Anxiety is a state of unexplained discomfort that is frequently coupled with guilt, doubt, fears, and obsessions. It is apt to occur in interpersonal situations that threaten prestige and dignity. A little anxiety is helpful to the learning process, but as it escalates, selective inattention to details occurs, until a state of disorganizing behavior called panic is reached. At that point, the heart races, and a feeling of impending doom takes over. Physiological symptoms of sweating, weakness, nausea, numbness and dizziness, along with feelings of unreality and “going crazy,” are common.
At some point in their lives, 24 million Americans suffer from anxiety so intense that it interferes with their ability to function in everyday situations. Complementary therapies have been shown to be effective treatments for moderate and intense anxiety. Some treatments for which there is clinical, but not research support, include avoiding drinking more than 4 cups of coffee, tea, or cola drinks a day; pressing acupressure calming points; using Bach flower remedies; breathing from the abdominal area; keeping a panic diary of each attach, what triggers it, and the individual coping responses to the attack; using homeopathic remedies such as Aurum met, and ignatia; and taking antistress vitamins (B-complex, or B-complex and C).
Sakai (1996) reported the use of the second autogenic training exercise for panic disorder with 34 individuals treated by the researcher. Fifteen participants had no further symptoms, 9 were much improved, 5 improved and 5 remained unchanged.
Combined Treatments to Reduce Anxiety
Field and colleagues (1997) reported a study testing the immediate effects of brief massage therapy, muscle relaxation with visual imagery, and muscle relaxation and social support group session for job stress among health care workers. All groups reported decreases in anxiety, depression, fatigue, and confusion, as well as increased vigor, which suggests that all therapies were equally effective.
Gagne and Tovc (1994) found that both relaxation (treatment) and therapeutic touch (placebo, control group) produced significant reductions in reported anxiety in 31 individuals in a Veterans Administration psychiatric facility. Rest, music therapy, and music-video therapy were equally helpful in producing a relaxation response in a study of individuals undergoing heart surgery (Barnason, Zimmerman, & Nie-veen, 1995).
Brown and colleagues (1997) found that both focused and standard cognitive therapy worked well for panic disorder. Both groups (20/group) reported significant decreases in panic, and over 84% in both groups were free from panic attacks a year later.
Leste and Rust (1984) studied the effects of modern dance on anxiety. State anxiety was assessed before and after a 3-month education program, using the Spielberger State-Trait Anxiety Inventory. The class in modern dance was compared with a physical education group, a music group, and a mathematics control group. Dance training significantly reduced anxiety, but no control activities did.
Noreau, Mortineau. Roy, and Belzilc (1995) investigated the use of aerobic dance-based exercise for 19 people with rheumatoid arthritis who participated in a 12-week biweekly program. Ten people served as controls. Besides improvement in movement and decrease in pain, the treatment group showed positive changes in anxiety and other negative feelings.
Desensitization Through Reexposure
Swinson and colleagues (1992) found that people who experienced panic attacks often headed for the emergency room of the hospital, fearing they were having a heart attack. In a study of 33 people who came to the emergency room of one hospital, half were given reassurance and half were advised to reexpose themselves to the situation as soon as possible and to wait there until their anxiety decreased. During the next 6 months, people who had been reassured experienced an increase in panic-related behaviors. Those who had been given exposure (desensitization) directions showed a significant decrease in panic behavior.
Distraction may be a better coping device for upsetting situations than discussion of what happened. Sharing thoughts about the day’s woes can worsen mood, according to a study of 79 men who tracked their biggest upset of the day, how they coped with it, and what their moods were that day. As a reliability check, their wives also kept notes on what their husbands’ moods were. The most effective coping strategies, in terms of lifting mood, were distraction (e.g., cleaning house, quietly meditating, or pumping iron in the gym), relaxation, and acceptance of the ill-fated day. Distraction allows the mental screen to clear and allows the mind to focus on less aggravating things (Stone, 1996).
Positive changes in anxiety and tension were observed after a 12-week exercise program for individuals with arthritis (Noreau et al., 1995). Exercise was also found useful in significantly decreasing anxiety in women during radiation therapy treatment for breast cancer (Mock et al., 1997).
Kugler and colleagues (1994) completed a meta-analysis of 15 studies on the psychological effects of exercise programs on people diagnosed with coronary heart conditions. They found a positive effect size both for anxiety and depression.
Pierce and Pate (1994) examined the effects of a single bout of physical activity among older participants. Sixteen trained women completed an abbreviated Profile of Mood States prior to and immediately following a 75-minute session of aerobic line dancing. A series of one-way analysis of variance with repeated measures from pre- to posttest scores showed significant decreases in scores on tension.
O’Connor, Bryant, Veltri, and Gebhardt (1993) reported the effect of resistance exercise in females on state anxiety and ambulatory blood pressure. Young women undergoing high-intensity exercise reported significantly less stress than participants in the less intense exercise groups. However, the relationship between stress and anxiety/depression/ hostility weakened at the end of the training period, but strengthened in the less intense exercise groups. The study provided evidence to support the hypothesis that, in an adolescent population, aerobic exercise has positive effects on well-being.
Raglin, Turner, and Eksten (1993) also provided evidence for the use of exercise as an anxiety reducer. Eleven female and 25 male collegiate varsity athletes completed 30-minute sessions of leg cycle ergometry or weight training in a randomized order on separate days. State anxiety and systolic (SBP) and diastolic (DBP) blood pressure were measured at baseline prior to exercise and 20 and 60 minutes post-exercise. State anxiety increased significantly following weight training, but decreased significantly below baseline 50 minutes following ergometry. SBP (but not DBP) was reduced by 6.5 mm/Hg below baseline at 60 minutes following ergometry.
Rejeski, Thompson, Brubaker, and Miller (1992) evaluated the experimental hypothesis that aerobic exercise buffers psychosocial stress responses in low to moderately physically fit women. Forty-eight (24 white, 24 black) 25- to 40-year-old women participated in either an attention control group or a 40-minute bout of aerobic exercise at 70% heart rate reserve. Both groups were followed by 30 minutes of quiet rest, exposure to mental and interpersonal threat, and 5 minutes of recovery. Aerobic exercise reduced both the frequency and the intensity of anxiety-related thoughts after the interpersonal threat as compared to the placebo group.
Individually selected homeopathic remedies were used on an outpatient basis to treat 12 adults who had social phobia, panic disorder, or major depression. Overall response rates were 58% according to the clinical global improvement scale and 50% on the SCL-90 and the Brief Social Phobia Scale.
Miller, Fletcher, and Kabat-Zinn (1995) found that an intensive, time-limited group stress reduction based on mindfulness meditation significantly reduced anxiety and panic for 22 individuals with DSM-III-R-defined anxiety disorders.
A convenience sample of 97 adults receiving chemotherapy for the first time was assigned to either an experimental group offered taped music and a message from their physician (n = 47), or a “no intervention” control group (n = 50). After the fourth chemotherapy treatment, Sabo and Michael (1996) found significant results on the Spielberger State Anxiety Inventory (as compared to initial evaluation) for the taped music group, but not for the control group. These preliminary’ findings indicate that this simple and cost-effective intervention can decrease anxiety when receiving chemotherapy.
Using a conceptual framework of holism Weber (1996) investigated the effects of relaxation exercises on anxiety levels in an inpatient general psychiatric unit. The researcher used a convenience sample of 39 participants. Anxiety levels were measured prior to and after the relaxation exercises using me state portion of the State-Trait Anxiety Inventory. Treatment included progressive muscle relaxation, meditative breathing, guided imagery, and soft music. There was a significant reduction in anxiety level on the posttest.
Ashton and colleagues (1997) hypothesized that self-hypnosis relaxation techniques would have a positive effect on individuals1 mental and physical condition following coronary artery bypass surgery. The researchers used a prospective, randomized trial (n = 32) and followed participants from 1 day prior to surgery until the time of discharge. The treatment group was taught self-hypnosis relaxation techniques preoperatively, whereas the control group received the usual care. Individuals who were taught self-hypnosis were significantly more relaxed postoperatively compared to the control group. Pain medication requirements were also significantly lower for the treatment group.
Simington and Laing (1993) studied the effect of therapeutic touch versus a backrub on anxiety level in 105 institutionalized elderly. A double-blind, three-group experimental design was used. State anxiety was measured using the Spielbcrger State-Trait Anxiety Inventory. The anxiety level of subjects who received therapeutic touch was significantly lower than for those who received a back rub without therapeutic touch. The researchers suggested that therapeutic touch has some potential for enhancing the quality of life for this population.
Research news on anxiety :
- New Study Finds New Connection Between Yoga and Mood – Researchers from Boston University School of Medicine (BUSM) have found that yoga may be superior to other forms of exercise in its positive effect on mood and anxiety. The findings, which currently appear on-line at Journal of Alternative and Complementary Medicine, is the first to demonstrate an association between yoga postures, increased GABA levels and decreased anxiety.