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Endocrinology is a branch of medicine dealing with the endocrine glands when they go wrong.

Psychiatry is a branch of medicine dealing with anxiety when it has gone wrong

a. the understanding treatment and management of what is causing abnormal anxiety;

the care and treatment of mental illness;
b. the responsibility for recommending the appropriate deprivation of liberty provided for under the Mental Health Act, for those with mental illness, which has damaged capacity for clear thought and for insight into what is going on in the mind of a sufferer from serious mental illness, largely schizophrenia, and the medical mood disorders - illnesses where mood has turned into its own autonomy;

c. to advise in Reports to the Courts, on matters affecting the application of the law to the mentally ill who appear in Court.


About Anxiety

G C Homans.
Consider the porcupine in companionship: the closer it gets to another, the more prickly and irritable; the further away from another, the colder it is.
The degree of sentiment tie between people increases with the increased contacts.
The more you are with someone, the more you like to be like them, or you move to hating them
- the more often you are with one person the less time is available to spend with another.

The people you spend most time with, most often with, is your family of origin. That builds up feelings of obligation which last. Not many other relationships manage to be that strong.
Frequency of meeting may well include reminiscing in memory .
From that frequency of contact comes feelings of loyalty and of residual obligation. It is a strong 'support system'

Leaving that positive support leaves a big hole.


About anxiety.

Anxiety ...

... what is felt in uncertain circumstances, alone or with uncertainty in the support system.
Support system being the network of people whom you can draw upon.

The paradigm is somebody leaving a familar territory, unaccompanied, moving across a border - to uncertainty in time, place and company - into another unknown territory, where the rules are not personally secure, where the others are better supported there, where the hierarchy is uncertain:
called transitional states
- all deriving from crossing property boundaries
For the receiving territory - are you a friend or an enemy, a threat or an ally.

The same uncertainties occur in growing out of one stage onto another - nursery, primary school, secondary school, puberty changes, adolescence, now facing independence in living skills; in interests, in further education choices, in new companions, in new settings, finding and changing jobs, changing and abandoning partnerships, in sexual challenges; in marriage, in pregnancy, in dependent baby, infant, in children starting school, in accepting promotion, in facing redundancy and retirement, in facing death - the unknown
Previous security in the support systems behind one, relied on , are not always there.

For some this is a temporary state - reflecting anticipation about failure on some particular matter, which is time limited to that particular occurrence, and returns to base level after that.
For others, they are always somewhat anxious personalities - sensitive - ready to anticipate and fear the worst, and this will peak as some deadline approaches, often replacing a previous over confidence in facing a particular problem.
Some public exposure seems necessary for the anxiety.
On their own, failure brings self criticism, shame,guilt, and depression, which dissipates over time.


There are general points to be held in mind when thinking about anxiety.

It is a universal feeling, if more with some, born with them more than others.
Therefore there have always been cultural ways of 'handling it'.

1. Reliable companionship.
Someone present at your side , guarding your back.
Your support system, is it standing up?

2. A safe place where your own support kind live. Familiarity. Your own crowd and your own position in it, with friends. A tribe, a state, a religion.
Best to anticipate change and have another network in hand.
If the companionship becomes uncertain unstable then ...

3.... 'Distancing' is available backing off, letting time go by from exposure until re-grouping about the anxiety object or situation.
Money helps.
Going out to settled work brings distancing from home and different companionship and security. Going home from work provides another safe resource.
But what about the 'stay at homes' solitary and/or minding smaller people - they depend critically, upon the companionship and security from those who leave the home and go out to work; or if abandoned, what is left in the neighbourhood - not so reliable ? Doubt the confidence in those and .. ?

Men make distancing - they can shout and aggress.
Women, on the whole, look to companionship, and try to replace a bad one?

Failure in 1. and 2.

3. the, sometimes Sedatives - alcoholic drink of various cultural kinds - institutionalised in any culture - so that everybody knows the rules. Generally used where uncertain people come together in mixed companies of people - at feasts - at football matches, in 'protests', at parties, to ease the anxiety of what might come, and is unknown.
Troublesome when cultures and generations with different traditional 'street drugs' , clash.
The sedatives that can substitute for alcohol - the valiums - benzodiazepines , and the hypnotic class, which if taken with alcohol add to the addiction or dependency.


John Bowlby - of maternal separation anxiety fame - declaiming what happened to infants when both their base and their chief companion was lost for a while
- drew attention to the value when assessing, the added effect of different sources of anxiety coming together.

alone 1.
in a strange place 2.
in the dark 3.
hearing a noise 4.
without companionship 5. add 6. with a reckless companion who won't go away.

Bear these points in mind when assessing anxiety and how to relieve it.
Any anxieties in the background should be settled before taking on new ones.

Marry well.


Helping phobias - phobic anxieties - follows the same lines.

Start off with the background of a safe place, obtain a companion in whom you have built trust. Then try out the fear object under the most favourable conditions, increasing a bit at a time, with your trusted companion somewhere on hand at appropriate distances.
All psychotherapy depends upon building and testing out the trusted relationship - the length of the interviews the time inbetween interviews the work set or expected in-between

Take house-bound anxieties. Begin with explanation. Create the companionable trust.
Then best to start from somewhere outside, a safe place known by sufferer - library, friend's house - with the trusted companion, and the testing exposure outside is in a safe homeward direction. Whilst out with companion, find and try out sanctuary sites - fail safe places that can be eventual stopping points, breaking up journeys.
Overdo the cure


M ental I llness C oncerns A ll