BY JENNIFER WOODWORTH PSY.D In military families, service members are involved in situations on a daily basis where significant physical, emotional and psychological injuries are possible. But once daily functioning becomes impacted due to the distressing thoughts or feelings, it may be time to seek assistance.
According to the National Institute of Mental Health (NIMH), anxiety disorders impact approximately 18 percent of the United States adult population in any given year (40 million people). Compared to men, women are twice as likely to suffer from an anxiety disorder. Anxiety disorders typically begin in childhood through middle adulthood and have been attributed partially to biological factors, family history and life experiences. What does it mean to have anxiety? Mild or moderate anxiety can self-motivate or encourage positive behavior and lead to successful projects and events. Many people experience anxiety based on situational or specific experiences; for example, the fear of speaking in public or test anxiety. This nervousness
can usually be overcome by talking yourself through the situation, taking deep breaths or being appropriately prepared. For the most part, these fears or worries do not impede everyday functioning or the ability to complete daily tasks. However, anxiety becomes a disorder once it begins to interrupt and inhibit functioning at an expected and appropriate level.
Anxiety disorders include two main features: excessive fear, which is the response to real or perceived imminent threat; and anxiety, which is defined as the anticipation of future threat. An anxiety disorder is diagnosable once symptoms have been experienced for six months or more, however recognizing symptoms and getting treatment early contributes to the management of the symptoms and the least amount of interruption in functioning. In military families, service members are involved in situations on a daily basis where significant physical, emotional and psychological injuries are possible. This can lead to feelings of worry and fear about the safety of self or family. It is important to remember that anxiety can be beneficial in creating boundaries, protection and support in times of higher stress, however once daily functioning becomes impacted due to the distressing thoughts or feelings, it may be time to seek assistance.
Listed below are risk factors that may contribute to feelings of anxiety or fear, symptoms to be aware of, and resources for assessment or assistance.
RISK FACTORS THAT MAY CONTRIBUTE TO SYMPTOMS OF ANXIETY IN THE SERVICE MEMBER OR THEIR SPOUSE:
• Upcoming deployment, separation or homecoming
• Health issues (physical, emotional, or mental) for themselves or a family member
• Family history of anxiety disorders or other mood disorders
• Financial hardship
• Retirement from active duty
• Changes in roles at home
• Moving to a new duty station
• Changes in the family structure (divorce, re-marriage, new baby)
• Death of a family member or friend
• Trauma (car accident, witness to violence)
• Abuse (physical, emotional, sexual)
• Substance or alcohol use
ADDITIONAL RISK FACTORS FOR CHILDREN:
• Being a victim of bullying at school or in the neighborhood
• Struggling in academics
• Hormones/puberty
• Friends moving, feeling “left behind”
• Changing schools (either due to moving or transition to middle or high school)
GENERALIZED ANXIETY DISORDER (GAD)
GAD is experienced by approximately 3.1 percent of the population annually and may include the following physical and emotional symptoms being experienced for at least six months:
• Excessive worry and anxiety about a number of events or activities and difficulty controlling this worry
• Feeling something bad is going to happen
• Feeling restless or on edge
• Being easily fatigued or feeling tired
• Impaired concentration, feelings of confusion or indecisiveness
• Irritability
• Muscle tension. Look for increase in trembling, twitching, feeling shaky or
muscle aches or soreness .
• Somatic symptoms including sweating, cold hands, nausea or diarrhea. Also tightness in the chest or feeling breathless or light headed could be experienced.
• Sleep disturbances including difficulty falling asleep, staying asleep or unsatisfying sleep.
Other anxiety disorders include additional and more specific criteria:
Social Anxiety Disorder includes symptoms of a marked fear about one or more social situations that may include negative evaluation by others, and social situations are avoided or endured with intense anxiety. This impacts relationships with others and can lead to isolation
from community supports which can be particularly important for military families moving to new places. Social anxiety may be managed through a variety of interventions.
Separation Anxiety might be thought of as a disorder of childhood; however this is not necessarily the case. Symptoms include excessive fear inappropriate to age regarding separation from attached relationships. This includes excessive distress occurring when thinking about separation from the relationship, worrying about losing the relationship, or the possibility of harm occurring to the attachment figure when separated. In relationships including active duty military, it is understandable how these fears and worries may be founded in the reality of the
separation; especially when the active duty service member is deployed to an active war zone or hazardous environment.
However when the anxiety inhibits daily functioning (grocery shopping, sleep interference, physical symptoms) the entire family system becomes impacted. In children and adolescents, you may see clinging to a parent’s leg when separation is expected, complaints of stomach or headaches or constant checking in with a parent (texting).
IMPACT ON THE FAMILY
It is important to note that a family does not have to be experiencing a deployment to be experiencing increased anxiety or other mental health complications. As mentioned above, there are many variables that can contribute to an increase in anxiety. Daily responsibilities within the home can be similarly stressful at any point in the deployment cycle— pre-deployment, during deployment, or post-deployment.
When a member of the family is experiencing anxiety at a level where their functioning is impaired, typically those close to the person notice a change in mood and/or behavior. A spouse may decrease communication with their partner, notice the negative more than positive, or begin many tasks without completing them. This can cause tension between partners; and may lead to feelings of anger, agitation, fear and increased anxiety. Excessive anxiety also impacts the ability to parent effectively in a variety of ways including over-reacting to small incidents, becoming fatigued easily and also being unable to focus in the present moment. Children look to their parents/caregivers for appropriate reaction to situations and therefore can become increasingly agitated or reactive to a parent’s anxiety.
WHAT YOU CAN DO
If you recognize these symptoms in yourself, your spouse or your child, here are some suggestions:
• Open a discussion with your spouse or child about changes you have noticed and express your concern. Ask if your spouse or child has noticed these changes and what may be contributing
to them.
• Contact a primary care physician or insurance for a referral to mental health professionals who specializes in anxiety and understanding of the current military lifestyle.
• Explore multiple treatment interventions, including a physical health screening, individual or group psychotherapy and/or medication assessments.
• Contact and reach out to supports or programs including schools, religious communities, military programs, family, financial resources and/or assistance with food and housing options.
• Continue to provide support to your spouse or child by listening to their concerns and following up with mental health appointments. Intervention programs available for military families include education and skill development for handling situations unique to military life.•
ABOUT THE AUTHOR:
Jennifer Woodworth graduated from The Chicago School of Professional Psychology – Irvine Campus – in August 2013 with a doctorate in Applied Clinical Psychology. She is a licensed clinical psychologist and will be in private practice in Vista, CA. She has worked in the mental health field for six years, and is a Marine Corps wife of 12 years and mother to three children ages five, seven, and nine.
