Feeling anxious in troubled financial times

ASK THE EXPERT

Ask The Expert Jack Vaeth Sheppard Pratt Health System

October 27, 2008|By Holly Selby | Holly Selby,Special to The Baltimore Sun

With all the news about the economic crisis, is it any wonder that some of us feel stressed out about our financial futures? Although experiencing some stress may be a reasonable reaction to the global financial situation, feeling deeply anxious during tough economic times doesn't have to be inevitable, says Jack Vaeth, staff psychiatrist at Sheppard Pratt Health System, who also is in private practice in Hunt Valley and Annapolis.

Given the reports about the economy these days, is feeling more anxious than usual about our financial futures unavoidable?

Not necessarily. But there are individuals who already tend to be more anxious than the rest of us; they have quiescent anxiety disorders, or anxiety disorders in remission, and may be prone to relapse or resurfacing. However, if you consider yourself mentally healthy - not prone to depression, pessimism, sadness and gloom - you might suffer a little or not at all. Some individuals might be diagnosed with an "adjustment disorder" rather than major depression or an anxiety disorder. Adjustment disorders are "maladjustments to stress." As a physician, I am cautious not to overtreat or medicate unnecessarily.

What is an adjustment disorder?

Essentially, with an adjustment disorder, your maladjustment to stress results in a lesser degree of depression and/or anxiety than the full-blown syndromes. There are times in our lives that we are prone to adjustment disorders if we don't adjust with normative grief, like the death of a loved one, or even a pet, or being jilted by a lover, or divorce. In time, we usually recover on our own, and this is a part of nature, of life.

How do you know the difference between an adjustment disorder and stress that might be part of clinical depression?

If, over a matter of weeks or months, you are feeling worse than you did when the bad news was broken to you, then that is when you want to look into it further. It may be a diagnosable disorder that requires treatment.

And there is a fine line. Your loved one dies, you cry, you are depressed. I may see you a few months later, and you may still be sad, but you aren't dysfunctional, you are getting better. But if you can't go to work or school or if it is affecting marital relations, that is a problem.

Could you elaborate on the symptoms of clinical depression?

You might have greatly increased or decreased sleep such as sleeping 14 hours or four hours. Your appetite might go way up (usually people eat carbohydrates) or down (you have no zest for food). Your general interest in things you used to enjoy drops.

That is called anhedonia: a loss of interest in things that used to be pleasant and this includes sexuality. You also might start feeling helpless and hopeless and persistently sad ... around the clock and it goes on for two or more weeks.

When should you seek an expert's advice?

There are a lot of ways to answer that. You might ask a friend or loved one. I get a lot of referrals who say, "I'm not here because of me, I'm here because my wife [or friend] sent me."

If you have a lot of those symptoms ... then you should seek help. If there is a doubt, get a quick assessment from a mental health professional. And if ever you have suicidal or homicidal thoughts, then go straight to the emergency room or a crisis center.

Are there any steps that can be taken to avoid anxiety that stems from the current economic situation?

Disconnect yourself from negative sources like TV - TV and radio are significant stressors. Turn to a music station. Read something other than a newspaper. If you like TV and you are watching cable news, then maybe you need to move on to a comedy.

Do things you have always wanted to do, but have had on a back burner: Lose weight, exercise daily. Stay busy, because if you stay busy chances are you won't need medication.

Does news of the economy make you feel anxious?

I am not anxious about it because what can I do about it? I am not in control of the economic situation, other than deciding who I want to vote in or out of office. Don't worry or fret over things that are out of your control.

Is there anything else you'd like to add?

The media really have a role in influencing what society hears and consequently what it thinks. And there is a need to balance positive stories with negative. To the media's credit, I did hear [the reports last week] that the stock market was at a record high. [But] in 1999, I didn't get any calls from the media saying, "Hey, the economy is going really well, how is this going to affect us?" And this is the second story about stress this week I've been called about.

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