In life, one experiences alternating and sometimes mixed emotions of joy and sadness as well as of carefree laughter and deep frowning concerns. While joy and laughter are seldom experienced as problems, when something in your environment triggers an internal alarm, you will start to worry. Worrying can encourage you to focus energy for a task at hand, in problem solving, or in securing a needed level of certainty. However, when worry gets out of control and results in persistent anxiety, loss of sleep and/or ongoing increased blood pressure, it is no longer helpful. At such a point, it no longer helps you achieve a goal. Instead, it self-perpetuates in a seemingly endless loop of stress.
Nowadays, there is a tendency to see every ordinary emotional up and down as a kind of pathological disorder in need of treatment. If you present concerns about your emotions to a busy doctor, it is likely that a magic pill will be prescribed “to take the edge off” whatever worries you.
In DID, worrying can transform into an almost perpetual anxiety, which may then get taken to the extreme of crippling hyper-vigilance. Psycho-active medications can be very helpful when worrying has become incapacitating anxiety. Nevertheless, thoughtlessly employing medication may mean that we miss out on opportunities to mature, to grow stronger and to become more self-reliant. My recommendation was always to include psychotherapy as part of any regimen that included psycho-pharmaceuticals.
But, are all kinds of worrying pathological? No.
If your teenager is going out with friends, you may worry and automatically look for specific danger signals. If the driver has had a couple of beers, then your worry crystallizes – you identified a true predictor of the risk of catastrophe. You may need to actively intervene as a result of this clear and present danger.
Your worry in that example is clearly not pathological. It is a sane response to evaluate known risks of danger. Once we have scrutinized the situation, and ensured that the driver is not drinking then the worry has resulted in reasonable actions of protection. At that point, continuing to worry is a waste of energy.
Having taken reasonable precautions, remaining paralyzed with disabling worries fits into the psychiatric category of “Anxiety Disorder.” If that is the case, then yes, you have an Anxiety Disorder. This leads to follow-up questions, “Are drugs are the only treatment? Are they necessary?”
When necessary, I sometimes prescribed medication but only as an adjunct to psychotherapy. A principal argument against pharmacological treatment alone is that while drugs can ease your mental tension for a short period of time, they take away your autonomy and the possibility of self-empowerment. Taken alone, medications can lead you down the path of chemical dependency.
Training yourself to deal with tension solely with medication does not allow for correcting and refining the balance of your innate alarm system or for modulating your responses to those alarms as appropriate. For example, if you hear a car horn honk some distance away, you notice the sound and scan to identify what is going on. You do not jump and run in a panic. If you are jay-walking and you hear a car horn honk very close, then the appropriate response may indeed be to jump and run out of the way.
Life is full of obstacles for everyone. You will likely meet situations in the future that are similar to what is triggering the anxiety. Relying solely on medication without embarking on the necessary internal re-calibration work of psychotherapy, brings only an even stronger reliance on the drug! It is like starting on sleeping pills to put you back to normal sleeping pattern. Once you find them helpful, you start worrying that you will need them again. But this time the worry is truly justified! Why? Because you have not used the situation to learn about and process the root causes of the obstacle you face. This is the task, this is the essence of the healing journey.
