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Anxiety/Worry

What is Anxiety Disorder?

Anxiety is a normal reaction to stress and can actually be beneficial in some situations.  For some people, however, anxiety can become excessive.  While the person suffering may realize their anxiety is too much, they may also have difficulty controlling it and it may negatively affect their day-to-day living.  There are a wide variety of anxiety disorders, including post-traumatic stress disorder, obsessive-compulsive disorders, and panic disorder to name a few.  Collectively, they are among the most common mental disorders experienced by Americans.

Signs & Symptoms:

Unlike the relatively mild, brief anxiety caused by a stressful event (such as speaking in public or a first date), anxiety disorders last at least 6 months and can get worse if they are not treated.  Each anxiety disorder has different symptoms, but all the symptoms cluster around excessive, irrational fear and dread.

Anxiety disorders commonly occur along with other mental or physical illnesses, including alcohol or substance abuse, which may mask anxiety symptoms or make them worse.  In some cases, these other illnesses need to be treated before a person will respond to treatment for the anxiety disorder.

Effective therapies for anxiety disorders are available, and research is uncovering new treatments that can help most people with anxiety disorders lead productive, fulfilling lives.  If you think you have an anxiety disorder, you should seek information and treatment right away.

Treatments:

In general, anxiety disorders are treated with medication, specific types of psychotherapy, or both.  Treatment choices depend on the problem and the person’s preference.

People with anxiety disorders who have already received treatment should tell their current doctor about that treatment in detail.  If they received medication, they should tell their doctor what medication what used, what the dosage was at the beginning of treatment, whether the dosage was increased or decreased while they were under treatment, what side effects occurred, and whether the treatment helped them become less anxious.  If they received psychotherapy, they should describe the type of therapy, how often they attended sessions, and whether the therapy was useful.

Often people believe that they have “failed” at treatment or that the treatment didn’t work for them when, in fact, it was not given for an adequate length of time or was administered incorrectly.  Sometimes people must try several different treatments or combinations of treatment before they find the one that works for them.

Medication will not cure anxiety disorders, but it can keep them under control while the person receives psychotherapy. Medication must be prescribed by physicians, usually psychiatrists, who can either offer psychotherapy themselves or work as a team with psychologists, social workers, or counselors who provide psychotherapy.  The principal medications used for anxiety disorders are antidepressants, anti anxiety drugs, and beta-blockers to control some of the physical symptoms.

Before taking medication for an anxiety disorder:

  • Ask your doctor to tell you about the effects and side effects of the drug.
  • Tell your doctor about any alternative therapies or over-the-counter medications you are using.
  • Ask your doctor when and how the medication should be stopped.  Some drugs can’t be stopped abruptly but must be tapered off slowly under a doctor’s supervision.
  • Work with your doctor to determine which medication is right for you and what dosage is best.
  • Be aware that some medications are effective only if they are taken regularly and that symptoms may recur if the medication is stopped.

Psychotherapy involves talking with a trained mental health professional, such as a psychiatrist,  psychologist, social worker, or counselor, to discover what caused an anxiety disorder and how to deal with its symptoms.

Living With

If you think you have an anxiety disorder, the first person you should see is your family doctor.  A physician can determine whether the symptoms that alarm you are due to an anxiety disorder, another medical condition, or both.

If an anxiety disorder is diagnosed, the next step is usually seeing a mental health professional.  The practitioners who are most helpful with anxiety disorders are those who have training in cognitive-behavioral therapy and/or behavioral therapy, and who are open to using medication if it is needed.

You should feel comfortable talking with the mental health professional you choose.  If you do not, you should seek help elsewhere.  Once you find a mental health professional with whom you are comfortable, the two of you should work as a team and make a plan to treat your anxiety disorder together.

Remember that once you start on medication, it is important not to stop taking it abruptly.  Certain drugs must be tapered off under the supervision of a doctor or bad reactions can occur.  Make sure you talk to the doctor who prescribed your medication before you stop taking it.  If you are having trouble with side effects, it’s possible that they can be eliminated by adjusting how much medication you take and when you take it.

Ways to Make Treatment More Effective

Many people with anxiety disorders benefit from joining a self-help or support group and sharing their problems and achievements with others.  Internet chat rooms can also be useful in this regard, but any advice received over the Internet should be used with caution, as Internet acquaintances have usually never seen each other and false identities are common.  Talking with a trusted friend or member of the clergy can also provide support, but it is not a substitute for care from a mental health professional.

Stress management techniques and meditation can help people with anxiety disorders calm themselves and may enhance the effects of therapy.  There is preliminary evidence that aerobic exercise may have a calming effect.  Since caffeine, certain illicit drugs, and even some over-the-counter cold medications can aggravate the symptoms of anxiety disorders, they should be avoided.  Check with your physician or pharmacist before taking any additional medications.

The family is very important in the recovery of a person with an anxiety disorder.  Ideally, the family should be supportive but not help perpetuate their loved one’s symptoms.  Family members should not trivialize the disorder or demand improvement without treatment.

Source: National Institute of Mental Health, www.nimh.nih.gov

 

 

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