What is Anxiety?
Anxiety is a normal reaction
to stress. It helps you deal with a tense situation at work, study harder for an exam, or keep focused on an important speech.
In general, it helps you cope. But when it becomes excessive, inappropriate, or irrational it can be disabling. People who
are anxious typically have recurring disturbing thoughts or concerns, avoid certain situations out of worry, and have physical
symptoms such as sweating, trembling, dizziness, a rapid heartbeat, or increased blood pressure. Anxiety Disorders affect
about 40 million American adults (about 18% of that population) in any given year. Unlike the relatively mild, brief anxiety
caused by a stressful event such as speaking in public or going on a first date, anxiety disorders last at least six months
and can get worse if not treated.
What types of Anxiety
Disorders are there?
Anxiety Disorders include:
- Panic Disorder — sudden, uncontrollable attacks of terror that cause heart palpitations, dizziness, shortness of breath, and the feeling
that things are out of control;
- Agoraphobia —
a fear of leaving home which develops in some people with Panic Disorder;
- Specific Phobia — irrational fear and deliberate avoidance of something that causes anxiety or a panic attack;
- Social Phobia — persistent fear of one or more situations in which you believe you’re being observed or judged by others;
- Obsessive-Compulsive Disorder (OCD) — repeated, disturbing, and unwelcome thoughts that cause anxiety, often accompanied by ritualized behavior that’s
intended to relieve the anxiety;
- Posttraumatic Stress Disorder (PTSD) — recurring nightmares and/or flashbacks and other symptoms of psychological and physiological distress caused when
someone experiences or sees a severely upsetting or traumatic event;
- Acute Stress Disorder (ASD) — dissociative symptoms and other
symptoms of psychological and physiological distress caused when someone experiences or sees a severely upsetting or traumatic
event, not lasting as long as PTSD;
- Generalized Anxiety Disorder (GAD) — excessive anxiety and worry
that last for at least six months and are accompanied by physical and behavioral symptoms.
[Note: Clicking on the underlined disorders will take you to in-depth articles
about each disorder by Dr. Hranilovich.]
What are the
symptoms of these Anxiety Disorders?
Panic Disorder is characterized by Panic Attacks that seem to come out of nowhere. Panic Attacks are sudden
attacks of terror accompanied by at least four of the following:
- an irregular heart beat, a pounding heart, or accelerated heart rate;
- trembling or shaking;
- sensations of shortness of breath or smothering;
- a feeling of choking;
- chest pain or discomfort;
or abdominal distress;
- feeling dizzy, unsteady, lightheaded, or faint;
- derealization (feelings of unreality) or depersonalization (feelings of being detached from oneself);
- fear of losing control or going crazy;
- fear of dying;
(numbness or tingling sensations, especially in the hands, feet, and/or face);
- and chills or
An attack usually peaks within 10 minutes, but some symptoms may last much longer. People having Panic Attacks sometimes believe
that they're having heart attacks and go to an Emergency Room, where they’re often misdiagnosed as having a medical
condition or told that it’s all in their heads. Panic Attacks can occur anywhere from a few times a year to several
times a day at any time, even during sleep. People with Panic Disorder can't predict
when or where an attack will occur, and spend their time worrying about having another attack.
which often accompanies Panic Disorder but can also occur by itself, is characterized
by fear of being alone in public places, especially places from which escape would be difficult if the person had a Panic
Attack. Agoraphobia can be the most disabling of the Phobias, since it may significantly
interfere with a person’s ability to function outside the home. Agoraphobia
sufferers prefer to be accompanied by a friend, family member, or other trusted companion in such places as busy streets;
crowded stores; closed-in spaces such as tunnels, bridges, and elevators; and closed-in vehicles such as subways, buses, and
airplanes. They may insist on being accompanied every time that they leave home. People with severe Agoraphobia may simply refuse to leave home at all.
Specific Phobias are characterized by an intense, irrational fear of something that poses little or no actual
danger.While adults with phobias realize that their fears are irrational, they often find that facing or even thinking about
facing their fears brings on anxiety or even a Panic Attack. In decreasing order of commonness, sufferers of Specific Phobias fear animals, storms, heights, illness, injury, and death. If the feared situation is easy
to avoid, people with Specific Phobias may not seek help; if it's not, they can become
disabled and are then more likely to seek help.
There are five types of Specific Phobias: Animal
Type; Natural Environment Type; Blood,
Injection, and Injury Type; Situational Type; and Other Type.
Social Phobia (Social Anxiety Disorder)
is characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations. People with Social Phobia have an intense, persistent, and chronic fear of being watched and judged
by others and of doing things that might embarrass them. They might worry for days, weeks, or even months before an event
is to occur. Their fears can become so severe that they can't work, go to school, or engage in other ordinary activities simply
because these activities involve other people. While many people with Social Phobia
realize that their fears are excessive or inappropriate, they're unable to overcome them. Even if they manage to confront
their fears and be around others, they're usually very anxious beforehand, are intensely uncomfortable throughout the encounter,
and for hours afterward worry about how they were judged. Social Phobia can be limited
to one situation, such as talking to others, eating or drinking in public, or writing in public (paying for something with
a check or writing on a blackboard), or may be so broad that the person experiences fear around almost everyone except family.
Physical symptoms that often accompany Social Phobia include:
- Animal Type is characterized by fear of animals or insects. It generally
starts in childhood.
- Natural Environment Type
is characterized by fear of storms and other weather phenomena, heights, or water. It, too, generally starts in childhood.
- Blood, Injection, and Injury Type is characterized by fear of having
blood drawn, receiving immunizations, having surgery, or even seeing blood or an injury. It tends to run in families and to
- Situational Type is characterized
by fear of specific environments or activities such as using public transportation, traveling in tunnels or on bridges, flying
in an airplane, driving or being a passenger in a vehicle, or being in a small enclosed space such as an elevator. It’s
most common during childhood and the mid-twenties.
Type is characterized by fear of anything else, such as choking, vomiting, germs, or clowns.
Obsessive-Compulsive Disorder (OCD) is characterized
by persistent, upsetting thoughts (obsessive thoughts or obsessions) and/or rituals (compulsive behaviors or compulsions)
intended to control the anxiety that these thoughts produce. Most of the time, however, the rituals end up controlling the
person. Common obsessions include:
- profuse sweating;
- and difficulty talking.
Common compulsions include both physical actions and mental actions. Physical
- repeated fears of contamination (becoming infected by
- repeated doubts ( wondering whether or not you hurt someone in a traffic accident
or left a door unlocked);
- a need to have things in a particular order (intense distress when
objects are disordered or messy;
- aggressive or horrific impulses (to hurt your child or to shout
an obscenity in church);
- and sexual imagery (recurrent pornographic images).
Mental actions include:
- hand washing (a symptom of fear of contamination);
- ordering (“A place for everything and everything in its place.”);
(making sure that the stove is turned off, the doors are locked, the iron is turned off, etc.);
asking for reassurance (“You still love me, don’t you?”);
- and performing sequences
of certain actions (flipping the light switch on and off a certain number of times when entering and/or leaving a room).
- praying (praying
constantly or saying different prayers for different times of day or situations);
- counting (making
sure that certain “bad” numbers are avoided, or doing things by threes, fours, etc.);
repeating words silently to yourself (checking to make sure that you didn’t say the wrong thing or say something incorrectly).
A symptom that’s getting a great
deal of media attention at present is hoarding (an inability to discard worn-out or worthless objects even when they have
no sentimental value). People with OCD perform these compulsions even though doing
so takes so long that it interferes with daily life and is extremely distressing. Symptoms may come, go, get better, or get
worse. If they become severe, they can and often do interfere with the person’s ability to work or to carry out responsibilities.
Stress Disorder (PTSD) develops in reaction to seeing or living through a dangerous
event involving someone’s death or the threat or risk of death or serious injury to you or someone else and which causes
intense fear, helplessness, or horror. Symptoms usually begin within three months of the event but can begin years later.
The disorder was first recognized in veterans of the Vietnam War but is now recognized as also happening to people involved
in other traumatic experiences, such as:
PTSD is characterized by three categories of symptoms: Re-experiencing, Avoidance,
and Hyperarousal. Re-experiencing symptoms include:
- being mugged, raped, tortured, kidnapped,
held captive, sexually assaulted, and/or physically assaulted;
- being in a motor vehicle accident
(MVA), train wreck, ship sinking, and/or plane crash;
- being in an explosion and/or a fire;
- or being in a natural disaster such as a hurricane, tornado, flood, and/or earthquake
Avoidance symptoms include:
- frightening memories of what happened;
- unpleasant dreams or nightmares about what happened that may awaken the person or cause the person to speak, cry
out, or strike out while asleep;
- “flashbacks” -- reliving what happened over and
over, including physical symptoms like a racing heart or sweating;
- crying or becoming angry
or enraged by thinking about, remembering, or being reminded of what happened;
- and increased
pulse and respiration rates, sweating, trembling or shaking, nausea or abdominal distress and similar anxiety symptoms in
reaction to thinking about, remembering, or being reminded of what happened.
Finally, Hyperarousal symptoms include:
- efforts to avoid thoughts, feelings, or conversations associated
with what happened;
- efforts to avoid activities, places, or people that bring up memories of
- an inability to recall an important aspect of what happened;
- markedly diminished interest or participation in significant activities;
- a feeling
of detachment or estrangement from others;
- being unable to experience normalemotions;
- and not expecting to have a career, marriage, children, or a normal life span.
Acute Stress Disorder develops the same way that PTSD does. The symptoms
begin within four weeks of the event and last between two days and four weeks, and include three or more of the following
- difficulty falling or staying asleep, which may
be due to recurrent nightmares about what happened;
- irritability or outbursts of anger;
- difficulty concentrating;
- being constantly on edge;
an exaggerated startle response.
It’s also characterized by:
- a subjective sense of numbing, detachment, or the absence of emotional
- a reduced awareness of what’s going on around you (being in a daze);
- a feeling of unreality;
- a feeling of being detached from yourself;
- and an inability to recall an important aspects of what happened.
Anxiety Disorder (GAD) consists of exaggerated worry and tension, even though
realistically there’s little or nothing to worry about. People with GAD anticipate
the worst and are overly concerned about health issues, money/finances, family problems, or difficulties at work or school.
Sometimes just the thought of getting through the day produces anxiety. It’s what most people mean when they think of
a “worry wart” or “anxiety neurotic” and is exemplified by Charlie Brown of the “Peanuts”
gang. People with GAD can’t seem to get rid of their concerns, even though they
usually realize that their anxiety is excessive and inappropriate. Those with mild GAD
can usually function socially and hold down a job or go to school. Those with moderate to severe GAD have increasing difficulty carrying out the simplest daily activities and responsibilities. GAD is characterized by difficulty controlling the worry and by three or more of the following symptoms:
- recurrent images, thoughts, dreams, or illusions about
what happened; flashback episodes or a sense of reliving what happened; and/or distress on exposure to reminders of what happened;
- avoiding thoughts, feelings, conversations, activities, places, and/or people associated with what happened;
- and difficulty sleeping, irritability, poor concentration, edginess, exaggerated startle response, and/or restlessness
- restlessness or feeling keyed up or on edge;
- being easily fatigued;
- difficulty concentrating or having your mind go blank;
- muscle tension;
- and sleep disturbance, such as difficulty falling or staying asleep
and/or restless unsatisfying sleep.
What disorders often accompany Anxiety Disorder?
Anxiety Disorders commonly occur along with other mental or physical illnesses, including alcohol or substance abuse, which
may mask anxiety symptoms or make them worse. In some cases, these other illnesses need to be treated before a person will
respond to treatment for the Anxiety Disorder.
is commonly accompanied by any of a number of medical symptoms and conditions, including but not limited to dizziness, cardiac
arrhythmias, hyperthyroidism, asthma, chronic obstructive pulmonary disease (COPD), and irritable bowel syndrome (IBS). Mitral
valve prolapse and thyroid disease are more common among individuals with Panic Disorder.
Other Anxiety Disorders are also common, especially in those with more severe symptoms. Social
Phobia and GAD have been reported in 15% to 30% of those with Panic Disorder, Specific Phobia in 2% to 20%, and OCD in up to 10%.
Agoraphobia is sometimes present in individuals with certain general medical conditions
who avoid certain situations due to realistic concerns about being incapacitated or being embarrassed. These individuals aren’t
diagnosed with Agoraphobia unless the fear or avoidance is clearly excessive.
Phobias, depending on type, can be associated with certain medical conditions. About 75% of individuals with Blood-Injection-Injury Type report a history of fainting. Certain general medical
conditions may be worsened as a consequence of phobic avoidance. For example, Blood-Injection-Injury
Type may have a negative impact on your dental or physical health if you avoid necessary medical care. Similarly, fear
of choking may have a negative impact on your health if you limit your food intake to things that are easy to swallow but
nutritionally incomplete, or if you refuse to swallow medications. Other Anxiety Disorders, Mood Disorders, and Substance-Related
Disorders are also common. From 50% to 80% of people diagnosed with a Specific Phobia
are also diagnosed with another Anxiety Disorder.
Social Phobia doesn’t seem to be associated
with any general or specific medical conditions. However, it may be associated with other Anxiety Disorders, Mood Disorders,
Substance-Related Disorders, and Bulimia Nervosa (an Eating Disorder), and it’s frequently associated with Avoidant
Personality Disorder (a pattern of social inhibition, feelings of inadequacy, and hypersensitivity to criticism).
Disorder does not seem to be associated with any general or specific medical conditions in adults, although excessive
hand-washing in those with a fear of contamination may cause skin problems. OCD in
adults is sometimes associated with Major Depressive Disorder, other Anxiety Disorders, Eating Disorders, and some Personality
Disorders. In children, it’s sometimes associated with Learning Disorders and Disruptive Behavior Disorders. From 35%
to 50% of children and adults with Tourette’s Disorder also suffer from OCD,
although only 5% to 7% of those with OCD also suffer from Tourette’s. Childhood
onset of OCD is sometimes associated with Group A beta-hemolytic streptococcal infection
(scarlet fever and “strep throat”).
Posttraumatic Stress Disorder may be associated with increased rates of physical symptoms
and, possibly, general medical conditions. It’s associated with increased rates of Major Depressive Disorder, Substance-Related
Disorders, other Anxiety Disorders, and Bipolar Disorder.
causes Anxiety Disorders?
There's no single cause for Anxiety
Disorders. Rather, they most likely results from a combination of genetic, biochemical, environmental, and psychological factors.
Anxiety Disorders are disorders of the brain. Brain-imaging scans such as magnetic resonance imaging (MRI) have shown that
the parts of the brain responsible for regulating mood, thought, sleep, appetite, and behavior function abnormally in anxious
people. In addition, important neurotransmitters (chemical messengers) are out of balance. This knowledge doesn't explain
WHY people become anxious, however.
Some Anxiety Disorders appear to run in families, suggesting a genetic component. Anxiety Disorders also occurs in people
without family histories of anxiety, however. The probability that anyone will experience an Anxiety Disorder results from
the interaction between multiple genes and environmental or other factors. In addition, trauma, the loss of a loved one, a
difficult relationship, or any other significantly stressful situation may trigger an Anxiety Disorder. Subsequent episodes
of anxiety may not have an identifiable trigger, though.
are Anxiety Disorders diagnosed?
Even the most severe Anxiety
Disorders are highly treatable. As is true of most medical and psychological disorders, the earlier that treatment begins
the more effective it is and the higher the likelihood that recurrences can be prevented.
The first step toward getting help is to see your
Primary Care Provider (PCP), the medical provider whom you see for other disorders. Certain medications and medical conditions
can cause the same symptoms as Anxiety Disorders. Your PCP can rule out these conditions by conducting a physical examination,
asking questions, and/or ordering lab tests. If medications and medical conditions can be ruled out, your PCP will then prescribe
an appropriate medication and/or refer you to a mental health professional for further evaluation.
A mental health professional will conduct a complete
diagnostic evaluation, including a discussion of any family history of Anxiety Disorders and other psychological disorders
and a complete history of symptoms. This history will include when your anxiety started; how long you've been anxious; how
severely anxious you are; whether or not you've had an Anxiety Disorder before; if so whether or not you received treatment
and how successful that treatment was; whether or not alcohol and/or substance abuse are involved; whether or not there are
other psychological disorders present; and whether or not you feel suicidal and/or are planning to harm or kill yourself.
How are Anxiety Disorders treated?
Effective therapies for Anxiety Disorders are available, and research is uncovering
new treatments that can help most people with Anxiety Disorders lead productive, fulfilling lives. The most common treatments
are medication, psychotherapy, and a combination of the two. Medication can’t cure an Anxiety Disorder, but it can keep
it under control while you participate in psychotherapy. The most common medications used to treat Anxiety Disorders are antidepressants,
anti-anxiety drugs, and beta-blockers. Antidepressant medications were developed to treat depression but are also effective
for anxiety. Although these medications begin to alter brain chemistry after the very first dose, their full effects require
a series of changes to occur in the brain, so it usually take about four to six weeks for symptoms to begin to fade. It’s
therefore important to take an antidepressant long enough for it to work for you.
Antidepressant medications, or antidepressants,
were developed to treat depression but are also effective for anxiety. Although antidepressants begin to alter brain chemistry
after the very first dose, their full effects require a series of changes to occur in the brain, so it usually take about
four to sixs weeks for symptoms to begin to fade. It’s therefore important to take an antidepressant long enough for
it to work for you. Antidepressants normalize the functioning of neurotransmitters (chemical messengers)
in the brain, primarily serotonin, norepinephrine, and dopamine. These particular chemical messengers are involved in regulating
mood, although there's still no complete understanding of how this occurs. Antidepressants include newer types, such selective
serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs), and older types, such
as tricyclics/tetracyclics (TCAs) and monoamine oxidase inhibitors (MAOIs).
SSRIs are used to treat Panic Disorder, Obsessive Compulsive Disorder (OCD), Posttraumatic Stress Disorder (PTSD),
and Social Phobia, and combinations of these disorders. The SSRIs include:
SNRIs are used to treat Generalized Anxiety
Disorder (GAD), Obsessive Compulsive Disorder
(OCD), Panic Disorder,Agoraphobia, and Social Phobia, alone or in combination with other
disorders. These antidepressants affect the chemical messengers seratonin and norepinephrine, a different set of neurotransmitters
than the SSRIs. The SNRIs include:
- Celexa (citalopram);
- Lexapro (escitalopram);
- Luvox (fluvoxamine);
- Paxil (paroxetine);
- Prozac (fluoxetine);
- and Zoloft (sertraline).
TCAs, although older than SSRIs
or SNRIs, work just as well for Anxiety Disorders, excluding Obsessive Compulsive Disorder
(OCD). Tofranil is used to treat Panic Disorder
and Generalized Anxiety Disorder (GAD); Sinequan/Adapin
are also used to treat GAD; Anafranil is the only TCA useful for treating OCD. The TCAs include:
- Cymbalta (duloxetine);
MAOIs are the oldest type of antidepressant medication. MAOIs are used to treat a variety of Anxiety Disorders, including
Posttraumatic Stress Disorder (PTSD), Panic Disorder and Social Phobia. The MAOIs include:
- Anafranil (clomipramine);
- Elavil (amitriptyline);
- Loxitane (loxapine);
- Ludiomil (maprotiline);
- Norpramin (desipramine);
- Surmontil (trimipramine);
- Pamelor/Aventyl (nortriptyline);
- Tofranil (imipramine);
- and Vivactil (protriptyline).
People who take MAOIs have to eliminate foods containing tyramine from their diets because tyramine can interact with MAOIs
to cause dangerously elevated blood pressure. They also have to avoid taking certain medications because these, too, can cause
dangerously elevated blood pressure. MAOIs and SSRIs should not be taken together because they can interact to cause a serious
condition called “serotonin syndrome” characterized by:
- Eldepryl (selegiline);
- Marplan (isocarboxazid);
- Nardil (phenelzine);
- and Parnate (tranylcypromine).
- increased sweating;
- muscle stiffness;
- changes in blood pressure or heart rhythm;
other potentially life-threatening conditions.
Finally, Wellbutrin (bupropion) is a unique antidepressant, unrelated to any other, which, while it's more effective for depression
than anxiety, is sometimes used to treat anxiety by itself or in conjunction with an SSRI.
Anti-anxiety medications, primarily benzodiazepines, reduce daytime anxiety
and excessive excitement and generally quiet or calm people. At low doses they have few side effects other than drowsiness
and dizziness; at higher doses they produce significant drowsiness and facilitate sleep. (WARNING; It is especially important
to limit or better yet avoid alcohol while taking any benzodiazepine.) Because they are potentially addictive, benzodiazepines
are typically prescribed for only short periods of time, especially for people with histories of alcohol and/or drug abuse.
An exception to this is people with Panic Disorder, who can generally take benzodiazepines
for up to a year without risk of harm. Benzodiazepines include:
- Ativan (lorazepam);
- Centrax (prazepam);
- Dalmane (flurazepam);
- Doral (quazepam);
- Halcion (triazolam);
- Klonopin (clonazepam);
- Librium (chlordiazepoxide);
- Paxipam (halazepam);
- Restoril (temazepam);
- Serax (oxazepam);
- Tranxene (clorazepate);
- Valium (diazepam);
- Versed (midazolam).
- and Xanax (alprazolam).
Some people experience
withdrawal or discontinuation symptoms if they stop taking benzodiazepines abruptly instead of tapering off of them gradually.
Some also experience rebound anxiety, a resurgence of anxiety stronger than they felt before starting on the medication. Unfortunately,
these problems inhibit some Primary Care Providers from prescribing benzodiazepines in adequate doses or, in some cases, prescribing
them at all.
Buspar (buspirone), which is not a
benzodiazepine, is a unique anti-anxiety medication primarily used to treat Generalized Anxiety
Disorder (GAD). Unlike benzodiazepines, Buspar must be taken consistently for
at least two weeks before it begins to provide significant benefit.
Beta blockers such as Inderal (propranolol) are used to treat heart conditions, but can also be used to prevent the physical
symptoms of some of the Anxiety Disorders, particularly Social Phobia. Inderal can
be used preventitively to treat stage fright, which is classifiable as a Specific Phobia,
If one medication doesn't work, be open to trying another. People who don't improve after taking one medication increase their
chances of getting better by switching to a different medication or adding a second medication.
Psychotherapy involves talking with
a trained mental health professional, such as a Counselor, Psychiatrist, Psychologist, or Social Worker, to explore what is
causing the Anxiety Disorder and how to manage or eliminate the symptoms. Some types of psychotherapy are short-term (10 to
20 weeks) and others are long-term (more than 20 weeks). Which might be suitable for you can be determined between you and
the mental health professional whom you see. There are many types of psychotherapy, all of which can be effective in treating
Anxiety Disorders, but two types, Cognitive-Behavioral Therapy (CBT) and Interpersonal Therapy (IPT), have well-established
histories of being effective.
CBT helps people
change negative and self-critical styles of thinking and behaving that contribute to or worsen anxiety, replacing them with
more positive, functional, and adaptive ways. For example, CBT can help people experiencing Panic
Disorder learn that their Panic Attacks are not really heart attacks and help people experiencing Social Phobia learn how to overcome the false belief that other people are always observing and judging them.
There are several parts to CBT. These include:
- Exposure Therapy. This helps people
face and control their fears by exposing them to the situation or experience they fear, but in a safe way. It is particularly
helpful in treating Specific Phobias.
- Cognitive Restructuring.
This helps people neutralize the negative self-talk and irrational belief systems that often underlie Anxiety Disorders.
- Stress Inoculation Training. This reduces symptoms by teaching the person how to reduce anxiety through looking at
his fears in a more adaptive and functionalway.
CBT often lasts about 12 weeks. It can be conducted individually or in a group of people with similar problems. Group therapy
is particularly effective in treating Social Phobia. CBT often entails “homework,”
or exercises, for the client to do in between sessions. Research indicates that the effects of CBT last longer than those
of treatment with medication for people with Panic Disorder, and possibly for those
with OCD, PTSD, and Social Phobia. If CBT is effective, a recurrence of the disorder can often be effectively treatedquickly and
easily with a brief refresher.
IPT helps people understand and work through dysfunctional and/or maladaptive relationships that contribute to or worsen anxiety.
It emphasizes the relationships between a person and other people rather than that person’s internal psychological processes.
It’s intended to change the person’s symptoms by helping him deal more realistically and effectively with his
family, marital, parental, and work situations.
For those who are mildly or moderately anxious, psychotherapy alone is often the best treatment option. However, for certain
people, especially those who are severely anxious, a combination of psychotherapy and medication may be necessary.
How can I help someone who is suffering from an Anxiety Disorder?
If you know someone who has an Anxiety Disorder, odds are that his or
her anxiety affects you, too. The first and most important thing that you can do to help a friend, family member, or coworker
who has an Anxiety Disorder is to help him get diagnosed and treated. You might have to schedule an appointment on behalf
of the person or even go with him to see a provider. Encourage him to stay in treatment or to seek different treatment if
no improvement occurs after six to eight weeks of medication or eight to 12 weeks of psychotherapy. In addition:
- don’t downplay or trivialize the anxiety;
- don’t demand improvement if the
person isn't in treatment;
- offer emotional support, understanding, and patience;
- engage the person in conversation and, most importantly, listen nonjudgmentally;
criticize or belittle feelings the person expresses, but rather point out realities and offer hope;
ignore comments about suicide. Encourage the person to share these thoughts with his provider and/or mental health professional,
and report them yourself if you believe the person won't;
- invite the person to participate in
walks, outings, and other activities. Keep trying even if he declines, but don't push him to do too much too soon. Making
the person feel as if you have too many expectations of him may inadvertently cause feelings of failure;
- and remind the person that, with time and treatment, the anxiety will inevitably improve.
Dr. Thomas E. Hranilovich
Psychiatric Associates / 4084 Okemos Rd. / Suite A / Okemos, MI 48864
Phone: (517) 347-4848 / Fax: (517) 347-4844