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Identifying Anxiety Problems & Disorders

Determining the presence & nature of anxiety problems in children & adolescents can be challenging. If a child has specific anxiety about performing in a class, the behaviors are often apparent & can be readily identified.

If an anxiety disorder is present, however, identification becomes more complex because anxiety is a normally occurring pattern & also tends to co-exist with other disorders, such as depression. The diagnostic challenge is to determine when anxiety is beyond normal expectations for the child’s age & circumstances & to use assessment methods that are likely to identify the problem(s).

Co-morbidity refers to the presence of two or more disorders in one client at the same time. Because anxiety is a normal developmental patterns & also tends to be co-morbid w/many other disorders, differential diagnosis is particularly challenging.

Last, et al. (1987) compared co-morbidity patterns in adolescents who were referred to an anxiety disorders clinic for overanxious disorder, separation anxiety disorder or depression. When more than one diagnosis was given, anxiety disorders were identified in 50% to 75% of the cases, supporting the thesis that anxiety has high rates of co-morbidity.

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Assessment of Anxiety Problems & Disorders

As the first step to complete identification of anxiety & the development of intervention plans, the school psychologist should develop a strategy for systematic assessment.

Because anxiety is a naturally occurring phenomenon in all persons, the clinician should first consider whether the presence of the anxiety in the child is normal for the current developmental level.

Huberty (1997a) provided a list of developmental considerations that should be addressed prior to engaging in any type of formal or informal assessment of anxiety that can be used as a preliminary checklist:

  • What's the child’s current developmental level?

  • Are the signs of anxiety a normal aspect of development?

  • If so, are these signs expected, considering the child’s developmental level?

  • Are the signs of anxiety excessive for the child’s developmental level?

  • Are the signs of anxiety of a long-standing nature or have they emerged as a temporary increase in severity for the child?

  • If the anxiety is a normal developmental phenomenon (e.g., social anxiety at adolescence), is it nevertheless sufficiently intense to require intervention?

It's important to determine if the anxiety is normal & expected for he child’s current developmental level, so that the clinician may proceed appropriately & not "look for" a disorder that may not be present.

It should also be noted, however, that, although a child might not meet the diagnostic criteria for an anxiety disorder, the symptoms may be of such intensity that intervention is warranted.

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Assessment of Anxiety Problems & Disorders

Anxiety is a complex emotion & assessment requires a multi-method, multi-setting & multi-trait approach. There are many methods of assessment & not all may be needed or are possible to conduct in all situations. Multi-method approaches should emphasize objective measurement techniques, such as some of the following:

Systematic observations

Conduct observations across home, school & other settings

Use a structured observation system

Record & summarize data according to frequency, intensity or duration of the behaviors

Use peer normative comparisons

Observe at different times of the day

Record data for different activities

Obtain multiple data points, i.e., conduct multiple observations

Behavioral interviews with child, parents, teachers or others

What anxious behaviors occur

When anxious behaviors occur

Settings where anxious behaviors occur

What does the child do when the behaviors occur

Effects do these actions have

What do adults do when the behaviors occur

Effects of those interventions

Effects of these behaviors on the child’s personal, social & academic functioning

Desired outcomes by each person interviewed

It's important to remember that when assessing children for possible anxiety problems, often there will be externalizing problems present. Conversely, a child may show externalizing behaviors (e.g., aggression, defiance, etc.) but internalizing problems such as anxiety may exist, but may not be readily apparent.

Therefore, it's important to assess all aspects of the child’s behavior in order to gain a complete perspective of the child’s functioning. Finally, the psychologist should be prepared for the likelihood that when all the data are collected, some will be discrepant from other data.

The reasons for these discrepancies are attributable to the type of instruments used & their psychometric properties, the accuracy & reliability of the informants, the pervasiveness of the problems or other factors.

For example, adults typically aren't reliable informants of a child’s internal mood state. When assessing internalized patterns, it's common for discrepancies to occur among data. Parent & teacher ratings often don't correspond with each other or w/the child’s self-report.

If the child is young, obtaining reliable data from self-report measures may not be possible & the practitioner will need to rely more on observations & interviews w/the child. It'll be necessary to place more emphasis on others’ reports if objective information is needed, e.g., behavior rating scales.

Older children who can provide reliable self-reports may offer a more accurate picture of their anxiety. In cases where there are many discrepant data, the clinician should make conclusions based on the overall clinical picture, while not completely discarding other data which may have value in helping to determine interventions.

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Interventions for Anxiety Problems & Disorders

All interventions should be based on clearly established referral questions & what are the desired outcomes. Without this clarity, the clinician is likely to proceed in an unfocused way that, at the least, will consume unnecessary time.

At the worst, there's the possibility of misidentification of the problem & the development of an appropriate intervention plan. Each intervention plan must be individually tailored to the child, rather than trying to use one approach for all situations.

Although the clinician may find the DSM-IV helpful in determining the presence or type of anxiety disorder, it should be remembered that the diagnostic criteria must be operationalized & defined for the student.

Also, the DSM-IV criteria are polythetic, i.e., different combinations of symptoms may lead to the same diagnosis, but different children’s behaviors may vary considerably.

For example, the diagnostic criteria for Generalized Anxiety Disorder under Section C indicate that only one of the 6 criteria are necessary to be present for children (p. 436). Therefore, any criterion may contribute to receiving this diagnosis, but the specific behaviors may become the focus of an intervention, independent of the label given.

The interventions ultimately chosen must be linked to what are the referring questions & the desired outcomes that are in the best interests of the child.  

A Problem-Solving Approach for Anxiety Problems & Disorders

All approaches to interventions for emotional & behavioral problems should have a problem-solving focus that'll help to guide the development, implementation & evaluation of the plan.

Typically, problem-solving approaches have a series of steps or stages from problem identification to evaluation of the plan. Huberty (1997b) developed a 6 step problem-solving plan that can be applied to anxiety disorders.

Problem Identification

In this stage, the psychologist emphasizes identification of the specific concerns of the referring persons & uses multiple techniques to specify those behaviors that'll become the focus of treatment.

In general, the most useful information will be gained directly from the child, although the input of others will be of importance.

Self-report measures

A general measure of trait anxiety should be administered to the child, such as the Revised Children’s Manifest Anxiety Scale (C. R. Reynolds & Richmond, 1978). This scale contains a total anxiety score, but specific factors of Worry / Oversensitivity, Social Concerns / Concentration & Physiological symptoms can be obtained.

Although this scale is useful, its "yes" or "no" answer format may provide limited information about the specific aspects of anxiety identified in a "yes" response. For those responses, the psychologist can ask follow-up questions to gather more information about whether the concern is rather global or specific to a particular situation. The scale also may be useful at follow-up as a measure of intervention effectiveness.

Another useful scale is the Fear Survey Schedule for Children-Revised (Ollendick, 1983), which gives information about specific fears or worries. Some items reference specific concerns, such as fear of animals, while others emphasize more global concerns.

Think-aloud tasks & Thought-listing techniques

With these techniques, the goal is for the child to identify & record thoughts & feelings of anxiety, when they occur & the events that precipitate them. These tasks can be a part of clinical interviews or counseling sessions & may be done several times.

Another technique is to have the child keep a daily log or journal & record specific information about anxiety-producing situations as they arise. These logs should be kept for several days & then analyzed for content & patterns of anxiety-producing situations & the child’s reactions to them.

Interviews.

Either structured or semi-structured interviews may be used to identify specific targets for intervention. In general, however, a functional, behavioral interview is likely to give valuable information about

(a) target behaviors

(b) possible alternative appropriate behaviors

(c) controlling antecedent & consequent variables

(d) the mediational value of parents, teachers & others

(e) to identify positive & negative stimuli (Goss, 1984).

A structured diagnostic interview specifically for anxiety is the Anxiety Disorders Interview Schedule for Children (ADIS-C; Silverman, 1991).

Behavior rating scales.

These scales are frequently used in child assessment & may be useful in gaining the perception of others about the nature of a child’s symptoms.

Because they tend not to correlate well w/a child’s self-reports of internalizing symptoms, however, (Achenbach, McConaughy, & Howell, 1987), they don't provide the same type of information as that gained directly from the child.

Many of these scales have anxiety subscales or related factors that may identify specific behaviors for consideration as target behaviors.

Behavioral observations.

Although observations may be useful in the Problem Identification phase, they're limited to identified behaviors. Little is gained about the child’s thoughts & cognitions, which must be derived by other methods.

If the behaviors are infrequent, systematic observation may not produce a large amount of data. Nevertheless, observations should be conducted & considered in this phase, so that precise information is available about the settings where anxiety occurs & the child’s reactions.

Observations also may be useful as measures of treatment effectiveness.

When this stage is completed, the "target" behaviors, i.e., those behaviors, cognitions or feelings that will be the focus of problem-solving have been identified. It's essential that this stage be completed w/specific descriptions of the problem(s), so that the remaining stages can focus on the development of interventions.

Problem Analysis

After the problems have been identified in the first stage, they must be analyzed in order to determine the nature, extent, severity, frequency or duration of the symptoms. In this stage, the degree & type of interference with personal, social & academic functioning is determined as precursors to developing interventions plans.

The first task is to determine if the anxiety is comorbid with other patterns or disorders. Because of this tendency toward overlap, the psychologist should conduct assessment to determine if comorbidity exists. Often, objective personality measures & behavior rating scales will indicate elevations in subscales for both anxiety & depression.

The reader is referred to Self-Study Activity #4 to review the common & unique criteria of those 4 disorders. It isn't as important to place a label on the patterns as it's to identify the behaviors or thoughts that are problematic.

A key component of this stage is to analyze the effects of anxiety on the child’s functioning. Personal problems may include difficulties with concentration or performance. Social problems may be shown in fear reactions or reluctance to enter into unfamiliar settings.

Academic problems may be shown in difficulties with starting tasks, showing initiative or sustaining effort.

Kovacs, Feinberg, Crouse-Novak, Paulauskas & Finkelstein (1984) studied a sample of children referred for emotional or behavioral problems & found that anxiety to be comorbid w/attention deficit disorder, conduct disorder, depression & dysthymia.

The authors also attempted to determine the order of onset of these disorders & found that anxiety appeared to precede depression & that conduct disorders were antecedents to depression when they were comorbid.

Research over the past several years has focused on the relationship of anxiety to depression & found that children who are given either diagnosis are likely to show symptoms of the other disorder (Ollendick & King, 1994).

Thus, "pure" diagnoses of anxiety or depression are difficult to obtain in clinical practice or research. Some differences have been found between these disorders that have implications for understanding their comorbidity.

Stark, Humphrey, Laurent, Livingston & Christopher, (1993) compared children who were screened for anxiety & depression. The depressed children tended to have more negative attitudes toward themselves, the world & the future; were more impulsive & angry; were more likely to live in a dysfunctional family & more difficult to manage, as compared to children with anxiety disorders.

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factors that make adults anxious?

fear of aging or death?

Are older adults are less anxious about death than are younger & middle-aged adults?

Yes. Although death in industrialized society has come to be associated primarily with old age, studies generally indicate that death anxiety in adults decreases as age increases.

Among the factors that may contribute to lower anxiety are a sense that goals have been fulfilled, living longer than expected, coming to terms with finitude & dealing w/the deaths of friends.

The general finding that older adults are less fearful of death than middle-aged counterparts shouldn't obscure the fact that some subgroups may have considerable preoccupation & concern about death & dying. Some fear the process of dying much more than death itself.

THE HARRIS POLL #60, December 5, 2001 

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fear of terror attack or national security

Many People Unprepared for Terrorist Attacks or Other Disasters

Large numbers don't know who to contact (52%) or have no plans to evacuate their homes (58%) or their workplaces (45%)

by Humphrey Taylor

A new issue of The Harris Poll looks at the level of public anxiety about personal safety because of recent events, & people's preparedness to evacuate their homes & workplaces in the event of a terrorist attack or other disaster.

The level of anxiety is smaller than some other surveys have suggested. Only 10% of all adults say they are "extremely" or "very anxious" about their personal safety, while 52% are "not very" or "not at all anxious." Over a 1/3 of the public (37%) are "somewhat anxious."

Most people (57%) say they are no more anxious now than they were before September 11th, but more than 2 out of 5 people (42%) say they are more anxious now.

These are the results of The Harris Poll of 1,011 adults surveyed by telephone between November 14 & 20, 2001, by Harris InteractiveSM.

This survey also found very large numbers of people have done little to prepare themselves for a terrorist attack or other disaster:

  • 52% of all adults say they don't know who to contact about emergency plans for their community
  • 58% say they have no plans to evacuate from their homes quickly & safely
  • 45% of those who work say they have no plans to evacuate their workplaces quickly & safely.  

teens on the internet - are they safe?

The Chat's Out of the Bag (you must subscribe to usnews.com - it's free to read the entire article, sorry, but it does have its benefits!)

Walter Minkel -- 2/1/2000
Tech Knowledge Chat Room

Chat rooms + e-mail + libraries = lots of anxiety

Chat & e-mail, particularly chat, present one of the scariest faces of the Internet for many adults. Chat rooms have assumed a reputation as hotbeds of pedophiles cruising for innocents. Unlike pornography sites, the topic at hand when children or teens are chatting isn't immediately apparent to passersby.

Adults may worry, "Who are they really chatting with?" Most Net filters thus default to a setting that blocks out chat sites. The way you handle chat rooms & e-mail on the Net stations in your library, particularly when young people are involved, tells a lot about your institution's culture. (I'm dealing primarily w/public libraries here, as library media specialists do in fact serve in loco parentis, while public librarians don't.)  

parental anxiety over young adult children

 

Don't yield to worries on lives of new 'adults'

By SANDRA THOMPSON

St. Petersburg Times
published June 1, 2002

On one side of the cake was an icing photograph of a little girl, a baby really & on the other side a photograph of a beautiful young woman.

"Congratulations," it said, as so many cakes will say this weekend. It struck me that the two pictures on this graduation cake are illustrative of what's going on in the minds of the parents of these young people who've put high school & home behind them & are going off to college.

The graduate looks like a young adult, but the parent knows better: The graduate is really a child, a baby really. Which is why in the past few weeks this year, as well as in other years, parents of graduates have been really losing it.

They're freaking out because their child has already made a stupid adult decision, even before graduation. He has chosen the wrong college. He has chosen a big state school ("He'll be a number there!") over a small liberal arts school. She has thrown over schools in the Northeast ("Because it's too cold there!") in favor of a school in the Sunbelt. Or vice versa.

And even if the choice of school is not at issue, there are other things to fear your child will screw up on once she's out of your view. There's campus drinking, & drugs & sex. There's getting up with nothing more insistent than an alarm clock. There's laundry!

kids growing up & moving away? are you fearful about it? 

click title above to read the entire article

then visit anxieties 101's Young Adults page to see what may truly be in store for your young adult...  you may have to take action to avoid worry, anxiety & even more serious mental health issues  

Keep informed thru your positive actions! turn your anxiety over the economy & war issues by using the resources available to you to stay informed of positive progress being made by the government instead of dwelling on the negative "trouble spots" in our society today! do what you can to make positive progress!

 

 

 

Poll: Worries Over War & Economy

NEW YORK, Feb. 13, 2003

 

The economy is clearly a major problem for the President. Just 38% approve of the way George W. Bush is handling the economy, the lowest percentage since he has been in office.

 

Perceptions of the economy continue to decline, as they have since the start of the Bush Administration; in this poll, 60% think it's in bad shape, while 39% think it's good, the worst evaluation of the state of the economy since September, 1993.

 

Survey reveals public-school worries

By Siobhan McDonough
Associated Press

Updated: April 23, 2003

Washington - Ill-mannered pupils, demoralized teachers, uninvolved parents & bureaucracy in public schools are greater worries for Americans than the standards & accountability that occupy policy-makers, a new study says.

Teachers, parents & students said they were concerned about the rough-edged atmosphere in many high schools, according to the report released Wednesday by Public Agenda, a research & policy organization in New York City.

Only 9% of surveyed Americans said the students they see in public are respectful toward adults.

 

High school students were asked about the frequency of serious fights in schools & 40% said they occurred once a month or more; 56% said they hardly ever happened; 4% had no opinion.

 

Only 15% of teachers said teacher morale is good in their high school. 

 

Coping strategies. Try these easy-to-implement techniques. 

The key to resolving fears & anxieties is to overcome them.

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Depression's role in marital health probed

United Press International / Monday, October 11, 2004

WASHINGTON, Oct 11, 2004 (United Press International via COMTEX) Research into marital happiness has determined each spouse's level of anxiety & depression predicted marital satisfaction for both partners.

In a sample of 774 married couples from 7 U.S. states, researchers Mark Whisman & Lauren Weinstock of the University of Colorado in Boulder & Lisa Uebelacker of Brown Univ. Med. School found the more anxious &/or depressed either spouse was, the more dissatisfied he or she was with the marriage.

The study found no gender differences in the levels of marital satisfaction by either husbands or wives who had similar anxiety & depression symptoms.

Depression was found to influence both husbands & wives more than anxiety in how satisfied they felt about the marriage. But only a spouse's depression level affected the other spouse's marital satisfaction. When a spouse suffers from anxiety, but not depression, the affect on the marital partner was less.

The findings are reported on in the October issue of the Journal of Consulting & Clinical Psychology published by the American Psychological Association. 

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How to reduce anxiety when affirmations don’t work - By Sarah Malik

Have you ever read that you should think positively when you're feeling anxious?

Have you ever been told to argue back when you have negative thoughts?


How’s that working for you?

Why do affirmations only sometimes produce results?

Because as we argue back to our negative & irrational thoughts, we don’t always believe the new things we're telling ourselves.

What we really believe is our original thoughts – the thoughts that have led us to feel anxiety in the first place.

The other reason that affirmations sometimes produce limited results is that we might not really believe that saying the affirmations will create change in our lives.


So why do affirmations come so highly recommended?

How are these affirmations supposed to work?

If you can get yourself to begin to believe them, if you can begin to see a kernel of truth in what you're saying, then affirmations may help you to install new, more helpful beliefs.

New beliefs!

That's the key to permanently & more positively changing how we feel & react to the world around us.

There's a difference between what we really believe & all of the infinite number of possible thoughts that we're capable of thinking – which we may or may not believe.

It's the thoughts that we really believe that seem to possess the power.

Rather than the thoughts that are positive yet not believable.

Our beliefs are the source of the actions we take. We act ultimately based on what we believe to be true.

It's possible to use affirmations to bring a conscious effort to alter our actions.

But if we don't believe that this new perspective or thought that we're affirming is going to be effective, then we'll revert back to what we really believe beneath the self-imposed, positive thoughts.

If you can begin to agree with the thoughts & affirmations you're feeding yourself, you'll begin to act from them. And you'll indeed be in the process of changing your beliefs.

It can be done thru affirmations. But what’s the key?

There has to be something in there that you believe, that you can see as true in some way.

It probably won’t work if you see the affirmations as touchy-feely mumbo-jumbo.

The caveat for anxiety sufferers

For anxiety sufferers, however, the affirmation process may have a limited & disappointing effect.

Here’s why:

If we go into a social situation where we normally feeling significant amounts of anxiety & try to affirm our way thru the experience, old beliefs may very easily strong arm our fragile, new, positive thoughts. And create a nerve-wracking experience.

And, as a result of this nerve-wracking experience, affirmations will look like a very ineffective tool.

It's in the deeper realm of our beliefs that the power for having a permanently altered, more calm experience lies.

Go there & see a difference in your feelings of anxiety!

Recovery From Anxiety - By Paul David

I've been asked all sorts of questions througout my years of helping people with Anxiety & Panic & certain questions came up far more than others. So for everyone's benefit I decided to list some of the most popular ones below.

Q.1 I feel so strange & out of touch with the world around me. Am I going mad?.

No, you're definitely not. You may feel as if you are, but this is just another offshoot of anxiety.

Anxiety isn't a mental illness. These feelings can't harm you & there's nothing to worry about.

Otherwise known as depersonalization & derealization, this feeling of unreality & detachment has a totally logical explanation. It comes from the constant worrying about how you feel as you search your mind for answers to your condition.

Your mind has become tired & less resilient thru watching yourself & worrying about your symptoms, day in, day out. It's been bombarded with worrying thoughts & becomes fatigued. Just as our limbs can tire, so can our mind.

It craves a rest from all this introspection of oneself.

In fact these feelings of unreality are your body's way of protecting you from the onslaught of worrying thoughts. Your mind has a safety mechanism that protects against all this, causing us to feel strange & not "with it."

It's crying out to be left alone & just like a broken arm will heal itself so will your body, you just have to step out of the way & let it.

The key to recovering from this feeling of detachment is to surrender to this strange feeling, to pay it no respect & realize it's just the product of an over-tired mind, fatigued by your constant worrying thoughts & the constant checking in to how you feel.

Constantly worrying about this symptom is the very thing that keeps this feeling alive. When people are caught up in the worry cycle, they begin to think deeply & constantly. They study themselves from deep within, checking in & focusing on their symptoms. They may even wake in the morning only to continue this habit, “How do I feel this morning?

“I wonder if I will be able to get thru today”. What’s this new sensation I feel?”

This may go on all day, exhausting their already tired mind further. This constant checking in & constant assessing of their symptoms then becomes a habit, but like all other habits this one can also be changed.

This Question I've been asked more than any other over the years & I go into a lot of detail in my book to explain this harmless yet disturbing symptom. This condition can really throw people into thinking it's something far worse than it really is.

I myself found this feeling of detachment very hard to accept & understand, but when it was explained to me in full, I was able to rid myself of this symptom of anxiety.

Q.2 Why do I feel better in certain situations & not in others?

This is a very common one & it all comes down to how you think in other situations.

For example, you may feel better in the safety of your own home rather than at a family gathering. There's no difference in both of these situations, the only difference is in the way you think. You're the same person & it isn't the situation that makes you feel worse - it's your thought pattern.

You may spend the day worrying about going to a particular function, setting your body up to be anxious on arrival * then blame it on the situation you are in rather than the thought pattern you have created during the day while at home.

You may get there & then also worry about making a fool of yourself, spending the whole time tensing against how you feel & creating more anxiety.

Do you see how we do this to ourselves? It isn't the situation, but our perception of the situation that causes us to feel worse in certain situations. You're merely doing it to yourself with your thoughts.

You must just accept how you feel wherever you are & in whatever situation you find yourself; deal with yourself & not the place. Sometimes a place may hold certain memories of failure, which makes us feel anxious, but this soon passes when we learn to accept how we feel & let go of that tension. Don't try & hold on to yourself, learn how to let go & just be.

If you truly accept how you feel in every situation & stop all the "What if's" & other negative thoughts that just increase anxiety, you'll find that although you may feel uncomfortable at times, nothing bad is going to happen to you & in time your reactions lessen until you feel more able to cope, day by day.

Anxiety loves avoidance, so take it's power away & move forward & embrace these feelings of fear, this is the key , moving towards your fears is far more productive than hiding from them.

By continually hiding & running away from how you feel you're training your mind & body to fear, this again is another habit born thru anxiety, but again like with all habits it can be reversed.

Avoiding symptoms just doesn't work, as you must realize by now. you need to let all feelings be there, not to avoid them but to go thru them, invite them even. This worked for me, I had faced my demons head on & realized this was the only way to stop fearing them.

I ignored my body's instinct to avoid & started to embrace how I felt, I moved towards the feelings of fear. Eventually, I started to understand my condition so much more. I went from not being able to even mention or hear the word anxiety, to barely giving it a second thought.

I mention the word 'understanding' again, because this is the key to recovery. How can you not fear something you don't understand! How can you accept something that still scares you?

Q.3 Will these feelings ever go away?

Yes they will, once you understand why you feel like you do, you can then start to unmask a lot of the fears you hold about anxiety. There are so many myths about anxiety that it worries me just how many people are misinformed & truly believe they'll never get better & that they'll just have to live with this condition.

Too many people spend years like I did, searching for that elusive miracle cure that just doesn't exist. Your body has been thru a lot in the time you have had this condition, it maybe emotionally spent & feel so tired.

None of this has done you any long term harm. Just see your body as running at 75% at the moment, in time when we learn to step out of our own way & start doing things the right way & changing our habits, it improves & starts to feel more healthy & refreshed.

Letting your body recover at it's own pace is the key, overnight cure is impossible after what you have been thru. But what a journey recovery can be when we allow it to happen.

Understanding anxiety also takes away so much fear out of how we feel. A lot of anxiety is habit, a learned behavior that can be reversed. Every stage & symptom has a logical explanation that can be explained.

With less fear & more understanding, we also calm the constant worrying; it's the lack of information on the subject that keeps the worry cycle going. Constant worrying that we'll never get better also adds to the belief that we'll just have to live with it.

Once we start to understand anxiety & use the tools we have learnt to cope with how we feel, the change can be dramatic. In my recovery, I found that the more knowledge I had & the more I understood my condition the easier it was to accept how I felt.

I started to lose fear of my symptoms & how I felt. Eventually they began to hold less power over me & I started to pay them less respect.

It's your desperation to rid yourself of how you feel that keeps your anxiety alive. The stress you put on yourself day in day out, the constant worrying & thinking about your condition, this puts a tremendous pressure on your body. Is it any wonder you stay anxious? It's time to stop beating yourself up about how you feel & give your body the rest it craves.

Knowledge is power. The less you fear your symptoms, the less they mean. This also stops the worry cycle you may find yourself in, which is the very thing that keeps anxiety going. You are bound to worry if you don't know what's wrong with you, that's why you need an explanation to help break this cycle.

Q.4 Why do I find it so hard in social situations? I find it so hard to communicate with people.

Is it any wonder we find it difficult to follow a conversation when all we're concerned about is ourself & how we feel. We can't concentrate on what the other person is saying because all we're concerned about is how we're feeling & how we maybe coming across.

I found myself trying to hold on to myself, trying not to crack. It was like acting out a part in a film. It was like being two separate people, one trying to hold a conversation, the other watching my body's reaction. Is it any wonder we struggle to fit in to the world around us?

Once we find the courage to accept how we feel & try to not put too much importance on how we come across, we find it easier to follow what the other person is saying. We become less concerned about how we feel, which gives us more time to be interested in the situation we are in & we start to become more involved in the present.

Q.5 Why do I seem to have so many bad thoughts running around all day?

The reason you seem to have your attention on yourself all day & it feels like there are hundreds of thoughts running thru your mind is because of all your confusion about how you feel. You go round in your mind all day long, looking for answers, trying to find a way out of this hell.

Some people may even stay up all night reflecting on the whole day, trying to figure it all out. Mostly these are negative or worrying thoughts & that's why they seem to come automatically & with so much force. When you're in an anxious state, emotions seem to be ten-fold. Everything magnifies, a little problem becomes massive & something that you could dismiss when you were healthy, sticks around all day.

Eventually thinking just becomes automatic; it becomes a habit. All day, every day, these thoughts seem to come before you even think them.

Looking at it from another angle, when people meditate, they stop thinking for hours on end until it becomes a habit & they can go all day without a worrying thought. That's why they feel so refreshed.

Not you, your thoughts just carry on & on & when your mind is tired, like it is now, it grasps hold of every thought, pulls them in & they seem to stick. Some people worry to the extent that they believe everything they feel is life threatening.

A headache becomes a brain tumor, a stomach ache can become cancer & so on & no matter how many times their doctor tells them there's nothing wrong with them, they're never quite convinced.

If this is you, then realize these thoughts of illness are just figments of your imagination, mainly created by your anxious state. Everything becomes magnified when we're anxious. Let these thoughts go, don’t react to them & see them as just that, thoughts that carry no weight whatsoever, no matter how loud they shout.

When we try too hard to do ANYTHING, it seems to slip further from reach. This applies to ridding oneself of unwanted thoughts. The more you "try" to push them away, the longer they linger & the stronger their impact.

When we welcome, yes actually embrace, unwanted thoughts, they lose their significance & quickly diminish. When you impose a false sense of importance upon a thought, it'll often appear more serious than it deserves.

Time is a great healer, especially concerning this condition. I allowed them to flow in & flow out & I didn’t react. When I did this, I noticed the scary thoughts seem to lose their scary edge. Stop fighting them, just say: come if you wish, I'm ready for you.

Don't be thrown by these symptoms or this experience. Once you begin to recover, the mind & body settle down & these overwhelming thoughts disappear, along with the anxiety condition.

Don’t ever think, "I must not think that". Let all thoughts come, don't run away from any of them.

See them for what they are - thoughts - exaggerated because of the way you feel. They can do you no harm & they mean nothing. They won’t be around when you recover, so pay them no respect.

Why not try following a negative/scary thought thru & ask yourself, "What’s the worst thing that could happen?" Ask yourself, "Is it really going to happen? Is this thought rational in any way?" If you do this, you may find an answer to a thought you've been so frightened of.

So the next time you can see them for what they are & let them go & deep down inside of you there's a place where you can see thoughts for what they are, you'll realize they just come from habit & are just not important.

Quick Help for Anxiety - By Terry Richard

There are steps to overcoming anxiety. The sufferer must be serious about gaining control over the symptoms. Steps require time & effort.

POSITIVE AFFIRMATIONS:

Repeat the following upon waking, several times thruout the day & at bedtime:

1. I am getting calmer. I am feeling calmer. I am calmer.

2. I am getting stronger. I am feeling stronger. I am stronger.

3. I am getting better. I am feeling better. I am better.

4. I am becoming in control of myself. I am feeling in control of myself. I am in control of myself.

5. I can't change others. Others can't change me. I can only change myself.

VISUALIZATION:

Visualization is a key element in learning to RELAX. The GOAL is to eventually be able to envision a calm, relaxing thought or scene & FEEL that state of being.

RELAXING BREATHING TECHNIQUE: Close your eyes. Place your hand just under your ribcage. (This is where you'll breathe from. Your hand should move up & down with each breath.) Focus all your attention on breathing as instructed.

* Inhale, slowly, deeply, to a count of 5. Hold for a count of 4. Exhale, slowly, until all air is released. Repeat. Return to normal breathing.

Steps to Visualization:

1. Find a quiet setting.

2. Make yourself as comfortable as possible. (Prepare to relax.)

3. Close your eyes and perform the RELAXING BREATHING TECHNIQUE. Focus on the 'light feeling' you have when breathing. Try to envision yourself as 'floating.'

4. Once returning to regular breathing, continue to focus on the way you breathe. Breathe slowly. Make each breath PRODUCTIVE. Allow the breaths to flow through your body, saturating you with clean, comforting oxygen. FEEL your whole body breathing. Focus on this thought as you breathe.

SELECT A PLEASANT MEMORY

The memory may be of a certain place you have visited, a picture you have seen which was pleasing to you, or even a fantasy vacation spot. The important factor in VISUALIZATION is that you are calm and content with the visual.

Focus on the visual. SEE, HEAR, SMELL, FEEL. It takes time to reach the 'perfect state of visualization,' but with practice, it is possible.

TIPS FOR DEALING WITH SOME ANXIETY SYMPTOMS

CHOKING SENSATION: Stick out your tongue, inhale through nose, exhale through mouth. This should alleviate the choking feeling associated with panic attacks.

RAPID HEARTBEAT and/or SHAKINESS: Do the RELAXING BREATHING TECHNIQUE (shown on this page).

YOUR POSITIVE JOURNAL

Another key to getting better is changing our attitude. Many of us don't even realize how NEGATIVE we are. One way to change our attitudes is by keeping a 24 hour journal of all our thoughts and feelings. Do not try to rationalize what you are feeling or thinking at the time, just write it down. After 24 hours of journal keeping, review your thoughts and feelings. Most of us will be shocked at how negative we have been! This will help us to focus on our thoughts and feelings more, become aware of what we think and feel, change the way we think and feel. Now that we know, we can work on changing this attitude to POSITIVE.


Terry Richard/Author

Anxiety - Understanding & Treating The Condition - By Michele Carelse

Most people suffer from anxiety at some stage of their lives. Anxiety is usually a relatively natural response to a situation which appears threatening or one to which we aren't accustomed.

So, for example, people are sometimes quite naturally anxious about passing tests, going for job interviews, or even speaking in public. They may experience 'butterflies' in their stomachs, sweaty palms, restlessness, insomnia, or even slight dizziness.

This usually goes away after the actual event has passed or once they've become used to it. The person who is terrified of their first public speech may become so accustomed to public speaking after awhile that she doesn't give it a second thought!

1. Diagnosis of Anxiety Disorders

When anxiety becomes so chronic or intense that it affects the person's day to day functioning & hampers performance, we will usually diagnose an Anxiety Disorder.

Some people have what is called a Generalized Anxiety Disorder (GAD). This means that their anxiety doesn't have a specific focus like, i.e., a phobia, but is more 'free floating' & forms part of their everyday functioning & response to life.

Symptoms of GAD include motor tension (edginess, jumpiness, trembling, restlessness, twitching, muscle aches, easily startled, furrowed brow, inability to relax), autonomic activity (sweating, heart palpitations, dry mouth, dizziness, tingling in hands and feet, upset stomach, shortness of breath, frequent urination), apprehensive expectation (anxiety, fear, worry, and persistent thoughts of potential misfortune), vigilance & scanning (constantly on the alert for danger, failure or disaster, resulting in difficulties in concentration, irritability, impotence and insomnia). GAD is diagnosed if these symptoms have been present continuously for more than one month.

Other sufferers of anxiety are diagnosed with Panic Disorder, Phobic Disorders, or Obsessive Compulsive Disorder.

A Panic Disorder will be diagnosed if there are at least three panic attacks within a 3 week period in reaction to situations that aren't life threatening & which aren't associated with physical exertion.

Symptoms include:

  • shortness of breath
  • choking sensations
  • heart palpitations
  • chest pain
  • dizziness 
  • faintness
  • tingling in hands or feet
  • hot & cold flashes
  • sweating
  • trembling
  • fear of dying or heart attack 
  • a feeling of unreality or danger - click here

Phobic Disorders include a persistent fear & compelling desire to avoid an object or situation to the extent that the person's life, functioning & relationships are significantly impaired.

Examples of phobic events include Social Phobia (fear of embarrassment in social situations) & Agoraphobia (fear of public places), fear of heights, flying, etc. Phobic objects may include anything from animals & insects to numbers or colors.

Obsessive Compulsive Disorder (OCD) may take the form of excessive & intrusive obsessive thoughts, images or impulses that are almost impossible to ignore or stop, even if the individual understands that they're senseless or unfounded.

The disorder may also include repetitive & often purposeless behaviors that are often performed according to certain rules & which are sometimes believed to prevent or produce some future situation or event.

The person doesn't find the activity pleasurable but does experience a sense of relief from tension when performing it. The obsessive thoughts, behaviors or impulses usually interfere significantly with functioning.

2. Causes of Anxiety Disorders

There are many different theories about the causes of anxiety disorders. Some theories say that they're genetic & are purely chemical in nature. There's some evidence for this, as anxiety disorders very often tend to run in families, even when children have been adopted at birth & never meet their biological parents.

Other theorists say that extreme anxiety is learnt from an overly anxious parent or that it originates from some trauma during early childhood or from overly punitive parenting. It's very likely that there's usually a combination of these potential causes & each case must be viewed as a unique one & well investigated before any pronouncements are made about the causes.

3. Differential Diagnosis

When we speak about differential diagnosis, we speak about ruling out the possibility that the anxiety symptoms may be caused by something other than an Anxiety Disorder. Anybody who experiences clusters of symptoms similar to those discussed above should always have a thorough medical examination.

Symptoms similar to those above may be attributable to thyroid problems, heart problems (particularly mitral valve), reactions to certain prescription or recreational drugs & even ear infections or allergies.

If these are ruled out, the likelihood is that the person is suffering from an anxiety disorder. It makes little sense to keep treating someone for anxiety when that isn't the real problem & it's surprising how often that actually happens!

4. Treatment

Different therapists treat anxiety in different ways & this depends largely on their particular training, experience & outlook. Also some clients respond better to one form of treatment than others & it's important for the therapist to do a thorough assessment & get to know his client before deciding on treatment.

Some therapists treat their clients with prescription drugs like anxiolytics, beta blockers, or even antidepressants. This means that they're treating the symptoms of the anxiety.

Anxiety symptoms or OCD can often be successfully controlled by the careful use of prescription drugs. Unfortunately many of them can be addictive or produce side effects & the person often builds up a tolerance to them, needing to take more & more to achieve a similar effect.

Another criticism is that no attention is paid to the causes of the anxiety or to helping the person learn ways of controlling or managing the anxiety without drugs.

Many therapists use techniques like progressive relaxation or meditation to help the client learn how to access his own calming response (everybody has one!) & to lower anxiety levels to more comfortable states.

This is often combined with psychotherapy to help improve self-esteem & understand the causes of the anxiety, cognitive therapy to 'reprogram' the negative thoughts underlying the anxiety, or desensitization aimed at eliminating phobias.

There are also many natural products which help & may be used alone or in combination with therapy.

It's usually best to speak to your pharmacist, health store owner, or health care professional to find out what's best for you & how to take it, but some common herbs are Passiflora, Pasque Flower, St John's Wort, Melissa, Chamomile & Kava Kava. For more information go to http://www.nativeremedies.com/

It's important to note that most anxiety disorders respond well to treatment & I would encourage anyone who suffers from anxiety to go for help. It can make all the difference to your life!

5. Self Help:
There are many things that will help with anxiety.

If you're experiencing stress at work, in your relationships or anywhere else, look & see what changes need to be made. Get help if you feel you're unable to do this yourself.

Regular exercise is one of the most beneficial things one can do & has been shown to have a significant effect on lowering anxiety symptoms & improving well being. At least 45 minutes 3 - 5 times a week will make all the difference!

Make sure that you eat regularly to avoid fluctuations in blood sugar level & have at least 7 to 8 hours of sleep a night! Sleep deprivation can cause symptoms of anxiety.

Avoid stimulants like coffee, tea (except herbal teas), sugary foods, chocolate or carbonated drinks, particularly the cola variety. People who suffer from anxiety, who are at greater risk for dependence, should never take alcohol & most recreational drugs. These substances can also worsen the anxiety symptoms.

Include:

  • oats
  • bananas
  • avocado
  • pears
  • whole-wheat pasta
  • bread 
  • brown rice

in your diet.

Set aside at least 15 minutes twice a day to sit in a quiet spot, close your eyes & practice deep breathing. Listen to soothing music or a relaxation tape or CD.

If there's something specific that's causing anxiety (like shyness or fear of animals) see if you can't gradually become accustomed to it, little by little. This will also improve your confidence & self esteem.

Talk to people about how you feel! Try and socialize, start a hobby, take up a sport or develop new interests! Perhaps think about offering your services as a volunteer to help others. Anything which takes your mind off yourself & keeps you interested will help!

6. Conclusion

As we've discussed, anxiety can take many different forms & can be treated in many different ways. There are also many things which one can do oneself to control or significantly reduce the symptoms of anxiety. Most of these take some work & persistence, but then so does an Anxiety Disorder!

Believe in yourself & spend time getting to know what works for you & then persevere with it. You'll be surprised how much you can help yourself.

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