Keep calm: therapy, not drugs, increasingly being used to treat anxiety; the national dubai

The National Dubai, Rob Kemp

Stress levels are on the rise globally, so it’s no surprise that experts based here in the UAE are witnessing an increase in reported health disorders related to the pressures of work and the demands of a 24-hour society.

Health professionals have even diagnosed Dubai as being victim of a “stress epidemic” as citizens present with symptoms as varied as muscular skeletal disorders, insomnia, ulcers and panic attacks – that are all a result of excessive stress levels.

In the past, health awareness campaigns – such as the “Relief” initiative established by the UAE ministries of health and education, Abu Dhabi’s Health Authority and the Emirates Medical Association – sought to highlight issues of pain management and in particular one of its main causes, stress.

Now the focus is increasingly on how to most effectively treat those suffering from anxiety disorders and ideally arm people with the self-help tactics to cope with the stress and strains of modern life.

One form of treatment that continues to grow among therapists is Cognitive Behavioural Therapy (CBT) – coping tactics that victims of panic attacks learn to control their physical response to a worrying event.

“We deal a lot with anxiety and panic attacks and there does indeed seem to be a rise over the past two years maybe due to the financial crisis and everything that follows from it, such as fear of losing one’s job, family problems, etc,” explains Dr Martin Kramar of the German Neuroscience Clinic at Dubai’s Healthcare City (

There are many different types of anxiety-related ailments including Generalised Anxiety Disorder (GAD), Panic Disorder and Social Phobia. Exact data on the number of sufferers is understandably difficult to pin down, though in the US the National Institute of Mental Health (NIMH) estimates around 40 million adults suffer from anxiety disorders – of which maybe six million experience Panic Disorder.

Signs of panic attacks include palpitations (a racing heartbeat), dizzy spells, unexplained shortness of breath and chest pain that’s unrelated to any physical exertion. For many, prescription medicine can provide relief – Beta-blockers, Valium and antidepressants such as Prozac are among the drugs used by sufferers. But in many cases medication designed to calm the body and mind can have quite obvious, sedative side-effects – they trigger drowsiness, while there’s also the risk of users becoming dependent upon them.

Kramar’s teams treat sufferers of anxiety and panic attacks with non-medical treatments; either a very sophisticated kind of Bio-Feed-Back Relaxation method or CBT, or a combination of both.

“This kind of treatment is especially designed for people who are under a lot of pressure in their jobs, yet cannot afford to take sedating medication all the time such as managers, athletes, pilots, bankers, lawyers – and media people, of course,” Kramar says.

“The most common symptoms are stress-related problems, especially worries about the future, worries about the financial situation, fears, phobias and various kinds of panic attacks. Each patient has different values of happiness, meaning of life, and different attachments to situations that trigger unpleasant feelings of stress, anxiety or panic attacks.”

The demographic make-up of Kramar’s patients – predominantly westerners and workers from other parts of the Middle East – is a factor that’s key to stress disorders suffered by many of them too. “Most of the people who come to Dubai for work have no intention of settling down here for good. Thus, many patients here suffer from not having friends, social interactions or emotional support as they were used to having in their native countries,” he explains. “Dubai is also a place well known for businesses going down very quickly and unexpectedly, thus, people can easily be fired and within a few days, everything is changed.”

Equally, a number of his patients have come to Dubai to start a new life. “Some have already experienced stress in their native countries from recent divorces, bankruptcies, or similar failures,” adds Kramar.

Specialists treating anxiety sufferers with CBT-based therapies aim to help them establish defence mechanisms against their stresses. “Patients learn to identify and eliminate the roots of their anxiety,” Kramar explains. “It’s often established by breathing techniques and concentrative exercises.”

Sufferers using this method are taught to initially recognise the signs of a panic attack, such as their heart-rate rapidly escalating, they then learn how to quickly lower their heart rate with special awareness of concentration and prolonged exhalations.

“These exercises are trained within the therapy sessions,” says Kramar. “Through proper diaphragmatic breathing techniques the patient activates their ‘parasympathetic’ nervous system – this in turn lowers the heart rate and activates relaxation responses to the mind and the body.”

CBT therapies are being developed to help cater for the growing number of anxiety and panic attack victims. But many, particularly those in high-pressure jobs, are still reluctant to reveal their problem for fear of how it will be perceived by their bosses.

“I found cognitive behavioural therapy to be extremely helpful, after I’d tried medication including beta-blockers, counselling and hypnotherapy,” explains Joanne Bramley, an adviser with AnxietyUK in Manchester, England. “I suffered with Social Disorder and CBT helped me to recognise the signs of the condition at time when I was most anxious and taught me to deal with it through self-talk, through challenging and changing the way I was thinking and through helping me to physically relax, too.”

“When I was using medication solely I would feel lethargic, like a limp rag and I often had trouble waking up in the mornings, but CBT has helped restore my energy levels, too, which also gives you more strength to deal with the negative aspects of the condition.”

The treatment options for anxiety sufferers are becoming comfortingly more diverse, especially for those wary of or unable to take medication that could affect their work. CBT practitioners hope that by realizing “drugs” aren’t the only option, more sufferers will come forward and take the first steps towards combating their fears.