Question:
Hospital anxiety/depression scale leading to other problems?
Answer:
There has been work done showing that anxiety and depression, if
untreated, can lead to more serious problems like heart disease and
diabetes. It's research conducted mainly by a guy at the NIH in Maryland,
though others have done similar research. I'm trying to get in touch with
him personally so I can find some of his work on the topic. I say this
not to scare those of us with with these problems (I have both depression
and anxiety, and both are pretty serious), but to encourage people to make
sure they get treated. Make sure you find a form of treatment that will
treat effectively these problems. This ties into the anti-benzo rhetoric
on the list. For many of us our anxiety is treatable only with benzos.
So taking benzos for some may well be important not only for quality of
life, but for avoiding more serious life-threating problems down the road. My mom was chronically depressed from about her mid-40s on. She *never*
ever would have considered getting help for this (or even admitting that
she *was* depressed, even though it was obvious to those around her). When
-- with no known risk factors, either hereditary or environmental -- she
developed kidney cancer that quickly metastasized and killed her in 1998,
at age 76, I felt sure that her long years of being depressed had
something to do with it. Like -- maybe depression compromised her immune
system and made her more susceptible to cellular abnormalities.
That sad experience made me more than ever determined to keep battling The
Monster (in my case, anxiety, panic, phobias, and depression), no matter
how hard it seems at times. And it also made me realize I should never
"tough it out" without therapy and/or meds; there is a Puritanical streak
in my family a mile wide, and I've had to work hard to overcome that and
stop blaming myself, and seek help without shame.
Other problems anxiety can lead to are depression, marital
discord and divorce, alcoholism and substance abuse, and social
isolization and occupational disability. All the more reason to treat ADs a soon as possible with
modalities that work (e.g. meds and CBT) and avoid the rest. I'd like to see some data on this if you can get it. My shrink says he has
never seen data where anxiety leads to physical diseases. It certainly needs
to be treated for other reasons, like peace of mind. OTOH, Dr. Shipko has been known to say that ER physicians have a saying that
people who show up there with false symptoms too many times will eventually
show up there with a real problem.
I can certainly see how depression, if untreated, can lead to disastrous
consequences, including death.
nor have I in 25 years of clinical practice or the 16 associates of mine in
theirs -there are corelations between chronic stress and various health issues
as well as classic type A personalities and health issues but in the long run
our lifestyles in general cause more harm then the sensitivities of our nervous
system does- In other words if I drop dead its' from smoking not from panic
LM
PURPOSE: Previous studies of the association between hypertension and
panic disorder were uncontrolled or involved small numbers of patients.
PATIENTS AND METHODS: We compared the prevalence of panic disorder and
panic attacks in 351 patients with documented hypertension who were
randomly selected from all hypertensive patients registered in one
primary care practice with age- and gender-matched normotensive
patients from the same practice and with hypertensive patients
attending a hospital clinic. All three groups completed questionnaires
for panic disorder based on standard criteria, as well as the Hospital
Anxiety and Depression scale.
RESULTS: The prevalence of current (previous 6 months) panic attacks
was significantly greater in primary care patients with hypertension
(17%, P <0.05) and hospital-based hypertensive patients (19%, P <0.01)
than in normotensive patients (11%). Similar results were seen for
lifetime panic attacks (35% versus 39% versus 22%; both P for
comparisons with normotensive patients <0.001).
The prevalence of panic disorder was significantly greater in primary
care patients with hypertension (13%) than normotensive patients (8%, P
<0.05). Anxiety scores were significantly higher in both hypertensive
groups than in normotensive patients.
Depression scores were significantly higher in hospital-based
hypertensive patients than in the other two groups.
The reported diagnosis of hypertension antedated the onset of panic
attacks in a large majority of patients (P <0.01).
CONCLUSIONS: Physicians caring for patients with hypertension should be
aware of the significantly greater prevalence of panic attacks in these
patients.
