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Originally written December, 1997. Updated August, 1999.

Anxiety on PBS

In August, 1997, television producer Christian Lindstrom was in the midst of producing a four program series for PBS entitled "Exploring Your Brain." One program, "Fear, Stress and Anxiety," would be devoted to anxiety and panic disorders. While researching this subject, Ms. Lindstrom posted a message to the Internet news group alt.support.anxiety-panic (ASAP) requesting references and information.

Naturally, my fellow ASAP members and I saw this as a golden opportunity to promote public education regarding anxiety and panic disorders. I promptly sent an e-mail to Ms. Lindstrom and we exchanged many messages in the following weeks. Basically, I described what I had learned from personal experience, fellow sufferers, doctors, various books, published research, and I did my best to answer any of her questions. I was nearly interviewed for the program, but my interview fell victim to a communications mishap. Nonetheless, I was invited to attend the taping of the program as a member of the audience and take part in the program's question and answer (Q-and-A) segment towards the end of the show. In return for my efforts, Ms. Lindstrom was kind enough to list me in the special thanks portion of the program credits.

The program was taped on the evening of December 17, 1997. My brother Aaron generously drove me down to the WETA studios in Arlington, Virginia; a 3-hour drive from our homes in Philadelphia. After a little traffic and a few wrong turns, we found the WETA building without too much trouble. Moments after entering the building, I met Rosita for the first time (a popular member of ASAP who had done much Spanish translation for ASAP's on-line Dictionary). We gave each other a friendly hug, and I was introduced to her handsome and friendly husband. For the next half hour we enjoyed chatting with each other. Altogether, an audience of about 50 people showed up, and the lot of us were eventually escorted to the building which housed the actual TV studio.

As the show got started, we first watched a ten or fifteen minute video which became the opening of the TV program. Following the video, the panel discussion was started. Garrick Utley, who may be familiar to PBS viewers, hosted the program. The panel consisted of three neuroscientists; Dr. Joseph LeDoux (author of "The Emotional Brain"), Dr. Judith Rapoport (author of "The Boy Who Couldn't Stop Washing His Hands"), and Dr. James Ballenger (member of the scientific advisory panel for the Anxiety Disorder Association of America (ADAA)).

The panel discussion lasted about 30 to 40 minutes and addressed various anxiety, panic, and OCD topics. I remember feeling that there was a bit too much focus on CBT, however genetics, neurotransmitters and other biological aspects were seriously presented as well, so there was a good overall balance to the discussion.

The difficulty of diagnosis was raised, but I was somewhat annoyed by the apparent criticism of patients rather than doctors. The panel opinion seemed to be that patients were not doing enough to seek help, were reluctant to discuss anxiety and panic symptoms, and were not consulting psychiatrists enough (the fact that many patients don't know the difference between psychiatrists and psychologists seemed to be overlooked). In fairness, I know such issues can be problems even with educated patients, and they did mention the efforts of the National Institute of Mental Health (NIMH) to better educate doctors. Still, I felt the shortcomings of contemporary doctors were rather glossed over and too much blame was placed on patients; after all, few people have a background in mental health before being struck with panic disorder. I squirmed in my seat and impatiently waited for the Q-and-A session to address such issues.

Eventually, the panel discussion ended and the Q-and-A session began. Whoever wanted to address the panel was encouraged to ask one, and only one, brief question. Well, I jumped up, my mind swimming with a dozen interwoven points I wanted to express, and I launched into a rather babbling monologue of comments, struggling to form a coherent question from it all. I wanted to emphasize the severity of panic attacks, address the obstacles that patients faced seeking diagnosis and treatment, raise various issues regarding medication, etc. The host, Mr. Utley, soon stopped me and asked that I express a simple question. So I asked, "What is being done to educate doctors about panic disorder?" Fortunately, the WETA people did a good job of editing this moment for TV.

Dr. Ballenger responded to my comments and question. He supported my comments about the severity of panic disorder, saying that panic attacks are one of the most extreme experiences a person can face. He also answered my question by explaining that the ADAA was in the process of making doctors more aware of panic disorder. Fair enough, but I desperately wanted to press the issue a bit further. My own impression of the ADAA was that they have devoted most of their energy to promoting CBT and I feared the medical aspects were not getting enough exposure. But, having asked my one question, Mr. Utley asked me to step aside for the next person's question. Being civil, I cooperated and went back to my seat.

Both Rosita and her husband asked questions too. I was a bit distracted by my own thoughts at the time, but I believe Rosita's question regarded the interrelationship of anxiety and depression, to which the panel responded that some interesting research was investigating the relationship. Rosita's husband asked about treatment options (if I remember correctly), to which the panel commented on the combined medication and CBT approach.

Of course, once the show had finished, I darted forward to talk to Dr. Ballenger in person. I raised my concerns about the ADAA perhaps being too CBT oriented. He sympathized with my perspective, explaining that the ADAA had traditionally focused on psychotherapies; mostly because the organization was formed before the biology of anxiety disorders was recognized. The organization still carries some of that past momentum, but as part of the scientific advisory panel he and others were in the process of changing this to further stress the medical issues. This made me feel considerably better, although I wish we could have done this on camera.

I spoke with Dr. Ballenger a bit more about how many doctors had exaggerated fears of benzodiazepine addiction, and also about the problem of how many doctors did not understand the SSRIs they were prescribing. He strongly agreed, to the great enthusiasm of myself and a woman who had joined our conversation. I would have liked to talk more with Dr. Ballenger, but he seemed pressed for time and the PBS crew was trying to clear the studio.

I met up with Rosita and her husband again in the lobby. There, I was finally introduced to Ms. Lindstrom, who I had exchanged so much e-mail with a few months back. She introduced me to a woman involved with the NIMH panic disorder education program; whom I enjoyed a very brief conversation with.

Overall, I was very glad to have been involved with the program. The program was eventually broadcast throughout the United States; on many PBS stations at different times. I first watched the show on TV during the summer of 1998, and again during the summer of 1999. In hindsight, my appreciation of the program has grown. At first I was disappointed that some issues were left out, but looking back I'm impressed with the diversity of issues the program addressed. To date, few programs have addressed anxiety and panic disorders with such detail, and I believe the program has boosted public awareness and education of these disorders.

The "Exploring Your Brain" series was sponsored by The Dana Alliance for Brain Initiatives. Videos and free transcripts of this and similar series are available at www.dana.org.

Special thanks to Christian Lindstrom, WETA, The Dana Alliance for Brain Initiatives, Dr. James Ballenger, Dr. Joseph LeDoux, Dr. Judith Rapoport and my brother Aaron.