There are many types of psychotherapies used to treat anxiety. Unlike counseling, psychotherapy is more long-term and targets a broader range of issues such as patterns of behavior. The patient's particular anxiety diagnosis and personal preference guides what therapies would be best suited to treat them. The ultimate goal with any type of psychotherapy, is to help the patient regulate their emotions, manage stress, understand patterns in behavior that affect their interpersonal relationships. Evidenced-based therapies like Cognitive Behavioral Therapy (CBT), Prolonged Exposure Therapy (PE), and Dialectical Behavioral Therapy (DBT) are some of the most effective at treating anxiety.
In an anxiety-related disorder, your fear or worry does not go away and can get worse over time. It can influence your life to the extent that it can interfere with daily activities like school, work and/or relationships. Fear, stress, and anxiety are "normal feelings and experiences" but they are completely different than suffering from any of the seven diagnosable disorders plus substance-induced anxiety, obsessive-compulsive disorders, and trauma- or stressor-related disorders.
Panic disorder involves repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks). You may have feelings of impending doom, shortness of breath, chest pain, or a rapid, fluttering or pounding heart (heart palpitations). These panic attacks may lead to worrying about them happening again or avoiding situations in which they've occurred.
Generalized anxiety disorder involves persistent and excessive worry that interferes with daily activities. This ongoing worry and tension may be accompanied by physical symptoms, such as restlessness, feeling on edge or easily fatigued, difficulty concentrating, muscle tension or problems sleeping. Often the worries focus on everyday things such as job responsibilities, family health or minor matters such as chores, car repairs, or appointments.
The problem with catastrophizing is that it is rigid thinking. Suppose you worry that you’re having a heart attack every time you experience some chest pain. It’s usually easy for a health professional to distinguish between anxiety and a heart attack. But catastrophizing resists new information. Even though, your doctor has done tests in the past and has reassured you many times, you worry that this time will be different. Your exaggerated fear is preventing you from changing your thinking, and is keeping you stuck.
The degree of accompanying stress response and its physiological, psychological, and emotional changes are directly proportional to the degree of anxiety. For example, if you are only slightly concerned, such as being slightly nervous about meeting someone new, the body produces a small degree stress response. The small degree stress response can be so slight that you don’t even notice it.
Exposure therapy has been around for a long time. It involves exposing the patient in a safe and controlled environment to physical sensations they experience during a panic attack much the same way you‘d expose in small increments a person with a fear of trains or puppies or snakes to the things that scares them. With panic disorder, there’s often a heightened sensitivity to ordinary physical sensations such as racing heart, stomach ache or feeling faint. In exposure therapy, the therapist will ask you to mimic activities—like running around or doing jumping jacks or holding your breath—to cause panic symptoms. The idea is that by repeating the things that may trigger a panic attack those triggers will eventually lose their power.
The signs and symptoms of a panic attack develop abruptly and usually reach their peak within 10 minutes. They rarely last more than an hour, with most ending within 20 to 30 minutes. Panic attacks can happen anywhere and at any time. You may have one while you’re in a store shopping, walking down the street, driving in your car, or even sitting on the couch at home.
Paula had her first panic attack six months ago. She was in her office preparing for an important work presentation when, suddenly, she felt an intense wave of fear. Then the room started spinning and she felt like she was going to throw up. Her whole body was shaking, she couldn’t catch her breath, and her heart was pounding out of her chest. She gripped her desk until the episode passed, but it left her deeply shaken.
For example, a person with obsessive-compulsive disorder may experience a panic attack when their schedule or compulsions are interrupted. Individuals who struggle with specific phobias are also susceptible to panic attacks. A person with an extreme fear of heights (acrophobia) may experience a panic attack in a penthouse apartment. And for someone with generalized anxiety disorder (GAD), a condition characterized by extreme fear or worry, the unending anxiety can escalate to a panic attack. People with post-traumatic stress disorder (PTSD) have a higher incidence of panic disorder than the general population. Illness or traumatic events increase the chances of panic attacks.
Chest pain is always an alarming symptom, because most of us (appropriately) associate it with cardiac conditions, in particular angina or a myocardial infarction (heart attack). However, chest pain can also be caused by a number of conditions that have nothing to do with the heart. And one of the more common non-cardiac problems that frequently produces chest pain is an anxiety attack.
Shortness of breath and chest pain are the predominant symptoms. People experiencing a panic attack may incorrectly attribute them to a heart attack and thus seek treatment in an emergency room. Because chest pain and shortness of breath are hallmark symptoms of cardiovascular illnesses, including unstable angina and myocardial infarction (heart attack), a diagnosis of exclusion (ruling out other conditions) must be performed before diagnosing a panic attack. It is especially important to do this for people whose mental health and heart health statuses are unknown. This can be done using an electrocardiogram and mental health assessments.
Those who experience anxiety attack disorder are not alone. It’s estimated that 19 percent of the North American adult population (ages 18 to 54) experiences an anxiety disorder, and 3 percent of the North American adult population experiences anxiety attack disorder. We believe that number is much higher, since many conditions go undiagnosed and unreported.
What happens, exactly? "We all physically respond to stress," says Barbara O. Rothbaum, PhD, psychiatry professor and director, Trauma and Anxiety Recovery Program, at Atlanta's Emory University School of Medicine. "You might feel anxious about work-related problems, taking a big exam, or making an important decision. But someone who suffers from panic disorder may react to those same moderate pressures with an exaggerated physical reaction-as if he or she were about to be attacked by a wild tiger or fall from a great height. It's full-on, adrenaline-pumping, fight-or-flight response."
While the term "test anxiety" refers specifically to students, many workers share the same experience with regard to their career or profession. The fear of failing at a task and being negatively evaluated for failure can have a similarly negative effect on the adult. Management of test anxiety focuses on achieving relaxation and developing mechanisms to manage anxiety.
Experiencing a chronic medical condition or severe or frequent illness can also increase risk for anxiety disorders, as well as dealing with significant illness of a family member or loved one. Given that several medical conditions have been linked to significant anxiety, in some cases a physician may perform medical tests to rule out an underlying medical condition. For instance, thyroid disease is often characterized by experiencing significant symptoms of anxiety. Menopause, heart disease, and diabetes have also been linked to anxiety symptoms. Additionally, drug abuse or withdrawal for many substances is characterized by acute anxiety, and chronic substance abuse can increase risk for developing an anxiety disorder. Anxiety can also be a side effect of certain medications. Experiencing significant sleep disturbances, such as difficulty falling asleep or staying asleep, may also be a risk factor for developing an anxiety disorder.
Anxiety during social interactions, particularly between strangers, is common among young people. It may persist into adulthood and become social anxiety or social phobia. "Stranger anxiety" in small children is not considered a phobia. In adults, an excessive fear of other people is not a developmentally common stage; it is called social anxiety. According to Cutting, social phobics do not fear the crowd but the fact that they may be judged negatively.
SSRIs and SNRIs are commonly used to treat depression, but they are also helpful for the symptoms of panic disorder. They may take several weeks to start working. These medications may also cause side-effects, such as headaches, nausea, or difficulty sleeping. These side effects are usually not severe for most people, especially if the dose starts off low and is increased slowly over time. Talk to your doctor about any side effects that you have.
Another important prevention strategy for anxiety is to incorporate exercise into your daily activities. Exercise has been shown to decrease stress hormones that influence anxiety and also improve overall mood. Exercise can also help you disengage from worry and stress and focus on the current task of exercising. Exercises such as light jogging or brisk walking that can be incorporated into your daily activities can help reduce the impact of anxiety when it occurs.
Everyone experiences anxiety from time to time. Perhaps the person has watched a scary move, or seen something upsetting on TV. Or, more ominous, perhaps the person has experienced or witnessed a crime. Anyone might get anxious in these situations, but the person with an anxiety disorder has persistent or recurrent anxiety that prevents him or her from full participation in life. Anxiety can range from relatively mild (occasional “butterflies,” jitteriness, accompanied by a sense of unease) to severe (frequent, disabling panic attacks). Severe anxiety disorders can lead the person to alter his lifestyle to accommodate the anxiety, for example not leaving home. More
Occasional anxiety is an expected part of life. You might feel anxious when faced with a problem at work, before taking a test, or before making an important decision. But anxiety disorders involve more than temporary worry or fear. For a person with an anxiety disorder, the anxiety does not go away and can get worse over time. The symptoms can interfere with daily activities such as job performance, school work, and relationships.