Marketing is hard. But I'll tell you a little secret. It doesn't have to be. Let me point something out. You're listening to a podcast right now, and it's great. You love the host. You seek it out and download it. You listen to it while driving, working out, cooking, even going to the bathroom. Podcasts are a pretty close companion. And this is a podcast ad. Did I get your attention? You can reach great listeners like yourself with podcast advertising from Lib Sin ads. Choose from hundreds of top podcasts offering host endorsements or run a pre-produced ad like this one across thousands of shows to reach your target audience in their favorite podcasts with Lib Sin ads. Go to LibSynads.com. That's L-I-B-S-Y-N. Ads.com today. Welcome to the psychiatrist's sweating room. A show where I interview my dad. A psychiatrist who's been in the business for 50 years. A true OG. All about mental illnesses. The aim? To explain the complexity of mental illness in as simple terms as possible. Welcome dad. Good morning, children. Today, we're talking about anxiety, focusing on what a generalized anxiety disorder is. One in five Australian adults, firstly, experience mental illness every year. 45% of Australian adults will be affected by mental illness at some time in their life. Anxiety, mood disorders such as depression and substance used disorders are the most common mental illnesses experienced by Australian adults. The main mental illness is anxiety. Firstly, 17% of the population. That's one in four people. 3.4 million Australians have anxiety. Now, what's the difference between anxiety and a generalized anxiety disorder? Let's begin with the flight fright episode. If you look at a movie, say about dinosaurs, Jurassic Park, you'll always see the same sort of creature attacking human beings. You'll see a big ugly dinosaur rushing into and screaming with its mouth wide open and frightening the people. This is what's used by lots of movies. So the basic thing that causes anxiety rapidly approaching objects, dark rooms, loud, awful sounds, strangers, or being isolated. In the movies, you have all of these in the jungles of the island of Jurassic Park. And this frightens the audience enormously who will get a sort of subjective fear. So is fear anxiety? Within fear, there is the anxiety symptoms. So that's the best way to explain it about where anxiety is in the general population. So those five particular things I just mentioned, if they're around one or two of them, you'll get a mild anxiety. If you get the five of them, you're going to extreme fear and anxiety. So in the general population, we'll all have episodes like this and know what anxiety is. So we will feel a stress, we'll feel a need to escape. And we'll find out our heart rate and our breathing's increased. And we want to varmous out of here. And all of us have experienced that in life. Yeah, natural five. But some people get the anxiety without the dinosaur, without the dark room or the loud sounds. It just gets triggered on its own over minor things. And so the person is being overwhelmed by minor things when the threat is very minor or not there. Well, they don't even have a threat. They just happen to have the episodes occurring. So they feel anxious. And so a lot of the public have this. We might call them nervous. But it gets to the point where this starts to interfere with your life. And you can't work properly. Your relationship's suffering. You're not able to parent well. And so on. And you become disorganized and disordered. And therefore you end up with an anxiety disorder, which means you're malfunctioning because of that condition. Why is it that a lot of humans now are getting anxious over things that they don't need to be anxious over? Well, for some reason, humans like watching bad news on television, good news TV failed. But bad news TV has been very successful. And it's just part of nature that we-- I think it all goes back to the fear of the unknown and what could possibly happen. So when we watch television, newspapers, we even talk with friends and so on about unlikely events causing a major problem. We are concerned about that. But we are inundated by it all the time. Now, you're saying it's environmental? Well, that's why the increase. Yeah. There's a base line of anxiety. But why is it increasing more in our current society? Society's becoming more complex. Even every day you've got to learn something new on the internet because you have to update your bank asks you to update things or your email address or whatever it is that you've got. And these are continually harassing you from day to day. OK. So society is really the pressures of society is creating a lot of anxiety. A lot of change is taking place continuously. How much of this is genetic? Well, we're talking about something different now. We were just talking about anxiety there. And when we're getting to genetics, we're talking about the disorder. So in the disorder, which is not a large percentage, maybe 10% or 15% of people, we don't really know, that are disordered by their anxiety. Runs in families. Actually, runs in families. So they tend to call that familial rather than hereditary because there's a mixture of modeling on the anxious parent or being influenced by the anxious parent or having the genetics of the anxious parent. And what is it about genetics that makes someone anxious? Is it a serotonin issue? Is it a kind of imaginance and neurological one? But is there, biologically, what is malfunctioning in your body to make you anxious? Well, yes. The idea is that serotonin, dopamine, or adrenaline, those particular chemicals are disordered. And it's primarily a dopamine and an adrenaline issue. It is. So then for the ones who have the disorder, where they become paralyzed and can't function normally in their day-to-day living, they take the medication, anxiety medication, to balance out the serotonin and dopamine. Is that correct? Well, it depends on the medication you're doing. Dealing with there's basically two medications, which is the anti-depressant SSR rise. And they work on those neurotransmitters that we just mentioned. There's also the benzoes, like Valium, and which work on a different network called GABA. And I think GABA, I mean, a butyric acid. And they work in a different system and they actually relax you in a different manner, including relaxing your muscles and your thoughts. Going back to the environment, because there's a lot of talk around trauma these days, dealing with trauma from youth, and just sort of making it one's way through the jungle without thinking that that was just a normal part of life. Later in life, they realise that trauma that they grew up in has created anxiety. Is that correct? Trauma. Yeah, I suppose so. If a child's being sexually abused or physically abused or verbally, and it's not aware that what's happening, that's how life is until they will have anxiety, but they will think that it's part of their existence until they leave home and find out that other people aren't like that. And then they notice that they are different, and then they start to recognise the symptoms, or somebody tells them about it or a therapist. And they become aware that if they're racing heart or did it go breathing or they're fear, the way they think or they avoid things is now part of condition rather than their world that they live in. There are some really good medications out there for anxiety. What are your thoughts on the natural therapies? Like, I have seen that they plan incredibly important part in reducing one's anxiety. That's things like meditation, yoga, cognitive behaviour, therapy, CBT. What's your view on these? Well, it depends what we're treating. And if you've got a very severe case of anxiety where the person's so disordered, they'll require medication. CBT therapy is extremely good. probably the main tool in most anxieties and anxiety disorders.
people learn how to stop their thinking processes, how to control their breathing, how to deal with their intruding thoughts by techniques that the psychologist has, is expert at. The other one is of course, is what is the cause of the anxiety and of course this is the most important thing that a doctor does or any therapist is looks at the underlying cause rather than just treating the symptoms. So there are anxieties as part of other mental illnesses such as obsessive-compulsive disorder, post-traumatic disorders, alcohol, drug addiction, etc. and there's even conditions like thyroid disease, etc. which mimic anxiety and are not actually anxiety but they're due to being hyperactive thyroid. So the doctor has to sort of get to the bottom of why they are the way they are and even with ADHD we'll know that people who are forgetful, disorganized, will develop self-esteem and become anxious. So you may have to treat the underlying disorder for all of those conditions mentioned and some of the ones I haven't mentioned. Would you say a large percentage of anxiety is an environmental response because it does sound like it? I think anxiety in general not the disorder is environmental and it depends on how you were brought up and how you educated and how you manage your life. And the other thing, then and if we eliminate those that there's a separate cause for anxiety like the conditions I mentioned recently, then we get just down to a plain generalized anxiety disorder. If we can isolate that, how much of that is genetic? Probably most of it, yeah. It's very hard to actually make that diagnosis because life is complex. People are getting, having difficulty in relationships and having difficulty and they get masks by drug taking or it's a very interesting topic anxiety because it's not as clear as some of the other psychiatric conditions. And it's quite broad. And there's many causes. One cause that's just chat about quickly actually is for me it was sugar. So I found that if I was in a stressful situation or high pressured and I was eating lollies or and then had to go and do something high pressured. For example, give a presentation or you know meet your boyfriend's parents for the first time. I couldn't have sugar beforehand because I would get this raging anxiety. And I noticed this when I was in about 20 and I thought I can't eat sugar and it was just a fleeting thought and I stopped it. Today I know that balancing your sugar levels out during the day is extremely helpful for anxiety. But it was funny because a few years ago an author and Australia came out with a book called I Quit Sugar and she claimed that not eating sugar eliminated her anxiety or diminished it substantially. And I remember you got quite worried about that because I remember saying you know now I'm going to have these patients cutting out sugar thinking it's the answer. But it was fleeting. It didn't really happen. I remember you being worried though. Why were you worried? Let me just go back to the original purpose that you also described having anticipatory anxiety and we haven't talked about that. Right. And you anticipated that if you took sugar you would be having anxiety episode but you're already anxious before you actually got anxious because you're anticipating it. And a lot of people have anticipatory anxiety and then get performance anxiety which we haven't talked about either. And they're separate things but they're probably understandable by most people who have issues with public speaking or having to be in the public eye. But getting back to do substances cause anxiety of course they do we know that with people who are on all the types of drugs, the illegal drugs and even some of the prescribed drugs. But if we get to a natural substance like sugar getting a sugar hit, well the trouble with sugar is basically in big doses. It becomes addictive so you get these highs and lows. So you get a rapid high and then you get a crash effect. So you may be getting anxious about the crash effect or you may be just getting anxious about the fact that you're behaving in a different way because of the high. And that's what I think it is. Whether it's biological or not is another matter. The reason I got concerned about it is I thought that it was one of those panaceas where patients would give up their medications, the psychology therapy and rush off and put themselves at risk by going on sugar free diets and things like that and going off to various health farms and fads and stopping everything altogether. Yeah. There has been a talk of people who have gone to those health farms completely stopped everything they know and they get a massive anxiety. But the awareness around that is really good now. What's the solution to anxiety dad? What is the solution? Is it a matter of having a very good medication plan, self awareness, going on programs? It does boil down to self awareness at the end of the day from what I see. But how do you see the future of anxiety and how to trade it? Well in my practice in recent years, particularly since the government started allowed psychologists to receive Medicare benefits. There's been a great shift. I've noticed in over the years a move that patients become aware that anxiety first stop of call is the psychologist and they tend to do the CBT and it seems to be probably the best start because when we're just talking about anxiety in general, people are learning to manage their life in the workplace and a relationship, parenting, that's probably the best first out of call other than the GP. But once that is not working or one has made a diagnosis of a disorder, they should be seeing a psychiatrist or even the GP to commence them on some sort of medication. And the first ones are the SSRIs like Zoloft or ProZank or Lixopro. And they're usually very effective. Sometimes we'll use the Benzo Dysapan, but the medical profession is very cognizant that it's very, it can be addictive and a try and use that for short period of time or not at all. Or leave it up to a specialist to manage those particular drugs. Now do you think anxiety is on the increase or do you think even if it is on the increase we're managing a better what's your final managing a better man. The people I see now who got anxiety would not have come to see me 30 years ago. Right. They have managed it. But what there is is there are services available now and people use them. If they use them they'll function better. They'll be more productive for society. Alright dad so on that note we will wrap it up. If you'd like a question answered about mental health please email me at
[email protected]. See you next time. Bye dad!
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