FAQs

I have this 30 year old male friend who seems very shy around people he does not know well.  I only got to know him a year or so ago when we met in our apartment building.  After bumping into him several times at the mail boxes, I invited him to come by my place for coffee.  He did, but he seemed to have trouble making eye contact.  After we shared several coffees and drinks he seemed less shy.  He even invited me to go to lunch with him at a small cafe nearby.  At the cafe he was once again very shy with me and I could smell alcohol on his breath.  His shyness and mid-day drinking concerned me.  I really like this guy and would like to spend more time with him.  What do you think is the problem?

Sincerely,

Mary

Dear Mary:

Without spending some time with your friend I can't say for sure what his problem is, but from your description I would bet he has Social Anxiety Disorder.  Social anxiety is characterized by extreme shyness.  It is also not uncommon for people with Social Anxiety to use alcohol to bolster their courage when they are in situations of meeting new people.

There are two forms of Social Anxiety:  fear of specific situations or activities such as giving a talk to a group of people, and generalized Social Anxiety.  People with the generalized form have difficulty with almost all social activities, except for when they are with people they know well and whom they trust.

Most people with Social Anxiety have a dread fear they will say or do something “stupid.”  As a result they often avoid social activities.  It should come as no surprise that many people with Social Anxiety drop out of school if they think they will have to interact with others.  They are also often unemployed or underemployed, preferring jobs that keep them away from others.

You may wish to discuss this with him (in a gentle and caring way) and suggest that he contact British Columbia Anxiety Disorders Association.  You can get more information about Social Anxiety here.

Thank you for your letter.

Doctor

I can not find a resource page I used regularly?

When in the process of updating content on our web site some document titles were changed. If you were used to using the documents in the resources section that listed the materials in one location you will now find the resources you are looking for in the menus of the Self-Help: Children (previously called Parents), Adult, Youth, Parent (previously called New Moms), and CBT (now under treatment).

The fasted way to find the document you are looking for is to use the search tool, in the top most menu bar.

What has happened to the pdfs you had which were easy to manage?

We used to have a page of PDF documents in the Resources section of our old web site. When we updated the information on many of our web pages some of those documents became out of date. To spare the expense we chose not to up date them. All of the pages on the present web site are printable, just look to the upper right hand corner of the web page you will find a print icon. Clicking on the icon eliminates the graphic elements.

How can I print documents?

On every page look to the uper right corner there is print icon. Click on it and the page will be reformated into a printable document.

What are your referencing and copyright requirements?

The conditions for using our material is as follows:

1. It is not to be used for monetary gain

2. The material is not to be modified in any way that would change the meaning or intent of the information

3. AnxietyBC is given credit for the material being used.

Help! Your web site has changed and  there are so many new things, what can I do?

Fortunately the search tool on our web site is really good, so to find what you are looking for faster.

Change is difficult and frustrating. We at AnxietyBC thought long and hard about changing our web site, especially the menu system. We knew that it would be challenging for those who use our web site regularly.

We needed to respond to the needs of the users who are using mobile devices to connect with our resources. To do that the old menu system had to go, so in with the new.

We have confounded the situation by adding new information and changing the titles of the main sections: Children is the new Parents section, Parents is the new New and Expectant Moms (perinatal) section. These changes were made to further ease future growth (adding a new Dads resource).

This is a short article that was originally printed in an issue of Strides after Christmas in 2004. The information and advice is good all year round though. There really is no time like the holiday season to cause a rise in anxiety. With all the expectations that come with it, it is no wonder our anxiety goes up. Just keep in mind what you can afford, and don't feel obligated to over spend.

After the Christmas season, many of us are left feeling anxious about bills and debts. If you feel overwhelmed and have the urge to stick your head in the sand or do nothing, consider yourself human! Unfortunately, the longer we avoid things the worse the problem can get and the higher our anxiety will rise. If you are anxious about your debts we recommend you take a problem solving approach - anxiety tends to go down rapidly if we gradually face the things we fear.

Breaking down the tasks into a series of steps make things more manageable. Start by writing out a list of all the various debts and bills. At this point one might feel overwhelmed and anxious. Keep going, as this is normal. Remind yourself that you are making progress by facing the problem. Next, rank each debt in the list according to urgency-your top priorities will be the debts that may result in loss of service or those with high rates of interest. Great, you have solved 50% of your task now.

Pick up the phone and start making calls to the companies or people you owe money to. Enquire about options that will make it easier for you to clear your debts. You will be amazed at how often they will agree to lower your monthly payments, or take post-dated cheques that permit you to spread out your payments over time. You will be overcome with a sense of accomplishment and satisfaction. The pressure that you felt earlier will now seem to recede. Your finances are more manageable and you are in control. If you need more detailed information about managing your money check out your local library or bookstore for a good self-help book

Dear Doctor,

 I am a Canadian soldier who recently returned from almost two years in Afghanistan.  Several members of my platoon have been diagnosed with Post-traumatic Stress Disorder (PTSD.  I think I have a fairly good understanding of what PTSD is.  Both of my buddies who have PTSD have horrible dreams, can't get the fighting off of their minds, and are very irritable.  My question is why don't I have these problems?  I experienced the same horrors that they did.  I do have moments when I think about my experiences in Afghanistan, but I don't get too upset by these memories.  Is there something wrong with me?

 Sincerely,

 A Proud Vet

Dear Proud Vet,

Thank you for your question and service to our country.  No there is absolutely nothing wrong with you.  Recent research by neurobiologists and psychologists has shown that humans are very resilient to the horrors we sometimes experience.  When we are faced with danger our bodies react in ways that prepare us to face the danger by either fighting or fleeing the situation.  When the danger is prolonged and/ or intense as in combat, some people are unable to recover from these bodily and psychological events, but most do.  The reason why some people develop serious problems such as PTSD and others don't is not totally clear, but genetics and previous life experiences seem to play important roles.  For example, people who have suffered previous psychological problems are more vulnerable to developing PTSD following horrific events than are those who did not have prior psychological problems.  I would suggest that you read Richard McNally's article in a previous edition of Strides.  It provides an excellent overview of PTSD.

Sincerely,

The Doctor

Dear Doctor, I have Panic Disorder and I have two young children. I'm worried that they might also develop this disorder at some point in their lives. Is there anything I can do to prevent this from happening? Concerned Mother

Dear Concerned Mother,

Your question is very timely: The article by Dr. Watt and Ms DiFrancescant in this issue of Strides discusses a number of factors that can increase a child's vulnerability to developing an anxiety disorder.

There is good news for people such as yourself. There are several groups of researchers around the world who are attempting to determine which children are at greatest risk for developing Panic Disorder and other disorders. They are also attempting to devise effective tools for preventing the disorders from occurring. Two main groups, one in Australia and one in Canada, have found that parents' and teachers' reports of children's responses to stressful events are very helpful in identifying children who are at risk. Children who get easily upset, resist engaging in social or school activities, and who report a lot of bodily concerns (e.g., upset stomachs) during or prior to activities they perceive as stressful are possible indicators they might develop an anxiety disorder. There is also evidence that children of anxious parents are also more likely to develop anxiety related problems. These groups of researchers have also shown that early intervention can reduce or prevent the development of anxiety disorders. The procedures they use are very similar to those of Cognitive Behaviour Therapy. Children are taught, often with the help of parents or other aides, to make more realistic evaluations of the way they think about activities they see as threatening (e.g., going to a new school or joining a new play group), engaging in feared behaviours in progressive manner, such as going to the play group with the parent for the first few times. The amount of time in this activity might also increase. While the child is doing this, he/she might be asked to tell the parent/aide what they are thinking and feeling. If they are experiencing undue fear or anxiety, the parent/aide can help the child have more realistic thoughts/feelings. This is done in a positive manner. Once the child shows positive changes, these are verbally reinforced and bragged about to others, such as grandparents. There is very good evidence these techniques work for many at risk children.

Dear Doctor: 

I have read many of the articles in Strides about anxiety disorders.  What I don't understand is the difference between being anxious and having an anxiety disorder.  Don't most people have anxiety?  Isn't that normal?

Answer:

Thank you for your excellent question.  You are correct in stating that most of us experience anxiety some or much of the time, and yes, that is very normal.  We experience anxiety during a variety of situations when we are uncertain about things.  For example, it would be perfectly normal for a person to be anxious when interviewing for a new job, dating a person for the first time, or wondering how to find money to pay for your son's visit to the dentist.  It is also normal to experience anxiety when feeling threatened.  It would be perfectly normal for a person walking along a dark street to be fearful if he/she felt someone was following.  Fear and anxiety are very similar states.  The difference between these normal anxieties or fears and having an anxiety disorder is in how exaggerated the feeling of anxiety/fear is to the actual threat being experienced.  Another difference is how persistence the feelings of anxiety or fear are.  For normal states of anxiety, the anxious feelings usually disappear once the threat is gone.  People who have anxiety disorders often exaggerate the persistence of threats.  For example, some people with Obsessive Compulsive disorder feel threatened when they have to touch things because they have an exaggerated belief that very nasty germs are on things like door knobs and touching the door knob might infect them with a horrible disease.  Similarly, people with Social Phobias might exaggerate how negatively other people will perceive them to be.  Dr. David Barlow, in his excellent book, Anxiety and its Disorders, talks about "alarms," which are perfectly normal responses to uncertainty and threat and "false alarms," where the emotional response (anxiety or fear) is out of proportion to the actual level of threat.  I hope this helps clarify the differences between anxiety and anxiety disorders.

Dear Doctor, I have an aunt on my mother's side who is very strange.  She cannot throw out anything.  She keeps all her newspapers, magazines, cardboard boxes, and even plastic wrappings from item she buys.  She puts these in bundles all over her apartment.  Two weeks ago when I was visiting her, she spent all the time I was there checking these bundles and moving them around.  Her apartment, in addition to being very crowded,  is also very dirty.  She spends so much time with the things she collects that she doesn't have time to clean her place.  Can you tell me what is wrong with her?  

Answer:  Without a complete assessment I cannot be perfectly sure, but from what you described I would speculate that she has a form of Obsessive-Compulsive Disorder (OCD).  When we usually think of OCD, we think about people who fear being contaminated by things like germs.  Often these people engage in elaborate cleaning rituals to get rid of their feared contamination. But there are other forms of OCD.  One form is referred to as hoarding.  People who hoard things, possibly like your aunt, become very uncomfortable getting rid of things.  For some hoarders it is only specific things, such as bottles, that they hoard.  Others hoard many things.  OCD is usually composed of two elements: obsessions (thoughts) and compulsions (ritualistic activities).  Many hoarders have thoughts (obsessions) that if they throw out something something bad will happen.  They often justify these thoughts by saying, "Well you never know when you will need a box."  The ritual for many hoarders is the act of checking to see that the items they hoard are intact.  They may also spend a lot of time ordering their "collection" in piles.

These types of problems often can be treated using appropriate medications and/or cognitive behaviour therapy which let the person lead a more normal life. The trick is getting treatment for them.  Many are reluctant to see that they have a problem and may refuse treatment even when it is available.  I hope this helps answer your question.

Dear Doctor, My nine year old son's teacher has suggested to me that he might have problems with hyperactivity, and thinks I should have him tested.  In school and at home he has difficulty sitting and paying attention.  He can also be loud and aggressive.  Could he have problems with anxiety rather than hyperactivity?

Answer.  Dear parent, it is very unlikely your son has an anxiety problem rather than a problem with hyperactivity.  Anxious children usually are very quiet and do not wish to draw attention to themselves.  Usually an anxious child will only act out when faced with a situation provoking his/her anxiety.  For example, a child who becomes very fearful when separated from his/her parents may act out when he/she believes separation, such as being sent off to school, will occur.  Many children with hyperactivity problems do get anxious when being chastised for their hyperactive behaviours, but this is very normal.  We all get anxious when we fear we will be punished.