COLUMBIA — She was breathing and uninjured, but sure she was going to die.
Kristin Rohlwing, 18 at the time, called 911 and ran toward the ambulance waving her arms as it drove up to her home. She got in the back and was quickly sedated. When she woke up, she learned she'd had her first panic attack. Her second would occur about a year later.
Several health centers in Columbia treat people for anxiety:
- Burrell Behavioral Health
3401 Berrywood Drive, Suite 300
- McCambridge Center
201 N. Garth
- Missouri Psychiatric Center
3 Hospital Drive
- MU Counseling Center
119 Parker Hall
- National Alliance on Mental Illness
515 Cherry St., Suite 300
(does not treat or diagnose anxiety disorders, but advocates support)
- New Horizons Community Support Services
1408 Hathman Place
(treats anxiety with other mental illnesses such as post-traumatic stress disorder or panic disorders, does not diagnose)
Rohlwing, now 20, was diagnosed with anxiety and depression in August and was prescribed antidepressants soon after.
Anxiety is defined as excessive fear or worry in situations that wouldn't cause most people to have those feelings. It can get worse if untreated and can become a disorder when it lasts a minimum of six months, according to the National Institute of Mental Health.
From 2008 to 2012, the number of people in Boone County seeking treatment for anxiety increased almost 160 percent, Debra Walker of the Department of Mental Health said via email. Over the span of the same four years, the number of people seeking treatment for anxiety rose an average of 162 percent statewide.
Anxiety has been increasing nationwide for a variety of reasons; some cite stress at work, relationships, or money as causes. For many of the students licensed clinical social worker Mary Beth Schillinger sees at the MU Student Health Center, schoolwork or academic performance is a major source of anxiety.
According to the National Institute of Mental Health, about three-fourths of people diagnosed with anxiety disorders have their first episode by the time they're 22.
Rohlwing said it wasn't always a problem for her.
"I don't think I grew up an anxious kid," she said. "It was brought on by social issues — I was seeking my peers' approval."
It began her freshman year in high school after a difficult transition from middle school. She felt isolated — the subject of gossip. Although she made new friends after losing her old ones, she never quite recovered from the feeling that people were talking about her.
Older and more anxious
According to the Department of Mental Health, anxiety tends to increase over one's lifespan. In the U.S., about 20 percent of people have a type of anxiety at any given time, according to the National Alliance on Mental Illness.
Mary Kelley, Boone County coordinator for the National Alliance on Mental Illness, said that work, family, money or relationship issues — all of which can contribute to a stressful environment — can increase anxiety.
Biology may also play a role in anxiety, according to the National Alliance on Mental Illness. Some anxiety disorders like obsessive compulsive disorder have a clear genetic link, but anxiety is not necessarily hereditary.
Schillinger said that anxiety diagnoses may be increasing because the symptoms are easier to recognize now, and people talk about mental illness more freely and are more willing to seek help.
She said it's hard to list specific causes for anxiety because they're different for every person. Social anxiety is caused by personal interactions, but specific phobias can be caused by a number of things, like tight spaces or germs.
Demographic of the diagnosed
According to the Department of Mental Health, 14 percent of people under 18, 20 percent of people between the ages of 18-24, and 20 percent of people 25 and older suffer from an anxiety disorder.
Christy Hutton, outreach coordinator for the MU Counseling Center and a psychologist, said that anxiety is more common in females than males. Anxiety can affect people as early as childhood and last through adulthood.
Disorders may last for several months or several years, depending on the severity of the case and the treatments used, Hutton said.
Kelley said that one in four people is affected by some kind of mental health issue and that anxiety is commonly diagnosed along with other illnesses or disorders such as schizophrenia or attention deficit hyperactivity disorder.
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Graphics by Heather Adams/Missourian
Anxiety is caused by a number of things, including traumatic experiences, social interactions or even stress. These traits characterize some of the most common anxiety disorders, according to the National Alliance on Mental Illness, including:
- Specific phobia — This type of anxiety is characterized by constant fear of particular objects or situations. Hutton said that some specific examples are fear of heights or spiders. The fears can be so severe that they inhibit normal functioning, she said, but that's rare.
- Generalized anxiety disorder — People with generalized anxiety disorder are typically characterized by excessive worry about everyday problems, and that it is common on a college campus, Hutton said.
- Post-traumatic stress disorder — Typically people who have experienced traumatic events develop this disorder and often have flashbacks, nightmares or intrusive memories. According to the Anxiety and Depression Association of America, about two-thirds of people exposed to mass violence develop the disorder.
- Obsessive compulsive disorder — People diagnosed with this disorder often have repeated thoughts, such as fear of germs, dirt or intruders, according to the National Institute of Mental Health. Some people with this disorder have specific compulsions they must do several times each day to relieve their anxiety.
- Social anxiety disorder — People with social anxiety disorder typically have an extreme fear of being scrutinized in social situations and constantly seek other people's approval. Rohlwing, who was diagnosed about nine months ago, said that her anxiety started her freshman year of high school and that she had a constant fear of being talked about.
- Panic disorder — People diagnosed with panic disorder are often preoccupied with the fear of an attack. Hutton said that panic attacks can happen to anyone, regardless of whether they have an anxiety disorder.
Symptoms and treatments
Hutton said that anxiety disorders are diagnosed by assessing the symptoms a person is having, how severe those symptoms are and how they affect day-to-day functioning.
"Some of the symptoms are tightness in your chest, feeling sick at your stomach, racing thoughts, being unable to focus or being fearful," Kelley said. "If you're having an anxiety attack, it feels like you might be having a heart attack because you also have trouble breathing."
Other symptoms include muscle tension or headaches, but Hutton said that the most overarching symptom associated with anxiety is excessive worry.
"A lot of times it (anxiety) has to do with not being able to fall asleep, and then not being able to concentrate, and it kind of snowballs," Schillinger said.
Rohlwing said that when she went home for Thanksgiving in November, her anxiety spiked up to the point where she couldn't eat turkey or keep it down. She couldn't sleep because of the constant feeling of anxiety, she said.
"I know I'm getting anxiety when my chest contracts," Rohlwing said. "That's probably one of the first symptoms I recognize."
There are many ways people can begin to work through their anxiety, Hutton said. Counseling helps people understand it better, develop new skills and manage it on their own, she said. People may also choose medication or exercise, she said.
"It doesn't really matter whether people do counseling, medication or exercise," Hutton said. "But some kind of combination of two of those help people recover more effectively."
Yoga practice and meditation may help, too, Hutton said. She talks about the importance of breathing slowly and deeply. It's called conscious breathing, and it tells the brain you're safe, which lessens the feeling of anxiety.
"It calms the brain and slows it down a little bit," Hutton said.
Nine months after being officially diagnosed, Rohlwing said she now has some tools for dealing with her anxiety. She said her family and faith helped her. And although she is still on medication and goes to a counselor, she's hoping to be off medication by the summer.
"I'm a huge advocate for expressing your emotions," Rohlwing said. "Let yourself feel it — let the emotion run its course. If you start to recognize what you're feeling, you can start recognizing why you're feeling that way."
Supervising editor is Katherine Reed.