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5.22.04 Anxious about Anxiety

We've signed onto a new video project. The local Mental Health Association got a grant to do community outreach in the area of anxiety disorders in old people. They will be producing a variety of training materials, but have commissioned us to do a 15-minute video that will either accompany a training or be available as a standalone through workplace Employee Assistance Programs.

The idea is basically to tap middle-aged people on the shoulder and say, "Hey, is your mom (or dad) freaking out? If so, stop being annoyed with her for a minute and consider this. Maybe they have an Anxiety Disorder and, you know what? There's help for that."

Part of the deal is filming a few well-acted "vignettes" showing possible situations. The trick is to show people being anxious, not psychotic or senile or merely stressed out. But it's okay if they are somewhat depressed, because anxiety and depression often go hand-in-hand.

The problem is, by the time you are old, you've accumulated all kinds of baggage: lifelong personality traits, chronic illnesses, some short-term memory loss, long-standing relationship issues, a pile of regrets, multiple medications, sore feet, and too much wisdom about what a screwed up place the world is. And if you're lucky enough to be long-lived, all your friends have died. So, it may be hard to sift out a specific mental health concern.

But we will try. We're working off the official list of anxiety disorders (panic, phobias, obsessive-compulsive, post-traumatic stress and generalized anxiety). Our situations might look something like these (and by now you can tell I'm using this entry to brainstorm):

Dad keeps thinking he's having heart attacks: pounding heart, chest pains, sweating, shaking, numbness, hot flashes, and a sense of becoming "unreal." The son keeps rushing him to the emergency room, only to be told "nothing is wrong." The son is beginning to think this is just attention-seeking on the part of the old man. "There's absolutely nothing wrong with you," the son wants to shout. "Snap out of it!" [Panic Disorder]

Mom won't leave the house. She's opted out of a couple First Communions, a high school graduation, lots of family holiday celebrations, and now says she won't go to her granddaughter's wedding. She is full of excuses: her dress shrunk in the dryer, new dentures don't fit right, furnace is acting up, feels like the flu coming on, etc. Some smoldering relationship issues make some family members claim this is deliberate and mean-spirited. [Phobia: Agoraphobia or Social Phobia]

You can't really talk to Uncle Ralph anymore because he is always checking and rechecking the locks on the doors, the electrical fixtures, the gas stove. He was a damned good maintenance man in his day, always on top of his game. But it's been years since he retired. He can't visit your house without running through his routine maintenance check. Your enjoyable conversations seem to be a thing of the past. [Obsessive-Compulsive Disorder]

After 65 years Dad is starting to have nightmares about being a prisoner of war in the Pacific. The family is trying to be nice about it but it's not going away. They can't decide whether to assume he's just getting senile or to tell him to snap out of it. [Post-Traumatic Stress Disorder]

Mom's always been a worrier, but it's getting extreme. She won't sleep if she has an appointment the next day. If she's expecting company, she calls them 4 or 5 times to make sure all the arrangements are in order and that she has the time correct. [Generalized Anxiety Disorder]

Okay, enough brainstorming. This has been helpful to get the juices flowing.

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