Anxiety Disorders

Cognitive Behavioral Therapy (CBT)

2010-06-02T08:17:00.001-07:00

Do you know what Cognitive Behavioral Therapy (CBT) is? CBT is a model of psychological change, used by some psychologists to treat anxiety disorders, mood disorders, and other mental helath conditions. Throughout the last decades, CBT has been subjected to many studies, having earned its place as one of the main (although not the only one) empirically-proven therapy for these kinds of disorders.

We will take a closer look at how it applies to anxiety disorders, in the near future, so stay tuned to our CBT news.

Remember: Even though CBT may be learned as a self-help technique, having also shown good results when being used that way, it is best learned and applied with the help of a licensed professional.

Feedback

2010-05-06T09:59:00.001-07:00

Do you have any feedback about the blog or site that you would like to share with us? Contact us! We're always interested in the opinions of our readers. Let's us know what you would like to see discussed, or what you would improve in the overall layout.

New developments soon!

2010-04-12T18:03:00.001-07:00

Hello again! While being true that I haven't updated in a while, please know that it has been for valid reasons :)

Soon, there will be something new to show for: a complete website is being prepared, to serve as a home for new articles.

See you soon!

Hope versus anxiety

2010-01-22T17:58:00.000-08:00

In the late 1960's, American psychologist Martin Seligman developed the concept of Learned Helplessness, as he observed the behaviors of both animals and humans. This concept assumed some relevance in the field of mental health, being one that many may recognize by essence, even if not by name.

What is this learned helplessness, then? Seligman noted that when people are subjected to an unavoidable stress and discomfort for a long time, such as the stress many of us face daily in our frantic lives, they start behaving as if there is nothing they can do to help themselves out of their unpleasant circumstances. As time goes by, people simply resign themselves from even trying to improve things, conforming to whatever is hurting them... sometimes, for a long time after the actual ability to change things has been restored to them. It is something akin to a depressive state.

People sometimes learn to feel this way, that they have no control over the outcomes of things in their lives... one day they simply conform to being towed daily by their external circumstances. Well, if truly nothing can be done, then acceptance can be positive... but often, something CAN be done to improve, even if only a bit. If we can't see it, then we should ask for other people's opinions, since someone looking from the outside in can have a clearer perspective. But for it to be possible, we first need to believe it, and to understand that however small the improvement may be, it is still worth it: the smallest of things can sometimes do the greatest of differences.

In our quest to deal with our anxieties, it is important to constantly remind ourselves that we CAN change things. Even if there is no clear path to a best-case scenario, we can at least attempt make our own lives a bit better, little by little, one thing at a time. Realizing that today is today, tomorrow will be a bit better... if we just do something to make it that way.

(PS: Avoidance of feared situations is seldom the best solution, if that's the first thought that came to mind.)

The important thing is to not let yourself fall into a learned helplessness: Hope is more than just a word, if only you hold on to it. "Action" equals "possibility of change".

Panic and Heat

2009-11-26T18:47:00.000-08:00

It is widely known that humour disorders, more specifically depressive states, are more common when the cold season arrives. Temperatures go down, there is less light, the days are shorter (equals less exposure to the light of the Sun or none at all), and the weather is usually uninviting, which means that for the most part we have to remain indoors. All of these factors can contribute to people feeling depressed.

It is less known, however, that panic attacks are more frequent in the hot seasons, or when there are abrupt changes in temperature. In the current absence of a definitive explanation to this statistical tendency, it is assumed that these are triggered in part by a similarity between the bodily response to heat and to anxiety or fear: as body temperature rises, the normal response is sweat, an increased heatbeat, and an increased difficulty in breathing (sounds a lot like anxiety as well, doesn't it?).

Panic attacks can manifest themselves as difficulty in breathing, a pain in the chest, dizziness, tingling in upper and/or lower limbs, increased heartbeat and sweating. The first reaction for many people, as the heart begins to race, is that there might be something wrong with them. In turn, this increases anxiety, which deepens both the symptoms and the fear the person feels, in a anxious loop... and thus conditions are set for panic.

A small reminder that the physical environment plays an important role in our mental health, as well, along with many other factors.

White Coat Syndrome

2009-10-28T15:18:00.000-07:00

Today were going to talk about another common anxiety problem, that's also not included in the ranks of the anxiety disorders: it is called "white coat hypertension". Or more commonly, "white coat syndrome".

Described simply, it refers to increased anxiety and anxious symptomatology when one is in a medical setting, resulting in an higher blood pressure. Many people experience it, so if you do too, know that you're not alone.

Both patients and professionals should be aware of this anxious condition, since it actively influences the measure of blood pressure. If you have this syndrome, be sure to let your doctor know, so that he may correctly interpret the results he will collect.

What distinguishes this kind of hypertension from the more constant type is that this one occurs exclusively in medical settings, and not in other contexts such as at home or work, making it a bit trickier to diagnose and address properly. If you experience constant high blood pressure, inform your doctor. The important thing to remember is that high blood pressure, whatever the cause, should always be checked and treated.

White coat syndrome should also be distinguished from Social Anxiety Disorder, in that this anxiety is not caused by social interaction, but by the antecipation of being examined by a doctor. From there derives the name given to it: the anxiety is usually provoked by the presence of people in white coats (doctors, nurses, etc.), or more accurately, by the reactions your mind has when presented with medicine-related stimuli.

If you suffer from this problem, you may want to complement the treatment your doctor prescribes, by trying to find different coping strategies to help you manage your anxiety. Most important of all, don't avoid medical appointments on account of the anxiety you feel... your health comes first, always.

[Plus, on the positive side, exposure to the feared situation (when it is safe to do so) is often one of the best ways to sucessfully desensitize yourself against anxiety. Knowing that may not give a lot of comfort when one is in the midst of the feared situation, but after the anxiety is gone it may.]

Here are some simple coping strategies you may want to try:

- Make use of distraction techniques... these can help you to take your mind off the automatic thoughts that cause you to feel anxious;

- Avoid eating or drinking stimulant foods and drinks, as they have the potential of increasing your anxiety;

- Breath control (more on that soon): breathe slowly, to the count of 3, constantly focusing your mind on the breath, as it flows in... and as it flows out again to the count of 3.

Book Review: Overcoming Social Anxiety and Shyness

2009-10-20T07:27:00.000-07:00

Author: Butler, G.
Publisher: Basic Books

[For your convenience, you can find links to the product at Amazon.com (US residents) and Amazon.co.uk (UK residents) at the end of this article.]

Gillian Butler's Overcoming Social Anxiety and Shyness: A Self-Help Guide Using Cognitive Behavioral Techniques is a compact and very useful book. It is very popular, being part of the series that is currently the international market leader of self-help titles. However, usually you're only given a generic description of that series, not knowing what a specific book is really worth... so, here's a full review of the book itself.

First things first. From the very first information you see, the index, you will expect to find chapters on:

- Understanding Social Anxiety (origins, causes, awareness and the experience of it)
- Overcoming Social Anxiety (where to begin, changing thinking patterns and behaviours, building confidence)
- Related Topics (assertiveness, the influence of bullying, relaxation)

In its 288 pages, this book starts by introducing Social Anxiety Disorder itself: the history of its diagnosis, possible causes, and how it is like for the people who experience it. This, in my opinion, is fundamental, not only in order to create awareness, but also to show people who have the disorder that they are not alone. To show them that others share the same concerns and anxieties. And for those who don't know for sure if their problem is at a level in which treatment could be beneficial, it also includes diagnostic questionnaires.

Different types and degrees of social anxiety are talked about in Overcoming Social Anxiety and Shyness: A Self-Help Guide Using Cognitive Behavioral Techniques. As for actual treatment, it presents a number of techniques derived from Cognitive-Behavioral Therapy (CBT), to help in identifying and changing automatic thoughts, be aware of emotional states that influence behaviour. As far as self-help goes, it has quite a number of very helpful material... if you find that something doesn't suit you, try it another way. But as could be expected in a responsible work, the book also discusses formal treatment, beyond self-help. So, in short, it is useful not only for self-help, but also as a worthy complement to something more thorough.

One of the things I like best about this book is its organization, meant for clarity. At each chapter, there are often bulleted lists that sum up the most important aspects to know or follow. Its clear orientation for the public makes it a possibly good choice of book for professionals to recommend to their patients, as a complement to actual cognitive-behavioural therapy.

Conclusion: A must for socially anxious or simply shy people, or just about anyone who'd like to know more about social anxieties or the disorder that characterizes higher levels of that same anxieties. More oriented for the public than for health professionals, and thus more accessible.

Order it today from Amazon.com:
Overcoming Social Anxiety and Shyness: A Self-Help Guide Using Cognitive Behavioral Techniques

Or, if you live in the UK, you can order from Amazon.co.uk:
Overcoming Social Anxiety and Shyness: A Self-help Guide Using Cognitive Behavioral Techniques

Recommended.

Post-vacation anxiety

2009-10-17T08:23:00.000-07:00

How can it be possible… the words “anxiety” and “vacation” present in the same sentence?

Post-vacation anxiety is the name given to the anxiety people feel when the time comes to return to work, after a nice and relaxing period of vacations... more commonly, its known as vacation blues. The thought of restarting the daily routine of “getting up, getting ready, commuting, going through the workday, and commuting back” is enough to cause in those people pronounced symptoms of anxiety. It's natural, but it happens mostly when people aren’t satisfied with the work they do. Note that this is not considered an anxiety disorder, but it is still a problem for those who feel it.

How can this anxious state be fought (not countered, like with substances, but actually worked on to get better)? First of all, the improvement of work and workplace conditions is fundamental.

Interpersonal relationships are usually an essential factor in this problem, since the links we establish with those whom we work side-by-side daily are some of those that generate the strongest and/or most frequent emotions. Working conditions, such as lighting, equipment and safety, are also very relevant. A stimulating setting is also nice to return to: one or two plants, wall decorations, and the likes, if possible (more often than not it isn't, like in industrial settings).

In second place, the task itself. If a person is not satisfied with her work, she should seriously consider if that is where she should be. Often, people don't have a choice (bills have to be paid)... but if you build a paralel career, step by step, perhaps one day there will be the possibility to change career, leaving the job you dislike.

In third place, comes the ability to develop or adopt coping strategies to cope with the stress generated by professional demands (and domestic demands that arise from the professional ones). This is different for each person... hobbies and other distractors are a must, when you have a stressful job or life.

So, the main elements in countering post-vacation anxiety would be:

- Improvement of workplace conditions
- Interpersonal relationships
- Stimulating work environment
- The assigned task
- Coping strategies against professional stress
- Coping strategies against domestic stress

World Mental Health Day

2009-10-10T03:29:00.000-07:00

For those who don't know, October 10 marks the World Mental Health Day.

It is a date celebrated globally, aiming to raise public awareness about mental health issues. So, today is a good day to speak, to share... or simply to listen.

Attention and Anxiety

2009-10-09T03:35:00.001-07:00

When people have a anxiety disorder, there are usually a number of triggers in the environment that cause in them the anxious symptoms. But the main factor in that equation isn't necessarily the presence of the triggers... it's the attention that the anxious person pays to them.

As a person with a specific anxiety disorder goes along her daily life, the mind finds itself scanning the surroundings for that feared something. This can often lead to panic by antecipation (worrying about the possibility of finding a threat). So, in view of this, anything that can distract the mind is an effective coping strategy, in the sense that it eliminates not only the worry, but also the probability of being triggered. Here are a few examples:

- Listening to music (be careful when using headphones on the street)
- Talking to another person
- Calling a friend
- Reading a book or magazine
- Doing favorite activities
- Focus on a specific harmless element of the surroundings

As for professionals, one of their tasks can be to help the anxious person find these coping strategies or activities, taking advantage of the distraction strategy, helping to take attention away from the stimuli that trigger the disorders.

Disorders don't need to take over your mind (and life)... your mind can be a great help in taking over the disorders.

Social Anxiety Disorder

2009-09-28T15:28:00.000-07:00

Much has been written in last few years on Social Anxiety Disorder (SAD). But what does it really mean to be socially anxious? As many people well know, it means facing a variety of anxiety symptoms (including panic attacks) when presented with situations that involve social interaction or exposure. Sometimes, just anticipating such situations is enough to trigger the anxious response. The person usually recognizes that the fear is excessive or irrational, but that alone does not diminish it in any way.

Social anxiety can be generalized, spanning all social situations, or it can be specific, limited to particular situations such as public speaking or eating in public. This latter type is more common than the former, but, depending on the situations involved, its interference in everyday life can range from almost inconsequential to quite disturbing. If a person has a specific phobia of public speaking, but never has to enter such situations in everyday life, the SAD diagnosis needs not be made, as it ends up not having negative effects on actual performance.

The cause behind the anxiety is usually automatic (and often unconscious) thoughts about the possibility of performing poorly at some task, or being negatively judged by others. This evaluation component is quite frequent in social anxiety sufferers: there is susceptibility when it comes to situations where they feel judged (also including situations like academic test-taking).

Stimulants and anxiety

2009-09-15T16:16:00.000-07:00

A number of substances, that we go about consuming in our daily lives, have the effect of stimulating our organism without us knowing it. These cause an enhanced activity of the central and peripheral nervous systems, resulting in an increased arousal, heart rate and blood pressure.

These stealthy common ingredients include (but are not limited to) alcohol, caffeine, nicotine, and sugar. Yes, candy and chocolate are included in that last one.

What is the problem in this? Well, in people with anxiety disorders (and those without them too), the intake of these ingredients often causes an increase in anxious symptoms. They sometimes trigger headaches as well, being a known cause for migraines.

As a consequence, when people have anxiety disorders it is often recommended that consumption be moderated. Which, before you start to worry, doesn't mean it needs to be avoided at all costs. Doctors recommend a healthy and balanced diet, that often assists in the reduction of anxiety levels.

Just how much, depends on each person.. but any help in feeling a bit less anxious is always welcome, right?

Anxiety Awareness - Part II

2009-09-12T02:58:00.000-07:00

(continued from the previous post)

Oddly enough, not even medical professions seem to be immune to this problem. Many people can, even nowadays, attest to their experience of consulting a doctor with clear-cut symptoms of a specific disorder and coming out with a generic anxiety diagnosis and an often inadequate anxyolitic prescription (plus, without any indication to consult a mental health specialist for counseling / psychotherapy).

Let's take an example (fictitious, yet no doubt common): a person with Social Anxiety Disorder (SAD) finally decides to go see a doctor, employing an enormous effort to fight the anxiety derived from having to schedule an appointment, actually facing the doctor, and trying to explain to him what the problem is. And yet, that person still comes out uninformed and without a real, effective, treatment plan (SAD most often requires psychotherapy, which may or may not be supported by anti-anxiety medication). Sounds strange? It is actually something that mental health professionals sometimes still come across, after their patients stopped postponing specialized treatment for months or even years.

Awareness is fundamental; in medical professions, it is vital; in patient's relatives and friends, essential. Understanding is a huge part of the process of recovery. Anxiety disorders are NOT an exageration, and should be addressed: with help, they can be minimized or even overcome.

Anxiety Awareness - Part I

2009-09-11T06:15:00.000-07:00

There's a topic that has subtly been coming up in some of the last posts which deserves to be deepened, being often overlooked: the incomprehension that people with anxiety disorders are faced with, due to lack of information regarding anxiety-related problems.

A few years back (and not too long ago, too), when anxiety was still regarded as a secondary symptom of other illnesses, specific treatment was for the most part unavailable or outright inadequate... thus, the effects of living with anxiety were downplayed.

Today, despite the global growth of the anxiety industry and the large amounts of investigation available, the situation is different but not far from that: treatment is now widely available, and with great rates of success; but still, most people who never experienced an anxiety disorder cannot understand what it is like. Thus, the effects of anxiety are still downplayed, as this is often translated into accusations of "exageration" or "lack of trying to overcome the problem".

(continued on next post)

The anxious experience today

2009-09-08T08:59:00.001-07:00

Nowadays, billions of dollars are spent yearly in the treatment of anxiety. More funds are spent on the treatment of anxiety-related problems than in many other areas of healthcare. Accordingly, the anti-anxiety psychopharmacology business grew exponentially (and keeps on growing), to the point where these medications are the most widely prescribed in the world. Anxiety and stress are considered THE problem of the century.

However, it is important to point out that (regular) anxiety is a normal part of life. It most often serves as a protection of the individual, warning the body that the person is in a potentially dangerous situation. If there is danger around, you will want to be anxious enough to be ready to react. For many, even our ability to adapt and plan ahead depends on anxiety. A little anxiety is normal, even good... a lot of it is not, especially when it hinders everyday life.

So, what about the disorders? Anxiety disorders are diagnosed when the situation that causes the effect is not proportional to the level of anxiousness it originates. For people suffering from them, the anxiety felt is very real (even if they themselves recognize it is excessive) and should not be underestimated or ignored.

In cognitive-behavior methods (the most widely used), treatment often starts with a deeper understanding of the processes involved in the anxious response, followed by cognitive restructuring (altering the underlying thoughts and beliefs) with the support of behavioral techniques.

An introduction to the disorders

2009-09-05T08:51:00.000-07:00

Today I bring you an interesting and useful video, found on Youtube, that is general in its scope and thus serves as a good starting point for a better understanding of unadaptive anxiety. It also provides a small glimpse over how it affects people who experience it, something that is often not easily understood by those who don't.

Words to the wise

2009-09-04T04:12:00.000-07:00

One common aspect of life in a modern society, where information is easily accessible and readily available, is the impulse to know more about the things that surround and affect us. This is even more true in things that concern us.

When a person has a health problem, there is often the urge to go online, to seek out information concerning symptoms and treatments. This can be good, as knowledge is power, but it can also have a negative aspect attached to it: some people are content with just gathering information and trying self-help methods. Consider this: information is NOT a substitute for specialized treatment.

My point: please keep in mind that all acquired information is good only as a guidance to seek a professional, more specialized, kind of help. Self-help (through books or other publications) can also be very positive, as it promotes a commitment to getting better instead of passively waiting for others to fix the situation, but it should only work as a complement to said professionally-oriented treatment.

Always seek what is best for you, in the search for a better quality of life. Doing otherwise would be kind of like, when faced with a crack in a dam, trying to fix it with duct tape instead of resorting to the help of the dozens of engineers around you.

The Anxiety Disorders

2009-09-03T15:51:00.000-07:00

There are many ways in which anxiety can manifest itself, on a degree that interferes with a person’s everyday life. The main disorders, detailed in the latest versions of specialized publications (such as the DSM-IV-TR and CID-10), are:

- Specific phobias
- Social anxiety disorder
- Panic disorder
- Generalized anxiety disorder
- Agoraphobia
- Obsessive-compulsive disorder (OCD)
- Post-traumatic stress disorder (PTSD)

Of course, there are other ways, uncategorized and specific, in which anxiety can be felt. Here are a few examples:

- Evaluation anxiety
- Separation anxiety
- Post-vacation anxiety

All of these are worthy of a future closer look. The first step to controlling something is to gain an understanding of how it works.

A kind of mission statement

2009-09-03T15:27:00.000-07:00

And here we are... the "Anxiety Disorders" blog receives its welcome into the blogosphere, and you, the reader, are hereby welcomed into it.

So, what it is this space all about?

This will be a place intended to foster a better understanding of anxiety, the various anxiety disorders, stress, available coping strategies, treatment options, and many other anxiety-related themes. Bringing together professional knowledge and real life experiences.

An anxiety-pedia of sorts, hoping to contain in its essence a very human element. After all, anxiety is a fundamental part of human existence, as we will discuss as this blog unfolds. This will ideally be a place to learn, so feel free to interact with the different resources that will be added along time.