Anxiety disorders respond very well to therapy—and often in a relatively short amount of time. The specific treatment approach depends on the type of anxiety disorder and its severity. But in general, most anxiety disorders are treated with therapy, medication, or some combination of the two. Cognitive-behavioral therapy and exposure therapy are types of behavioral therapy, meaning they focus on behavior rather than on underlying psychological conflicts or issues from the past. They can help with issues such as panic attacks, generalized anxiety, and phobias.
While separation anxiety is a normal stage of development, if anxieties intensify or are persistent enough to get in the way of school or other activities, your child may have separation anxiety disorder. Children with separation anxiety disorder may become agitated at just the thought of being away from mom or dad and complain of sickness to avoid playing with friends or going to school.
A number of medical conditions can cause anxiety symptoms. These include an overactive thyroid, hypoglycemia, mitral valve prolapse, anemia, asthma, COPD, inflammatory bowel disease, Parkinson's disease, and dementia among others. Your physician may perform certain tests to rule out these conditions. But it is important to remember that anxiety is more often due to poor coping skills or substance abuse than any medical condition.
Obsessive-Compulsive Disorder (OCD) is characterized by uncontrollable anxious thoughts or behaviors. Individuals with OCD are plagued by persistent, unwelcome thoughts and images or by the urgent need to engage in certain rituals. Some OCD sufferers may only have obsessive thoughts without the related rituals. The disturbing thoughts or images (e.g., fear of germs) are called obsessions, and the rituals performed to try to get rid of them (e.g., hand washing) are called compulsions. For example, people who are obsessed with germs may wash their hands excessively. The individual is not happy to be performing the ritual behaviors but finds this to be the only way to get temporary relief from the obsessive thought.
Psychotherapy – often referred to as “talk” therapy is one treatment option. Cognitive behavioral therapy is a very common method of psychotherapy that has shown great results for people living with Generalized Anxiety Disorder. This form of therapy is geared toward helping you recognize and understand your thoughts and the pattern of any negative thoughts you may experience. Cognitive behavioral therapy focuses on teaching you coping skills or mechanisms you can use to help you return to normal functioning and ease your feelings of anxiety. It is normally a short-term therapy and people who undergo this type of psychotherapy have found great results.
Medication: Many antidepressants can work for anxiety disorders. They include escitalopram (Lexapro) and fluoxetine (Prozac). Certain anticonvulsant medicines (typically taken for epilepsy) and low-dose antipsychotic drugs can be added to help make other treatments work better. Anxiolytics are also drugs that help lower anxiety. Examples are alprazolam (Xanax) and clonazepam (Klonopin). They’re prescribed for social or generalized anxiety disorder as well as for panic attacks.
Some types of drugs may work better for specific types of anxiety disorders, so people should work closely with their doctor to identify which medication is best for them. Certain substances such as caffeine, some over-the-counter cold medicines, illicit drugs, and herbal supplements may aggravate the symptoms of anxiety disorders or interact with prescribed medication. Patients should talk with their doctor, so they can learn which substances are safe and which to avoid.
In contrast, the term anxiety attack is not a specifier outlined in the DSM-5. Rather, anxiety is used to describe a core feature of multiple different anxiety disorders. The culmination of symptoms that result from being in a state of anxiety—such as restlessness, shortness of breath, increased heart rate, and difficulty concentrating—may feel like an “attack,” but are generally less intense than those experienced at the height of a panic attack.
Once the panic attack is over and the person has returned to a calm state, encourage them to seek help from a mental health professional at their earliest convenience, if they haven’t already. You can help them further by assisting with the search for a licensed professional, researching coping techniques online, and looking for self-help books that might be useful.
Although the exact causes of panic attacks and panic disorder are unclear, the tendency to have panic attacks runs in families. There also appears to be a connection with major life transitions such as graduating from college and entering the workplace, getting married, or having a baby. Severe stress, such as the death of a loved one, divorce, or job loss can also trigger panic attacks.
I’ve had a lot of these symptoms and I know I also have depression. These anxiety attack’s come at the worst of times, when I work and I can’t get my mind focused back into what I need to do. I’m only 19 years old, but I’ve been to hell & back. Serving in the U.S.Marines to now, back home not doing anything I love after I got discharged. I feel lost and I haven’t got my life back together yet. I don’t have anyone to depend on besides my brother who is a Marine now, stationed 1000 miles away. I haven’t been able to establish myself well, since. I do have a wonderful girlfriend I love dearly and we have been together 2-years, traveling with me and moving near me. I’ve come home and things just feel like they’re slipping away. I was trained to not stress and be calm in the worst situations. But, even as a Marine, things can get very hard and wear on my mind. I thought nothing would be worse than Parris Island, but I am wrong. Life has been beating me down. I lost my car because someone sold me a stolen car and I feel like I’ve lost motivation to do my job; Walking and hitching rides to work to make best I can do. If there’s anyone that’s older that can give me some advice, that would be great. Because I don’t have a lot of people, my brother is not here, and I just need something. I want to do nothing but great things in this life. It’s just been hard to deal with lately and I’m losing hope. These anxiety attacks are slowly killing me. It’s every second of every-single-day.
In order to manage threatening situations, humans have evolved to experience a "fight or flight" response. As part of this response, when humans are confronted with a dangerous situation, their body mobilizes by sending blood away from their extremities (e.g. hands and feet) and into the major muscles, producing adrenaline, and increasing heart rate so that we are better equipped to fight off danger.
Panic attacks, a hallmark of panic disorder, are sudden and repeated bouts of overwhelming fear. These attacks, which often begin in adolescence or early adulthood, are much more intense than normal feelings of anxiety or stress. They usually pass after a few minutes and typically last no longer than an hour, but can continue to recur throughout a day.
Medications are also a common form of treatment for Generalized Anxiety Disorder. The most common types of medications prescribed to individuals living with this form of anxiety include anti-depressants, anti-anxiety drugs, and in some cases, sedatives. Antidepressants are used to treat depression, but have been found effective in the treatment of anxiety as well. They commonly take a couple of weeks to start taking effect and may cause some mild side effects, including headache, nausea, or difficulty sleeping. Most of the side effects are mild and tend to subside within a few weeks. Anti-anxiety medication is also often prescribed to help individuals cope with Generalized Anxiety Disorder. These types of drugs are powerful in their treatment of this type of anxiety; one of the most commonly prescribed types is a drug called buspirone often under the brand nane Buspar.
For example, a person with obsessive-compulsive disorder may experience a panic attack when their schedule or compulsions are interrupted. Individuals who struggle with specific phobias are also susceptible to panic attacks. A person with an extreme fear of heights (acrophobia) may experience a panic attack in a penthouse apartment. And for someone with generalized anxiety disorder (GAD), a condition characterized by extreme fear or worry, the unending anxiety can escalate to a panic attack. People with post-traumatic stress disorder (PTSD) have a higher incidence of panic disorder than the general population. Illness or traumatic events increase the chances of panic attacks.
Agoraphobia is often comorbid with panic disorder — meaning people often suffer from both conditions at the same time. It's an intense fear of not being able to escape whatever place you're in, and can often lead to an avoidance of leaving the house. People with agoraphobia can fear situations where this anxiety might flare up, and typically don't feel comfortable or safe in public, crowded places.
Genetics and family history (e.g., parental anxiety) may predispose an individual for an increased risk of an anxiety disorder, but generally external stimuli will trigger its onset or exacerbation. Genetic differences account for about 43% of variance in panic disorder and 28% in generalized anxiety disorder. Although single genes are neither necessary nor sufficient for anxiety by themselves, several gene polymorphisms have been found to correlate with anxiety: PLXNA2, SERT, CRH, COMT and BDNF. Several of these genes influence neurotransmitters (such as serotonin and norepinephrine) and hormones (such as cortisol) which are implicated in anxiety. The epigenetic signature of at least one of these genes BDNF has also been associated with anxiety and specific patterns of neural activity.
Benzodiazepines are sedatives indicated for anxiety, epilepsy, alcohol withdrawal and muscle spasms. Benzodiazepines demonstrate short-term effectiveness in the treatment of Generalized Anxiety Disorder and can help with sleep disturbances. A doctor may prescribe these drugs for a limited period of time to relieve acute symptoms of anxiety. However, long-term use of these medications is discouraged because they have a strong sedative effect and can be habit forming. In addition, taking benzodiazepines while also engaging in psychotherapy such as PE can reduce the effectiveness of the exposuere therapy,. Some well-known brand names are Librium, Xanax, Valium, and Ativan.
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Exposure therapy has been around for a long time. It involves exposing the patient in a safe and controlled environment to physical sensations they experience during a panic attack much the same way you‘d expose in small increments a person with a fear of trains or puppies or snakes to the things that scares them. With panic disorder, there’s often a heightened sensitivity to ordinary physical sensations such as racing heart, stomach ache or feeling faint. In exposure therapy, the therapist will ask you to mimic activities—like running around or doing jumping jacks or holding your breath—to cause panic symptoms. The idea is that by repeating the things that may trigger a panic attack those triggers will eventually lose their power.
A licensed mental health professional that has earned a Master’s degree from a variety of educational backgrounds (e.g. general counseling background, social work, marriage and family counseling). Once their formal education is completed, these clinicians are supervised in the field 1-2 years and pass a State exam to become fully licensed in the state in which they practice. These mental health professionals are licensed to diagnose emotional, mental health and behavioral health problems. They can provide mental health treatment in the form of counseling and psychotherapy, or work in other capacities as patient advocates or care managers. Licensed Master’s level clinicians work in many settings, including hospitals, community mental health clinics, private practice, school settings, nursing homes, and other social service agencies. Titles and licensing requirements may vary from state to state.
A panic attack? I thought panic attacks were reserved for women who were overly emotional and struggled with a mood disorder. The picture I had of these women from after-school movies and health class worksheets hadn’t prepared me for the idea that a relatively happy wife, mother, teacher, writer, and friend could be suffering from a panic attack. This had to be wrong.
Since panic attacks are caused by overly apprehensive behavior or chronic stress, addressing our overly apprehensive behavior and stress can stop and prevent panic attacks, and eventually, panic disorder. The combination of good self-help information and therapy is the most effective way of addressing overly apprehensive behavior. Accessing good self-help information and applying it is a good way to reduce stress.
As with most behavioral illnesses, the causes of panic attacks are many. Certainly there is evidence that the tendency to have panic attacks can sometimes be inherited. However, there is also evidence that panic may be a learned response and that the attacks can be initiated in otherwise healthy people simply given the right set of circumstances. Research into the causes of panic attacks is ongoing.
One of the most important things you can do is to listen to your family member or friend talk about the things in his/her life that are sources of stress. A first instinct might be to offer advice or ideas for a "quick fix". However, simply accepting your friend's stress levels can help them deal with their anxiety, knowing that they can rely on you as a source of support even when their symptoms might be tough to watch. Studies show that social support from family and friends can be one of the strongest protective factors against debilitating levels of anxiety.
Agoraphobia is the fear of being in situations where escape may be difficult or embarrassing, or help might not be available in the event of panic symptoms. The fear is out of proportion to the actual situation and lasts generally six months or more and causes problems in functioning. A person with agoraphobia experiences this fear in two or more of the following situations:
Cognitive Behavioral Therapy (CBT) is considered to be the gold standard of treatment, especially for panic disorder. CBT focuses on educating clients about their disorders, identifying and changing maladaptive thoughts and fears, learning relaxation and other coping strategies, and helping clients face their fears. Research has shown that CBT for panic disorder is also effective when there are other comorbid disorders present as well and that the key component that makes CBT effective is the exposure ("facing your fears") module (Hofmann, 2011).
Shortness of breath and chest pain are the predominant symptoms. People experiencing a panic attack may incorrectly attribute them to a heart attack and thus seek treatment in an emergency room. Because chest pain and shortness of breath are hallmark symptoms of cardiovascular illnesses, including unstable angina and myocardial infarction (heart attack), a diagnosis of exclusion (ruling out other conditions) must be performed before diagnosing a panic attack. It is especially important to do this for people whose mental health and heart health statuses are unknown. This can be done using an electrocardiogram and mental health assessments.
With panic attacks, we might show them a diagram and explain the fight-or-flight response; their mind or body is trying to help them. If you’ve had a panic attack that came out of the blue, you might become afraid of lightheadedness and avoid activities that spur adrenaline. So we might hyperventilate for a minute in a controlled way to get to the point where they’re not afraid of their own bodily sensation. We work on internal avoidance of those cues that become scary, and desensitize them.
Connect with others. Loneliness and isolation can trigger or worsen anxiety, while talking about your worries face to face can often make them seem less overwhelming. Make it a point to regularly meet up with friends, join a self-help or support group, or share your worries and concerns with a trusted loved one. If you don’t have anyone you can reach out to, it’s never too late to build new friendships and a support network.