Reining in the Fear

July 25, 2006

By Leigh Woosley

Editor's note: This is the third in a series of five articles looking at the complex problem of anxiety disorders, the most prevalent mental health disease in America.

The beach sand is as white as the Arabian horse that Becky Moyer rides in her dream.

The sun crests the horizon; the world is asleep. And Moyer is at peace.

The dream seemed improbable to a little girl in small-town Kansas, but the older Moyer grew, the less likely it became. Then it seemed absolutely impossible.

Elegant horses, white beaches and rising suns existed, but peace long eluded the woman who is now a 46-year-old grandmother.

An anxiety disorder crippled Moyer's life for more than a decade, robbing her of her freedom.

Moyer battles panic disorder, characterized by unexpected and repeated panic attacks, and agoraphobia, a fear of being in a place where escape might be difficult.

Many people with panic disorder become agoraphobic because they fear having an anxiety attack in public. That fear can twist into new shapes. For Moyer, it was an emotional prison.

Her world, once filled with work, family and friends, shrunk to an isolated ranch home she and her husband Mike share outside of Quawpa.

For years, she struggled to find the right support, but Moyer said the string of therapists and doctors she encountered weren't familiar with anxiety disorders or how to treat them.

"In rural areas there is no help," she said. "There are no support groups. People don't understand. Nobody understands."

Fear Has a Name

It took years before a therapist told Moyer that the severe anxiety and panic attacks she experienced were symptoms of an anxiety disorder.

She finally had an explanation for her feelings.

Before that, "I didn't know what was happening to me," she said. "Of course I thought I was crazy, and I was ashamed."

Moyer kept her diagnosis a secret, because she worried what people might think. She hesitated to say the words "anxiety disorder" and looked away when she did.

She got over that, realizing her panic disorder is like any other sickness that can be treated.

Today she talks about it freely and does many things that once terrified her.

Moyer started therapy a year ago, and only months after her first session, she sat by her husband in the middle of a local café abuzz with a bustling lunch crowd. She never reached for the anti-anxiety medication she carried just in case.

After leaving the café, she went to Woodland Hills Mall, the first mall she'd been to in years, to buy a dress for her daughter's wedding.

A few months later, Moyer went to a friend's house alone. She gambled at a packed casino.

She's begun to loosen the noose of anxiety that once choked off her dreams of white beaches or prancing horses.

A Prisoner With No Cell

"I long to be able to do so many things people take for granted," she wrote last year. "Simple everyday things that I am reminded of 24-7 that I cannot do now. I am a prisoner. There is no locked cell, but my life is so severely limited."

Those words came from a written assignment Moyer was given by psychiatrist Charles Cobb, whose local practice specializes in the treatment of anxiety disorders. Moyer titled it "Brainwashed Becky."

It wasn't long ago that Moyer was terrified to leave her husband's side because she was convinced that only he could handle her panic attacks.

If Mike were out of her sight, it couldn't be far, it couldn't be for long. He had to have one of the walkie-talkies she bought in case their cell phones didn't work.

She could not be home without Mike. When they went out together, she couldn't be even as far from him as the next aisle over in Wal-Mart.

Mike said they were like prisoners chained together.

As the swells of anxiety took over his wife's life, they indirectly took over his.

He didn't see his friends or his father. He forfeited his passion for hunting and riding horses.

"We were basically forced into a whole new way of life," Mike said. "It was a stressful thing for everyone involved. Everything, everything changed."

Moyer quit her job as an office manager and ended her volunteer work.

"That's when everything got worse, my world got smaller," she said.

A year later, Mike started his own business laying cement so Moyer could work with him.

Even with her husband in sight, Moyer feared crowds and avoided going into public. Life essentially was their one-level home, where cows and horses roam the open space outside and no neighbors are in sight.

Their grandchildren were born after the onset of Moyer's anxiety disorder, and they didn't understand it. They just knew Grandma couldn't be alone and didn't go out much.

"None of them understood why I didn't go to their ballgames. It's an awful, awful feeling," Moyer said.

"You feel really guilty because you can't attend school functions. You can't pick them up and take them out to eat or go to a park. There are things that people take for granted every single day that I struggle with every single day."

She looked for help, but couldn't find any. One doctor prescribed Valium, she said. Another sent her to drug treatment for taking it.

Years later a psychiatrist told her there was no hope and that she would be on medication for the rest of her life.

Moyer told Mike to leave her. Take the family and go. Mike refused.

New Resolution

New Year's Day of last year changed their lives.

"I made up my mind right then and there," Moyer said. "I had become an expert at learning how to avoid (my fear), and get around it and manipulate it. I read the Internet a lot, and I read about people getting help.

"So I said, 'This is my New Year's resolution. I'm going to get the help I need, and I'm not going to give up."

A few months later, Moyer was sitting in Cobb's office after taking anti-anxiety medication just to make the trip to Tulsa. Cobb said he could help her, but she had doubts.

"Here I am, I can't even walk outside without Mike, and this doctor is telling me to do this and this, and I'm thinking this is just another doctor. I'm not going to get my hopes up," she said.

That was in June 2005. Since then, Moyer has found immense relief by following Cobb's instructions.

Cobb believes in teaching clients to manage their anxiety and get control over it. He first helps people understand the physiological nature of anxiety, that it's a feeling in the body that can be controlled.

That was a revelation to Moyer. She wasn't imagining the panic attacks.

"Managing the anxiety is the very first thing, and then we'll get you back involved in life," Cobb said.

He had Moyer challenge herself by going to crowded places and practicing anti-anxiety exercises. She recently stopped taking a drug used for anxiety and depression.

Cobb said if Moyer does the work, she could be well enough to end treatment in about a year.

"I started working the program," Moyer said. "I mean intensely working the program. I mean every day."

The pay off is grand.

Today, Moyer doesn't think twice about getting into the car alone, driving to the grocery store and going in to shop.

"I'm not going to let this beat me," Moyer said. "I don't know about a cure, but I can learn to deal with it. I can have control."

Moyer is riding horses again.

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AGORAPHOBIA

People affected: 1.8 million adults, less than 1 percent of the population.

Median age of onset: 20

Symptoms: Intense fear and anxiety of any place or situation where escape might be difficult. This leads to avoidance of situations, such as being alone outside of the home; traveling in a car, bus or airplane; or being in a crowded area.

Qualities: Desensitization is used in treating agoraphobia, and this approach means gradual exposure to the fear. Anti-anxiety and anti-depressant medication have also proven effective.

Where to go for help

If you or someone you know struggles with anxiety, help is available.

The Mental Health Association of Tulsa offers resources to treat anxiety and an anxiety disorders support group, which meets at 6:30 p.m. the second and fourth Tuesday of every month at 1870 S. Boulder Ave. It is free and open to the public. For help or more information, call 585-1213 or visit www.mhat.org.

Other helpful resources:

Anxiety Disorders Association of America: www.adaa.org

National Institute of Mental Health on anxiety disorders: www.nimh.nih.gov/publicat/anxiety.cfm

American Psychiatric Association: www.healthyminds.org

Freedom from Fear: www.freedomfromfear.org

Copyright 2006. Used with permission from Leigh Woosley and Tulsa World.