Identifying Anxiety

While only a qualified mental health professional can actually diagnose a mental health problem, the following information can be used to help assess what general area you might be having difficulty with (please note that this is not a comprehensive listing of all psychiatric disorders and does not substitute for an evaluation by a mental health professional):

Anxiety Disorders:

  • Generalized Anxiety Disorder: constantly feeling anxious, worried, on edge, hard to relax, irritable. Worrying causes significant impairment in functioning in at least one area (at home, at work, socially, etc.)
  • Social Anxiety: persistent fear of social or performance situations with unfamiliar people or possible scrutiny by others including fearing that one will act anxious or do something that will be embarrassing and humiliating. Persons with social anxiety may have panic attacks or intense anxiety and stress when confronted with social situations, or they may avoid these situations altogether. This avoidance or the anxiety when enduring social situations causes significant problems in at least one area of the person’s life.
  • Panic Attacks: heart pounding, difficulty breathing, sweating, feeling as if you are going to die. The first attack may come from out of nowhere but later attacks are often brought about by fearing another attack. Common triggers are bridges, tunnels, elevators or other enclosures or social situations. Panic attacks are well treated with Cognitive Behavioral Therapy and Relaxation Training.
  • Post-traumatic Stress Disorder: following serious threat or harm to your personal self or witnessing serious harm or threat to another. Symptoms include nightmares, flashbacks, fear of things that remind you of the event, feeling numb or as if things are no longer real, problems with memory, irritable mood, extreme response to being startled, having trouble imagining the future, feeling withdrawn from others and suicidal thoughts. Treatments for PTSD that have good support in the research include EMDR (eye movement desensitization reprocessing), Trauma Focused Cognitive Behavioral Therapy and Exposure Therapy. Medications are also often helpful for the depression, anxiety and nightmares associated with the disorder.
  • Phobias: fears of specific things such as heights, snakes, bridges, elevators, closed spaces, public speaking. Being confronted with the object of one’s phobia causes significant anxiety and may lead to panic attacks. Persons with phobias will usually go to great lengths to avoid the thing they are phobic of (ie: driving 20 hours rather than taking a 4 hour flight). Phobias respond well to gradual exposure to things that approximate the fear (ie: someone phobic of snakes first looks at a picture of a snake while being guided through relaxation exercises. Over time they learn to be exposed to a real snake in very small steps while maintaining a relaxation response).
  • Obsessive-Compulsive Disorder: obsessive thoughts, impulses or images that reoccur and are distressing such as fears that one has harmed someone, fears that germs are present, images that are unpleasant, impulses to perform an act, etc., and compulsive behaviors such as counting, checking or washing excessively. These can cause significant problems in functioning such as loss of jobs, loss of relationships, or avoidance of numerous places or situations. Common compulsions that are rarely talked about include picking at scabs, blemishes or moles, chewing lips or the inside of one’s mouth, excessive chewing of fingernails or the skin around the nails (to the point of bleeding) or hair pulling (including eyelashes or eyebrows). These behaviors are sometimes called Body Focused Repetitive Behaviors. They respond well to cognitive behavioral treatment as well as antidepressant medications, especially Effexor and or Zoloft.

Impact Of Anxiety:

  • Generalized Anxiety Disorder has a 20% recovery rate within 2 years.
  • In the US, Anxiety Disorders are the #1 mental health problem for women and the #2 problem for men (#1 for men is alcohol and/or other drug problems)
  • Lifestyle changes, including managing interpersonal relationships and stress well, are cornerstones to treating Generalized Anxiety Disorder
  • 17% of the US population, or 50 million people, have suffered from an anxiety disorder in the past year
  • 25% of adults will suffer from an anxiety disorder at some point in their life

Benefits Of Therapy​​:

  • Psychotherapy has been shown to change levels of serotonin, the brain chemical involved in depression. This is the same mechanism that drugs such as Prozac, Zoloft, Effexor and other SSRI’s work by.
  • Studies show that antidepressant medications and psychotherapy both work equally well for psychological problems (this may not apply to some diagnoses such as schizophrenia or bipolar disorder which have a stronger genetic component).
  • Brain scans have shown that psychotherapy increases the thickness of fibers that connect the frontal lobe to the limbic system. This allows us to better control our emotions and remain calm and not react even when we feel provoked.
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