High Anxieties: The Social Construction of Anxiety Disorders

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Dowbiggin (2009) essays a comprehensive review of anxiety disorders, employing as his springboard the many sub-types listed by the Diagnostic and Statistical Manual of Mental Disorders (third edition or DSM-III) and observations that anxiety is the most prevalent mental health concern, not only in North America but worldwide as well.

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The review in the Canadian Journal of Psychiatry is strewn with numerous facts and insights. For the sake of brevity, this synopsis covers just: a) the six anxiety sub-types; b) the claimed antecedents behind an “alarming” increase in anxiety; and, c) the role of the pharmaceutical industry in forming attitudes around this group of mental illnesses.

The author refers to such sub-types as: body dysmorphic disorder, generalized anxiety disorder, obsessive-compulsive disorder (OCD), panic disorder, posttraumatic stress disorder (PTSD), and social anxiety disorder or SAD (Dowbiggin, 2009). The first insight this span of mental “illnesses” elicits is that the typologies vary in validity. After all, these were created by the very same DSM III that is not much more than a dictionary for the psychiatric specialty and which fairly recently decided to legitimize homosexuality, contrary to the beliefs of the majority of the population.

The rationale for a mixed view on validity is that certain anxiety syndromes are truly crippling while others seem made up to bring pronounced affect under the wing of psychotherapy. Certainly, one can appreciate how OCD can prevent an adult from being fully effective as both worker and empathic parent. PTSD as a result of domestic violence and sexual assault in childhood definitely needs resolving with professional help else the prospect of lingering defense mechanisms and other maladjustment can persist well into adulthood. On the other hand, one ponders the wisdom of hanging the “mental illness” label on GAD or SAD (whether of the social anxiety or seasonal affective type). For it seems too facile to categorize the physiological manifestations of stress as problems requiring intervention. The world is not perfect and humans probably do not require counseling or psychotherapeutic drugs to cope with learning experiences that they hurdle with ease soon enough. Hence, the “finding” of wide prevalence as the century progressed may well be a creation of the profession.

This is why the second point a readers “takes away” from reading the subject article is that pharmacological breakthroughs like Upjohn’s Xanax had more to do with recognition of new classes of anxiety disorders. The ethics are questionable. And the sorry consequence is that too many adults use mood-altering drugs for every little discomfort, a vicious cycle that can only end in addiction.

The third learning concerns prevalence by patient characteristics. There is reason to believe, for example, that both OCD and SAD afflict men and women equally. However, females seem more vulnerable to generalized anxiety disorder, panic attacks, PTSD, and certain phobias.

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As with previous submissions, one concludes that RN’s would do well to apply Dowbiggin’s synthesis and insights in many aspects of day-to-practice. Psychiatric nurses and those rotating through the Neuro-Psychiatric service naturally have the most to gain, fortified as they are with the contexts, prevalence, and analysis of patient characteristics. Others serving on critical-care and surgical services are constantly reminded of the miasma of anxiety that adds to patient vulnerability during pre-operation and recovery. As the huge “Baby Boomer” generation falls prey to degenerative diseases in advanced middle age, RN’s must counsel patients who are conflicted about end-stage renal disease, for instance, while wanting to luxuriate in food and drink as usual. Worst of all are the wards where end-of-life crises erupt from shift to shift and anxiety is all-pervasive.

In other areas of practice, Dowbiggin certainly adds to RN expertise and knowledgebase when screening the mental health condition of incoming patients, whether for somatic complaints or suspected of substance abuse.

References

Dowbiggin, I. R. (2009). High anxieties: The social construction of anxiety disorders. Can J Psychiatry, 54(7): 429-36.

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PsychologyWriting. (2022, February 16). High Anxieties: The Social Construction of Anxiety Disorders. Retrieved from https://psychologywriting.com/high-anxieties-the-social-construction-of-anxiety-disorders/

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PsychologyWriting. (2022, February 16). High Anxieties: The Social Construction of Anxiety Disorders. https://psychologywriting.com/high-anxieties-the-social-construction-of-anxiety-disorders/

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"High Anxieties: The Social Construction of Anxiety Disorders." PsychologyWriting, 16 Feb. 2022, psychologywriting.com/high-anxieties-the-social-construction-of-anxiety-disorders/.

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PsychologyWriting. (2022) 'High Anxieties: The Social Construction of Anxiety Disorders'. 16 February.

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PsychologyWriting. 2022. "High Anxieties: The Social Construction of Anxiety Disorders." February 16, 2022. https://psychologywriting.com/high-anxieties-the-social-construction-of-anxiety-disorders/.

1. PsychologyWriting. "High Anxieties: The Social Construction of Anxiety Disorders." February 16, 2022. https://psychologywriting.com/high-anxieties-the-social-construction-of-anxiety-disorders/.


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PsychologyWriting. "High Anxieties: The Social Construction of Anxiety Disorders." February 16, 2022. https://psychologywriting.com/high-anxieties-the-social-construction-of-anxiety-disorders/.