Anxiety at Work: A Career-Busting Condition

Katrina Gay always worried about her on-the-job performance, but she used the anxiety to her advantage by pushing herself to produce quality work. After the terrorist attacks on Sept. 11, 2001, however, she felt a little less in control.

"I would wake up in the middle of the night and my heart would be racing. I'd be sweating and I'd feel like I was having a heart attack," says Gay. At work, she felt physically and emotionally drained, and found it difficult to talk and listen at meetings.

Fortunately, as the chief of field operations for the National Alliance for the Mentally Ill (NAMI), Gay recognized her symptoms right away and visited a psychiatrist. She was diagnosed with anxiety disorder.

Anxiety disorders are the most common mental illnesses, affecting 19 million children and adults in the U.S., reports the Anxiety Disorders Association of America (ADAA).

ADAA also reports that the ailment consumes almost a third of the total $148 billion total mental health bill for the nation. That's not surprising, given people with anxiety disorder are three to five times more likely to go to the doctor, and six times more likely than non-sufferers to be hospitalized for psychiatric ailments.

Although anxiety disorder describes a group of illnesses such as generalized anxiety disorder, obsessive-compulsive disorder, panic disorder, post-traumatic stress disorder, and phobias, there are some symptoms that characterize the illness as a whole.

According to the American Psychiatric Association, when people suffering from anxiety disorders talk about their condition, they often include these descriptions:

• Unrealistic or excessive worry
• Exaggerated startled reactions
• Sleep disturbances
• Jitteriness
• Fatigue
• Dry mouth
• Lump in throat
• Trembling
• Sweating
• Racing or pounding heart

In the workplace, these symptoms could translate into difficulty working with colleagues and clients, trouble concentrating, preoccupation over the fear instead of focusing on work, and turning down assignments because of fear of failure, flying, going in to the elevator, or public speaking.

For people who think they might have anxiety disorder, Jeffrey P. Kahn, MD, a clinical psychiatrist and author of Mental Health and Productivity in the Workplace, recommends the following first steps of action:

• Talk about the problem with someone you feel comfortable with. Also ask that person what he or she notices about you.
• Take a break from your worry by playing sports, listening to music, praying, or meditating.
• Join a self-help group.
• If talking about the problem or relaxation techniques don't work, seek professional consultation.

Source: http://www.webmd.com/anxiety-panic/guide/anxiety-at-work

The Link Between Anxiety and Depression Disorder

Anxiety and depression disorders are not the same although there are similar elements. Depression generates emotions such as hopelessness, despair and anger. Energy levels are usually very low, and depressed people often feel overwhelmed by the day-to-day tasks and personal relationships so essential to life.
A person with anxiety disorder, however, experiences fear, panic or anxiety in situations where most people would not feel anxious or threatened. The sufferer may experience sudden panic or anxiety attacks without any recognized trigger, and often lives with a constant nagging worry or anxiousness. Without treatment, anxiety and depression disorders can restrict a person's ability to work, maintain relationships, or even leave the house.
Both anxiety and depression treatment are similar, which may explain why the two disorders are so often confused. Antidepressant medication is often used for anxiety and depression and behavioral therapy frequently helps people overcome both conditions.

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 disorder, and panic disorder to name a few. Collectively, they are among the most common mental disorders experienced by Americans.
The following anxiety disorders are discussed on this website:

• generalized anxiety disorder (GAD)
• obsessive-compulsive disorder (OCD),
• panic disorder,
• post-traumatic stress disorder (PTSD), and
• social phobia (or social anxiety disorder).

Causes

NIMH supports research into the causes, diagnosis, prevention, and treatment of anxiety disorders and other mental illnesses. Scientists are looking at what role genes play in the development of these disorders and are also investigating the effects of environmental factors such as pollution, physical and psychological stress, and diet. In addition, studies are being conducted on the “natural history” (what course the illness takes without treatment) of a variety of individual anxiety disorders, combinations of anxiety disorders, and anxiety disorders that are accompanied by other mental illnesses such as depression.
Scientists currently think that, like heart disease and type 1 diabetes, mental illnesses are complex and probably result from a combination of genetic, environmental, psychological, and developmental factors. For instance, although NIMH-sponsored studies of twins and families suggest that genetics play a role in the development of some anxiety disorders, problems such as PTSD are triggered by trauma. Genetic studies may help explain why some people exposed to trauma develop PTSD and others do not.
Several parts of the brain are key actors in the production of fear and anxiety. Using brain imaging technology and neurochemical techniques, scientists have discovered that the amygdala and the hippocampus play significant roles in most anxiety disorders.
The amygdala is an almond-shaped structure deep in the brain that is believed to be a communications hub between the parts of the brain that process incoming sensory signals and the parts that interpret these signals. It can alert the rest of the brain that a threat is present and trigger a fear or anxiety response. The emotional memories stored in the central part of the amygdala may play a role in anxiety disorders involving very distinct fears, such as fears of dogs, spiders, or flying.
The hippocampus is the part of the brain that encodes threatening events into memories. Studies have shown that the hippocampus appears to be smaller in some people who were victims of child abuse or who served in military combat. Research will determine what causes this reduction in size and what role it plays in the flashbacks, deficits in explicit memory, and fragmented memories of the traumatic event that are common in PTSD.
By learning more about how the brain creates fear and anxiety, scientists may be able to devise better treatments for anxiety disorders. For example, if specific neurotransmitters are found to play an important role in fear, drugs may be developed that will block them and decrease fear responses; if enough is learned about how the brain generates new cells throughout the lifecycle, it may be possible to stimulate the growth of new neurons in the hippocampus in people with PTSD.
Current research at NIMH on anxiety disorders includes studies that address how well medication and behavioral therapies work in the treatment of OCD, and the safety and effectiveness of medications for children and adolescents who have a combination of anxiety disorders and attention deficit hyperactivity disorder.

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.

Who Is At Risk?

Anxiety disorders affect about 40 million American adults age 18 years and older (about 18%) in a given year, causing them to be filled with fearfulness and uncertainty.
Women are 60% more likely than men to experience an anxiety disorder over their lifetime. Non-Hispanic blacks are 20% less likely, and Hispanics are 30% less likely, than non-Hispanic whites to experience an anxiety disorder during their lifetime.
A large, national survey of adolescent mental health reported that about 8 percent of teens ages 13–18 have an anxiety disorder, with symptoms commonly emerging around age 6. However, of these teens, only 18 percent received mental health care.

Diagnosis

A doctor must conduct a careful diagnostic evaluation to determine whether a person’s symptoms are caused by an anxiety disorder or a physical problem. If an anxiety disorder is diagnosed, the type of disorder or the combination of disorders that are present must be identified, as well as any coexisting conditions, such as depression or substance abuse. Sometimes alcoholism, depression, or other coexisting conditions have such a strong effect on the individual that treating the anxiety disorder must wait until the coexisting conditions are brought under control.

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 was 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
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. With proper treatment, many people with anxiety disorders can lead normal, fulfilling lives.
Antidepressants
Antidepressants were developed to treat depression but are also effective for anxiety disorders. Although these medications begin to alter brain chemistry after the very first dose, their full effect requires a series of changes to occur; it is usually about 4 to 6 weeks before symptoms start to fade. It is important to continue taking these medications long enough to let them work.
SSRIs
Some of the newest antidepressants are called selective serotonin reuptake inhibitors, or SSRIs. SSRIs alter the levels of the neurotransmitter serotonin in the brain, which, like other neurotransmitters, helps brain cells communicate with one another.
Fluoxetine (Prozac®), sertraline (Zoloft®), escitalopram (Lexapro®), paroxetine (Paxil®), and citalopram (Celexa®) are some of the SSRIs commonly prescribed for panic disorder, OCD, PTSD, and social phobia. SSRIs are also used to treat panic disorder when it occurs in combination with OCD, social phobia, or depression. Venlafaxine (Effexor®), a drug closely related to the SSRIs, is used to treat GAD. These medications are started at low doses and gradually increased until they have a beneficial effect.
SSRIs have fewer side effects than older antidepressants, but they sometimes produce slight nausea or jitters when people first start to take them. These symptoms fade with time. Some people also experience sexual dysfunction with SSRIs, which may be helped by adjusting the dosage or switching to another SSRI.
Tricyclics
Tricyclics are older than SSRIs and work as well as SSRIs for anxiety disorders other than OCD. They are also started at low doses that are gradually increased. They sometimes cause dizziness, drowsiness, dry mouth, and weight gain, which can usually be corrected by changing the dosage or switching to another tricyclic medication.
Tricyclics include imipramine (Tofranil®), which is prescribed for panic disorder and GAD, and clomipramine (Anafranil®), which is the only tricyclic antidepressant useful for treating OCD.
MAOIs
Monoamine oxidase inhibitors (MAOIs) are the oldest class of antidepressant medications. The MAOIs most commonly prescribed for anxiety disorders are phenelzine (Nardil®), followed by tranylcypromine (Parnate®), and isocarboxazid (Marplan®), which are useful in treating panic disorder and social phobia. People who take MAOIs cannot eat a variety of foods and beverages (including cheese and red wine) that contain tyramine or take certain medications, including some types of birth control pills, pain relievers (such as Advil®, Motrin®, or Tylenol®), cold and allergy medications, and herbal supplements; these substances can interact with MAOIs to cause dangerous increases in blood pressure. The development of a new MAOI skin patch may help lessen these risks. MAOIs can also react with SSRIs to produce a serious condition called “serotonin syndrome,” which can cause confusion, hallucinations, increased sweating, muscle stiffness, seizures, changes in blood pressure or heart rhythm, and other potentially life-threatening conditions.
Anti-Anxiety Drugs
High-potency benzodiazepines combat anxiety and have few side effects other than drowsiness. Because people can get used to them and may need higher and higher doses to get the same effect, benzodiazepines are generally prescribed for short periods of time, especially for people who have abused drugs or alcohol and who become dependent on medication easily. One exception to this rule is people with panic disorder, who can take benzodiazepines for up to a year without harm.
Clonazepam (Klonopin®) is used for social phobia and GAD, lorazepam (Ativan®) is helpful for panic disorder, and alprazolam (Xanax®) is useful for both panic disorder and GAD.
Some people experience withdrawal symptoms if they stop taking benzodiazepines abruptly instead of tapering off, and anxiety can return once the medication is stopped. These potential problems have led some physicians to shy away from using these drugs or to use them in inadequate doses.
Buspirone (Buspar®), an azapirone, is a newer anti-anxiety medication used to treat GAD. Possible side effects include dizziness, headaches, and nausea. Unlike benzodiazepines, buspirone must be taken consistently for at least 2 weeks to achieve an anti-anxiety effect.
Beta-Blockers
Beta-blockers, such as propranolol (Inderal®), which is used to treat heart conditions, can prevent the physical symptoms that accompany certain anxiety disorders, particularly social phobia. When a feared situation can be predicted (such as giving a speech), a doctor may prescribe a beta-blocker to keep physical symptoms of anxiety under control.
Taking Medications
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
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.
Cognitive-Behavioral Therapy
Cognitive-behavioral therapy (CBT) is very useful in treating anxiety disorders. The cognitive part helps people change the thinking patterns that support their fears, and the behavioral part helps people change the way they react to anxiety-provoking situations.
For example, CBT can help people with panic disorder learn that their panic attacks are not really heart attacks and help people with social phobia learn how to overcome the belief that others are always watching and judging them. When people are ready to confront their fears, they are shown how to use exposure techniques to desensitize themselves to situations that trigger their anxieties.
People with OCD who fear dirt and germs are encouraged to get their hands dirty and wait increasing amounts of time before washing them. The therapist helps the person cope with the anxiety that waiting produces; after the exercise has been repeated a number of times, the anxiety diminishes. People with social phobia may be encouraged to spend time in feared social situations without giving in to the temptation to flee and to make small social blunders and observe how people respond to them. Since the response is usually far less harsh than the person fears, these anxieties are lessened. People with PTSD may be supported through recalling their traumatic event in a safe situation, which helps reduce the fear it produces. CBT therapists also teach deep breathing and other types of exercises to relieve anxiety and encourage relaxation.
Exposure-based behavioral therapy has been used for many years to treat specific phobias. The person gradually encounters the object or situation that is feared, perhaps at first only through pictures or tapes, then later face-to-face. Often the therapist will accompany the person to a feared situation to provide support and guidance.
CBT is undertaken when people decide they are ready for it and with their permission and cooperation. To be effective, the therapy must be directed at the person’s specific anxieties and must be tailored to his or her needs. There are no side effects other than the discomfort of temporarily increased anxiety.
CBT or behavioral therapy often lasts about 12 weeks. It may be conducted individually or with a group of people who have similar problems. Group therapy is particularly effective for social phobia. Often “homework” is assigned for participants to complete between sessions. There is some evidence that the benefits of CBT last longer than those of medication for people with panic disorder, and the same may be true for OCD, PTSD, and social phobia. If a disorder recurs at a later date, the same therapy can be used to treat it successfully a second time.
Medication can be combined with psychotherapy for specific anxiety disorders, and this is the best treatment approach for many people.

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.
Most insurance plans, including health maintenance organizations (HMOs), will cover treatment for anxiety disorders. Check with your insurance company and find out. If you don’t have insurance, the Health and Human Services division of your county government may offer mental health care at a public mental health center that charges people according to how much they are able to pay. If you are on public assistance, you may be able to get care through your state Medicaid plan.
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:  http://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml

The kindest way to banish anxiety

melia Adams has suffered from anxiety since she was a teenager – a constant worry that can leave her light-headed, shaky and exhausted.
Now aged 22, she had her first panic attack at 17 and has spent years trying to overcome her overwhelming feelings.
Today, after two courses of cognitive behavioural therapy – the standard NHS treatment for anxiety – proved ineffective, Amelia is finally being helped by a new type of psychological intervention: compassion focused therapy (CFT).
Inspired by Buddhism, CFT was  conceived 30 years ago by Professor Paul Gilbert, a clinical psychologist for Derbyshire Health Care Foundation Trust. It is now being offered as a therapy option at a number of NHS hospitals.
Sessions can be either for individuals and last about 50 minutes, or be 90-minute group discussions.
‘It’s similar to CBT, which works by helping patients to consider their negative thoughts and come to more realistic alternative views,’ says Prof Gilbert.
‘But while CBT focuses on changing behaviour in a neutral, practical way – such as using timesheets to plan the day more productively –  in CFT the focus is more on being kind to yourself.’
Sessions have three elements: encouraging patients to do activities or make changes that are kind to themselves, such as writing to a friend; helping them focus on seeing the good in other people and their own lives rather than the negative aspects; and getting the patient  to speak out loud to themselves in a kind, warm tone.
‘Our brains naturally focus on the negative,’ says Prof Gilbert. ‘For example, if we go shopping and in nine shops the assistants are extremely helpful but in one shop the assistant is very rude, we focus on the latter and lose sight of the positive experiences.

‘Deliberately training our attention to notice kindness in others can be very helpful, which CFT does.’
Through tackling the self-criticism and replacing it with kindness, patients then judge themselves and their lives less harshly and therefore feel happier.
‘By helping people feel compassion, we believe you can create  a positive physiological change in your body – just like imagining a delicious dinner will stimulate saliva and appetite,’ continues Prof Gilbert. ‘CBT is primarily focused on thinking and behaviour change but CFT looks at the emotion behind people’s thoughts.’

+2

Kind words: In compassion focused therapy (CFT) the focus is on being kind to yourself and encouraging positivity

CFT therapist Chris Irons adds: ‘It is a relatively new therapy but we are working hard to show that this approach has something important to offer.
‘So far there has been one successful randomised control trial of CFT which found a reduction in symptoms in patients with depression.’ Up to 30 per cent of the population suffers anxiety at any one time.  Last month a report from the  Office for National Statistics said young women are more anxious than young men, while growing numbers of middle-aged women  are suffering chronic anxiety – females aged over 60 are the most likely group to need hospital treatment for the condition.
‘My anxiety started on a night  out with friends when we were on holiday in Greece,’ says Amelia, a personal assistant from Surrey.
‘I felt suddenly overwhelmed by panic and I ended up walking back to our apartment alone and then  was up all night in absolute bits trying to calm myself down.
‘I ended up getting in the shower every hour to cool down and I had no one to speak to, which made it ten times worse.
‘It was so terrifying I flew home early from the holiday, and afterwards I was always really nervous that I’d have another panic attack somewhere far from home with nobody there to comfort me.’
Following that trip, Amelia’s attacks became regular, happening once or twice a month. They lasted about ten minutes each time and left her upset and exhausted. Her GP referred her for two courses of CBT, but the anxiety persisted.
‘It sounds silly, but I couldn’t stop worrying about my cat during the day – thoughts about her getting run over. Whatever the trigger, I feel light-headed and shaky, my stomach churns and for a moment it’s a bit like I’m having a panic attack. It’s really upsetting.’
Amelia heard about CFT through her volunteer work at a mental health charity and, hoping to eliminate her anxiety, she booked a course of six sessions with a private therapist.
Amelia says: ‘CBT had helped with my generalised anxiety but I preferred CFT because it involved more talking and delving into things like my childhood. I’m usually quite hard on myself so it’s taught me to be kinder, which has really helped.
‘Now when I’m on my own and start to feel panic, I am more gentle on myself, so instead of panicking  I sort of talk myself round with comfort. I now know that the anxiety I feel is not my fault. For the first time in years I have found a way to calm down rather than wind myself up still further.’

Source: http://www.dailymail.co.uk/health/article-2619470/The-kindest-way-banish-anxiety-Compassion-Focused-Therapy-help-conquer-crippling-worries-teaching-sufferers-nice-themselves.html

Generalized Anxiety Disorder

If you have Generalized Anxiety Disorder (GAD), you're up against the same Anxiety Trick - you experience Discomfort, but respond as if it were Danger - but here, the source of the Discomfort is your own thoughts.
A person with GAD does a great deal of worrying. It isn't so much that you have a particular problem you worry about, because over time you'll worry about lots of different problems. It's more that you have the problem of worrying. Just like Panic Disorder is a fear of fear, Generalized Anxiety Disorder is worry about worry.

Arguing with Your Thoughts...

People with GAD get into a conflictual relationship with their own thoughts. Sometimes, they take the content of their worries very seriously, and fret about it. For instance, you might have the thought, "what if I lose my job?", and spend a lot of time wondering if your boss likes you or not; where you might look for another job; how you could find out if you'll be fired; how your spouse would react; and so on. You'd think about it a lot in an effort to reassure yourself, and find that you just get more worried.

...and Fearing Your Thoughts

Other times, you'd stop thinking about the idea of getting fired, and focus instead on how all this worry might affect you. You would worry that the worry will lead to a stroke, or a nervous breakdown. You'd be worrying about worry.
There are other symptoms of Generalized Anxiety Disorder - aches and pains, restlessness, sleep disturbances - but all these other symptoms seem to be caused by the excessive worrying.

What if...?

There are two words which, much more than any others, signal that you're getting into worries. These words are "what if...?".
People with GAD imagine something bad (what if I get too anxious to work?), regardless of how likely or unlikely it is, and imagine the terrible consequences should this event occur. Then they try to figure out how they could make sure that this bad thing will never ever happen.

How can I be Sure?

People with Generalized Anxiety Disorder want to make very sure that their bad thoughts will never become reality. They want to eliminate all doubt. Since it's impossible to prove, beyond a shadow of a doubt, that something could never happen, this opens the door to worry without end.
If you have GAD, you probably spend a lot of time trying to get your thoughts just the way you want them. You don't want to have any negative thoughts, and if you have any, you want to be able to prove to yourself that they can't possibly happen. You spend so much time and effort trying to get your thoughts cleaned up and arranged the way you want, that you spend less of your time and energy out in the real world.

Change Your Response,
Rather than Your Thoughts

The problem is this. If there was a rock or tree stump on your property, you could remove it, and that would be the end of it. The rock would not return. But if you have a thought in your mind and try to remove it, the very act of trying to remove the thought practically guarantees that you will have the thought again.
This is the problem with thought stopping, and distraction in general. If you tell yourself not to think about dandelions, you'll probably be seeing plenty of them in your mind. The more you try to suppress a thought, the more it tends to return. Objects won't return when you dispose of them, but thoughts will.
Since you can't simply "turn off" thoughts, progress with Generalized Anxiety Disorder (and with worry in general) comes when a person becomes more accepting of his thoughts - the good, the bad, and the unlikely - rather than opposing them. Effective treatment will help you change your relationship with your thoughts. It will help you respond to them as nothing more than symptoms of anxiety,rather than treating them as important signals about your future. One of the best ways to make this change is the use of worry periods.
Source: http://www.anxietycoach.com/generalizedanxietydisorder.html

10 things we learned about surviving anxiety

Generalized anxiety disorder is the single most common mental health diagnosis, and yet it's still taboo to talk about it. I recently went public with a very personal essay about my battle with it, and in doing so, realized an awful lot of people have been aching for a chance to talk about their struggles.

After comments poured in through CNN.com, e-mails, Facebook, Twitter and other channels, CNN Living hosted a live Google Hangout to address some of the issues. Scott Stossel, author of "My Age of Anxiety: Fear, Hope, Dread, and the Search for Peace of Mind"; Daniel Smith, author of "Monkey Mind: A Memoir of Anxiety"; and psychiatrists Dawn M. Porter and Scott Krakower joined me for a robust, hourlong video chat about treatment, taboos, triggers and the breaking of bad habits.

Here are 10 things we learned from that conversation:

Military families may be especially susceptible to anxiety

Porter is a military spouse and treats people in the community. She says that anxiety -- and stressors -- are present and constant.

"There are a lot of issues that our families go through with every transition," she said. "You're moving every two to four years, depending on what your service member's responsibilities are. The service member has to settle into a new position and figure his or her way out; the spouse or partner also has to navigate a new environment and connect with a new community. If there are children involved, they have to get settled into a new school."

The general public isn't aware of such adjustments, Porter said, making it difficult for military families to assimilate into life outside a base. "They don't get that our children are struggling, and their children don't pick up on it. They have their stability and structure and don't bring the military families in -- which makes it even more difficult."

She said she believes her own experiences help make her a more effective therapist for military families.

Physical symptoms are par for the course, but they'll pass

A viewer wrote in, describing "feeling like I am going to faint, my heart will race and I get hot. I went to the doctor and they ran blood tests. Now they are sending me to a cardiologist. After looking up my symptoms it kind of sounds like anxiety but I am not sure. Since I ... went to the doctor I keep feeling this tight pressure in my chest and I keep crying for no reason. Does this sound familiar?"

Members of the panel all shook their heads emphatically. "That's the remarkable thing about anxiety: It's so embodied, such a physical experience," said Smith, who has undergone botox injections to counter excess sweating.

Stossel, whose memoir vividly detailed gastric symptoms he's suffers, said, "My physiology has commandeered my sympathetic nervous system."

I also fight a rapidly beating pulse, twitching muscles and deeply painful acid reflux. These symptoms are no picnic -- and sufferers and ER doctors often mistake them for a heart attack -- but they're not fatal.

Living with anxiety, searching for joy

Anxiety begets more anxiety

My son Has a mental illness

Coping with PTSD during the holidays

Krakower noted even seeing a specialist to deal with treatment can cause more stress. "We can't rule out a medical problem, but that, in turn, can feed the anxiety."

That response is "definitive of anxiety," Smith said. "You're anxious about something, which leads you to focus more attention on the feeling -- which leads you to be more anxious. Before you can snap your fingers, you're on that merry-go-round, which once it starts, can be inordinately difficult to jump off of."

Stossel agreed the cycle is hard to break. "I know a lot about the neuromechanics and the physiology of panic," he said. "I feel myself having anxious thoughts and I'll tell myself, 'You've been through this a million times, and this is probably a panic attack.' More often than not I can tell myself that it's just a panic attack ... but every once in a while, I'll think, 'But this feels slightly different than the previous 782 times. Maybe I am having a heart attack!' "

Medications aren't one size fits all

People may not be able to benefit from talk therapy if they're in a state of panic. "If the level of anxiety is very high, it may be necessary to bring that down so they can use some relaxing techniques," Porter said.

Stossel started his journey with medication at age 11 or 12, using Thorazine in the 1980s. He's studied all sides of the argument, from those who feel a "rapacious" pharmaceutical industry makes issues worse and prefer a med-free treatment, to physicians who believe that drug therapy should be the first recourse. His view falls somewhere in the middle.

"Medication can be part of a psychotropic arsenal," he said, discussing one therapist who urged him to stop taking Xanax so he could address his anxiety directly and not mask the physical symptoms.

But a psychopharmacologist felt his physical symptoms were so extreme that unless he tamped those down, he couldn't benefit from other coping techniques, according to Stossel.

"Some drugs have worked some of the time," Stossel said. "I couldn't have gotten through my book tour without benzodiazepines, but there are reasons to be wary of dependence, abuse and masking the symptoms but not treating the underlying source of the anxiety."

Here's what to do about your anxiety

Younger people may feel less stigma about mental health than their parents

"There's more publicity about anxiety," Krakower said, "and it's becoming more acceptable in the community."

But there are certain things to consider when dealing with children and adolescents, these experts said.

"You first have to work at trying to engage them. If they're not on board, it's not going to work," he said.

Krakower, a child and adolescent psychiatrist, uses a two-pronged approach of cognitive behavioral therapy and gradual medication if needed. He said he pays close attention to which treatment is working best and tries to make younger patients feel comfortable with the process.

He also said some youths self-medicate by smoking pot, but the temporary relief often results in a loss of motivation at school.

Porter agreed that it's important to relate to children and teens. "They're very perceptive about if you're really interested in helping them." She said she also tends to steer clear of certain groups of medications with that age group, so these drugs don't become a crutch in the midst of change, or trigger suicidal impulses.

She also cautioned parents against overloading children with too many activities, expectations and pressures. "They have no downtime to be themselves. How do we balance their lives?"

Cultural taboos can get in the way of people seeking help

"Especially in the African-American community, there are a lot of issues that we face," Porter said. "There's always the stigma, there's always the feeling that you have to be twice as good to get half as much. Because of this, there's always a fear that anything someone finds out about you will be used against you. We're also a strong community, based in our religion. With that, there's a feeling that if you have an issue, you need to take it to God."

As a Christian, she said, she leans into her faith -- but she also believes it's God who brings people to a psychiatrist and provides the medication that helps people to do better or feel better. Porter said pastors, community groups and even celebrities are normalizing the notion of seeking help and encouraging people to share their own stories.

National Depression Screening Day: Sharing experiences can help

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Anxiety can be the enemy of romance

In Smith's research for "Monkey Mind," he saw a pattern emerge when it came to love. "When you're anxious, you tend to scan around for what may be causing it. And often you alight upon that person who is right next to you."

In addition to assuming a relationship is the root of a problem, he noted some people often experience shame that their partners will see them as weak.

In his own life, Smith pushed away a partner, and then in midst of the resulting sadness, felt he needed her and pulled her back. "That speaks to the whole stigma," he said, "the whole worry that if someone knows you are suffering from anxiety, they will consider you to be somehow less."

Can anxiety kill your ability to love?

Gender expectations take a toll

Writer Stossel was struck by the extra burden many men face when it comes to anxiety. "There's a stigma around vulnerability," he said.

"Women have higher rates of diagnosis of anxiety disorder than men do," Stossel said. "That could be for temperamental reasons or for social reasons -- because of glass ceilings or extra pressures. It could also be because it's more acceptable for women to seek out treatment and accept a diagnosis. Whereas men have higher rates of alcoholism, and it may be that we're all just trying to sublimate and are afraid to seek help."

Krakower said he believes it's important, when working with young, male patients, to understand they may feel more stigmatized by school and friends than their female peers. "It's important to make them feel accepted in the individual therapy sessions and then teach them more ways to control their anxiety." These may include learning relaxation techniques, or how to be more assertive and not feel so nervous.

Anxiety doesn't have to define you, so make peace with it

Smith was diagnosed in college -- by his mother, a therapist who specializes in anxiety -- and he called the diagnosis a doubled-edged sword. "It's helpful to name something, but at the same time makes you feel trapped in that particular diagnosis," he said.

"It's important not just to think of it as a disorder or a mental construct, but as an emotion -- a universally held and rather important emotion. We need anxiety, and if we didn't have it, we'd be hit by cars far more frequently," Smith said. "You don't necessarily want to banish your anxiety; you want it to be there to some extent but not rule your life."

Stossel, now 44, spent the first 43 years of his life trying to hide his condition -- before penning a wildly popular and public memoir about it. "There are times when the level of suffering (is) so high, not to treat it as an illness ... is unfair and almost handicapping the therapist's ability to treat it. Even then, I've had to come to terms with thinking of this as woven into my personality and part of my temperament, but not what completely defines who I am."

Anxiety, you're not the boss of me

It might not feel like it in the thick of things, but it's possible to fight back

Porter starts by asking her patients to make a list of what relaxes them and what activities they enjoy. These might include exercising, taking a walk around the block, deep breathing, talking to family members or listening to music. When in the throes of a panic attack, they will have some solutions at the ready and can pick out which are the most effective in the moment.

Smith has found cognitive behavioral therapy effective in changing some of his patterns and also seeks peace through Buddhist meditation, and in particular Zen. Both methods focus on mindfulness and paying attention to thoughts that trigger anxiety.

"The one thing you're not doing when you're anxious is existing in the present moment," Smith said.

Stossel recalled that when an excerpt of "My Age of Anxiety" ran in The Atlantic, strangers inundated him with advice to cut out gluten, sugar and caffeine, eat more fish oil and magnesium, try massages or yoga and smoke pot. But the things that sound the most banal are the most effective, he said.

"They're the things that your internist and your mother and your grandmother told you," he said. "Get enough sleep. It's good for you physically; it reduces depression and anxiety." He also swears by exercise, breathing techniques and cognitive behavioral therapy.

"So many of us with generalized anxiety disorder are gifted catastrophizers and worry that any decision we make or anything we enter into is going to be absolutely catastrophic and existentially damaging," Stossel said.

"But if you actually think it through and imagine the worst thing that could happen, well, did anybody die? Is it really that bad? Then use that to try to calm yourself."

Source: http://edition.cnn.com/2014/01/28/living/anxiety-disorder-survival-ideas/

Traveling with Anxiety Disorder -How one woman with anxiety disorder overcame her fear of traveling.

Traveling this holiday season? You’re in good company: In 2011, an estimated 91.9 million Americans traveled 50 miles or more from home during the holiday season, according to the AAA.

For most individuals, traveling offers an exhilarating opportunity to break out of the mundane rhythms of everyday life and explore new sights, sounds and tastes. But for individuals who suffer from severe anxiety disorders, the mere thought of traveling may provoke intense fear, dread and even panic.

RELATED: Depression or Anxiety: How to Tell the Difference?

“Travel constantly exposes you to new and different things, and comes with a range of unknowns and what-ifs—a potentially endless array of scenarios that can pose a threat to someone trying to keep their nerves under control by way of controlling their environment,” says Rita Anya Nara, author of the book The Anxious Traveler.

Rita knows firsthand how devastating it can be to live with an anxiety disorder. For years, Rita was paralyzed by severe anxiety that inhibited her from doing the things she loved. She struggled with numerous forms of anxiety disorders, including seasonal affective disorder, panic disorder and social anxiety disorder. One day, tired of passively sitting and watching life go by, Rita overcame her dread of the unfamiliar and hopped on a plane. To date, she has ventured to 38 countries and has largely conquered her debilitating anxiety symptoms.

[ Author and blogger Rita Anya Nara[/caption]

Below, Rita shares her “top 10” strategies for conquering anxiety and exploring foreign lands with ease.

Start small. “Start out with small journeys in relatively nearby areas and regions, and by going for a short time with someone you trust and/or love.”

Come clean. “Be honest with yourself – and your doctor – about your phobias and disorder(s).”

Don’t switch it up. “Don’t abandon medications, make rash lifestyle changes, or take an all-or-nothing approach to feeling better.”

Physically prepare. “Recognize and learn how to manage the various physical impacts of traveling that are often a significant (but inadequately addressed) mental hurdle to going abroad. Talk to your doctor about jet lag, travel fatigue, acclimatization, altitude sickness, your sensitivity to environmental factors such as air or water quality, and other similar issues before you leave.“

Focus on you. “Don’t overwhelm yourself worrying about culture shock, etiquette and local customs, and language barriers.  Once you stop paying so much attention to yourself, it’s far easier to assimilate than you’d think.  Remember, you are a guest in another country; focus on being a good guest, and you will bring out the best in people around the world.”

Read more: http://www.pjstar.com/article/20131220/NEWS/312209940/10938/LIFESTYLE