Anxiety Disorders
Types of Anxiety Disorders
There are a number of different types of what we call anxiety disorders. Most people fall into what is called Generalized Anxiety Disorder or GAD for short. Other disorders that fall within this group are Social Anxiety, Performance Anxiety (not considered a diagnosable type of anxiety), Obsessive Compulsive Disorder or OCD (not to be confused with Obsessive Compulsive Personality Disorder, Panic Disorder, Separation Anxiety Disorder, Agoraphobia, and Post Traumatic Stress Disorder. I would consider other mental health disorders to have elements of anxiety within them as well. These might include Trichotillomania, Bulimia, Anorexia Nervosa, Body Dysmorphic Disorder, Pervasive Developmental Disorder, Schizoid Personality Disorder, and Avoidant Personality Disorder, just to name a few.
Phobias of various types would also be considered to be part of the family of anxiety disorders although these are not generally categorized as part of the DSM-IV (Diagnostic and Statistical Manual for Mental Disorders 4th Edition). Phobias can be about just about anything. Common phobias may include the fear of flying or Aviophobia, the fear of heights or Batophobia, or the fear of being in a confined space or claustrophobia. Others report having more esoteric types of phobias such as fear of Bolsheviks, France, or even the fear of going to bed. Below you will find a brief outline of the types of anxiety, their symptoms, and brief statements about their treatment.
Generalized Anxiety Disorder Signs and Symptoms
In generalized anxiety disorder, the person has persistent worry or anxiety that lasts for at least six months. This worry or anxiety is excessive, troubling and hard to control, and it often interferes with a person's ability to function at home, at work or in social situations.
To be diagnosed with generalized anxiety disorder, a person has to have at least three of the following symptoms:
- Feeling restless or keyed up
- Becoming tired very easily
- Having difficulty concentrating or remembering (your mind goes blank)
- Feeling irritable, crabby or grouchy
- Having tense muscles
- Having trouble falling asleep or staying asleep, or not feeling rested after sleep
People with generalized anxiety disorder also may have a wide range of anxiety-related physical symptoms that may seem like symptoms of heart disease, respiratory illness, digestive diseases and other medical illnesses. These symptoms can include:
- Chest pains, palpitations, abnormally rapid pulse, abnormally rapid breathing, shortness of breath, a smothering sensation
- Abdominal pains, abdominal gas, indigestion, nausea, diarrhea, constipation, frequent urination
- Abnormal or irregular menstrual bleeding
- Problems in sexual function
Everyone feels anxious from time to time — like when you're running late or interviewing for a job. People with generalized anxiety disorder (GAD); however, feel some anxiety or they will worry most of the time. They often anticipate disaster or have exaggerated worries about a wide range of issues, from their health to their families to their daily responsibilities. Yet even when they recognize that the worrying is excessive, it is hard to control. One of the primary prefaces to their thoughts tends to be “what if”, i.e. what if I lose my job, what if I get sick and can’t take care
of myself, etc. etc.
Physical Effects of Anxiety Disorder
Physiological disorders can cause anxiety. These are too numerous to name, but it is certain that because of the way we tend to treat anxiety with simply the administration of an antianxiolytic or an antidepressant and psychotherapy, that many physiological causes can go undetected. One fact that causes some to believe this, is the tremendous increase in the diagnosis of anxiety and depression over the past few decades in the United States. This coupled with the change in our basic American diet leaves some with the suspicion that food sources may in some cases be the cause of these disorders. Because of this, it is believed that many doctors tend to treat the symptoms of anxiety rather than the causal factors when simply administering a psychotropic medication for the individual’s mood relief. As well, having anxiety will affect your body. In fact, many people with generalized anxiety disorder visit their doctor with physiological problems and the anxiety may go undetected. These may be issues such as stomach problems, sleep issues, or various muscle aches. Normally the individual will not realize at first and not connect the physical symptoms with that of generalized anxiety disorder. A new concept that has come to the fore in the last number of years that is having some promise, is that some of these individuals that suffer from anxiety may be sensitive to certain proteins in foods or items in the environment. We’ve found that in these cases that many sensitivities can be treated and that some can be treated to the point that within two months to a year they can fully recover. (See our Allergies page) Many therapists and physicians are unaware of these treatments and so as a result will doubt not only the existence of such treatments but their efficacy. Many of these treatments have been around for 20 or more years and have been published in medical journals but have received little media time because they were not pharmacological agents and could not be patented. Therefore, very little money could be made by their awareness.
The DSM-IVTR states that about 5% of U.S. adults experience generalized anxiety disorder at some point during their lifetime, and about 3% have it in any given year. It is my belief that many of the people that truly struggle with generalized anxiety disorder will have a tendency toward being chronic and the anxiety may have entered into being a part of one’s personality. However it is also my belief that just like many other disorders, if one wants help and can trust their therapist and practice good self-care, that in many cases they can fully recover.
What Causes Generalized Anxiety Disorder?
Your genes may be partly responsible for why generalized anxiety disorder develops. The same genetic factors that influence your risk for this anxiety disorder may also be related to those for major depressive disorder. Although genes can be a factor for anyone when we find that certain traits run in families, this is not always a sentence of a lifetime of treatment for an individual. Since the human genome was mapped and new discoveries were found with respect to the DNA and RNA ties to cell production, having what is considered a genetically based disorder is not always now considered to be permanent. Thus a genetically based disorder can be permanent or it can be temporary if proper treatment is administered. In fact, it is now believed by some holistic physicians, based upon the human genome project, that genetic factors may be temporary a greater percentage of the time than not.
Research also suggests that while your genes may make you more vulnerable to developing this disorder, your environment could be the trigger that sets it off. Stressful experiences can intensify generalized anxiety disorder. These factors can again be an indication of food or environmental sensitivities and can again be treated successfully in many cases.
Brain Chemistry
Two natural chemicals in the brain, serotonin and norepinephrine or noradrenalin, are thought to be linked to this condition, as well as to other anxiety disorders and depression. Although prescription medications that affect these chemicals may help eliminate the symptoms of anxiety, there are also other holistic treatments that can in some cases eliminate the anxiety and the need for pharmaceutical assistance permanently.
Generalized anxiety disorder is more common in women than in men, and it usually starts in childhood or adolescence. Many adults with generalized anxiety disorder say they've been lifelong worriers, but it's not uncommon for this disorder to suddenly appear later in adulthood.
It should be understood that in the end that anxiety conditions are very treatable and that an individual should not go untreated and allow anxiety symptoms to become more inset. Generally, any disease or disordered state, if left untreated can become more inset and become harder to treat and require much more time in clearing the symptoms than if one had sought treatment early. Therefore find a good therapist who understands both the psychological and physiological symptoms and can treat such.
Social Anxiety Disorder Signs and Symptoms
Most people occasionally feel nervous meeting a new person or speaking in front of a group. People with social anxiety disorder (SAD), however, become overwhelmingly anxious and self-conscious even in everyday social situations.
Theirs is an intense and persistent fear of being scrutinized by others or of doing something embarrassing. Even though they may find their own anxiety unreasonable, they can't overcome it by themselves.
Avoiding Social Situations
As a result, people with social anxiety disorder, or social phobia, tend to avoid the social situations they fear. That can make their situation worse by interfering with work, ordinary activities, and the ability to make friends.
Forcing themselves to enter social situations can go something like this: anxiety before the encounter, intense discomfort during it, and worry afterward about how they were judged.
Social anxiety disorder can be limited to specific situations (such as eating in front of others or talking to authority figures) or so broad that the person feels anxious around almost anyone other than family members.
Common Symptoms of Social Anxiety Disorder
Up to 13% of U.S. adults will have social anxiety disorder at some point in their life. A recent estimate indicates that about as many American adults have social anxiety disorder as have major depressive disorder.
When people with social anxiety disorder are anticipating or encountering the social situations they fear, they may experience some of the following anxiety symptoms.
A. A marked or persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way (or show anxiety symptoms) that will be humiliating or embarrassing. Note: In children, there must be evidence of the capacity for age-appropriate social relationships with familiar people and the anxiety must occur in peer settings, not just in interactions with adults.
B. Exposure to the feared social situation almost invariably provokes anxiety, which may take the form of a situationally bound or situationally predisposed Panic Attack. Note: In children, the anxiety may be expressed by crying, tantrums, freezing, or shrinking from social situations with unfamiliar people.
C. The person recognizes that the fear is excessive or unreasonable. Note: In children, this feature may be absent.
D. The feared social or performance situations are avoided or else are endured with intense anxiety or distress.
E. The avoidance, anxious anticipation, or distress in the feared social or performance situation(s) interferes significantly with the person's normal routine, occupational (academic) functioning, or social activities or relationships, or there is marked distress about having the phobia.
F. In individuals under age 18 years, the duration is at least 6 months.
G. The fear or avoidance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition and is not better accounted for by another mental disorder (e.g., Panic Disorder With or Without Agoraphobia, Separation Anxiety Disorder, Body Dysmorphic Disorder, a Pervasive Developmental Disorder, or Schizoid Personality Disorder).
H. If a general medical condition or another mental disorder is present, the fear in Criterion A is unrelated to it, e.g., the fear is not of Stuttering, trembling in Parkinson's disease, or exhibiting abnormal eating behavior in Anorexia Nervosa or Bulimia Nervosa.
What Causes Social Anxiety Disorder?
Social anxiety disorder typically begins during the teenage years and continues into adulthood. People may develop the disorder after a childhood history of social inhibition or shyness. Others experience an abrupt onset after a very stressful or humiliating experience.
Like many anxiety disorders, your genes may play a role. If a biological parent or sibling has or has had social anxiety disorder, you're at greater risk for it. Environmental factors, such as an overprotective or hypercritical parenting style, may also be linked with social anxiety disorder.
Chemical abnormalities and overactive areas in the brain may also be at the root. Serotonin is one brain chemical that has been linked to social anxiety disorder, as well as to the depression that often accompanies it. Manipulating these brain chemicals via the use of nutraceuticals or prescriptive methods will likely be necessary to alleviate the symptoms of this disorder.
Performance Anxiety 
I will speak just briefly about this disorder. Although performance disorder is not a diagnosable mental disorder, many people still suffer from this disorder so much so that it can control their life. Actually this disorder is more generally considered to be more of a subset of Social Anxiety Disorder and may have elements of an Avoidance Personality Disorder within in it, or it may possibly be some type of phobia if symptoms are isolated to performance. In brief, performance anxiety is almost always expressed in a fear of public speaking or some related activity and is based on worries about being noticeably nervous and losing control due to panic in that situation. For many people suffering from performance anxiety physical symptoms such as increased pulse, blushing, breaking out into a sweat, nausea, and eye contact difficulty, are common. A myriad of deeper negative thoughts can also run rampant such as, “people will see who I really am”; “I will humiliate myself”; or “people will not get to see my true ability”. These are characterized by varying degrees of obsessive thinking. When public speaking anxiety and panic turn into avoidance, a social phobia is present. The more avoidance takes place, the more there is the risk that an avoidant personality disorder developing. However, like with any other disorder, it is not what we call it or how we categorize it that is really the important piece. The important thing is to get treatment. And the longer the person with an anxiety disorder waits and puts off getting treatment, many times because they are afraid of how they will fare in treatment, i.e. fear of failure, the more difficult it is to treat their condition.
Obsessive-compulsive disorder (OCD)
It’s normal, on occasion, to go back and double-check that the iron is unplugged or your car is locked. But in obsessive-compulsive disorder (OCD), obsessive thoughts and compulsive behaviors become so excessive that they interfere with daily life. And no matter what you do, you can’t seem to shake them.
If you or someone you love has obsessive-compulsive disorder, you may feel isolated and helpless. Just know that there is help available. Many treatments and self-help strategies can reduce the symptoms of OCD.
Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by uncontrollable, unwanted thoughts and repetitive, ritualized behaviors you feel compelled to perform. If you have OCD, you probably recognize that your obsessive thoughts and compulsive behaviors are irrational – but even so, you feel unable to resist them and break free.
Like a needle getting stuck on an old record, obsessive-compulsive disorder (OCD) causes the brain to get stuck on a particular thought or urge. For example, you may check the stove twenty times to make sure it’s really turned off, you’re your hands until they’re scrubbed raw, or drive around for hours to make sure that the bump you heard while driving wasn’t a person you ran over.
Panic Disorder
People with panic disorder (PD) experience repeated panic attacks that typically seem to come out of nowhere.
Their panic attacks strike with no warning and involve an intense surge of fear and powerful symptoms — such as a pounding heartbeat, dizziness, or a sense of being smothered. The attacks can be terrifying, and many people may feel as if they're going crazy or dying.
The Fear of a Panic Attack
For weeks, people with panic disorder may live in fear of the next panic attack — and what that might mean (a life-threatening disease? a mental breakdown?). They may also develop fears (phobias) of places or objects associated with a panic attack.
Some people who suffer from panic disorder make drastic behavior changes, such as quitting a job or avoiding any physical exertion. Over time, they may avoid situations or places where they fear they may not be able to escape or get help if another panic attack occurs.
Etiology and Symptoms of Panic Disorder
An estimated 1% to 2% of people experience panic disorder at some time during their life. The diagnosis is 2 to 3 times more common in women than in men. Most cases of panic disorder begin between late adolescence and the mid-30s.
A family history can put you at risk. If a biological parent or sibling has or has had panic disorder, you're up to 8 times more likely to develop it yourself.
Panic disorder is characterized by repeated and unexpected panic attacks followed by a period of constant worry about when the next attack will occur. These panic attacks include at least four of the following symptoms striking suddenly and peaking within 10 minutes.
Panic Disorder and Agoraphobia
About 30% to 50% of people diagnosed with panic disorder also develop agoraphobia. That means they avoid or experience tremendous distress in certain kinds of situations that they've begun to associate with their panic attacks (for example, crowded areas or inside moving vehicles).
When panic disorder progresses this far, people may become housebound or may be able to confront a feared situation only with a trusted companion. Early treatment may help prevent agoraphobia.
More than half of people with panic disorder also experience major depression at some point.
What Causes Panic Disorder?
As with other anxiety disorders, the exact causes of panic disorder are not definitely known. Panic disorder seems to involve an imbalance in the brain's "fear circuit," the parts of the brain that help us respond to situations we see as threatening.
A panic attack seems to be a fear response that is too strong for the situation we're in. Panic disorder may develop when we become afraid of the attacks or the things we associate with them.
Two neurotransmitters thought to play a role in panic disorder are serotonin and norepinephrine. Prescription antidepressant medications and antianxiolytics that affect the levels of these natural chemicals in the brain may help relieve symptoms.
Post-Traumatic Stress Disorder (PTSD) 
If you went through a traumatic experience and are having trouble getting back to your regular life and reconnecting to others, you may be suffering from post-traumatic stress disorder (PTSD). When you have PTSD, it can seem like you’ll never get over what happened or feel normal again. But help is available – and you are not alone. If you are willing to seek treatment, stick with it, and reach out to others for support, you will be able to overcome the symptoms of PTSD and move on with your life.
What is post-traumatic stress disorder (PTSD)?
Post-traumatic stress disorder (PTSD) is a disorder that can develop following a traumatic event that threatens your safety or makes you feel helpless. Most people associate PTSD with battle-scarred soldiers – and military combat is the most common cause in men – but any overwhelming life experience can trigger PTSD, especially if the event is perceived as unpredictable and uncontrollable.
Post-traumatic stress disorder (PTSD) can affect those who personally experience the catastrophe, those who witness it, and those who pick up the pieces afterwards, including emergency workers and law enforcement officers. It can even occur in the friends or family members of those who went through the actual trauma.
Traumatic events that can lead to post-traumatic stress disorder (PTSD) include:
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PTSD is a response by normal people to an abnormal situation
The traumatic events that lead to post-traumatic stress disorder are usually so overwhelming and frightening that they would upset anyone. When your sense of safety and trust are shattered, it’s normal to feel crazy, disconnected, or numb – and most people do. The only difference between people who go on to develop PTSD and those who don’t is how they cope with the trauma.
After a traumatic experience, the mind and the body are in shock. But as you make sense of what happened and process your emotions, you come out of it. With post-traumatic stress disorder (PTSD), however, you remain in psychological shock. Your memory of what happened and your feelings about it are disconnected. In order to move on, it’s important to face and feel your memories and emotions.
Symptoms of post-traumatic stress disorder (PTSD)
Following a traumatic event, almost everyone experiences at least some of the symptoms of PTSD. It’s very common to have bad dreams, feel fearful or numb, and find it difficult to stop thinking about what happened. But for most people, these symptoms are short-lived. They may last for several days or even weeks, but they gradually lift.
If you have post-traumatic stress disorder (PTSD), however, the symptoms don’t decrease. You don’t feel a little better each day. In fact, you may start to feel worse. But PTSD doesn’t always develop in the hours or days following a traumatic event, although this is most common. For some people, the symptoms of PTSD take weeks, months, or even years to develop.
The symptoms of post-traumatic stress disorder (PTSD) can arise suddenly, gradually, or come and go over time. Sometimes symptoms appear seemingly out of the blue. At other times, they are triggered by something that reminds you of the original traumatic event, such as a noise, an image, certain words, or a smell. While everyone experiences PTSD differently, there are three main types of symptoms, as listed below.
Re-experiencing the traumatic event
- Intrusive, upsetting memories of the event
- Flashbacks (acting or feeling like the event is happening again)
- Nightmares (either of the event or of other frightening things)
- Feelings of intense distress when reminded of the trauma
- Intense physical reactions to reminders of the event (e.g. pounding heart, rapid breathing, nausea, muscle tension, sweating)
PTSD symptoms of avoidance and emotional numbing
- Avoiding activities, places, thoughts, or feelings that remind you of the trauma
- Inability to remember important aspects of the trauma
- Loss of interest in activities and life in general
- Feeling detached from others and emotionally numb
- Sense of a limited future (you don’t expect to live a normal life span, get married, have a career)
PTSD symptoms of increased arousal
- Difficulty falling or staying asleep
- Irritability or outbursts of anger
- Difficulty concentrating
- Hypervigilance (on constant “red alert”)
- Feeling jumpy and easily startled
Other common symptoms of post-traumatic stress disorder
- Anger and irritability
- Guilt, shame, or self-blame
- Substance abuse
- Depression and hopelessness
- Suicidal thoughts and feelings
- Feeling alienated and alone
- Feelings of mistrust and betrayal
- Headaches, stomach problems, chest pain
Getting help for post-traumatic stress disorder (PTSD)
If you suspect that you or a loved one has post-traumatic stress disorder (PTSD), it’s important to seek help right away. The sooner PTSD is confronted, the easier it is to overcome. If you’re reluctant to seek help, keep in mind that PTSD is not a sign of weakness, and the only way to overcome it is to confront what happened to you and learn to accept it as a part of your past. This process is much easier with the guidance and support of an experienced therapist or doctor.
It’s only natural to want to avoid painful memories and feelings. But if you try to numb yourself and push your memories away, post-traumatic stress disorder (PTSD) will only get worse. You can’t escape your emotions completely – they emerge under stress or whenever you let down your guard – and trying to do so is exhausting. The avoidance will ultimately harm your relationships, your ability to function, and the quality of your life.
Why Should I Seek Help for PTSD?
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Early treatment is better. Symptoms of PTSD may get worse. Dealing with them now might help stop them from getting worse in the future. Finding out more about what treatments work, where to look for help, and what kind of questions to ask can make it easier to get help and lead to better outcomes.
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PTSD symptoms can change family life. PTSD symptoms can get in the way of your family life. You may find that you pull away from loved ones, are not able to get along with people, or that you are angry or even violent. Getting help for your PTSD can help improve your family life.
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PTSD can be related to other health problems. PTSD symptoms can worsen physical health problems. For example, a few studies have shown a relationship between PTSD and heart trouble. By getting help for your PTSD you could also improve your physical health.
Finding a therapist for post-traumatic stress disorder (PTSD)
When looking for a therapist for post-traumatic stress disorder (PTSD), seek out mental health professionals who specialize in the treatment of trauma and PTSD. You should find a doctor who understands trauma types of disorders and has the ability to administer EMDR (Eye Movement Desensitization and Reprocessing) (See our Trauma Page). You may also want to ask other trauma survivors for recommendations for support groups, or call a local mental health clinic, psychiatric hospital, or counseling center.
Beyond credentials and experience, it’s important to find a PTSD therapist who makes you feel comfortable and safe, so there is no additional fear or anxiety about the treatment itself. Trust your gut; if a therapist doesn’t feel right, look for someone else. For therapy to work, you need to feel respected and understood.
Treatment for post-traumatic stress disorder (PTSD)
Treatment for post-traumatic stress disorder (PTSD) relieves symptoms by helping you deal with the trauma you’ve experienced. Rather than avoiding the trauma and any reminder of it, you’ll be encouraged in treatment to recall and process the emotions and sensations you felt during the original event. In addition to offering an outlet for emotions you’ve been bottling up, treatment for PTSD will also help restore your sense of control and reduce the powerful hold the memory of the trauma has on your life.
Types of treatments for post-traumatic stress disorder (PTSD)
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Trauma-focused cognitive-behavioral therapy. Cognitive-behavioral therapy for PTSD and trauma involves carefully and gradually “exposing” yourself to thoughts, feelings, and situations that remind you of the trauma. Therapy also involves identifying upsetting thoughts about the traumatic event–particularly thoughts that are distorted and irrational—and replacing them with more balanced picture.
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EMDR (Eye Movement Desensitization and Reprocessing) – EMDR incorporates elements of cognitive-behavioral therapy with eye movements or other forms of rhythmic, left-right stimulation, such as hand taps or sounds. Eye movements and other bilateral forms of stimulation are thought to work by “unfreezing” the brain’s information processing system, which is interrupted in times of extreme stress, leaving only frozen emotional fragments which retain their original intensity. Once EMDR frees these fragments of the trauma, they can be integrated into a cohesive memory and processed.
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Family therapy. Since PTSD affects both you and those close to you, family therapy can be especially productive. Family therapy can help your loved ones understand what you’re going through. It can also help everyone in the family communicate better and work through relationship problems.
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Medication. Medication is sometimes prescribed to people with PTSD to relieve secondary symptoms of depression or anxiety, but it does not treat the causes of PTSD.
Self-help and support for post-traumatic stress disorder (PTSD)
Recovery from post-traumatic stress disorder (PTSD) is a gradual, ongoing processing. Healing doesn’t happen overnight, nor do the memories of the trauma ever disappear completely. This can make life seem difficult at times. But there are many things you can do to cope with residual symptoms and reduce your anxiety and fear.
Reach out to others for support
Post-traumatic stress disorder (PTSD) can make you feel disconnected from others. You may be tempted to withdraw from social activities and your loved ones. But it’s important to stay connected to life and the people who care about you. Support from other people is vital to your recovery from PTSD, so ask your close friends and family members for their help during this tough time.
Also consider joining a support group for survivors of the same type of trauma you went through. Support groups for post-traumatic stress disorder (PTSD) can help you feel less isolated and alone. They also provide invaluable information on how to cope with symptoms and work towards recovery. If you can’t find a support group in your area, look for an online group.
Avoid alcohol and drugs
When you’re struggling with the difficult emotions and traumatic memories, you may be tempted to self-medicate with alcohol or drugs. But while alcohol or drugs may temporarily make you feel better, they make post-traumatic stress disorder (PTSD) worse in the long run. Substance use worsens many symptoms of PTSD, including emotional numbing, social isolation, anger, and depression. It also interferes with treatment and can add to problems at home and in your relationships.
Challenge your sense of helplessness
Overcoming your sense of helplessness is key to overcoming post-traumatic stress disorder (PTSD). Trauma leaves you feeling powerless and vulnerable. It’s important to remind yourself that you have strengths and coping skills that can get you through tough times.
One of the best ways to reclaim your sense of power is by helping others: volunteer your time, give blood, reach out to a friend in need, or donate to your favorite charity. Taking positive action directly challenges the sense of helplessness that contributes to trauma.
Post-traumatic stress disorder (PTSD) and the family
If a loved one has post-traumatic stress disorder (PTSD), it’s essential that you take care of yourself and get extra support. PTSD can take a heavy toll on the family if you let it. It can be hard to understand why your loved one won’t open up to you – why he or she is less affectionate and more volatile. The symptoms of PTSD can also result in job loss, substance abuse, and other stressful problems.
Letting your family member’s PTSD dominate your life while ignoring your own needs is a surefire recipe for burnout. In order to take care of your loved one, you first need to take care of yourself. It’s also helpful to learn all you canabout post-traumatic stress disorder (PTSD). The more you know about the symptoms and treatment options, the better equipped you'll be to help your loved one and keep things in perspective.
Helping a loved one with PTSD
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Be patient and understanding. Getting better takes time, even when a person is committed to treatment for PTSD. Be patient with the pace of recovery and offer a sympathetic ear. A person with PTSD may need to talk about the traumatic event over and over again. This is part of the healing process, so avoid the temptation to tell your loved one to stop rehashing the past and move on.
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Try to anticipate and prepare for PTSD triggers. Common triggers include anniversary dates; people or places associated with the trauma; and certain sights, sounds, or smells. If you are aware of what triggers may cause an upsetting reaction, you’ll be in a better position to offer your support and help your loved one calm down.
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Don’t take the symptoms of PTSD personally. Common symptoms of post-traumatic stress disorder (PTSD) include emotional numbness, anger, and withdrawal. If your loved one seems distant, irritable, or closed off, remember that this may not have anything to do with you or your relationship.
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Don’t pressure your loved one into talking. It is very difficult for people with PTSD to talk about their traumatic experiences. For some, it can even make things worse. Never try to force your loved one to open up. Let the person know, however, that you’re there when and if he or she wants to talk.
TREATMENT SUGGESTIONS
Sticking with the treatment plan your doctor prescribes for your anxiety disorder is important and may help you continue to improve. Taking an active role in managing daily stressors may also enhance the effects of therapy. Here are some tips that can help.
Manage Your Anxiety Triggers
The way your body reacts to anxiety over time can become a learned response. But there are things you can do to help change your responses.
Take time every day to reflect. Concentrate on what's really going on in your life and not on what might happen. Then do your best to let your worries go for the rest of your day.
Prepare yourself through visualization. Picture yourself fully in the situation that triggers your anxiety disorder symptoms. Now imagine yourself feeling safe and comfortable and successfully handling what you've been avoiding. Over time, you may develop more confidence facing these triggers.
Change Your Health Habits. Replacing bad health habits with positive ones can help keep stress at bay.
Avoid stimulants. These include caffeine (found in coffee, tea, and cola drinks), nicotine, illicit drugs, and certain prescription and over-the-counter medications.
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Steer clear of sedating drugs and alcohol. They may seem like they calm you down, but in reality they can be self-defeating.
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Get some regular exercise. Studies show it may have a calming effect and improve sleep as long as it's done at least 5 hours before bedtime.
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Help yourself sleep better. Eliminate noise and light, and make sure your bedroom is a comfortable temperature.
Relaxation and Coping Strategies
Symptoms of anxiety disorders don't disappear overnight. In addition to medication or talk therapy, your doctor may suggest healthful changes to help minimize your anxiety symptoms. Some of these include yoga and other relaxation methods, dietary and other lifestyle improvements, and coping skills.
Talk Therapy for Anxiety Disorders
Many people with anxiety disorders also benefit from talk therapy (psychotherapy). Talk therapy helps you work toward changing the way you view the world around you and how you react to it. Talking with a mental health therapist can help you explore your relationships, feelings, and experiences in a meaningful way, to help you interact with others again.
There are three main types of talk therapy:
Cognitive-behavioral therapy (CBT) — helps a person recognize negative thought patterns and behaviors and replace them with positive ones. CBT can quickly bring important changes to a person's daily life and outlook for the future.
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Interpersonal therapy (IPT) — focuses on working through troubled personal and social relationships that may contribute to a person's condition. By learning how to deal with others more effectively, a person may be able to reduce conflict in daily life and gain support from family and friends.
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Psychodynamic therapy — helps a person look within himself or herself to uncover and understand emotional conflicts that may be contributing to his or her condition.
Medications for Anxiety Disorders
If you are diagnosed with generalized anxiety disorder, panic disorder, or social anxiety disorder, a physician may recommend one or some combination of the treatments described here: prescription medications, talk therapy, and relaxation and coping techniques.
Prescription Medications
Though not well understood, the causes of generalized anxiety disorder, panic disorder, and social anxiety disorder seem to involve an imbalance of certain brain chemicals, called neurotransmitters. These act as messengers between parts of the brain, or between the brain and the body. Serotonin (5HT) and norepinephrine (NE) seem to play an important role in anxiety disorders.
Nerve cells in the brain send out these neurotransmitters to deliver messages, and then take them back in (reuptake) and break them down. Antidepressants are used to try to slow down this process. This is believed to make more neurotransmitters available in the brain, which is believed to relieve symptoms.
Over the years, scientists have developed several kinds, or classes, of antidepressant medications. These medications may have different effects on different people, and many people may try more than one before they find one that works for them.
There are five main classes of antidepressants used to treat anxiety disorders:
Benzodiazepines
These drugs were often used to treat anxiety disorders from the 1960s until the 1980s. They act on a third neurotransmitter (GABA), which seems to play a role in fear. They generally work quickly, but due to concerns about abuse or dependency, other antidepressants are now more commonly prescribed.
Tricyclic antidepressants (TCA's)
These medications were developed in the 1950s and 1960s. They help prevent reuptake of 5HT and NE, but they also affect other neurotransmitters and can have serious side effects. They are not as commonly prescribed in the United States as are newer classes of antidepressants.
Monoamine oxidase inhibitors (MAOI's)
The MAOIs were developed at about the same time as the TCAs, but they are believed to work differently. They seem to stop the brain from breaking down 5HT and NE after reuptake. People taking MAOIs should be careful about their diet and other medications to avoid problems.
Selective serotonin reuptake inhibitors (SSRIs).
The SSRIs seem to help prevent reuptake of neurotransmitters in the brain. The SSRIs are called selective because they focus on serotonin. Although the various SSRIs seem to work in basically the same way and have similar side effects, people seem to respond differently to different SSRIs.
Serotonin-norepinephrine reuptake inhibitors (SNRI's)
A fairly new type of medication the SNRI was first developed in the 1990s. It works on 5HT, like an SSRI, but also helps prevent reuptake of NE. Effexor XR is approved to treat generalized anxiety disorder, and it is also approved for panic disorder, social anxiety disorder, and major depressive disorder.
