Anxiety

Overview of Anxiety: Anxiety is one of the most common reasons people seek therapy. Anxiety is defined as nervousness and an inability to relax. Some level of anxiety is normal in human beings; excessive anxiety can interfere with relationships, sleeping and eating patterns, work and school, and all areas of life.

 

• Body: People with anxiety may experience psychomotor agitation, pacing, shaking, trembling, quivering, sweaty palms, racing heartbeat, insomnia, tension, headaches, nausea, and difficulty breathing. A panic attack occurs when these somatic symptoms are severe and acute, sometimes mimicking the symptoms of a heart attack (though there is no record of panic attacks leading to actual coronary arrest).

 

• Mind: Anxiety can include racing thoughts, worries, excessive guilt, excessively fearful thoughts, obsessions, and magical thinking.

 

• Emotions: Anxiety is a dysphoric excitement or “apprehensive expectation” (DSM-IV), and may entail feelings of fear, confusion, frustration, and possibly shame and despair. Affect is worried and tense.

 

• Social: People who are anxious may display social avoidance, nervousness, neediness, blaming, and an inability to maintain relations or employment. Some people with anxiety can develop social phobia and agoraphobia, in which people experience intense anxiety in public and isolate in order to maintain a stable mood.

 

• Correlations: Anxiety is often associated with depression. Anxiety can take several forms, including phobias and obsessive-compulsions, which are addressed in separate sections. Anxiety is often found in people with psychotic symptoms, especially those who are paranoid. Anxiety is a symptom of Post Traumatic Stress. Anxiety in its most extreme form, as discussed above, can lead to a panic attack. Anxiety is also associated with passive personalities.

 

The Psychotherapy Model and Anxiety: The Psychotherapy Model views anxiety as a normal response to human experience and survival. Not unlike the fight, flight, or hide response, humans need anxiety in order to act and to protect from suffering. Because anxiety is normal, most people experience anxiety at some point in their life, however limited or mild. Yet, many experience a heightened and uncomfortable level of anxiety causing one to seek treatment. Rather than medicating the anxiety away as a permanent solution, the Psychotherapy Model approaches a person's anxiety with intense curiosity in an effort to help the person to understand and heal the source of the anxiety. Through the process of focusing internally a person can understand, unravel, and transform their anxiety. Sometimes anxiety is the result of an inner polarization (See Case Example: Anna). Sometimes anxiety is the result of unresolved trauma leaving the individual in a heightened physiological state of arousal in which certain experiences have the potential to reactivate the old trauma, as is often the case with Post-Traumatic Stress. Sometimes anxiety results from a lack of, or inexperience at, knowing how to self-sooth. And there are other psychological and emotional reasons for anxiety. Whatever the cause, anxiety can be reduced if not resolved completely with therapy. Indeed, anxiety may be hereditary to some degree, in that some people may be more predisposed than others to develop anxiety in response to life events. Whether one is predisposed to anxiety or not, there is nonetheless a great benefit in addressing anxiety with therapy.

 

The Medical Model and Anxiety:  The Medical Model approach to the understanding and treatment of anxiety views anxiety as a disease or disorder of the nervous system. The most popular medical treatment of anxiety is medication, such as Celexa, Lexapro, Luvox, Paxil, Prozac, and Zoloft. These medications are helpful, and sometimes absolutely lifesaving for those who are paralyzed with anxiety or suffering intense panic. However useful these medications may be at symptom reduction, they fail to address the emotional and psychological causes of anxiety, which more often than not, play a powerful role in the formation and maintenance of anxiety.

 

Diagnostic and Statistical Manual of Mental Disorders (DSM): The DSM identifies eleven basic subtypes of anxiety disorders, most of which are addressed in separate sections. Criteria for generalized anxiety are as follows:

 

A. At least 6 months of "excessive anxiety and worry" about a variety of events and situations. Generally, "excessive" can be interpreted as more than would be expected for a particular situation or event. Most people become anxious over certain things, but the intensity of the anxiety typically corresponds to the situation.

 

B. There is significant difficulty in controlling the anxiety and worry. If someone has a very difficult struggle to regain control, relax, or cope with the anxiety and worry, then this requirement is met.

 

C. The presence for most days over the previous six months of 3 or more (only 1 for children) of the following symptoms:

 

1. Feeling wound-up, tense, or restless
2. Easily becoming fatigued or worn-out
3. Concentration problems
4. Irritability
5. Significant tension in muscles
6. Difficulty with sleep

 

D. The symptoms are not part of another mental disorder.

 

E. The symptoms cause "clinically significant distress" or problems functioning in daily life. "Clinically significant" is the part that relies on the perspective of the treatment provider. Some people can have many of the aforementioned symptoms and cope with them well enough to maintain a high level of functioning.

 

F. The condition is not due to a substance or medical issue

 

Case Examples of Anxiety:

 

Hillary, 23, experiences severe panic attacks whenever she is afraid she has failed or done something to anger a family member or coworker. Whenever she receives criticism, she begins to have trouble breathing, becomes sweaty, and may break out in hives. Her mind becomes completely focused on the offense she has committed, and she may cry, though she suppresses the tears and prevents catharsis. She drinks large quantities of alcohol to help numb herself to these feelings, and may miss work for days, which furthers her anxiety, as she has little income.

 

Bob, 45, is popular at work and very competent, feels highly anxious whenever he is out in public, especially around crowds.  He races home each night, locks his door, and reads in bed, feeling fine once he is alone with the apartment secure. He cannot identify the cause of his anxiety, but in therapy discovers a great deal of repressed anger, which may explain his fear of being of being in public – people trigger his rage, which he has avoided for years.

 

Anna, 26, comes to therapy because of intense anxiety. Anna hasn't experienced a panic attack, but is often on edge, worried, stressed, and has a difficult time sleeping through the night. In therapy, Anna discovers that although a part of her wants to marry her fiancé, Jeff, another part of herself, which she has suppressed, is not in love with him. Identifying this internal conflict temporarily intensifies Anna's anxiety because now she has to face something she hasn't wanted face. Historically Anna has been a people pleaser. It's difficult for her to say "no" for fear of hurting other's feelings and then feeling her own guilt. Anna gains awareness about this and, through the process of unburdening her long-harbored guilt, Anna feels less anxiety others to feel pain. Although Anna hasn't yet decided what she's going to do about getting married, she feels less anxiety now that she is no longer suppressing her ambivalence and feels greater confidence about communicating how she really feels.

 

Therapy for Anxiety: There is a wide range of Psychotherapy Treatment Models or types of therapy used in the treatment of anxiety. Most of these approaches fall into three historic camps of psychology: Psychoanalytic / Psychodynamic approaches; Behaviorism and; Humanism. Regardless of the type of therapy, there are some generally agreed upon elements of "good therapy" which are universal to all forms of psychotherapy. Before beginning therapy for anxiety or any other issue, it is helpful to familiarize oneself with these elements.

 

Books Related to Anxiety:

 

   

 

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Anxiety Article Summaries

Anxiety: Stages of Recovery

By Evelyn Goodman, Psy.D, LMFT, Recovery from an anxiety disorder (and/or depression) usually happens in stages. I mean complete recovery, not only the reduction of symptoms. The first stage is learning how to cope with anxiety or panic attacks. This is achieved by learning and practicing breathing techniques, relaxation and calming exercises, and effective and supportive self-talk. One learns how to not be afraid of, and controlled by, the anxiety and panic. Life-style changes, such as diet and exercise, as well as stress-management strategies that include time management, ... Read the rest of this entry »

A Recession Regression

I, like you, am witnessing the events in our country and our world. I see the crises we are facing, among them the financial crisis. And like you, I have seen in clients the effects of ancient feelings and wounds on their attitudes, emotional states, and behaviors in relation to the present economic situation. I know people are afraid. I know some of the fear is here and now, and some of it is from long ago. To help you tease the two apart so you can respond better to ... Read the rest of this entry »

Positive Family History Contributes to Intensity of Depression - 30-Year Longitudinal Study Suggests

A GoodTherapy.org News Headline It's long been suspected and suggested through quality research that a positive family history for a range of issues can point to an increase in the likelihood that such an issue will present itself. But this isn't to say that people are “predestined” for feeling unwell or seeking treatment. Enforcing this idea and adding a new twist, a study performed over the course of thirty years in New Zealand has shown that while people with a family history of depression, anxiety, ... Read the rest of this entry »

Dialectical Behavioral Therapy (DBT) skills to cope with Rising Economic Anxiety

By Stacy Hall, MC, LAC, NCC The economic situation is hitting people hard across all corners of the country. Most everyone is being impacted at some level and people are experiencing widespread distress regarding a number of concerns ranging from a shrinking retirement savings to those losing jobs and homes. Although some are hit harder than others, the situation is certainly permeating all levels of our society. Whether you are petrified of opening your 401 (k) statement or simply unable to make your mortgage payment, fear and anxiety about finances are ... Read the rest of this entry »

Anxiety Issues

Anxiety - Update to Common Therapy Issues Anxiety is one of the most common reasons people seek therapy. Some level of anxiety is normal in human beings; excessive anxiety can interfere with relationships, sleeping and eating patterns, work and school, and all areas of life. The Basics: Anxiety is defined as nervousness and an inability to relax. In the Body, people with anxiety may experience psychomotor agitation, pacing, shaking, trembling, quivering, sweaty palms, racing heartbeat, insomnia, tension, headaches, nausea, and difficulty breathing. A panic attack occurs when these somatic symptoms ... Read the rest of this entry »

Childhood Experience and Adult Anxiety

Written by Lisa Brookes Kift, M.A Adult anxiety has many faces, manifestations and levels. The type of anxiety I’ve had the most contact with in my experience as a therapist is Generalized Anxiety and from here on when I speak of “anxiety” I will be referring to this. I work from a family of origin perspective, in that, I believe that people’s emotional and/or psychological distress as adults can partially be the result of problematic core beliefs developed in early childhood. A primary hallmark of anxiety ... Read the rest of this entry »

Research Report: Treatment for Children with Anxiety

LCSW A new study published in the New England Journal of Medicine supports the effectiveness of combined medication and cognitive-behavioral therapy for children with anxiety. The study, sponsored by the National Institutes of Health, utilized sertraline, which is sold under Pfizer’s brand name Zoloft, to treat a majority of 488 kids, aged 7-17. Some of the subjects also received CBT, and some got CBT alone. The rest were given a placebo. The results were quite convincing. While just under 60% showed improvement with either medications or CBT alone, over 80% improved with ... Read the rest of this entry »

Study Recommends Distinct Classifications for Childhood Depression, Anxiety

A GoodTherapy.org News Headline With the expected release of the DSM-V slated for 2012, there has been some deliberation within the mental health communities over whether to jointly classify childhood depression and anxiety issues. The extant version of the DSM classifies these concerns in a distinct manner, one which is recommended to be upheld by a recent study to be published in the Journal of Child Psychology and Psychiatry. The study examined symptoms of depression and anxiety among secondary school children ... Read the rest of this entry »

Anxiety and Depression Have Insignificant Effect on In Vitro Fertilization Success Rate - Study Suggests

A GoodTherapy.org News Summary When seeking fertility treatment in the quest to become pregnant, some women may experience symptoms of anxiety and depression, and may further be concerned that these issues could lower their chances of achieving a viable pregnancy. But a new study recently published in the Journal of Human Reproduction suggests that such mental health factors have little to no effect on the success rates of in-vitro fertilization. Though the researchers point out ... Read the rest of this entry »

Taking the "Dis-" Out of Social Anxiety Disorder

A GoodTherapy.org News Summary For millions of Americans and people around the world, social anxiety is a debilitating condition that can lead to depression and other symptoms, as well as detracting from overall quality of life. Given the tumultuous years of adolescence and young adulthood thereafter, it comes as little surprise that a high percentage of those with social anxiety disorder are under the age of twenty five. A litany of treatments from cognitive behavioral therapy to specific medications are often indicated for the disorder, but a new study ... Read the rest of this entry »

Headaches May Hurt More Than You Realize

No one appreciates the onset of a headache - whether dull or sharp, behind the eyes or covering the surface of the skull, a headache can interfere with work, school, playtime, and one's overall ability to focus and cope with the stresses of daily life. But for over thirty million Americans, headaches are far more debilitating. This group is afflicted by migraines, a type of headache notable for its intense pain and sustained duration, causing extreme sensitivity to noise and light, and making even the simplest of tasks difficult. Most ... Read the rest of this entry »

Survivor's Guilt of the Economically Untouchable

Times have been harrowing for professionals in nearly every field of late. As the unemployment rate rises and media attention to the recession shows no signs of taking a break, workers are finding themselves thrust into a financially unhappy situation at larger numbers every day. It's perfectly understandable that those laid off from their jobs are susceptible to ... Read the rest of this entry »

Anxiety: Can You Really Get Rid Of It?

By Becki A. Hein, MS, LPC, One of the most common requests I get from clients in my psychotherapy practice is “Please help me get rid of this anxiety!” I then get to explain the Bad news and the Good news. The Bad news is that you are not going to get rid of your anxiety. In fact, it would be harmful to not be able to feel anxious. Anxiety and fear come with being alive. Anxiety can be useful when it causes you to be extra alert or careful, ... Read the rest of this entry »

Anxiety: Why Me?

By Evelyn Goodman, Psy.D, LMFT, What causes someone to develop an anxiety disorder? This question is one asked by many people struggling with an anxiety disorder, be it panic, phobias, social anxiety or any of the various manifestations of severe anxiety conditions. Someone with social anxiety might start to sweat and shake and be unable to concentrate when meeting someone new. Another person with agoraphobia might want to avoid driving a certain distance from home since that’s the circumstance of the first panic attack. However the anxiety manifests ... Read the rest of this entry »

Back To The Future…Not! - Two Essential Self-Calming Skills

By Becki A. Hein, MS, LPC, You’re worried about money. You’re afraid you’ll catch the flu. You can’t sleep because you can’t stop fretting about… your children, your family, your job or lack thereof, the country/government, terrorists, the stock market, pollution, and on and on. Feeling overwhelmed? Anxious? Then it’s time to get back in the driver’s seat of your own mind! There are things you can do to take control and calm yourself. Did you ever notice that all your worries, ... Read the rest of this entry »

Fear of H1N1 Flu May Spark Anxiety Among Students

A GoodTherapy.org News Headline The symptoms of the so-called “Swine Flu” have been amply detailed among various media in recent months and weeks, but anxiety isn't typically listed. However, many students may be feeling anxious about their chances of contracting the virus, and about what effects absenteeism might have on their grades and other measures of performance. Recently,a counselor at Kansas State University has called for widespread attention to the potential for mental health difficulties among students in relation to ... Read the rest of this entry »

Are You Willing to Lower Your Anxiety?

By Ernest S. Schmidt, LCSW While you can seek out many powerful tools and methods to reduce anxiety, including cognitive behavioral therapy, relaxation exercises, and general stress management counseling, whether or not these methods will have a dramatic impact on your life depends on your willingness to live an anxiety-free life. Are you willing to conquer your anxiety? This may seem like a basic question with an obvious answer; it seems like common sense that everyone should want to free themselves from anxiety and the stress that comes along with ... Read the rest of this entry »

Childhood Anxiety

By Evelyn Goodman, Psy.D, LMFT, The idea that childhood is a carefree time of life is disproved by the high rates of childhood anxiety in the United States. Studies vary but show that at least 10% of school-age children report symptoms of anxiety. Untreated, at least 40% of these children will grow into adulthood with an anxiety disorder. Symptoms of childhood anxiety include extreme shyness, avoidant behaviors, constant worrying, clinging, physical distress (e.g. upset stomach, headaches, fatigue), sleeping problems, difficulty staying focused on a task, and expressions of self-doubt and ... Read the rest of this entry »

Panic Attack? Just The Facts!

By Becki A. Hein, MS, LPC, “I felt like I was going to pass out!”, “I felt like I was going crazy!”, “I thought I was having a heart attack”. These are statements people frequently make when they are describing what it was like to have a panic attack. A panic attack is a sudden rush of anxiety and terror. It can occur at any time, even during sleep, and frequently seems to happen suddenly, “out of the blue”. Symptoms include a pounding heart, sweatiness, weakness, faintness, or dizziness. People ... Read the rest of this entry »

Change Your Mind About Anxiety

By Ernest S. Schmidt, LCSW It is easy to forget that anxiety—a feeling of apprehension, uneasiness, or fear—is a normal human emotion. You might experience it as something physical, like sweating, trembling, or even nausea, or perhaps you feel irritable, worried, or “on edge.” Just like other emotions such as sadness or anger, we all experience anxiety in some situations and to some degree, and most of the time this is not a big problem; we feel a little anxious about taking a test or meeting new people, ... Read the rest of this entry »

Phobias

By Evelyn Goodman, Psy.D, LMFT, Phobias and avoidant behaviors are often a byproduct of panic attacks and high anxiety states. For example, if you have a panic attack while driving in traffic youmay want to avoid driving in traffic in the future. The two situations have become linked in your mind and just thinking about doing it can bring on some anxiety. When this becomes an on-going problem it is termed “agoraphobia” which is defined as the “fear of fear”. You really aren’t fearful of driving in traffic; ... Read the rest of this entry »

Are You Feeding Your Anxiety?

By Becki A. Hein, MS, LPC, Breathing deeply, relaxing your muscles, and staying in the present moment are some of the most common, most effective ways to manage anxiety. But did you know that changing your eating habits can also help you feel more calm and balanced? There are certain foods and substances which tend to trigger stress and anxiety in the body, and in fact, there are several foods that can even trigger a panic attack. Caffeine, sugar, and alcohol all increase lactic acid levels in the bloodstream. Recent ... Read the rest of this entry »

Please add your comments about Anxiety - (click here to add a comment)

  • Ashi 2008-01-10 01:54:42

    hey Lisa, It's really a wonderful experience to watch your kid toddling, playing, the first words he/she spoke... these remain in your memory throughout your life. Isn't it.

  • Ralph 2008-01-10 11:05:33

    I found this blog to be both helpful and insightful. It does seem that most anxiety does link back to childhood experiences. But, what about the adult that is anxious due to new fears developed in adulthood? Can something like watching the news on a regular basis trigger anxiety that wasn't previously there? Or, is it just a reawakening of an anxiety that has lain dormant for some time?

  • Martin 2008-01-10 11:07:49

    Do you find that those whom you treat break the cycle of abuse? Are abusers who they are because they are repeating what they have seen or are they abusers reacting to anxiety? Or, maybe both? It seems that some people who were abused as children have the ability to do a 180 in adulthood and be very nurturing, devoted parents. While, many others are abusers themselves. I wonder what the difference is in these two types of people. What makes one person go one direction while another person goes another direction?

  • Dianne 2008-01-10 11:10:13

    I think that those who were abused as children but do no abuse their own children have had rehabilitation of some sort. I don't know if you can just undo damage within yourself without some sort of outside guidance. Is it always therapy? No, not necessarily. I think that sometimes a single life experience can be this rehabilitation. It may be an award one that gave self esteem to the abused person. Or, it could have been a devoted teacher who really understood the abused child and was there to lend a helping hand and a listening ear. Whatever the source, I do believe that abusers will abuse others if they are not rehabilitated.

  • Augusta 2008-01-10 11:13:18

    I agree with Dianne to a point. However, I do think there are exceptions to this rule. I think that some people are born with insight and are able to sort things out themselves. But, then again, maybe that sorting is their own rehabilitation. But, I don't think it necessarily has to come from an outside source. As therapists, that's sort of hard for us to see. We only see those who are seeking help for one reason or another. We wouldn't necessarily know the people who have healed without outside assistance. But, I do think a conscious decision has to be made. I think that in order for the cycle of abuse to stop, an abuser has to find the strength to recognize the fallacies of his or her childhood, recognize that those fallacies were not his or her fault, and make a daily deliberate decision to turn away from those fallacies.

  • Michelle 2008-10-08 22:55:45

    I've been in therapy recently as I was rushed to hospital with symptoms of a heart attack. The ECG said so but on further investigations they found that I was suffering from an anxiety attack. I work as a stockbroker and life is pretty much 24/7. I've been asked to change profession or find ways of slowing down. Changing my scenario is hard as my job sometimes doesnt allow me access to even the hallway. I didnt realise I was anxious for everything and anything till my son told me to my hands were shaking at dinner time one day. Anyways this article definitely double confirms it.

  • margaret 2008-10-10 04:53:04

    Did I read somewhere recently that General anxiety disorder is one of the most common diagnoses in the country?

  • Sandy 2008-10-13 03:34:23

    I think that you are right. Seems like there are more people than ever before on anti anxiety medication!

  • James 2008-10-21 23:55:28

    how do i know if i have chronic anxiety disorder?

  • Nicole 2008-10-22 13:12:06

    My husband is on anti anxiety medication and it is the best thing that could have ever happened for him and for our marriage. Before consulting with a physician about this, his panic attacks would literally leave him confined to the house in a constant state of distress and anxiety. It was really taking a toll on our lives. Thanks to an understanding doctor and some trial and error with several different medications he is on the path to a strong recovery and everything is going well for us again. Do not doubt the seriousness of any anxiety disorder. They can be crippling and have a devastating effect on the lives of many today.

  • Jeanette 2008-10-26 13:10:50

    But don't you think that this is sometimes overdone as a diagnosis? A doctor does not know what else he can term what ails you so it is all chalked up to anxiety issues? I am all for talk therapy to get past these issues but I still fail to see how medicating someone for something like this will help them get to the root cause of what is causing all of the anxiety in the first place. I just think that this is kind of a catch all just to give someone a diagnosis for something which may or may not be real. I am not trying to step on any toes but I do think this should be considered as a valid point of view.

  • anxiety sucks! 2009-05-19 10:41:28

    For years and years I have taken meds to help me with my disorder. My world has shrunk due to avoidance, and I mean literally shrunk as I do not drive beyond my town and I will not be a passenger with anyone except the few people who know

  • john jacob smith :) 2009-06-09 12:45:02

    Go to a psychiatrist and ask. Everybodys different and they may have to try different meds on you until you find whats right.

  • Reena 2008-11-04 09:25:13

    Teenage suicide is at alarming rate now. I really hope this medicine could help to reduce this rate. Cognitive Behavioral Therapy (CBT) looks very promising. I hope CBT could be tested on adult individuals too.

  • Lisa B 2008-11-04 09:33:44

    That is very good news. Being the mother of a teenager who used to suffer from anxiety, I know how important effective treatments for anxiety in children are.

  • Larry_1950 2008-11-04 09:41:28

    Children these days ...... so many problems. It's good to know that there are many brilliant people working to help the children who have anxiety issues. @ Reena - I couldn't agree more.

  • jeni 2008-11-04 10:00:10

    I too have a teen age son and hope that he never has problems with anxiety. I am very much in favor of medicine to help correct this and as a parent would use this treatment myself

  • Tawnee 2008-11-04 11:17:28

    I believe that children, especially at a younger age, are innocent. They need all the help they can get and they need the understanding from an adult, if not from a therapist. Some doctors, I know, are hesitant in prescribing meds to young children, in whatever cases. If the medicine helps the child,then I think it would benefit them.

  • Maggie 2008-11-05 03:52:14

    Where is all of this anxiety in children coming from? I believe it is because we no longer allow kids to be kids. There are so many pressures applied to them at such an early age- be involved in extracurriculars, make straight A's in school, be the perfect child that I need you to be in order to reflect a positive image on me. Rarely are children given time to be free and just play and have a good time like they were given in the past. I see too many parents, teachers, etc who are contributing in such a negative way to the amount of pressure that children of all ages feel and then manifest openly. While I am glad that there are treatments out there which are working to help resolve many of these issues, these things are only a band aid which is masking the true problem. As a society as a whole we now expect too much from our kids and I personally think that the time has come to give them a break.

  • Shannon 2008-11-06 03:48:48

    Has there been any research done that shows any long term side effects all of this medicating of children can bring about? Didn't I hear several years back that Ritalin could stunt the growth of kids? Are some of the meds being used now showing the same effects?

  • Irene Williams 2008-11-06 10:31:29

    I think Maggie makes a good point. We do not let children do what they want and have fun. We force them to study, get good grades and so on. Let kids be kids!

  • Nehaa 2008-11-07 00:45:07

    I agree with Maggie that there is too much pressure on the kids nowadays but unfortunately in these competitive times it just can't be avoided. The next best thing to do is to seek medical aid so that the children do not have to suffer through the same anxiety syndrome that the adults go through. Jeni, I have a teenage son my self and examination days can be really nerve racking. If CBT helps,it is definitely a step in the right direction.

  • Johnson 2008-11-08 11:53:51

    I have to agree with Maggie as well but feel like this can be avoided. We are all so busy keeping up with the Joneses and their kids that we tend to forget about our own kids and their own unique needs. We profess to want everyone to be an individual yet when it comes right down to it we all try to make sure our kids and we are doing all that everyone else is doing. No wonder the kids are stressed- it makes me stressed just thinking about it! I am in no way innocent- I have found myself at times comparing my own achievements and those of my children to others. But at the end of the day I have to tell myself that this is not what matters. What I want more than anything is a safe and happy family, no matter whether or not anyone else thinks we measure up. I am the judge of that not society and I refuse to put this kind of pressure on myself or the kids anymore. We have to break this cycle because it can be avoided, we just have to work to make that happen!

  • Tiff 2008-11-10 02:53:57

    I agree we should let kids be kids, but also encourage them to do good in school and work hard. We shouldn't expect our kids to do better than someone else.

  • Danielle 2008-11-10 04:28:40

    OMG let kids be kids and we will not have to worry about all of this!

  • Melanie 2008-11-11 05:28:25

    My main concern here is giving children so much medication and having no real idea what this is going to do to them later in life. There must be better solutions for a problem that is so preventable and avoidable. What kind of long term health effects are things like this going to have on our kids? I know one thing- I would have to think long and hard before agreeing to put my child on medication like this.

  • neena 2008-11-11 07:35:42

    Unfortunately most of us live our dreams through our kids. As parents we are always guilty of pushing our kids to achieve where we failed or ask them to reach greater heights then we ever did. If we just guide them and accept them as they are with all their success and failures, I think we will have happy kids who will not require any form of therapy.

  • Juanita 2008-11-13 01:30:00

    I dont think we should live our dreams through our children. They have dreams of their own. Helping them along the way is the reason we are here. Birds dont teach their children to fly their way or make nests where they did. Happy children are not children without responsibilities but children who know that responsibilities can be fun when there is a fun way of doing something good and tangible. A winner is someone who learns to have fun along the way and has time to stop and smell the roses!!

  • Ryan 2008-11-13 04:05:56

    Treatment for children with anxiety? Treat the parents- therein probably lies the biggest source of the problem.

  • Kiera 2008-11-24 19:55:07

    Anxious children??? What is this world coming to?? Have we forgotten what it means to be a child?!!

  • William 2008-11-25 06:31:23

    It is readily apparent that a number of the posters to this blog do not have any experience of living with a child with anxiety or understand anxiety. Many children suffer from anxiety not because of being "structured" or not being able to "play" but rather because of a chemical imbalance. Blaming the parents or suggeting play therapy entirely misses the point. These children suffer from anxiety regardless of the situation. Going to school, new situations, playing, are all anxiety producing. This study is a welcome development.

  • Jenina 2008-11-27 01:31:47

    My baby is 7 months old and suffers from a weird acidity condition. The paediatrician said he seems anxious. Could this be a chemical imbalance from birth? This did not develop suddenly and the baby always seems uncomfortable.

  • Megan 2009-01-06 06:12:39

    I am dismayed that there are so many kids having to be treated for anxiety. What on earth are we doing to our children today to cause them so much worry? We have got to get better at being a little more low key and slowing down to smell the roses. We have provided our young children with so much worry that they are unable to handle that it is sad that they are losing their childhoods over this. I never had to deal with this when I was growing up and do not think that any of my friends did either. But there are lots of kids the age of my own children that I know have to take medications for this.

  • Noreen 2009-12-04 14:39:38

    Excellent points.

  • kea 2009-01-26 02:02:22

    I am very fortunate to not having migraines. I know lots of people who do and wonder why the medication does not help. I wish there were more that doctors could do to help alleviate their migraines.

  • Daniella 2009-01-26 02:03:25

    I usually get the sinus pressure... not really a headache but a dull ache due to sinus... This alone sometimes prevents me from doing a job 100%

  • Allie 2009-01-26 02:04:51

    Migraines are still a mystery to me... some people have these terrible headaches while others never have them. Could migraines also be genetic?

  • Tessa 2009-01-26 04:37:24

    I suffer from migraines and I know first hand how debilitating they can be and just how helpless they can make you feel. You try to avoid certain things that you are sure are what cause the headaches and then boom! Something else will trigger it. I have never been clinically depressed thank goodness but I know there have been times when I feel that I have lost so much of my life due to migraines and the sickness that they have caused me. It is easy for me to see why others who suffer from them could easily go into a decline and become depressed. When you have one there is nothing you can do to get past it but wait it out and that is not a good feeling at all. Hopefully one day there will be a more clear cut idea of what causes these and there will be some better treatments on the market for those of us who have to live with them.

  • Jennica 2009-01-26 08:21:25

    From what I hear of migraines I can understand as well why some may be depressed. As painful as migraines can be, it would drive anyone be upset, depressed and just plain tired of the whole mess. I hope something comes out to help with this.

  • Meleah 2009-01-27 02:16:03

    My mother suffers from these migraines and it is hard to see her go thru this pain. There's nothing I can do and the medicine she takes rarely works. She just tells me that it will just have to pass, but what can one do to help lift the pain somewhat.

  • Tanna 2009-01-27 02:22:56

    I wish there were more studies and remedies for this type of headache. It affects so many and intereferes in daily lives when you have a job to do.

  • Timothy 2009-01-27 02:58:29

    I dont know what comes first - the migraine or the depression. When u r depressed persistently you get a headache. When u get headaches often u get depressed. I've seen my mother have migraine attacks for 40 years now and I think she has tried every kind of treatment under the sun but it has persisted with the years.

  • Aimee 2009-01-27 05:28:05

    I have had great success with Topamax and treating my migraines. has anyone else out there tried this?

  • Viola 2009-01-28 01:51:55

    This was a very interesting article and having suffered from migraine attacks for 10 years I found yoga, tai chi and mild pain killers worked for me. I guess everyone has their own medicine.

  • Sue 2009-01-28 05:30:05

    I have never had a migraine and hope I never will! I know that this has to be something genetic to getting migraines because they do seem to run in families. My mother in law suffers from the occassional one but not enough to completely cripple her life. However I am sure that this could easily happen to some people if they experience them with regular frequency.

  • Noelle 2009-01-29 05:25:51

    It seems that more females suffer from migraines than men do. Is this true?

  • Michelle 2009-01-30 23:27:19

    I was thinking the same thing as Noelle. More women seem to suffer from migraines. Havent heard my male colleagues complain till today of one. I wonder whether it is because women seem to internalize their problems a lot more than men.

  • Andy 2009-01-30 23:28:47

    Sinal headaches can be bad as well. I have had a little relief with acupuncture and I think it helps with migraines too.

  • Nikki 2009-01-31 09:07:54

    If you have never had a migraine headache then you have no idea how devastating they can be. It is one of the most horrible pains you could ever imagine and it is so long lived that you might often feel like you just want to die. And the bad thing is that even once they go away I feel almost dazed and stunned for days afterward. I have never experienced a serious depression because of them but let me tell you something. I try to at all costs avoid those things which I know are my migraine triggers. Of course there have been times when one has completely sneaked up on me but I do everything that I can to stay far away from things that I know are more likely to bring one on.

  • Kelsey 2009-02-03 13:51:38

    Can anyone out there tell me if headaches, frequent ones, are associated with depression? My husband is really depressed right now and has had a headache for days but will not talk to his doctors about it, just keeps popping more and more Advil but with no help. Could this be brought on by his medication (Zoloft) or the depresison itself?

  • Tressa 2009-03-16 07:11:45

    I wish there were more studies, medicine and help for people who suffer from migraines. I know there are meds out there to relieve the pain somewhat, but nothing to actually relieve it significantly.

  • Jane Watson 2009-05-20 05:57:01

    Very nice article on migraines. Thanks for the great tips!

  • Stacy L 2009-02-07 08:33:24

    I read the beginning of ths article and it could have been talking about me. I am deathly afraid to open our investment statements when they come in the mail because I know the likely bad news that they bring and I know that I am unready to face these facts. I hope that I can get to the point where I can dig my head out of the sand but I am not sure that I am quite there yet.

  • Stacy Hall 2009-02-07 12:16:25

    Hi Stacy, Perhaps you are not truly sticking your head in the sand, but merely doing what's most effective for you in the moment. It may be a wise decision to choose to not open up those statements. Thanks for your comment.

  • Steve 2009-02-09 16:13:38

    It is so funny that I found the terms radical acceptance here. I had never heard of that before today when I was meeting with my own therapist and we were discussing some issues that have come up in my own life lately. I go into complete denial when it comes to so mnay of my issues in life, and her response was to get me thinking about radical acceptance and no longer being in fear to face what is out there. This direction in my own therapy has led me to some very critical realizations about myself and I am sure that it could do the same for others as well.

  • AMH 2009-02-17 14:20:40

    Radical acceptance of our situation is key to all healing processes. thanks for addressing this and bringing it to the forefront.

  • Hannah 2009-02-28 15:25:44

    Been going to therapy for a while now and it has helped me deal with a lot of issues from the past as well as the present worries. Recommend for anyone with stress.

  • Wildhaber 2009-07-13 12:22:13

    Very nice post! What I like most about is the fact that you don?t try to force your opinion on anyone. You just kind of lay the information out there and let people make their own decision. Keep doing what you do.

  • alli 2009-02-09 16:10:04

    I have found in my own life that I can greatly reduce the amount of stress that I feel by simply making goals for the day along with a to do list- I feel a great sense of accomlishment when i can mark things off of my list and it helps to greatly reduce the stress and pressure that I feel throughout the day.

  • Laura 2009-02-10 15:12:38

    Diagnosed with social anxiety disorder when I was a teenager I have found my twenties to be pretty horriffic. trying to balance my fears with college, a job, and everyday living has been quite difficult for me. The recent economic crisis has made my disorder even worse. None of my meds seem to be helping too much and I think I may need a new therapist but really do not know how to break up with my current one. Would it be ok to solicit advice elsewhere? How would I go about getting a referral to another doctor? I am clearheaded enough to know this is probably a step I need to take but I guess I am just not sure how to get started. I think the gwriting therapy sounds interesting and was thinking of finding someone who could help me to pursue this possibility.

  • Deborah 2009-02-17 14:19:12

    Without my anxiety medication some days I am a real mess. But it does help knowing that there are those of you out there who recognize that this is a real problem and are working to help those of us who experience very real issues with anxiety. There have been times in my life when I have gotten really down about it, and have not known how to deal. My medications do help as well as talking with doctors and friends whom I do not feel are judging me harshly for my condition or looking down on me. It is good to know that study continues forward with people with anxiety disorders and that there continues to be those who care about helping people like me with the symptoms.

  • Jim 2009-02-28 07:03:04

    I dont know if my son is suffering from this as he is always anxious about everything. He sweats and sometimes cant think or talk coherently when he has tasks to do. Happens a lot around times when he has work at school or while meeting new people.

  • Bonnie 2009-02-28 15:24:12

    Jim I think I would have my child seen by a psychiatrist or at least a counselor that you can trust at his school. In fact there are many school districts that offer free testing in situations such as this. If he is indeed suffering from some type of anxiety disorder it is probably going to only get worse as he gets older and that could really be damaging to not only his academic career but to his entire life in general. There is no time like right now to take action. If you avoid the situation it is probably not going to get better or go away on its own. I am speaking as the voice of experience because not ony do I suffer from this myself but have a young child who does as well and when left untreated it is not a pretty site. I am not saying any of this to scare you but to hopefully motivate you into taking positive action. There are some things we juat cannot handle alone and this happens to be one of them.

  • how to deal with anxiety 2009-08-03 03:19:58

    Anxiety can create problems for you if not taken care of in its earlt stage. There are many natural herbs and therapies which can cure anxiety. Some natural anxiety remedies to look into are St.John's Wort, SAMe, L-Theanine, and Tryptophan. There's also cognitive behavioral therapy (CBT) and programs like Panic Away and The Linden Method, to name a few. Hope this helps!

  • social anxiety treatment 2009-09-01 18:20:51

    Stress and some unpleasent experiences may lead to anxiety. Some natural anxiety remedies to look into are St.John's Wort, SAMe, L-Theanine, and Tryptophan. There's also cognitive behavioral therapy (CBT) and programs like Panic Away and The Linden Method, to name a few. Hope this helps!

  • Jean 2009-02-10 15:04:19

    There are so many of us out there myself included who have over the years developed such a sick relationship with money. We are told daily by advertisers and others what we need and why we need those material things and we have bought into the whole plan. We ate it hook line and sinker. And now look at us. Yes I know that the economy is in a bad way but it is not something that has never happened before and not something that will never happen again. It is the typical economic market at work and making the corrections that happen naturally. Yes things will eventually get better. But can we as a society? I am hopeful but I am not so sure.

  • Oliver 2009-02-11 16:17:57

    Jean we can all heal as a country but we have an awful lot of work to do. None of us want to lay the blame upon one person- we all have to take responsibility for our actions, own up to them, and work hard to make amends. I have felt myself sliding as the news all over the country gets worse and worse every day but I know that it is going to take a conscious effort to see that everyhting improves. I think that the power of positive thinking is what many of us need to be employing right about now.

  • Judith Barr 2009-02-11 16:40:21

    Dear Jean . . . The end of your post warrants a heartful response. You said, “Yes things will eventually get better. But can we as a society? I am hopeful but I am not so sure.” The hope lies in each of us doing our own inner work healing psyche and soul, wherever we are wounded, wherever our relationships are distorted. For example, our relationship with money has been formed much earlier than times when advertisers and others tell us anything about material things. If we have healed our relationship with money at the youngest ages – where it was formed – we would not be hooked by the advertisers and others. The hope lies in each of us doing our own inner work...working with all aspects of ourselves...dark/light, positive/negative, fear and hope. Each one of us who does that work, helps not only him/herself, but also helps all of us. I hope this inspires you and gives you hope, Jean.

  • Jean 2009-02-14 13:53:15

    I am working on that everday Judith. Thanks for your encouragement.

  • Judith Barr 2009-02-14 19:14:42

    Good for you, Jean! If you are a therapist, Noah and I are working on my offering a teleconference for therapists on this subject, which I'm hoping will help on even deeper levels.

  • Loveless 2009-02-28 06:56:15

    I think all of us realise the power of money in our life right from childhood. We always need more and we form needs for that more. When the basic means of earning that is cut off we dont know what to do with this castle that revolves on money. We went through hell as my wife and I both lost our jobs at the same time. 3 months later she has found work but our tornado has weakened. We are definitely rediscovering the simple joys of life and not our money.

  • Judith Barr 2009-03-01 07:45:17

    Dear Loveless, I'm so sorry for the hell you have been through and glad to hear you are coming through it. When you are ready, utilizing the exercise in the article you read, "A Recession Regression," can help you come through it at the deepest levels, and can help you sustain the new life you are creating. Many blessings, Judith

  • Ryan 2009-04-14 03:40:33

    My sister has one of those jobs as a nurse at a hospital with a critical shortage so she is being thrown more money and benefits everywhere she turns for them to keep her. While she knows that speaks highly of her and how valuable she is she does keep a lot of this to herself because she has friends around her losing jobs right and left and does not want to make them feel even worse. This does not really seem fair to her as she should be able to celebrate how worthy she is but knows now is not the time to be doing that.

  • Angela 2009-04-15 04:09:21

    Lost my job and I have to admit that it is hard to hear others who talk about their job security and how they are going to ride this storm out. It makes me feel bad to think thoughts like this but just once I wish that some of these people would have to take a walk in my shoes for a while and be a little more sympathetic to the situation that many of us now are finding ourselves in. It is not fun believe me.

  • Shannon 2009-04-17 03:51:49

    I just try to tell myself everyday to be thankful for what I have and to appreciate every opportunity that is thrown my way.

  • Madison 2009-04-19 04:15:04

    I have a job that is very safe and yet it does make me feel very guilty when I hear from others just how hard things are for them right now. This is definitely a scary time and I am pleased that my professional field will probably remain untouched. But that does not mean that I am immune to what is going on for others in the country or that I have no compassion for them. I do. But I cannot help that my field happens to have that job security that is not being affected right now. One day I may be in that same boat but I do not want to have to feel guilty. But I still do becasue that is what everyone seems to imply that I should feel.

  • Debbie 2009-04-26 23:15:49

    My situation gets a little more complicated as my husband, brother, best friend and neighbour have lost their jobs. I am their muse and I cant even tell them that I am upset about the jibes and ridicule as their situation is definitely bad when compared to my feelings.

  • Leon 2009-04-28 21:14:25

    Wow debbie!! I dont want to be in ur shoes girl!! Hey, jus' one thing to say to you. You didnt issue their pink slip. Stop feeling bad about this and get a loooong arm like elasto girl and wrap it around them. Do your best to help them get back into the job search.

  • Andrea 2009-04-30 02:28:08

    My boyfriend lost his job while I still have mine where we both worked. He is bugging me to quit saying that the organisation was very unethical in using me to tell him about his quitting. I am both guilty and confused and unable to do a good job at work. I am worried my guilt will make me lose mine.

  • HillaryL 2009-07-14 13:15:42

    interesting, makes we wonder what the contributing factor to more suffering would be for folks with a family history... Nature or Nurture? genetics or Learning? The Psychological effect on someone who knows their family history alone could worsen one's attitude and increase suffering. makes me wonder if the study took into account whether or not the subjects knew their family history or not...and other attitudinal measures. i'll have to check it out. thanks for the fascinating headline.

  • paul knowles 2009-07-14 13:18:20

    I think the subjects would have to know their family history in order for the study to collect the data they needed to make the correlations. Unless of course they took the family history from a relative...which would have been a very good idea. Please let me know what you find out. Thanks.

  • William 2009-07-15 02:42:26

    One of my aunt's died of schizophrenia not understood and left untreated more than 2 decades ago. It definitely left an impact on the family as my mother suffered from chronic depression because of taking care of her for 25 years. It impacted our lives as well and I dont think any of us has been able to keep relationships with people. Given that I wonder if there is a strong family history which plays a big part in mental well being.

  • Amy 2009-07-15 03:43:15

    Interesting info here. Although I do believe depression, alcohol and drug dependence may run higher is families with these problems, I also think that there are strong individuals whom faced with this in their families can overcome this and don't have to end up like their families.

  • Pam 2009-07-15 20:10:36

    Really interesting to note. Is this definitely proven? There is a large prejudice about mental illnesses being hereditary. It can be very difficult for families to lead a normal life when word gets around the neighbourhood about a mental illness.

  • themuse 2009-07-15 20:39:41

    My ex father-in-law was schizophrenic and my husband was scared he would be too. He was obsessive about his own mental health and our children's. He wasn't schizophrenic. The prejudice Pam's talking about isn't always outwith the family. Is that harder or easier to deal with? I don't know.

  • Olivia 2009-07-16 03:44:36

    When you grow up seeing family members enduring such suffering it is easy to see why there are people who think that this will be their destiny as well. What else do they have to compare it to or anything that would make them think that their life will be different?

  • guy 2009-08-04 02:34:06

    If this is proven true, then it calls for a celebration. But while further research is still needed, then we could only hope for the best.

  • casey 2009-08-03 21:26:06

    I think further research is needed, it's just hard to believe that anxiety and depression would not have an impact on one;s reproductive health...especially in the case of major depression and panic disorders.

  • Brandi 2009-08-04 03:48:01

    First of all let me say that I have experienced both the heartaches and the joys that come along with in vitro fertilization treatments. I had my first child via in vitro with no problems, but have yet to be successful with maintaining a healthy pregnancy the second time around. There have been many tears of anxiety and frustration as well as those of happiness. I too cannot believe though that stress and depression do not play a role in how successful the treatment can be. Stress just seems to have too much of an impact on our lives overall to not play a part in this as well. Sometimes the best surprises are those which come when they are least expected and thought about, and that is why I always try to just not think about the upcoming treatments and just get to a point where I can say that whatever is meant to be is what will be.

  • Carter 2009-08-05 09:04:17

    Agree with Casey on this one. For me the jury is still out and there needs to be way more research in the area before anything is deemed conclusive.

  • Elizabeth R. 2009-08-12 09:38:17

    I never understood why the doctor always told me to relax and not stress out about it when I was trying to conceive. I don't see the connection between the physical dynamics of fertilization and your mental state.

  • Martha T. 2009-08-14 16:56:07

    I can't side with this. A couple I know were informed they stood very little chance of conception. They tried for eight years before giving up and opting for adoption. Six months after they adopted a baby girl the woman got pregnant against all the odds. The reduction of the stress of trying for a baby has to have been a factor, don't you think?

  • VictoriaL. 2009-08-16 13:36:20

    I agree with Martha. This study's findings are flawed. I have a relative that decided to go with the flow because she was getting so obsessive about conceiving her marriage was in jeopardy. It was all she talked about, read about and thought about. When her husband said he would rather divorce her than live under that pressure any longer it shocked her into stopping. Within a year she conceived no problem.

  • Craig H 2009-08-16 13:45:49

    Ladies, you've got to admit though it's fun practicing until the stork comes along!

  • Marilyn Biggs 2009-11-12 11:05:35

    Please call me I am having anxity problems and need a good doctor to help me through this . I need a doctor that will get me medicine to handle my life better and i need an apt soon also I am not sleeping. thanks Marilyn Do you take atena medicare I sure hope so this is what I have I cant pay a doctor big money. I have insurance Im on social security thanks Marilyn Biggs

  • Stefanie Luna 2010-01-16 12:23:42

    Boy! This is so discouraging to read, especially when I see the emotional impact of infertility on my clients, on a daily basis. We already know that high levels of stress and stress-related hormones can lower our immune defenses, accelerate the aging process and from my experience often results in women dropping out of treatment because they don't have the emotional reserves to withstand the emotional roller-coaster associated with IVF and other fertility treatments. Studies also show that a history of infertility or pregnancy loss increases the chances of postpartum depression We also need to be thinking of the long-term affects of infertility for women and families. Read more here. http://www.fertilitycommunity.com/fertility/postpartum-depression-and-infertility.html I certainly hope we continue with longitudinal studies so we get a more comprehensive picture here.

  • Teen Anxiety 2009-10-11 08:30:02

    The verdict for this decision should be an interesting one.

  • Carol 2009-09-30 08:37:27

    makes sense because you know that the treatments have to be different for children with these symptoms than they are for adults, or at least they should be.

  • Justin 2009-10-05 04:16:54

    This world doesnt like good children. They are jeered at, called freaks and generally the ones that noone wants to be seen with. I would know since I watch my daughter everyday. Why is there so much pressure about sexual promiscuity these days? Isnt there anything more in high school than flashing yourself?

  • Ray 2009-10-01 05:43:32

    Common sense I would say!! Children definitely do not possess the same maturity level as an adult. Physiological changes are a constant in the pre-teen and teen years. A more relaxed yet patient, trusting approach has to be achieved when dealing with a child patient.

  • Gabby 2009-09-30 01:50:21

    I personally think children's psychology is very different from that of adults in a way that their mind is developing and constantly encounters new things that inturn trigger changes... This definitely calls for distinct treatment for children.

  • Laurel 2009-10-23 10:32:14

    Hello - Do you have any advice about how to deal with a relationship with a person who has symptoms of anxiety but who has not accepted or acknowledged that there are any problems? I am dating such a person and his anxiety is getting in the way of sustained intimacy or relationship growth, but I don't know how to help him become more aware of this. Thank you.

  • Evelyn Goodman 2009-10-22 17:53:47

    Counseling of psychotherapy can be very helpful when you are going through a very stressful time or when caught in the grip of an anxiety disorder. Understanding why and how you got to where you are is the first step. It also gives you some idea of what you may need to work on.

  • beaty 2009-10-22 03:06:01

    While the article is from an expert, I would say timely counseling can solve the problems of anxiety and stress. I got laid-off from my job about an year ago, and had difficulties even paying my bills... I developed a lot of stress in that period and thanks to a friend, went in for counseling and although I am in a much less-paying job today, I feel content and happy and I'm not stressed at all.

  • jason 2009-10-22 03:20:53

    A series of events may trigger the onset of anxiety and stress in a person and these events are mostly negative and any person, when in a negative situation, does experience feelings that are very new and are bound to push him into such a feeling of anxiety or stress.

  • Tawny 2009-10-22 04:50:39

    Loved the article- makes a great deal of sense. Goes to show that something like this can't be broken down into simple nature versus nurture problems. This is a combination of a lot of different factors and a lot of it boils down to the coping mechanisms that people have and how they are able to deal with and manage stressful situations.

  • Amy 2009-10-22 10:56:25

    If the physical aspects of a human are complex, the psychological and mental aspects are much more complex. There is no single reason for making a person have a fear about something or to make a person react in a particular manner in a particular situation. There are plenty of reasons for each action and reaction of a person, and although learning everything is a very daunting task, understanding atleast a little of it can help us.

  • Evelyn Goodman 2009-10-23 13:53:36

    Letting him know how his untreated anxiety problem affects you and how it affects how you feel about the relationship is the best approach for you to take. He can then decide how to deal with that. Ultimately it's his decision to acknowledge or change some aspect of himself.

  • Fletcher 2009-10-21 13:56:49

    Interesting article. Thank you Evelyn. Do you feel that any one of the four components you listed there is more of a precursor to severe anxiety than another? In other words, does one carry more weight?

  • Elizabeth R. 2009-10-21 14:48:17

    Evelyn, thank you for posting this. I don't understand the difference between a stress disorder and an anxiety disorder. When I am very very stressed I have moments when I feel like I shut down from the world around me. It's as if I'd flipped an on/off switch in my brain for a couple of minutes to give it a break from all the noise. I'm not unconscious or anything, just still. I'm aware of things going on around me. The best I can describe it is I'm looking at it all from behind a storefront pane of glass, where the sounds and goings on nearby are muffled and the volume turned low. I'm observing but not feeling. Is that anxiety then and not stress? I have a depression dx.

  • Evelyn Goodman 2009-10-21 17:08:28

    Thanks for the feedback. I don't think one area of contribution is more significant than another. They work together in a unique way in each individual. Do you have any thoughts on this?

  • Evelyn Goodman 2009-10-21 18:18:43

    Elizabeth, An anxiety disorder is a stress-related condition. Chronic stress can affect us in many different ways, anxiety being one manifestation, depression is another. From what you've written, it seems that you have a way of coping where you distance yourself from what's going on. I can't tell from what you've written whether this is helpful to you or not.

  • BARNEY 2009-11-09 10:57:43

    Wow...never thought there could be something like a 'earthing' to get rid of negative energy...its just like passing on the extra current to the ground to escape an electric shock! Great technique explained in the article, thanks a lot... and yeah, you can be sure I'm gonna try this the next time I have any 'future distress' :)

  • Peter Siddle 2009-11-09 11:10:28

    You are so right! While i was reading the article,i was just reflecting back to the times and things i keep worrying about and just realized that most of it is centered around the future and some events that i don't even have control on!Now what is the use of fretting and worrying for such things...? As if my worrying is going to solve the problems or is going to make sure I dont catch the flu;) It is infact more wise and practical to focus our energies on the present and accomplish goals and targets rather than wasting time over things that we have no control on, just as you have mentioned here.

  • wendy thomas 2009-11-09 16:41:52

    Yesterday was history, tomorrow is a mistery and today is a gift, and that is why it is called the present. One cannot stress enough about how true this statement is... we have little or no control over what is going to hapen in the future and worrying about it is just waste of time... Planning is good...planning is arranging something that is to be done when the future becomes the present, but worrying about it is worthless...

  • SHAWN ARMSTRONG 2009-11-10 10:27:50

    Although fretting is not too required, thinking bout it in moderation is a good thing... because just like you cannot just close your eyes and drive into a street, you cannot take everyday and longer future as it comes... you will have to plan and think and look ahead to the future.

  • Becki Hein 2009-11-10 15:17:45

    Barney - It is amazing, isn't it?! In fact, I use that example when I teach people about grounding their energy. It's like when you look at electrical lines, and every so often there is a line leading down into the ground, so that if there is an extra strong burst of charge, it goes safely into the ground.

  • Becki Hein 2009-11-10 15:21:53

    Peter, Wendy & Shawn, - I agree with you all! Planning is important. And there is a big difference between planning and worrying. Planning, for a finite period of time, is energy well spent. One doesn't generally get spun into a distressing emotional state during planning. Worrying, however, is a waste of energy. One is expending massive amounts of (negative) energy on an imaginary event. In fact, spending that much energy on thoughts of the future can even cause them to have a higher probability of actually happening. You're better off planning and then letting it be what it is. Thanks so much for your comments!

  • oram 2009-11-10 15:45:37

    There needs to be campaigns in schools saying panicking is not the way but precaution is... this would help in calming their nerves and keep the flu at bay and also in keeping it out of the campus...

  • Scott Styris 2009-11-10 16:01:25

    A little less stress from the teachers' side combined with advisories from the school will go a long way in keeping the students from being over-anxious during this kind of a scare...

  • Evelyn Goodman 2009-11-18 17:29:32

    I totally agree with you robert and Maylin. It is absolutely an opportunity to grow as a person, gaining confidence and self-esteem.

  • robert 2009-11-18 10:53:41

    The successful cruise through all these stages is not possible without help from a professional at all... when a person is suffering and the ones around him are under distress, it becomes all the more difficult for them to move through the difficult phase. In such a scenario, help from someone who is good in dealing with such problems is very much required.

  • Maylin Andrew 2009-11-18 14:59:21

    It is a difficult path to recovery from anxiety related disorders but nevertheless a very rewarding path, because at the end of it, the person would have overcome not only the disorder but also learnt to cope with things and adjust to situations and also grow a better attitude of tiding over problems. This will give the person a much better level of confidence in leading his/her further life.

  • Irene 2009-12-05 12:37:40

    The very thought of finding new ways to lower my anxiety levels in itself stresses me out!

  • EMILY GARCIA 2009-12-05 02:55:39

    While the answer to whether one needs to get rid of anxiety may seem obvious to some people, it is equally difficult for some others to actually make it happen. As well-explained in the examples in the article here, some people have problems just making up their minds because they fear other ill-effects to such a decision. I think such people really need professional help because otherwise, even if they do decide to get rid of the anxiety, they may soon revert back to their dilemmatic situation fearing consequences.

  • Ernest 2009-12-06 08:38:22

    That is an excellent point! Dealing with anxiety does cause anxiety. There is no way around this if you really want to work on it. This is why people wait until there life is really affected before they seek help. Like all humans if we are not in that much pain, why would we put any effort in to make a change, and why would we be willing to feel anxiety unless we saw how much anxiety affected us. The only way through anxiety is to feel it and the only way to really tackle it, is to push yourself to face the anxiety. This concept sounds crazy in some respects but with guidance and support it is amazing how well it works and there are ways to make it less painful. Great discussion!

  • d. blenda 2009-12-16 15:55:13

    I think therapy is the best of the options to look into if your child is exhibiting the above-mentioned behaviors. It is a good way to fix the problem and get your child out of it such that there is no chance of relapse.

  • Lydia 2009-12-16 16:34:32

    Sad to think that there are kids who can't enjoy being a kid due to pressures like this.

  • Kevin H. 2009-12-16 15:26:41

    Kids today are exposed to a lot of pressure from all sides...be it parental pressure, peer pressure or academic pressure. There is not one pressure that is more prevalent than the others, because all are equally damaging to the personality of a child. Parents, instead of putting their child under more pressure, should try and help relax and calm the kid. The kid needs reassurance!

  • Evelyn Goodman 2009-12-16 22:06:31

    What saddens me about this is that so many kids aren't getting the help they need. When they do it's usually a pill. The number of children on medication, especially antidepressants, is staggering. While meds are helpful for some kids, it's still very important to deal with the underlying issues. Another problem is the small number of therapists who have been trained to work with anxious children and their families.

  • cindy c 2009-12-17 05:27:34

    I feel sad that little kids go through such an ordeal... maybe we were lucky because the conditions were relatively better, with fewer things to worry about.

  • Charla Richardson 2009-12-17 14:17:18

    Most families are not having enough 'together time' due to high work-pressure for the parents,and this is leading to the kids being and feeling neglected and let to their gadgets and lonliness.This brings in a lot of negative thoughts and energy and the parents must act before this negative energy snowballs and takes over their kids' minds.It can have major impacts in the long run.

  • Pearl 2009-12-18 21:11:21

    Please, don't get me started on giving pills to children. For the vast majority they should be the last resort, not the first. Therapy should be top of the list and miles ahead of meds. Children need their family's attention and nurturing, not a prescription. Try a little tenderness.

  • soldy 2009-12-18 20:49:34

    I have an acquaintance who is very nervous. She's lovely but not good around strangers and worries about everything. Her seven year old daughter is taking on many of her traits like unconscious hand wringing, throat clearing when talking and very little eye contact. I don't feel it's my place to point it out. The child's a nervous wreck and my mother said that this woman's mother was exactly the same. How does a cycle like that get broken when the family doesn't see it?

  • LaScala 2009-12-18 22:15:03

    Evelyn, do you think parental attitudes about medicating children have shifted? Some parents even appear disappointed or angry if the doctor doesn't give them pills for their kids. I was on phenobarbital over thirty years ago and remember the look (a mixture of sympathy with a little disapproval and fear too) that was on other parents' faces when they saw little me taking the pill. I vaguely recall my mom being upset about having to give me them too. It was hardly spoken about although I was on them maybe two years. And Evelyn, thanks for a great article!

  • Evelyn Goodman 2009-12-18 22:37:03

    I agree with all the above comments. As for breaking the cycle of anxiety that is passed down this can be difficult if the parent is unaware of both her anxiety reactions as well as her daughter's. They say a picture is worth a thousand words. I know someone who took pictures of her (anxious) niece at a family gathering. She nonchalantly sent them to her brother and his wife. Some of the pictures had the little girl biting her nails and other anxious behaviors. She thinks it was the first step towards overcoming the denial of their daughters' anxiety. Very frequently it is a teacher who makes the parents aware of their children's difficulties. But if you are the only one concerned about her you might try in a gentle, nonblaming manner to point out how she and her daughter are similar in their anxious mannerisms. You'll find out how open she is to looking at that. Good luck!

  • Elizabeth R. 2009-12-18 22:39:58

    Children have lost that carefree air, have they not? With each generation that passes, we see more anxious and unhappy than uninhibited and carefree kids. It's very sad that fear is taking hold of their sensibilities at a younger and younger age. The sparkle of possibilities doesn't shine so bright in their eyes. Thank you for sharing your wisdom, Evelyn. That may help put it back. :)

  • Evelyn Goodman 2009-12-18 22:49:56

    Attitudes about children getting treatment has shifted over the decades. The good news is that stigma is being reduced. However, the expectation is the treatment means meds as the first line of help. This is convenient and cheaper and is reinforced by the medical community, HMO's, and pharmaceutical companies. Many parents don't realize there is treatment tailored for anxious children (and adolescents). Some don't have the time or money to deal with it. Clearly this isn't the case with all families, as I work with anxious children and their families. I used to do grand rounds at hospitals discussing these issues. Most of the questions the MD's asked pertained to medication for children. At that time only Prozac had been researched and approved. They didn't realize there were other options.

  • Francis W. 2009-12-18 22:54:39

    I agree, Elizabeth. Is it possibly because parents tell them too much too soon nowadays that so many are anxious? When I was small I knew nothing beyond don't talk to strangers and watch for cars before you cross the road. Now parents want to spill their guts and inform kids of every possible danger out there, no matter how remote the chances of it happening are. In the process, they are terrifying them! Parents themselves need to chill out and take a good look at the world view they're presenting to their children and how balanced their perspective is.

  • Evelyn Goodman 2009-12-19 13:23:21

    I think there were always parents who parentified a child, particularly a sensitive one. I started working with anxious adults 30 years ago and often heard how my client was a parents support system. Many of my adult clients described being anxious as children; some were even in therapy at a young age. Even if a child seems willing and able to listen to their parents problem it puts too much of a load on them emotionally. And there have always been anxious and cautious parents who warn their child about every possible danger out there. The sensitive, anxiety-prone child will take it in and become worried themselves.

  • Cassie V. 2009-12-22 16:49:00

    Ohhhhhh!! I think I had one of those and didn't know it. Does you become "spaced out"? Like a clockwork toy that has wound down and just stopped? That's how I would describe the episode. It was as if my mind had been wiped of all thought. I felt very nervous too. It only lasted perhaps three minutes and I was very conscious of the fact that I couldn't think, which made it scary. Thanks Becki.

  • Miek 2009-12-22 17:50:27

    I agree with most of your article, but let's consider 'angina pectoris' too... So the duration of the complaints and also (even when one has an heart attack) the place and the type of the pain patients are feeling, aren't so obvious like you wrote it here. Also, panic can be a provocative factor of angina or a heart attack. Even for a doctor it isn't always clear what the patient has. An ECG can help to make the differential diagnosis. Unfortunately, cases as these, aren't an exception...: http://www.ncbi.nlm.nih.gov/pubmed/15259595 I don't say that every pain on the chest has to been seen by a doctor, surely not. We don't need to increase somatisation by these people. But if it's the first time, or if the person has risk factors for angina or a heart attack, you would better be careful.

  • Katherine 2009-12-22 18:12:26

    What can you do if you're in a public place when it happens? I have a fear of falling apart in front of strangers. So far any I had happened at home, late at night. My father would be horrified if I were to make a public spectacle of myself.

  • Shona 2009-12-22 18:30:09

    Hi Becki. Thank you for a good read. I've not had a panic attack although feel that I'm heading towards one due to workplace stress. I'm at my most anxious at work and can't just go off to find a spot to meditate. Can you suggest what steps could I take to settle myself down when I'm on the job that would be discreet? Our office is open plan.

  • Nathaniel 2009-12-22 19:24:53

    Meik, thanks for the additional information. What is the meaning of somatisation please? I didn't understand your phrase: "We don’t need to increase somatisation by these people."

  • Pearl 2009-12-22 20:03:55

    It is so good to see the differences between a heart attack and a panic attack laid out in such a clear, easy manner. When you get to my age, you want to know how to tell them apart and fast. Thanks Becki!

  • danielson 2009-12-23 01:48:52

    Well I just think it is very important for an individual to think for himself and make sure that he does not troublem himself by getting under unnecessary worries. Although no one's life is without problems and issues, it is far better to think of getting a solution to the problems and issue than to fret about them and afftect our health!

  • Sandy 2009-12-23 05:55:57

    Why is it that some people simply are more prone to experiencing panic attacks and yet there are other people who never have to experience this feeling? I have had one before in my life that I can pinpoint and it was a dang scary feeling, nothing that I would veer wish on anyone else.

  • Miek 2009-12-23 09:08:23

    Nathaniel, I meant to say that you can't help people who are suffering of panic attacks, by telling them over and over again that there is maybe something wrong with their heart. Somatization means that one expressess his psychological and social stress by physical symptoms. So, in that case, it's wrong to give attention only to the body sensations and not to the real cause: the psychological and social factors.(see also: http://en.wikipedia.org/wiki/Somatization). So I think it's important to exclude a disease of the heart, especially the first time someone has a panic attack, or if someone has risk factors for a heart attack. But a professional (doctor, psychologist) won't help someone with panic attacks if he always think: 'Oh, I hope he hasn't got a heart attack!'. Most of the time it's really clear for a doctor or a professional to see if someone has a heart attack/ angina or a panic attack. But the symptoms that are described here aren't always as clear! The symptoms are the symptoms for a 'model' patient with a heart attack. But, 'models patients' are rather rare in the real world. So, if you had a panic attack for the first time, I think it's better you speak about it with your physician. He/ she knows you better and knows better when you need a physical examination or, hopefully and most of the time, when there is no reason to worry and you probably had a panic attack. I'm telling this as a physician and as a student in psychology (who speaks no English, normally, so that's the reason why sometimes I'm not totally clear ;o) ).

  • carmella Q. 2009-12-23 16:31:13

    My uncle once had a panic attack and as there was nobody else in the house at that time, I had to go and be by his side and his reaction almost gave me a panic attack! I was so frightened and dialled emergency... I think each one of us must educate ourselves about this and will be in a better position if we or anybody around us happens to have a panic attack.

  • Becki Hein 2009-12-31 09:38:30

    Thanks for all your comments! re: Cassie: So far, "spaced out" is not a description I've heard used for a panic attack. Most people report that their thoughts are racing. If you have any doubt about what you've experience, I always recommend checking with a doctor.

  • Becki Hein 2009-12-31 09:42:19

    re: Meik: I totally agree! Thanks for your comments. The heart attack symptoms I listed are "classic" and there can sometimes be other less common symptoms too. I always say, especially if it's a person's first "panic" experience, get checked out by a doctor. There's nothing wrong with eliminating other possible problems by seeing a doctor.

  • Becki Hein 2009-12-31 09:45:15

    Re: Shona Wow, I'm sorry your workplace is so stressful. You might check out my previous blog article:http://www.goodtherapy.org/blog/self-calming-skills/ In it I talk about grounding your excess energy and how proper breathing can help alleviate symptoms of anxiety. Thanks for your comment!

  • Becki Hein 2009-12-31 09:51:14

    re: Katherine Many times people start being fearful of having another panic attack, especially in public. Fear just increases the probability that it might happen. I think one of the best ways to combat this is to be prepared. Practice your breathing and grounding skills every day. (EVERY DAY!) That way your body is used to calming itself quickly and easily. Then use your logical thinking. You know that the panic symptoms are not harmful so as soon as you feel any symptoms coming on, start your breathing, grounding, and "talking yourself down". Use phrases such as " I am healthy, strong, and calm". Some people find that chanting words like this over and over (to themselves if in public) can help re-focus their minds. Some people count. Anything to get your attention off of your symptoms. Read more about grounding here at my previous blog article: http://www.goodtherapy.org/blog/self-calming-skills/ Thanks for your question!

  • Joan 2009-12-31 20:58:54

    This is a fascinating thread! Thank you Becki. Can young children have panic attacks too? I saw a five year old have what her mother thinks could be the start of asthma because there's a family history. I would have said it was more like a panic attack. They had been arguing just before I arrived.

  • Donna 2009-12-23 16:24:27

    I have observed that people who have an inferiority complex are anxious almost all the time. They think they will make a fool out of themselves even in seemingly calm situations. Well, maybe the inferiority complex developed from their lack of control over their anxiety in the first place...

  • alita 2009-12-24 07:37:27

    I know that the times that I am under the most pressure are the times when I really do perform my best. It is like the anxiety really gets my blood pumping and I know then that I can accomplish anything. On the other hand there are those who really crumble under the pressure and just can't take it at all. This cannot be healthy for anyone to deal with but from my own personal experience since the time I was a kid I really did do my best when the pressure was mounting and I was down to the last little minute.

  • richard louis 2010-01-19 16:04:04

    I completely agree with what's written in this post. Sometimes it so happens tht you get into a bad situation and experience something unpleasant and from then on, you never want to do anything even related to such a situation or thing. but each one of us needs to understand that if it happened once, it does not necessarily mean that it will repeat and also, doing in again will help us overcome the fear and prove to us that it is not always negative.

  • rob T. 2010-01-20 11:15:56

    It is all in the state of mind...go ahead and face your phobias... conquer them and gratify your soul...that is exactly what I did...I had stage fear...I then got help from my cousin and I started to speak in front of small audiences. Today, almost 2 years since I first seeked help, I can confidently speak in front of a crowd of hundreds :)

  • Martha T. 2010-01-21 17:46:02

    Thanks for the article, Evelyn. If a person wanted to address a fear of public speaking, is it helpful to give a small presentation to people they know or would that not be of help?

  • Evelyn Goodman 2010-01-22 00:49:51

    Martha, I would give it a try. It might be a good first step to overcoming the fear of public speaking. Even if it feels very comfortable and easy you will still be getting some experience in presenting. When dealing with public speaking anxiety it is very helpful to learn some public speaking skills in addition to practicing methods to reduce or control anxiety. Good luck!

  • Evelyn Goodman 2010-01-22 21:20:39

    LaScala, Flooding is not for everyone, but it's especially helpful if one has a high tolerance for a high anxiety state for a while. The anxiety always comes down. The adrenal glands get run down and can't keeping pumping out a lot of adrenal. For some people this is a more rapid way to overcome a phobic avoidance pattern than systematic desensitization. In some cases it's the only way. E.g., either you are flying in an airplane or not.

  • LaScala 2010-01-22 16:00:16

    With all due respect, implosion sounds downright cruel. How effective is that compared with systemic desensitization?

  • Wanderer 2010-01-22 18:01:02

    I must not fear. Fear is the mind-killer. Fear is the little-death that brings total obliteration. I will face my fear. I will permit it to pass over me and through me. And when it has gone past I will turn the inner eye to see its path. Where the fear has gone there will be nothing. Only I will remain. - Frank Herbert (in his book, Dune).

  • Neil 2010-01-23 22:06:08

    That was a good piece. My sister is terrified of snakes. She can't even watch them in a movie. I think she would literally pass out if flooding was tried. I like your reference there that you're either flying or you're not. It helps me understand that method more. Thank you Evelyn.

  • Victoria L. 2010-01-26 17:55:50

    Thank you Evelyn for explaining the different treatment options for phobias in your interesting article. Are these the only two options or are there more?

  • Joan 2010-01-26 18:53:45

    I was wondering. Is there such a thing as an incurable phobia or are they all curable? And thanks Evelyn.

  • Evelyn Goodman 2010-01-28 14:50:41

    Victoria, There are other options - EMDR, NLP, TFT - are techniques that say they are helpful for overcoming phobias. However, I'm not sure what research studies say about their effectiveness. Nor do I know anyone who used them for phobias. People who use these techniques swear by them. Hypnosis can be useful; it is primarily a combination of relaxation and visualization. The techniques I have described are well known, research validated and have a long history of effectiveness. Joan, Did you have a particular phobia in mind or is this a general question? There are phobias such as fear of heights, falling, or being trapped in a small place that are fairly common and may be part of our wiring. One can learn to tolerate them but may never completely overcome the discomfort.

  • John Lee LMHC 2010-01-21 17:17:36

    You are exactly on target! People come to me all the time for anxiety. I ask them how much coffee or colas do you drink? How much chocolate or candy? In treating anxiety one must look at the whole picture which includes diet, relaxation techniques and breathing exercises. I like as you walk..the first 4 steps inhale...the next 4 steps hold your breath..the next 8 steps exhale. Breathing and diet are bery important components to anxiety reduction.

  • Pauline 2010-01-22 05:44:50

    As an armchair nutritionist I am so glad to see all of this in print! These are things I have been telling my friends and family for years! You have to be so mindful of the things that you feed your body. Not only can they play the devil with your overall physical health but they also determine your mindset and how stable your are mentally and spiritually. For years people have thought I was nuts spouting all of this out but I know from my own experiences just how true this really is. Thank you so much for sharing this wonderful information with all of us, and I am definitely going to make sure that everyone I have been talking to has the chance to read it too.

  • Toure W. 2010-01-22 05:45:06

    wow...i never imagined that diet patterns can influence anxiety levels in an individual. i thought it was the other way around...if a person is anxious,he or she tends to dat fast and a much larger quantity.

  • emma 2010-01-22 11:50:49

    most of us use the above-mentioned food items with little thought of anything other than the calories. I did not know that certain foods could actually promote stress and panic attacks. I will now spread the word to my friends and try to be careful about my diet in the future.

  • yolanda 2010-01-23 10:34:11

    even more reason for schools to do better with what they feed our kids everyday! just think of how much school performance could improve if they would ever get around to giving our kids healthy nutritious lunches all of the time.

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