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My First Speech in Public Speaking 205: a subject that’s really important to me.

May 29, 2008

(image thanks to: http://www.rxpgonline.com/postt38455.html)


Public Speaking
May 29, 2008
Formal Outline

Topic: Anxiety Disorders

Specific Purpose: To educate my audience about the most common psychiatric illness affecting children and adults in the United States: Anxiety Disorders.

Introduction

I. Attention Getter:
June 17, 2006, my twentieth birthday. It was our last day in Shanghai; a city as smutty by day as it is neon by night. After nearly a month in China, I’d opted for a day trip to the Jade Buddha Temple, an opulent maze of statues, prayer flags, candles, and yellow-draped monks. Not only was I curious, like the rest of my traveling companions, to see the only state-sanctioned temple in all of China, but I also wanted peace. Since the day I stepped on the plane for Tokyo four weeks earlier, I had been experiencing an alarming and unknown illness.
That afternoon, the omnipresent symptoms began to make me more and more uncomfortable. By the late afternoon tea ceremony, I was dizzy, faint, pain shot through my chest and arms, my head pounded, my breath came in short gasps, and i felt as though something had lodged in my throat, painfully strangling me from inside. I signaled to our translator that I was feeling unwell, and he helped me to my feet, and out into the courtyard. The symptoms escalated. I felt disoriented, numbness crept up my fingers, arms, chest, face, legs, until I became paralyzed, unable to move my body, my hands contorted and pinned against my chest, I lay on a bench, screaming. In terror, I shouted at my traveling companion and the translator about the pain that radiated from my chest, the sharp glass in my throat. My face contorted with tears, as they carried me into an ambulance and sped me to the nearest major hospital. I was crying out that I couldn’t move, I couldn’t breathe, my heart was stopping, I was dying. I thought of my parents getting the news of my death, what they might have to do to get my body back into the States, of my grandmother, who died in 1977 on her own birthday. In an elevator now, I screamed: tell them it’s my birthday, today is my birthday, i don’t want to die.
They gave me shots in the thigh, unable to unfurl my arms. Then an oxygen mask, an IV, and I blacked out.

II. Introduce the Topic:
What I experienced was not a life-threatening condition. It was my first panic attack. Although in and out of therapy since early adolescence, having been diagnosed with clinical depression, generalized anxiety disorder, and borderline personality disorder, none of my healthcare professionals had ever told me what Panic Disorder might feel like, so I was completely blind-sided like most sufferers.
Anxiety Disorders are not merely the topic of my speech today, they are also literally the reason I am standing in front of you in Chandler, in the summer of 2008. More debilitating than many physical illnesses, these mental health issues can rob you of a quality of life, and even the ability to perform basic functions. My continuing struggle with Anxiety has reeked havoc on my college career, and delayed my graduation; hence, I am here.
III. State your purpose:
The purpose of my speech is to educate my audience about the most common psychiatric illness affecting children and adults in the United States: Anxiety Disorders.
IV. Preview your main points:
Anxiety Disorders are real medical conditions, which predominantly affect young people. They often go untreated and therefore cost the US government millions of dollars because of lack of awareness. Anxiety Disorders are not confined to Western countries, nor to affluent countries, but can be found around the globe.

Body

I. What are Anxiety Disorders?
A. The Spectrum of Anxiety Disorders
1. Anxiety Disorders are very real and potentially serious medical conditions. They are as threatening to the sufferer’s well-being as many physical illnesses, such as diabetes or heart disease.
The label “Anxiety Disorders” covers a spectrum of psychiatric illnesses which includes Obsessive-Compulsive Disorder, Post-Traumatic Stress Disorder, Social Anxiety Disorder, Borderline Personality Disorder, Specific Phobias, Generalized Anxiety Disorder, Panic Disorder, and Agoraphobia.
B. Statistics about Anxiety Disorders in the United States:
According to the ADAA, more than 40 million adults are diagnosed with an Anxiety Disorder each year in the US, making it the most common mental health diagnosis in the country.
About 13% of children between the ages of 9 and 17 have experienced some kind of anxiety disorder; and girls are more often affected than boys.
C. GAD and PD.
I want to focus on the two specific disorders which are the most common, and occur more frequently among young people and women.
1. Generalized Anxiety Disorder (GAD)
The ADAA provides this definition of GAD:
“Generalized Anxiety Disorder is characterized by persistent, excessive, and unrealistic worry about everyday things. People with the disorder [. . .] feel that worrying is beyond their control and they are powerless to stop it. They often expect the worst, even when there is no apparent reason for concern. This anxiety or worry occurs on more days than not for at least six months. The exaggerated and unrelenting worry often centers around issues of health, family, money, or work, and can interfere with all aspects of a person’s life. Some physical symptoms of GAD are muscle tension, fatigue, restlessness, difficulty sleeping, irritability, edginess, gastrointestinal discomfort or diarrhea.”
GAD affects 6.8 million people in the U.S. (approximately 3.1% of the population) and is twice as likely to be found in women than in men. It has a high comorbidity rate with other disorders.
2. Panic Disorder and Agoraphobia
The ADAA defines PD as a disorder that “is diagnosed in people who experience spontaneous, seemingly out-of-the-blue panic attacks, and are preoccupied with the fear of a recurring attack. Panic attacks occur unexpectedly, sometimes even during sleep.” Which leads to the question: what is a Panic Attack? The ADAA define it “as the abrupt onset of intense fear that reaches a peak within a few minutes and includes at least four of the following symptoms: a feeling of imminent danger or doom, the need to escape, heart palpitations, sweating, trembling, shortness of breath or a feeling of being smothered, a feeling of choking, chest pain or discomfort, nausea or abdominal discomfort, dizziness or lightheadedness, a sense of things being unreal, depersonalization, a fear of losing control or of ‘going crazy,’ a fear of dying, numbness, tingling sensations, chills or heat flush.”
Dr. Reid Wilson, licensed psychologist and director of the Anxiety Disorders Treatment Program at UNC-Chapel Hill summates the severity of the physical symptoms of an attack, “A panic attack causes the fastest and most complex reaction known within the human body. It immediately alters the function of the eyes, several major glands, the brain, heart, lungs, stomach, intestines, pancreas, kidneys and bladder, and all of the body’s major muscle groups.”
Panic Disorder affects 6 million Americans (2.7% of the population), women are twice as likely to be affected, and the disorder has a very high comorbidity rate with major depression and clinical depression.

II. Who suffers from Anxiety Disorders and What causes them?
A. Who suffers:
The majority of people in this room are at the prime age to develop an Anxiety Disorder. More than half of you are also the female, making your chances of experiencing Anxiety twice as likely.
“According to the National Institute of Mental Health, 75% of all people with an Anxiety Disorder will experience symptoms before they are 22 years old.”
The Anxiety Disorders Association of America produced an alarming study on college campuses, nation-wide, finding that “stress and anxiety are increasing on college campuses.” “A 2006 University of California-LA survey revealed that over 30% of college freshman reported feeling “overwhelmed a great deal of the time.”
B. What causes them:
Like other mental illnesses, Anxiety Disorders occur in individuals because of a mixture of factors, including genetic predisposition, brain chemistry, personality, and life events.
A study was conducted at VCU’s Department of Psychiatry within the Medical College of Virginia, which revealed that “in women, the liability to major depression and generalized anxiety disorder is influenced by the same genetic factors, so that whether a vulnerable woman develops major depression or generalized anxiety disorder is a result of her environmental experiences.”
C. Highly comorbid with other psychiatric illnesses:
1. All Anxiety Disorders are the more dangerous because they are highly comorbid with other psychiatric illnesses, such as Depression, ADD and ADHD, Bipolar Disorder, Sleep Disorders, Body Dismorphic Disorder, Eating Disorders, Hypochondria, Substance Abuse, and Suicide.

III. The Anxiety Disorder Epidemic and its Impact
A. The Rising Number of Sufferers:
1. College Campus Studies
B. The Impact on an already suffering Healthcare System:
1. According to the aforementioned University of California study, “Panic Disorder is frequently cited as a top reason for women dropping out of college.” Rising numbers of college students are seeking counseling and treatment over longer periods of time. I’m not sure if you have ever visited the Psychiatric Services offered here on the Mary Washington Campus, but you will quickly realize the underfunded and overburdened nature of their office. To make an appointment with a therapist generally means waiting about two weeks. This is alarmingly inadequate, and shows the epidemic outstripping the awareness and resources needed to control it. Anxiety Disorders are treatable and respond well to medication and various therapies, including exposure and cognitive-behavioral techniques. The care of those with Anxiety Disorders can prevent the onset of Depression, and even Suicide.
2. Lack of awareness about Anxiety Disorders prevents those affected from seeking treatment, because of stigmas associated with mental illness, lack of awareness that their symptoms are treatable, where to go for help, financial concerns, and fear of being labeled a hypochondriac.
3. According to The Rand Corporation, a nonprofit research institution, “people with Panic Disorder often make many visits to emergency rooms or doctor’s offices, convinced they have a life-threatening illness. It can take months or years and a great deal of frustration before receiving the correct diagnosis.” In addition, “Panic Disorder often occurs with other mental and physical disorders, including other anxiety disorders, depression, irritable bowl syndrome, insomnia, asthma, or substance abuse,” making it even harder to diagnose.
4. Anxiety Disorders cost the U.S. more than 42 billion dollars a year, almost one-third of the country’s total mental health bill, according to “The Economic Burden of Anxiety Disorders,” a study commissioned by the ADAA and the National Institute of Mental Health. More than half of those costs are associated with repeated use of emergency health care services by people unaware that they have an Anxiety Disorder, seeking relief for symptoms of seemingly physical illnesses.

IV. The Global Impact
A. Anxiety Disorders are not confined to the United States, the Western Hemisphere, or “developed” nations. They are not an illness of “The West” as is commonly believed. In fact, beginning in the 1980’s, with the streamlining of international healthcare and the introduction of the Diagnostic Interview Schedule, as a standard procedure designed for administration by lay persons, true screenings for mental illnesses became possible world-wide.
A study conducted in 2007 by the World Health Organization’s Mental Health Survey Consortium crossed 14 countries, representing every continent, political system, and level of affluence. The United States did lead the world with 26% of participants admitting to a mental health disorder (18% reported an Anxiety Disorder), it was closely followed by France and the Ukraine. The countries where mental illness was deduced to be least prevalent where Japan and Nigeria, with sample populations reporting less than 4% of the time that they experienced any kind of mental illness.
Conclusion:

Anxiety Disorders are the most common psychiatric illness in the U.S. and around the world, and they are becoming more common every day. Women and young people are especially vulnerable to the life-altering sensations of constant, irrational fear and worry, and the danger presented by many other mental illnesses which exist comorbidly with Anxiety. Genetics and environment both contribute to a person’s vulnerability to Anxiety Disorders, although the most important thing any young person can do is educate themselves about the symptoms. Awareness prevents stigma and helps more people to feel comfortable getting the help they need, which can put the brakes on a spiraling global epidemic of these Disorders.

Thank you.
Works Cited

“Anxiety Disorder” Wikipedia: The Free Encyclopedia. 29 May 2008, 12:57am. Wikimedia Foundation, Inc. 24 September 2005.
“Anxiety Disorders.” U.S. Department of Health and Human Services: NIH Publication No. 06-3879.
LeDoux J. “Fear and the brain: where have we been, and where are we going?” Biological Psychiatry, 1998; 44(12): 1229-38.
Nocon, A., Wittchen, Beesdo, Bruckl, Hofler, Pfister, Zimmerman, and Lieb. “Differential Familial Liability of Panic Disorder and Agoraphobia.” Depression and Anxiety. Anxiety Disorders Association of America.: Wiley-Liss, Inc. Vol. 25, No. 5. (2008).
Ross, Jerilyn, MA, LICSW, Anxiety Disorders Association of America. 22 May 2008.
Stein, MB, P Roy-Byrne, MG Craske, A Bystritsky, G Sullivan, JM Pyne, W Katon, and CD Sherbourne, “Functional Impact and Health Utility of Anxiety Disorders in Primary Care Outpatients,” Medical Care, Vol. 43, No. 12, December 2005, pp. 1164-1170.
Wilson, Reid, PhD. Don’t Panic: Taking Control of Anxiety Attacks. HarperCollins: New York, NY. 1996.

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2 Comments leave one →
  1. Momma permalink
    May 29, 2008 1:35 pm

    What a powerful speech. I hope it has its desired effect on your audience(s) and that it also gave you a well deserved sense of accomplishment and pride in your ability to articulate your subject so well. May this be but the beginning of your formal efforts to educate people everywhere about mental disorders of all kinds, as only those who suffer with them can. I am so proud of you, Sweetheart. You have major guts, and you use them very well. Write on!
    Love and Kisses, with Heartfelt Hugs,
    Momma

  2. Daddy permalink
    May 29, 2008 10:21 pm

    Sweety,

    I hope it came out as well as it was written because it was well written. Half the battle is education (not just yours but those around you). I hope it made an impact. Sometimes getting things out in the open is good therapy. I actually learned a good bit myself. I am here for you and will support you anyway I can…..By the way enjoy your weekend in Tenn.

    Love,
    Dad

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