patient’s life. The economic factors are seen as a great cause of mental anxiety. Poverty, homelessness, drug addiction, and unemployment are factors that most often seen as causes of mental anxiety. Aside from the psychosocial approaches, another innovative method in treating patients that are mentally disturbed is the use of psychological approaches. These approaches hold on to the idea on the creativity of human beings: (1) cognitive approach; (2) psychoanalytic perspective; (3) behavioral approach; (4) intrinsic motivational perspective; (5) historiometric perspective; and (6) developmental approach. Neisser (as cited by Sacks) defines cognitive approach to include all processes by which the sensory input is transformed, reduced, elaborated, stored, recovered, and used. The psychoanalytic perspective on the other hand is explained by Sacks (2006) to follow the principles of Freud. Accordingly, it is based on the theory that human beings attempt to avoid pain and create pleasure by daydreaming or dreaming. The behaviorist approach on the other hand Sacks stated that this does not agree with the proposition that there is an inner self guiding human thought or creativity. He said that creativity is a combination of a stored knowledge that gives the individual to come up with a new idea as a response to a new situation. The Intrinsic Motivational Approach is also part of the theory of creative thought. Sacks explained this approach takes unusually high levels of deep conceptual understanding to be insufficient to produce creativity. He said that external goals like public recognition do not enable human being to be creative but instead this approach believes that people reach their creative potential through their desire for pleasure in the activities in which they engage. Intrinsic motivation is an activity that is pleasurable or satisfying so it is through activities of this sort that creativity develops and enriched. Humanistic approach is another effective psychological approach in the treatment of mentally disturbed patients. This approach holds on to the idea that creativity is an agent and an important trait. Sacks said that advocates of humanistic approach believe that creativity is a complex characteristic that cannot be easily measured but can be observed through the lifetime of the person. Historiometric perspective is another psychological approach that aims to develop the relationship between psychology and history. This is a more complicated approach as there is the need for statistical analysis of quantitative data that are taken from the history of the patients. The historiometric approach takes political and social condition relevant and influential in the development of individual’ creativity. The last psychological approach than can be utilized in treating mentally derailed patients is the developmental approach which Lebovici (as cited by Sacks, 2006) presented to follow three rules which are as follows: (1) creativity is anticipatory and goal oriented; (2) creativity is both experienced as a shared activity and individually; and (3) creativity is an activity that requires observation and reaction. Review of Related Literature There are many related studies that have been published in line with this research. The author finds them important to be presented if only to give more insights and meaning to this paper. In an article Evans and Findler confirmed that cognitive behavior therapy has been found to be effective in the treatment of generalized anxiety disorder (GAD) however it is also found out that significant percentage of patients struggle with residual symptoms. According to them cultivation of mindfulness may be helpful for people with GAD and this part of the cognitive approach of treating disorder. The article discusses that mindfulness-based cognitive therapy (MBCT) is a group treatment derived from mindfulness-based stress reduction (MBSR) which introduced and developed by Jon Kabat-Zinn and colleagues. This approach uses training in mindfulness meditation and incorporates cognitive strategies and has been found effective in treating depression. MacFarlane (2006) stressed on the need for an integrative bio-psychosocial approach as mental disorders are seen to be the effect of biological, psychological, sociocultural conditions of the patient. He discussed for instance that treating schizophrenia requires not only pharmacological treatment but needs approaches such as psychological intervention, family intervention, and vocation and psychosocial intervention. He stressed that family plays a very important role in the health care of mentally derailed patients. Evans, D. L., Foa, E.D., Hendin, H. Et al. (2005) pooled their knowledge and expertise to come up with the best treatment of mentally disturbed patients. They studied patient with adolescent anxiety, schizophrenia, substance and alcohol abuse, depression and bipolar disorder, eating disorders, and suicide. They came up with a book discussing the relevance of the using psychological approaches in the treatment of these patients. They also stressed that parents and family should work together with the health care centers as their presence and commitment are essential to the progress of the condition of the patients. For the cognitive approach, Evans et al stated that there are two important phases in this approach: (1) education, and (2) practice. The first phase involves training, education, and skill-building which is facilitated and guided by the therapist. Jarvis (2000) introduced psychodynamics as part of the psychological approaches to treatment of mental anxiety. This approach is focused on the subconscious of the human person. The following are some of the established contribution of psychodynamic approach: 91) recognition of the importance of unconscious mind; (2) recognition of the early experience and relationship of the mentally sick; (3) dealing with important and difficult questions such as why the need to be involved in bad dreams; (4) useful in providing treatment of mental health; (5) provides a set of therapies and therapeutic techniques that can be of great benefit to those who are psychologically in distress. Reigada, L. C. Paige, H. Fisher, C. et al. (2008) made studies on anxiety disorders in children and adolescents and discussed that children’s anxiety are not usually detected and that majority of youth do not receive services. For early identification of the disease the authors suggested reasons as follows: (1) access to large numbers of children, (2) high prevalence of unrecognized anxiety disorders in medical settings, and (3) an association between anxiety disorders and medically unexplained somatic symptoms. These reasons where given as part of the cognitive-behavioral intervention for these children and youth who present to pediatric medical settings with nonmedical somatic symptoms and undiagnosed anxiety disorders explain that the rationale for and focus of cognitive treatment approach are effective methods of treatment. Evaluation The studies presented enlighten the researcher on the relevance of psychological and psychological approaches to the treatment of mentally disorder or derailed patients. It has already been established that anxieties, phobias, and the many types of disorder could be an effect of biological abnormalities but it has been established that more than biological factors these kinds of disorders resulted from social and psychological disturbances. Observation of patients and interview of therapists have shown that many patients who are emotionally derailed are not biological problematic but their conditions are affected by their disposition and the condition of their surroundings. For instance, many mentally disturbed patients are found to have come from the lower level of the social strata. This means that they are suffering from economic deprivation and lack of food. Others who are mentally sick also are unemployed and very much lacking in material aspect. And yet there are also those who are also very wealthy but result to drug addiction and become emotionally and mentally derailed. There are many psychological and psychosocial approaches that can be utilized in treatment mentally derailed patients however, it is also a fact that the health care centers still are so much lacking in terms of attention and provision of care to the mentally derailed patients. Perhaps what is needed is the training and education of more people who can attend to the patients not necessarily in mental hospitals but in their own homes. This means that the family should be trained to detect every members of the family. As it has been established that it is not only heredity but environment triggers mental anxiety, any member of the family may be distressed and become sick. It is important therefore that the family should be able to arrest the situation where a member shows tendency of being emotionally and mentally disturbed. It is also very important to stress that the society must be reeducated as regards to the illness. The stigma about mental diseases must be removed so that those whose family who are affected will not shun from medication and treatment. It is important that right on the onset or the first stage of the ailment, the patient should already be diagnosed and treated. The family can do the psychological or the psychosocial approaches but this if course should be done with training and knowledge as the patient instead of getting and feeling better may develop a deeper and graver stress. What being stressed here is that there are many approaches and theories but they cannot be effective unless the mental health care centers will train and equip the therapists to train every member of the family of the affected to understand what the patient is going through so they can help in the healing process of the mentally disturbed member of their family. A patient may be treated but there is no guarantee that when he goes back to the environment that contributed to his distress he can already cope up. There are cases where he becomes distress and be sick again. Conclusion Mental anxiety comes in many forms and types but this can be cured through medical treatment and through psychological and psychosocial approaches that have been found effective in the field of mental medicine. The psychological approaches are based on theories that deal with the behavior and creativity of human person. They can be utilized depending on the situation of the mentally disturbed patient. There is no better way to treat a patient than to attend to his needs as a social being and to allow him to grow and use his potential so that he will have his self-fulfillment. This means that combining psychological and psychosocial approaches can be effective tool to cure or treat mental anxiety. And yet it also very important to note that these approaches can not work unless there is enough training and commitment of the health care centers and therapist and the whole society. The negative notion put on mentally disturbed patients must be broken so that they will be in a better position not to be discriminated and not to feel back and be sick again. References: American Medical Association. (2004, October). Obsession-compulsion disorder. The Journal of the American Medical Association. 292(16). Antony, M.M., Craske, M.G., & Barlow, D.H. (1995). Mastery of your specific phobia (client workbook). Boulder, CO: Graywind Publications Department of Health and Human Services. (1999). “Mental health: A report of the surgeon general.” U.S.Public Health Service. Evans, D. L., Foa, E.D., Hendin, H. Et al. (2005). Treating and Preventing Adolescent Mental Health Disorders: What We Know and what We Don't Know: a Research Agenda for Improving the Mental Health of Our Youth. Oxford University Press. Evans, S., Fernado, S., Findler, M. (2008, May). “Mindfulness-based cognitive therapy for generalized disorder.” Journal of Anxiety Disorder. 22(4):716-721. Hofman, S. J., & Bitran S. (2000, December). Sensory-processing sensitivity in social anxiety disorder: relationship to harm avoidance and diagnostic subtypes. Journal of Anxiety Disorder. 21(7):941-954 Jarvis, M. (2000). Theoretical approaches in Psychology: Perspectives and research. Routledge Press. Katon, W. J. (2006). Panic disorder. New England Journal of Medicine, 354:2360-2367. Kessler RC, Chiu WT, Demler O, Walters EE. (2005, June). Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 62(6): 617-627. MacFarlane, M. (2006). Family therapy and mental health innovations in theory and practice. Haworth Press. Reigada, L. C. Paige, H. Fisher, C. et al. (2008, May). 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