Generalized Anxiety Disorder FAQs

Do you struggle with anxiety?

If you have generalized anxiety disorder (GAD), you almost always feel worried, fearful or anxious and you’ve felt like this for most of each day, on most days, for longer than 6 months. Sometimes you feel tense for no apparent reason, sometimes you worry about little things, blowing them up way out of proportion and causing yourself unreasonable stress and anxiety. People with generalized anxiety disorder tend to know that they worry too much, but they can’t control their worry – their worry controls them.

Generalized anxiety disorders affect nearly 7 million Americans each year. 

Symptoms of Generalized Anxiety Disorder

We all feel anxious sometimes, but people who suffer from generalized anxiety disorder (GAD) worry with an intensity that disrupts their ability to live a normal, happy and healthy life.

People with GAD tend to feel anxiety or worry without cause, feel worried or tense most of the time, or worry excessively about normal life events. People with this disorder cannot “control” their worrying.

Some common symptoms of this disorder include:

• An often present feeling of worry or dread
• Frequently experienced or ever present tension (feeling “on-edge”)
• A lack of patience and irritability
• Concentration problems – getting easily distracted
• Runaway anxious thoughts
• Being easily startled
• Feeling lightheaded, or breathless
• Fatigue
• Sweatiness
• Insomnia or sleeping problems (waking up frequently throughout the night)
• Physical symptoms of tension, such as muscle tension, stomach pains, diarrhea or nausea or headache
• Trembling or twitching

Children can sadly experience GAD and although they experience much of the same worry, they cannot usually verbalize the way that they feel; it is up to parents or caregivers to recognize the problem – spotting Generalized Anxiety Disorder in Children.

Few people will experience all symptoms and many people experience some variability in the severity of symptoms - feelings of anxiety may retreat to the back-burner at times.

To meet a clinical diagnosis of generalized anxiety disorder, symptoms of anxiety must have occurred:

• Most days, for more than 6 consecutive months
• With a sufficient severity to cause problems in social, professional or family life
• The anxiety cannot be caused by the use of drugs or alcohol, by another medication, by another medical condition and it cannot occur exclusively during an active phase of another mental health disorder

Is it Normal Anxiety, or a Generalized Anxiety Disorder?

There are three primary ways to distinguish normally experienced anxiety from the worry and anxiety experienced by someone with generalized anxiety disorder.

1. Most people can control their worries. While at work, a person without GAD might consciously “put-off” worrying about an anxiety provoking subject, for example, finances or relationships – someone with GAD could not likely delay this anxiety, and would spend much of the day worrying.

2. People with GAD worry more frequently, worry for longer periods and with greater intensity, than people without GAD. People with GAD often get anxious without external triggers and feel very anxious about a wide array of subjects. The more subjects that provoke extreme anxiety, the more likely the anxiety is caused by GAD.

3. People with GAD often experience anxiety caused physical symptoms, such as fatigue, restlessness or irritability – people without GAD do not typically experience these physical consequences of anxiety.

Who Gets Generalized Anxiety Disorder?

Women are twice as men to likely to succumb to generalized anxiety disorder, but the disorder can afflict men and women of any age.

The disorder can begin at any age, although symptoms most commonly begin before 25 years of age; and the symptoms tend to gradually worsen over time. People experiencing the disorder often seek treatment for physical symptoms, such as stomach pain or headache but it often takes doctors a while to put all the pieces together and determine that physical symptoms are in fact caused by a mental health disorder.

Most people with GAD (50% to 90%) experience a co-occurring mental health condition, such as depression or dysthymia, drug or alcohol abuse or panic disorder.

How Long Does Generalized Anxiety Disorder Last?

To meet the diagnostic criteria, symptoms of the disorder must occur for 6 months or longer. Untreated GAD can endure for years – many people entering into treatment for the disorder report feeling an underlying tension and anxiety for as long as they can remember.

Treatment can control the symptoms of GAD and treatment will work for about half of people within a few weeks and for three quarters of people within 9 months.

What Causes Generalized Anxiety Disorder?

There are a number of factors that increase the risks of experiencing general anxiety disorder, such as:

• Genetics - Having a close family relative with GAD may increase your risk.

• Stress – Living with chronic stress may predispose you to an anxiety disorder, especially uncontrollable stress or a history of chronic stress paired with a sudden trauma, such as an assault.

• Serious Illness – The diagnosis of a serious physical illness can cause great stress.

• Personality Traits – certain negative or pessimistic personality traits can cause people to worry excessively, which can lead to a clinical condition, in some instances. Borderline personality disorder is also associated with an increased risk or anxiety disorders.

• Stress or Trauma in Childhood – developmental stress during childhood can lead to altered functioning of the stress response system in the brain, leaving a person susceptible to anxiety disorders.

Treatment for Generalized Anxiety Disorder

The two most common treatments for GAD are medication and psychotherapy, commonly offered together (research has shown that a combination treatment produces a more sustained result).

Medications

The two most commonly used types of medication for GAD are anti-anxiety drugs and anti depressant medications.

Anti-Anxiety Medications

These drugs work quickly and they can relieve symptoms of anxiety very shortly after consumption. They tend to be slightly sedative in nature. Some examples of common anti-anxiety medications include the benzodiazepines, Xanax, Valium or Ativan. These drugs work well, but they are highly addictive, and a tolerance to their effects develops quickly. After a couple of weeks of continual use, you will not be able to stop taking medications of this class without experiencing withdrawal symptoms, unless you gradually taper the dosage down over time.

A newer form of anti-anxiety medication, buspirone, provides symptoms relief without causing a physical dependence and is considered a very safe drug for anxiety. Buspirone takes a few weeks to become fully active and effective, and most people report that buspirone does not remove all (only most) of baseline anxiety.

Anti Depressants

SSRIs, tricyclic anti depressants and selective norepinephrine reuptake inhibitors are all effective types of anti depressants for the treatment of generalized anxiety disorder (New England Journal of Medicine); due to the lower side effect profiles of the SSRIs these medications are often the first line choice. Antidepressants take up to 6 weeks to become effective.

Psychotherapy

Psychotherapy can help people take some control over their symptoms of anxiety and can teach ways to deal with anxiety that does occur.

• Cognitive Behavioral Therapy (CBT) – an evidence based therapy that helps people change unhealthy thinking and behavior patterns in order to produce symptoms improvements, has shown real efficacy in the treatment of GAD. (Read more about cognitive behavioral therapy for anxiety). CBT is the most commonly recommended psychotherapy for the treatment of GAD.

• Relaxation Therapy – Learning relaxation techniques, such as deep breathing, meditation, imagery and visualization can help to reduce the intensity of symptoms.

• Interpersonal Therapy – A therapeutic technique that looks to resolve relationship problems so as to reduce the anxiety and stress.

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There’s no denying it – the holidays can be overwhelming, especially if you're in recovery from addiction. Here are 5 ways to cope with stress during the holidays.

Tis’ the season to be jolly... perhaps, but for too many of us - tis also the season to get stressed out!

Work parties, family visits, buying those perfect gifts (and then worrying about to pay for it all), too much alcohol and too little sleep and always pushing towards creating that perfect holiday experience for your loved ones – it’s a perfect-storm recipe for a seasonal cocktail of anxiety and stress.

And since stress exacerbates anxiety and depression and can lead to excessive substance abuse or relapse, the holidays can be a difficult time for anyone in recovery from addiction and mental health issues.

Fortunately, you don’t have to get frazzled this year; and since a lot of the stress you’ve experienced in years past has likely been of your own creation – you can take steps this year to make certain you don’t make things any more difficult than they have to be and maximize your odds of having a truly enjoyable and low anxiety holiday season.

According to the American Psychological Association (APA), 5 things you can do to minimize holiday stress this year are:¹

I. Slow Down

Don’t try to do too much. If you’re getting worn out by your many obligations, take some time off from the holiday madness and do something to recharge your batteries. Go see a movie, read a book, go for a walk in the park – take a step back from all your ‘duties’ and take a little time for yourself.

You may miss an event or two but you’ll be much better company at those you do choose to attend and by doing less (you do not have to bake those homemade cookies) and by keeping your sanity you’ll actually be far more productive wherever you choose to direct your attention and energies.

II. Things Won’t Go Perfectly This Year. So What?

(They Never Do ANY Year – and That’s OK)

Creating unrealistic expectations for a magical and perfect holiday season leaves you wide open to stress when things don’t go exactly as planned (and when do things ever go exactly as planned!?!)

You do not need a picture perfect Christmas tree and you’ll remember the people and conversation at the table far more than you’ll ever remember the taste of the Christmas dinner. If the turkey dries out… it’s OK, it doesn’t matter and if you can’t find the kids’ requested toys – they’ll be just happy with whatever you can find them.

Do your best, don’t worry about achieving impossible perfection and remember that having an enjoyable time with people you care about is far more important than anything else.

III. Don’t Overspend

You do not need to spend a fortune this year. No one needs an extravagant gift or a gourmet meal; especially if paying for those gifts and all that entertaining is going to provoke stress and financial anxiety.

If you’ve got children who are clamoring for the latest and greatest, then simply explain to them about your budget and about what’s reasonable to expect this year.

Don’t spend more than you can afford, lose the financial stress and see if you don’t have a whole lot more fun this holiday season.

IV. Volunteer

Donate some time to a worthy organization and you may find that you gain a little perspective on those things that can seem so important and stress-provoking over the holiday season – but which are so unimportant in the grand scheme of things.

V. Get Some Support

Sometimes, despite your best efforts, things just get overwhelming. If stress and anxiety are getting the best of you, don’t try to slog through on your own. Talk about the way you’re feeling with a close friend or family member and ask for their support and assistance. 

And if things don’t get better or if you’re really having a hard time with your stress or anxiety, don’t suffer through it unnecessarily, make an appointment to meet with a mental health professional and learn more about how you can start feeling a whole lot better over the holidays - and for the rest of the year too.

The facts about OCD - What it is, making a diagnosis, understanding who is at risk and learning about effective treatment options.

What Is OCD?

Like a skipping CD, someone with OCD gets trapped in cycles of repeated worrisome thoughts or images and the actions they feel they are needed to counter these anxiety producing thoughts.

Obsessive compulsive disorder, as the name implies, is a disorder characterized by obsessive thoughts and/or by compulsive actions.

Common obsessions can include an obsessive worry about germs, a worry that the stove, or iron is on, or a worry that you caused a traffic accident. This worry causes obsessive repetitive thoughts or images that come at inappropriate times and that won’t go away, often repeating over and over again. These repetitive obsessive thoughts are beyond control and unwanted; and although someone with OCD may know that the way they worry is abnormal, they can’t keep themselves from it.

People who experience obsessive thoughts often develop compulsive behaviors or rituals that they use to manage them; to make the thoughts go away. These rituals do not give pleasure; they simply help to alleviate worry and anxiety. Someone who worries about germs, may develop a hand washing compulsion, ritualistically washing their hands until red and raw, to control the anxiety they feel. Someone who worries about leaving the stove on may count to 100 back and forth as they continually test the stove, to ensure that is off.

The ritualized compulsive act temporarily neutralizes the anxiety, but must be repeated when the thoughts again intrude. This pattern of thought and action can become very time consuming, occupying hours each day.

What Are Some Common Obsessions and Compulsions?

Intrusive thoughts can occur about a wide range of topics, but there are certain topics that are more frequently encountered.

Common obsessive topics include:

• A fear of germs or dirt
• A fear of hurting someone else
• A fear of making a mistake
• A fear of hurting yourself
• Sexual thoughts
• Religious worries, worrying about bad thoughts

Common compulsions include:

• Hand or body washing rituals
• Counting rituals
• Touching rituals
• Rechecking rituals
• Repeating certain words, prayers of phrases
• Performing a ritualized task a set number of times
• Collecting meaningless items

Do You Have OCD?

To meet a diagnosis of OCD, a person must experience either obsession or compulsion (often both)

Obsession includes:

1. Uncontrollable repetitive thoughts, images or urges that cause anxiety or worry and are felt to be intrusive. These worries are not simply an exaggerated response to realistic problems in life.

2. The person tries to ignore or suppress these obsessive thoughts, or develops a compulsive action to manage the anxiety produced.

3. The person realizes that the thoughts are produced by their own mind (not inserted in the mind)

Compulsion includes:

1. The development of repetitive ritualized behaviors or mental actions that are developed to manage obsessive thoughts

2. These rituals are used to mange the anxiety produced from obsessive thoughts or to prevent a terrible occurrence from happening. They are not a realistic or effective response to a real-life problem; they are excessive.

The person must realize that their compulsions or obsessions are not reasonable (children excepted) and compulsions and obsessions cannot be caused by drug or alcohol use or the use of another medication, or from another mental health diagnosis.

There is no physiological test that reveals the disorder, and most people with OCD live for a long time with the condition and visit many different doctors before receiving an appropriate and helpful diagnosis. If you suspect that you or someone you love suffers from OCD, you should seek out an assessment from a mental health professional experienced in the evaluation and treatment of anxiety disorders.

Who Gets OCD, and How Is It Treated?

Males and females are equally susceptible to OCD and about 4.5 million Americans have the condition. The age of onset can be during childhood, the teenage years or early adulthood.

The causes of OCD remain elusive. Researchers suspect that the neurotransmitter serotonin (too little serotonin) plays a role but the exact mechanisms of the disorder aren’t yet known.

Twin studies indicate that the condition has a genetic base; having a close biological relative with OCD raises your risks slightly. Environmental factors, such as stressful life events, a death in the family or major illness can also increase a person’s susceptibility.

Sudden onset childhood OCD is sometimes caused by a recurrent streptococcus infection, such as strep throat.

How is OCD Treated?

Treatment options include medication and psychotherapies, often a combination of the two.

Medication

A class of anti depressant medications known as the SSRIs increases the amount of serotonin available in the brain and has been shown to reduce the severity of OCD symptoms. Examples of SSRIs include Zoloft, Paxil, Prozac and Luvox.

These medications can take a few weeks to become fully active in the body. People have different responses to these medications, and it can take some trial and error experimentation before your doctor finds the medication that works best for you and produces the fewest/least severe side effects. You should not expect an overnight solution and you should never stop taking any SSRI abruptly; this can lead to a withdrawal like syndrome of side effects.

Psychotherapy

Cognitive Behavioral Therapy (CBT) is the most commonly recommended psychotherapy for the treatment of OCD.  Exposure therapy, a subset of CBT is commonly used to reduce the intensity of the anxiety produced by an obsessive thought and in doing so, to reduce the need to perform a compulsive ritual.

For example - a person who worries about germ contamination might, under a therapist’s guidance, work on shaking someone’s hand without then performing a compulsive ritual.

Exposure therapy can produce high levels of anxiety initially, but over time and with practice can greatly reduce the intensity of the anxiety experienced by intrusive thoughts or images.

Lifestyle Changes

OCD can be a debilitating disease and can greatly reduce quality of life, and it is vital to avail yourself of treatments that can help so much to reduce the severity of symptoms.

In addition to formal treatments, OCD patients can also take several self-help steps to improve their functioning; such as:

• Join a self help group
• Read up on the condition
• Follow your doctor’s advice and comply with therapy. Practice CBT techniques at home
• Get enough sleep
• Learn relaxation exercise, such as deep breathing or meditation, which can help you to control or manage any anxiety you experience

Image Copyright: Beatriz AG

Worries drain your mental energy and do little to solve a problem – so banish unhelpful worries by writing them down and then challenging them with a series of structured questions. Learn how a worry diary can help you to get past excessive worrying.

Worrying doesn’t solve a problem, and worse, the mental energy you waste when obsessing about worst case scenarios may keep you from actions that could actually help.

Roughly 40% of people worry on a daily basis and about 1 person in 20 will experience chronic daily worry and anxiety as a part of generalized anxiety disorder (GAD) at some point in life.¹

Excessive worrying causes stress and anxiety, it can affect physical health and it can stop you from participating in rewarding activities – excessive worrying does you little good…and a whole lot of bad.

Fortunately, you can choose to stop worrying so much!

Though it may take a bit of effort, you can retrain your thinking so that worries don’t cause you such distress. One way to do this is by writing a worry diary.

What’s a Worry Diary?

It’s difficult to rationally analyze distressing thoughts as they dance and swirl through your mind, but by writing them down on paper and tackling them with a structured set of questions, you can find the truth - and you can usually stop worrying about what’s not likely to occur.

A worry diary is simply a notebook you keep to record – and challenge – your worrisome thoughts.

Writing Down Your Worries (Step 1)

When you start feeling overwhelmed or when worries interfere with your ability to sleep or work, take a few minutes to write down exactly what you’re worrying about.

You write down your worries because:

1. Writing these worries down removes some of their power over you. You no longer have to stay mentally vigilant to keep track of them once they’re in your notebook.
2. Releasing the worries to paper frees up a little head space and this enables you to think more clearly and rationally.
3. Once you’ve written them down you can begin a structured worry-challenging exercise which should bring some healthy perspective.
   

Clarifying Your Worries (Step 2)

Once you’ve clarified and identified your individual worries in writing you can begin to evaluate and challenge these distressing thoughts.

For each worry, ask yourself:

• What bad thing do I think is going to happen?
• What are the odds that this negative consequence will occur?
• What emotions am I feeling right now?  How strong are these emotions? (Use a 1 – 100 scale)

For example:

• I am worried I am going to fail out of school.
• I really think it’s going to happen – The professors go much faster than the teachers did in high school and I am already feeling behind in the reading.  
• I am feeling very anxious right now – 70 out of a 100.

Challenging Your Worries (Step 3)

In this next step you examine the validity of your worries through challenging questions designed to elicit reality and truth.

For each worry, ask and answer:

• What evidence do I have to support my worry?
• Is there any evidence that would argue against my worry?
• In reality, how likely is it that what I am fearful of is actually going to happen?
• What’s the worst thing that could happen?
• What’s the best thing that could happen?
• What will probably happen?
• Is worrying about it helping at all?
• If my worst case scenario happened – could I cope? What would I have to do to cope?
• Is there another way I can look at this situation?

For example

• (Evidence for)  - I am worried I am going to flunk out because the readings are more challenging than I had expected and I am having trouble finding the time to get my work done.
• (Evidence Against) - I guess I have always been able to hand in assignments on time so far and my grades have been OK. In high school I was a very good student but even then I worried that I wasn’t going to get into college and sometimes I even worried I was not going to graduate. My professors seem to think my questions in class are interesting.
• (Reality) - I guess if I look at the reality I am probably not going to fail out of college this semester – there is maybe a 15% chance of that.
• (Worst Case Scenario) - If I failed I would have to go back home and get a job and live with my family.
• (Best Case Scenario) – I may end up getting high grades the semester.
• (Most Likely) – I will get average or good grades.
• (Is Worrying Helpful) – When I worry I have trouble concentrating on my studying…so it is definitely not helpful!
• (Handling Worst Case Scenario) – I guess if I failed out I could just work for a few months at home and then reapply to another program. It would be embarrassing but I could buy a car while I waited and see my old friends again for a few months.
• (Looking at Things in a New Light) – I guess the evidence suggests I will do OK in school here since I have always been a good student in the past and I am still willing to work. I seem to be as smart as other students here and most people don’t fail out. I am not partying all the time like some people I see here. Even if my grades aren’t perfect this semester I am still new here so I have lots of time to improve.

Re-framing the Situation (Step 4)

After completing the challenge exercise it’s time to finalize your processing of this worry – so you can leave it behind you.

The worry started as:

I am worried I am going to fail out of school.

Now, based on the answers from the challenge exercise, write out a new way of thinking about the situation:

College is harder than I thought it would be and I am worried about my grades, but since I am working hard and since I have always done well in school in the past I will probably find a way to get the grades I need.

Next, ask yourself how strongly you believe in your original worry:

• Now I guess I am about 70% sure I won’t fail out of school this semester.

Lastly, write down how you’re feeling about it after completing the exercise:

• I am still anxious, but it’s not as bad now – about 30 out of a 100.

The Benefits of Challenging Your Worries

People who use a worry diary to challenge the validity of their fears tend obsess less about the worst case scenarios and focus more on the reality of the situation. By doing this, they experience a reduction in negative emotions that accompany persistent worries.²

Image Copyright: Abdulmajeed Al.Mutawee

Here's how to make that important change. Change is scary but you already have the tools to do it. You are braver than you think. Try this.

Do you fear change? Are you afraid of what people will think? Are you afraid you’re not good enough?

You’re not alone.

When you think of making a change is it like seeing yourself on a flying trapeze, letting go and hurtling into space? Do you often wonder what would happen if you fail and you fall?

The good news is that the courage it takes to make most changes comes with wings that will help you to fly.

How to Change Smart

Making a change is different than simply hurtling yourself into the unknown. It’s not just leaving something, but moving toward something better, carefully and step by step.

• When you make a change, you create something. You make plans. You create a goal, with a road map and a direction.
• And a dream becomes a plan when you write it down.

Successful change is a matter of preparation.

Something to Consider about Change

There’s another reason you might fear change in addition to your fear of failure and fear of the unknown. When you change you say goodbye to a part of yourself that you know you won’t get back. Raymond Chandler the author wrote that to say goodbye is to die a little. When you make a change something has to go.

You might be miserable now, but it’s your misery and it’s familiar. The way you live may be uncomfortable but still feels safe…even if it’s dying one day at a time.

The famous novelist, Ellen Glasgow, said the difference between a rut and a grave are only the dimensions.

If you feel you’re in a rut and want to change and expand your life’s dimensions here are some things to consider.

1. Change is good, whether it is coins jingling in your pockets, new thoughts ticking your mind, or a commitment to a decision you’re finally ready for.
2. Change compels you to be more of who you are. It expands your life. It opens doors to possibilities. It forces you to be brave.
3. Change is a risk but it can be a calculated risk if you think before you leap.

C.H.A.N.G.E. Steps

• Consider the pros and cons of the change. Make a list. Put a line down a page and write the positive things on one side of the line and negative things on the other. There’s always a price to pay. What do you stand to gain? What can you lose? What is your strategy if things don’t go as planned?
• Will your change hurt or help anyone? Who? How much? In what way? When you change, you force those around you to change. Many of those closest to you will discourage you. How are you preparing for this?
• What is your attitude about the change? Are you doing it from your strength or from your weakness? Are you running from something; a bad situation that with effort, you can help change for the better, or are you embracing something healthy and new? Are you afraid or confident? Are you willing to pay the price for the change?
• Will the change cause you to neglect your responsibilities or commitments?
• What is the goal of the change? What are you aiming for? What do you want? It is important to be clear.
• Change takes effort. Major changes are hard work, emotionally, spiritually and physically for you and for those closest to you.

Sometimes you’re ready and you don’t yet know it.

Sometimes you just need a little push.

Sometimes change takes a leap of faith even if it feels like jumping off the edge of a cliff:

“Come to the edge,” He said.
“We are afraid.”
“Come to the edge,” He said.
They came.
He pushed them... and they flew.

- Guillaume Apollinaire

Your faith in yourself in taking the first step often gives you the courage to fly.

You’ve already taken the first step by reading this far.

Haven’t you?

Image Copyright: J. Star

Between 3% and 4% of children experience generalized anxiety disorder. It’s up to parents and caregivers to learn the signs and symptoms of this disorder and to initiate treatment, if necessary.

Sadly, children can experience generalized anxiety disorder (GAD).*

Children with GAD don’t generally understand that the fears and worries they live with are anything but normal, but living with GAD is not conducive to a happy childhood or healthy development, and so it is important for caregivers to learn to recognize the signs and symptoms of the disorder.

Once recognized, childhood GAD is treatable.

* GAD is an anxiety disorder characterized by frequently occurring, long lasting and severe worry or anxiety, often without legitimate cause, for a period of more than 6 months. The worry of GAD is severe enough to interfere with everyday life and it is not caused by another mental or physical health condition, by a medication or by the abuse of drugs or alcohol.

Signs and Symptoms of Childhood Generalized Anxiety Disorder

Children with GAD have normal childhood worries – but unlike kids without GAD, these worries are uncontrollable, more frequently occurring and far more severe.

Some typical subjects of worry include:

• Worrying about getting sick or dying, or a family member getting sick or dying
• Worrying about school performance
• Worrying about performance in sports or other extra curricular activities
• Worrying about war or natural disasters
• Worrying about getting hurt, attacked or kidnapped, or a family member getting hurt
• Worrying about the future (what if I can’t get into college and can’t get a job…)
• Worrying about being late

Some signs of childhood GAD include:

• Perfectionism – often restarting projects or schoolwork in a quest for perfection
• A need for frequent reassurance or praise from adults
  
• Severe worry about things without valid cause
• Worrying about things before they happen
• Inflexibility – absolute conformity to rules
• Self criticism
• Having many worries
• Clinging to family members (unable to spend the night away from home)
• Physical symptoms without obvious cause, such as muscle aches or soreness, stomach aches or headaches
• An inability to sleep
• Easily startled
• Tense, irritable
• Fatigue
• The feeling of having a lump in the throat

Who Gets Childhood GAD?

GAD affects between 3% and 4% of children and can occur in kids as young as 6 years old. Doctors advise watching kids closely between the ages of 6 and 8, a period during which normal childhood worries, such as a fear of monsters, for example, tend to fade and worries about school and relationships tend to begin. Anxious behaviors during this age period may signal risk for an anxiety disorder.

Childhood GAD is caused by a combination of genetic and environmental factors. Kids that live with close family members that also struggle with anxiety disorders may be most at risk – receiving a genetic predisposition and learning fear behaviors through observation.

How Can I Know if My Child Has GAD?

Look for the signs and symptoms of an anxiety disorder, and if you see anything that concerns you, bring your child to a children’s mental health professional for an evaluation. The earlier treatment starts the better.

When considering mental health professionals for childhood GAD treatment, SAMHSA (a federal mental health agency) recommends looking for someone that:

• Is trained and experienced in working with children
• Can and does prescribe medication if needed, or works with a doctor that will, when necessary
• Uses cognitive behavioral therapy

Childhood GAD Treatments

GAD treatments for children typically involve some form of psychotherapy, and sometimes combine this talk therapy with a medication.

Some common forms of psychotherapy offered to kids with GAD include:

• Cognitive behavioral therapy (CBT) – Our thoughts affect our emotions and so CBT teaches kids better ways to think about the risks of real life situations, to control the emotional response. Kids are taught to look at the most probable outcome of any given situation, instead of the worst possible outcome. CBT is an evidence based and proven effective therapy.

• Relaxation training – Children can learn relaxation techniques, such as deep breathing exercises, that can reduce the experience of anxiety.

• Family therapy

In some cases, anti-anxiety drugs or anti depressant medications are also recommended.

The Risks of Untreated General Anxiety Disorder

Children and teens with generalized anxiety disorder often don’t realize that the way they feel is anything but normal, yet untreated GAD increases the risks of a host of other conditions and behavioral or social problems, such as:

• Academic under-performance, frequent school absences or dropping out of school
• Poor or limited relationships with peers
• The abuse of alcohol or drugs
• A lack of self confidence and self esteem
• Continuing anxiety disorders into adulthood

It is important that caregivers know the signs and symptoms of GAD and intervene if necessary, to ensure a happy and healthy period of development.

Image Copyright: Maddy Lou

Anxiety in a dangerous situation is healthy; anxiety in a safe situation is not. A phobia is an unreasonable fear that can reduce quality of life. Phobias are very treatable but very few people with specific phobia get help.

A phobia is an unreasonable fear of something or some situation. Many of us have unreasonable fears, such as a fear of small spiders, but the anxiety people with specific phobia experience stemming from their irrational fear is great enough to compromise normal quality of life.

• You may not love flying, but if you were offered a great job that involved some travel, you’d probably take it. Someone with a specific phobia of flying would likely turn down the promotion.
• You may not like needles, but if a doctor advised that you get one, you would. Someone with a needle phobia might delay needed medical care out of anxiety about that needle.

People with a specific phobia know that the anxiety they feel, when thinking about whatever it is that scares them is unreasonable, but they can’t control it. The anxiety they feel can be intense – sometimes even thinking about the phobic stimulus can trigger a panic attack.

Diagnosing Specific Phobia

To meet a diagnosis of specific phobia:

1. The person must have an enduring and unreasonable fear of a specific stimulus or situation. This fear emerges when in the presence or when thinking about, the feared situation or stimulus.
2. The person experiences intense anxiety when confronted with the feared object of situation; in some cases, experiencing a panic attack.
3. The person realizes that their degree of fear and anxiety is inappropriate (Children may not realize this).
4. The person tries to avoid any exposure to the feared stimuli or situation and when forced to experience the stimuli, feels anxiety.

5. The phobia interferes with normal functioning or the person feels very upset about their phobia
6. The anxiety produced by the phobia is not explained by the co-occurrence of another disorder, such as social phobia, PTSD, panic disorder with agoraphobia, OCD or other anxiety disorder.

For children, the phobia must endure for more than 6 months.             

The 5 Types of Phobia

The American Psychiatric Association has defined 5 specific types of phobias.

1. Animal Phobias – fears and worries about animals, such as spiders, snakes, dogs
2. Environmental Phobias – fear originating out of the natural world, such as a fear of heights or water
3. Blood or Injection Phobias – Describes fears of seeing blood or of receiving an injection or other medical procedure
4. Situational Phobia – a fear of certain situations, such as being on an airplane, or in enclosed spaces, such as an elevator
5. Other Phobias – fear caused by other sources, such as a fear of getting sick

The three most commonly feared phobic stimuli are spiders, heights and snakes.

Who Gets Specific Phobia?

People normally succumb to a phobia in childhood or during the teen years, although adults can become suddenly phobic as well. Children tend to deal with their phobias, in time, but adult onset phobias rarely get better without treatment. Women are about twice as likely to experience specific phobia

About 6 million Americans suffer from a specific phobia. You are more likely to experience specific phobia if a family member has the condition – the disorder is likely passed genetically and through learned behaviors in families. A traumatic incident can also trigger a phobia (a dog bite triggering a phobia of dogs, for example.)

Do You Need Treatment?

A person who greatly feared snakes but who lived in a northern urban center, and who never came across a snake, might not have much of a problem and might not require any treatment.

When fear and anxiety start to compromise the ability to live a normal, happy and healthy life, it’s time to think about getting help.

Consider getting help:

• If your anxieties about a specific stimulus or situation stop you from engaging in normal everyday or required activities
• If your anxiety is severe, frequently occurring or causes panic attacks
• If you worry greatly about your irrational fears
• If the fear forces you to make changes in your life

Specific Phobia Treatment

The vast majority of people that live with specific phobia never get treatment, despite the fact that for adult onset, 80% of people will never get over their phobia and despite the existence of very effective treatments.

Exposure therapy is the most effective therapy for specific phobia. During exposure therapy sessions, a specific phobia patient will work with a therapist to very gradually confront the source of their anxiety by increasing exposure in steps, over time.

A person with a fear of spiders might over a period of sessions, for example:

• Draw a picture of a spider
• Look at a real picture of a spider
• Watch a video of a spider
• Look at a live spider in a jar from across a room
• Gradually decrease the distance towards the live spider

The repeated exposure to the feared stimuli in a controlled environment reduces the fear response.

Specific phobia patients are also often taught relaxation techniques, useful for managing anxiety when it emerges.

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A condition that can emerge only days after a traumatic event and that produces symptoms similar to post traumatic stress disorder.

People who experience traumatic experiences that put them at fear for their life or that induce feelings of powerlessness are at risk of 2 primary anxiety disorders:

1. Acute Stress Disorder
2. Post Traumatic Stress Disorder

People who experience a very frightening or horrible event, such as a rape, or a natural disaster, can shortly thereafter succumb to acute stress disorder; a disorder that can leave people feeling dazed, irritable, guilty and prone to flashback-like nightmares and other symptoms. People who experience acute stress disorder are very likely to also later experience post traumatic stress disorder.

Similar kinds of events cause both conditions, but:

• Acute stress disorder occurs within a month of a traumatic event and lasts between 2 days and a month – post traumatic stress disorder must last for a month or longer
• Acute stress disorder produces more “dissociative” symptoms; symptoms like emotional numbness, a sense of diminished personal identity, or a loss of memory.

What Kinds of Events Cause Acute Stress Disorder?

The kinds of events that can produce acute stress disorder:

1. Threaten to kill or seriously hurt you or someone near you
2. Produce profound feelings of fear, helplessness and or horror

Rapes, physical assaults, combat, terrorist attacks and natural disasters are examples of the kinds of events or situations that can cause the disorder.

What Are the Symptoms of Acute Stress Disorder?

According to the American Psychological Association (APA), the symptoms needed for a diagnosis of acute stress disorder include:

At least three of the following symptoms that occur during the event or within a month of it:

1. Feelings of numbness, a reduction in emotional reactions
2. Feelings of being in a dream or a daze (being absent from the present)
3. Feeling depersonalized – (experiencing a loss of feelings of personal identity)
4. Losing touch with reality (feeling like things aren’t quite real)
5. Losing your memory of one or more aspects of the traumatic event

The experience must also produce at least one symptom from each of the following three symptoms categories:

1. A desire to avoid remembering the event (avoidance)
2. Symptoms of hyper vigilance (difficulty sleeping, jumpiness, irritability etc.)
3. Re-experience symptoms, such as daydreams of the event, flashbacks or nightmares

The experience of symptoms must cause you serious problems and distress in your life, at work, at home or in relationships.

If these symptoms of acute stress disorder last for longer than a month, the diagnosis changes to post traumatic stress disorder.

Who Gets Acute Stress Disorder?

According to an overview of research provided by the VA hospital system:

• 7% of survivors of a natural disaster studied exhibited symptoms
• 13% to 21% of people involved in serious car accidents show symptoms
• 19% of violent assault victims show symptoms
• 25% of robbery and assault victims show symptoms
• 33% of survivors of a mass shooting show symptoms

Research has shown that people with past or present mental illness may be at increased risk of acute stress disorder, as are past sufferers of post traumatic stress disorder.

Acute Stress Disorder Treatment

Left untreated, acute stress disorder often progresses to the longer lasting condition, post traumatic stress disorder, but there is some evidence that treatment interventions administered soon after traumatic exposure can help minimize the symptoms of acute traumatic disorder and reduce the likelihood of a progression to post traumatic stress disorder.

Treatment can help you feel better now and can prevent the occurrence of a serious condition down the road.

• Cognitive Behavioral Therapy (CBT) – Numerous research studies have found CBT to be the most effective treatment for the acute stress disorder and some research also indicates that very brief CBT may also prevent the likelihood of later emerging PTSD.

• EMDR – this therapy, that involves recalling a traumatic situation while following a moving object with both eyes, has been shown effective in reducing stress exposure symptoms. Other exposure type therapist can also sometimes help.
  

• Medication – Although no medications are explicitly FDA approved for the treatment of the disorder, SSRIs, which work for PTSD are sometimes prescribed and anecdotally, seem to work to reduce symptoms severity. Anti anxiety medications, such as benzodiazepines, are also sometimes used, but concerns over their addictive nature limit their usage.

Because acute stress disorder is highly predictive of PTSD, if you find that you’re having a lot of trouble dealing with a recent traumatic event, you should strongly consider talking to a mental health professional about treatment options that can help you feel better, and that can decrease your odds of longer lasting PTSD.

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Answering some frequently asked questions about Post Traumatic Stress Disorder (PTSD).

Between a quarter and a third or people who experience a very traumatic life event will suffer a syndrome of anxiety symptoms in the weeks, months or even years following the event. PTSD is not a sign of weakness; it is a very treatable mental health disorder.

If you endured a terrible life experience and you can’t seem to get past it and you may have PTSD.

What Kinds of Traumatic Experiences Can Cause PTSD?

While many of us associate PTSD with war, as something experienced by combat veterans, combat exposure is only one of many types of experiences that can lead to the disorder.

Any situation that puts you in fear for your life or in fear of great bodily harm, or a situation where you see others being harmed or killed, can cause PTSD. Some examples of these types of situations include:

• Military combat
• A traffic accident
• A mugging
• A violent assault
• A rape
• A major disaster, such as a hurricane
• A terrorist attack

The kinds of situations more likely to cause the disorder:

• Are long lasting
• Are very horrific
• Leave you feeling trapped
• Leave you seriously injured
• Affect kids
• Kill or seriously injure many people
• Are very unexpected

When Do Symptoms Emerge After a Traumatic Experience?

On average, symptoms of PTSD emerge within a couple of weeks or months and usually within 6 months, but in some cases, PTSD lays dormant for years. It’s quite normal to feel stressed and upset after experiencing a trauma, but if distress lasts for longer than a couple of weeks or if symptoms of distress are very severe, symptoms may indicate PTSD. PTSD may not go away without treatment.

What Are the Symptoms of PTSD?

PTSD causes 3 types of symptoms: Hyper arousal anxiety symptoms, symptoms of avoidance and symptoms of intrusive and uncontrollable thoughts or memories.

Hyper arousal (anxiety) symptoms

Like a state of constant vigilance to threat, hyper arousal puts you on constant alert, a state your body is not very well able to tolerate. Some symptoms of hyper arousal include:

• Irritability
• Being very easily startled
• insomnia
• Stomach upset or aches and pains
• Using drugs or alcohol to cope
• Hallucinations (auditory)

Avoidance Symptoms

Avoidance is also known as emotional numbing, and is a defense mechanism used to manage the fear and worry produced by the incident.

• Avoiding places, people or things that remind you of the incident
• Closing yourself emotionally
• Feeling numb
• Feeling hopeless
• Having difficulty concentrating and remembering things
• Feeling guilty
• Losing the ability to completely recall the traumatic experience

Uncontrollable Thought Symptoms

• Uncontrollably thoughts about the traumatic experience
• Flashbacks
• Nightmares

These thoughts can be triggered by something or someone in the environment (such as a car backfiring) and can be very unsettling.

To Be Diagnosed with PTSD:

According to the American Psychiatric Association, to be diagnosed with PTSD, a patient must:

1. Have experienced symptoms for at least 1 consecutive month and symptoms must interfere with regular life.

2. Symptoms must include at least 1 intrusive thought (re-experience) symptom, at least 3 avoidance symptoms and at least 2 hyper arousal symptoms.

When to Seek Help?

It’s quite normal to feel stressed and upset after experiencing a trauma, but if distress lasts for longer than a couple of weeks or if symptoms of distress are very severe, or if your symptoms are interfering with your ability to live a normal happy and healthy life – you may have PTSD - a treatable mental health disorder.

PTSD is very treatable, but the earlier treatment is initiated, the better the prognosis and the faster you’ll get back to feeling like yourself again. If you think you have PTSD, it’s worth seeking an evaluation from a mental health professional.

Who Is at Risk for PTSD?

About a third of people who experience a major traumatic event will develop PTSD. Scientists don’t know exactly why some people develop the condition and some people don’t, but people thought to be at increased risk of PTSD include:

• People who lack social support systems
• People who have a close relative that has had either PTSD or depression
• People that have another mental health disorder
• People who endured childhood abuse
• People who feel badly about the way they acted during the traumatic situation
• People who experience additional stressors after the traumatic event, such as relocation or job loss

Women are at greater risk to experience the condition; this may be because women are more frequently the victims of traumatic assault.

What Kind of Treatment Works?

PTSD symptoms may or may not go away on their own. Without treatment, in many cases, symptoms will actually worsen in time.

Fortunately, effective treatments are available that help a great deal to reduce the intensity and frequency of PTSD symptoms.

The two types of PTSD treatments are psychotherapy and medication therapy.

Education is an important aspect of any form of PTSD therapy, and patients should endeavor to learn as much as possible about the condition and the treatments available.

Psychotherapy

Some different types of psychotherapy (talk therapy) include:

Exposure therapy – which involves using imagery to recreate a traumatic situation while in a safe environment. Under a therapists’ guidance, this can reduce the power of traumatic memories.

EMDR – similar to exposure therapy, but an EMDR therapist has a patient move their eyes back and forth as they remember traumatic memories. This is thought to reduce the emotional power of the memories – a form of emotional reprocessing.

Cognitive behavioral therapy – a form of therapy that has patients develop new healthier ways to think about traumatic memories causing problems.

Medication

The SSRIs, a class of anti depressant that work primarily through modifications of serotonin levels in the brain, are FDA approved for the treatment of PTSD. Some examples of SSRIs include Prozac, Zoloft and Paxil.

Helping Yourself

Self-help should not replace the expertise and treatment of a mental health professional, but you can take some steps to improve the way you feel, and to shorten a period of PTSD symptoms.

Here are a few ideas for PTSD self help:

• Find a support group and share and learn with a group of others going through similar experiences

• Avoid alcohol and drugs as a way of dealing with symptoms. Intoxication can suppress symptoms temporarily, but makes things worse in the long run. Habitual drug or alcohol use also puts you at risk of a substance abuse disorder

• Reduce or eliminate coffee. Caffeine can exacerbate anxiety symptoms

• Get enough sleep, exercise and eat well.

• Talk to friends and family about the way you’re feeling and about the traumatic incident – don’t try to repress it

• Meditate, learn deep breathing exercises, or do yoga

• Try to keep a normal routine, follow your doctor or therapist’s advice and expect that things will get better in time

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Do you or someone you love have a problem with compulsive hoarding? Take this self test to find out.

Answer yes or no to the following questions. The more statements you strongly agree with; the greater the probability of a diagnosis of compulsive hoarding.

1. I will keep multiple copies of identical items. Just in case.

2. I feel ashamed by the state of my house

3. My quantity of personal possessions causes family discord

4. It is difficult to walk through certain areas of my house, due to the quantity of possessions

5. There are certain rooms in my house that cannot be used as they were intended for, due to the amount of personal belongings stored within

6. Sometimes when I throw something out, I later change my mind and retrieve it out of the garbage

7. I often misplace items amongst the clutter

8. I do not like to have visitors over to see the way I live

9. I sometimes buy many copies of similar items, more than I need

10. When I try to throw things out, I feel anxiety

11. I keep old newspapers or magazines, so that I have access to that information if needed

12. Some of the chairs or tables in my house are unusable, as they have been covered with possessions

13. I do not like it when friends of family members handle my belongings

14. I like to keep any belonging with sentimental value

15. I love bargains and will buy things that are great deals, even if I do not need them

16. Some people consider the possessions that I keep and love to be “junk”

17. I spend a lot of time thinking about my belongings

18. There are things in my house that need repairing, that are not getting fixed due to the clutter

19. I buy things that I do not need, especially when they are “good deals”

20. I cannot control my urges to buy new possessions

21. The clutter in my house keeps me from doing things that I want to do

22. The clutter in my house feels “overwhelming”

Although not a clinical evaluation of compulsive hoarding, the more statements that you strongly identify with, the greater the likelihood that you have a problem with compulsive hoarding.

If you have a problem with hoarding and decide you want treatment, then cognitive behavioral therapy, and sometimes medication, can help you to overcome your disorder and take back control of the way you live.

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Although a drink or two can reduce anxiety temporarily, in general, alcohol makes anxiety worse; and sometimes significantly so.

Alcohol is a no-no for most people with anxiety disorders, but people who experience anxiety, particularly disorders like PTSD, social anxiety disorder and panic disorders, are 2 to 3 times more likely than people in the general population to develop a substance abuse problem.

People with anxiety are clearly drawn to the use of alcohol and drugs, but how does a substance (alcohol) that temporarily abates anxious feelings actually exacerbate these conditions?

Reasons Why Heavy Alcohol Use and Anxiety Don’t Mix

• Many people find that while alcohol can temporarily reduce symptoms of anxiety, the day after alcohol use, anxiety symptoms rebound with severity. There can be a real temptation to counter these exacerbated anxiety symptoms with alcohol once again, and this can start off a very negative spiral into alcohol abuse or alcoholism.

• Binge drinking can cause physiological changes in the body that can trigger a panic attack

• People abusing alcohol (or other drugs) may be less compliant on anxiety treatments, such as medications; and even if taking these medications as directed, alcohol may lessen their efficacy.

• Alcohol withdrawal symptoms (which can include anxiety) can induce (or awaken) an anxiety disorder in some people. People who suffer from an anxiety disorder may endure more severe alcohol withdrawal symptoms

• People abusing alcohol may cause themselves family, workplace or legal problems that serve to increase anxiety provoking thoughts

Don’t cope with anxiety through the use of alcohol or drugs. Although a tempting self-medication solution, these substances always make things worse.

 If you find that you do have a problem with both anxiety and alcohol or drug abuse/addiction, remember that treatment for the two conditions needs to be integrated to be effective.

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Learn why avoiding what causes your anxiety isn’t a very good strategy and learn what steps you can take to break out of a negative cycle of social anxiety.

While our natural impulse is to avoid situations that provoke anxiety, this only serves to consolidate fears and reduces our ability to handle social situations in the future.

You feel anxiety in some situation… you evaluate what caused you to feel anxious and you avoid that situation in the future as a way to avoid re-experiencing the anxiety.

It’s a logical response to a negative sensation, but unfortunately, avoidance as a strategy for minimizing anxiety doesn’t work very well, in fact, it generally just makes things worse.

Here’s why:

Say you experience anxiety at the thought of going to a party alone and so you either don’t go or you go but only after convincing a friend to come with you.

By avoiding or minimizing the source of your anxiety you feel short term relief from not facing the anxiety provoking situation. However, by not meeting the challenge of going to the party alone you lose the opportunity to disprove your anxieties.

If you had went and faced your fear you might have ended up having a great conversation with someone or otherwise having a great time. This positive experience would have lessened your anxiety at the thought of future parties. It is very unlikely that the experience of going to the party would be as bad as you imagine it would be in panicky thoughts of anxiety.

And so the next time you are invited to a party alone you are even more anxious and less confident about your ability to handle the situation, and so even more likely once again to avoid putting yourself in the situation.

This is the negative cycle of anxiety.

Breaking the Negative Cycle of Anxiety

The best way to break out of the negative cycle is to reverse it with a positive cycle.

If you fear parties or social gatherings, you would gradually increase your exposure to these situations as a way to build your confidence. For example:

• Start off by going to a bar or a café with a friend and staying for 10 minutes, then 20 minutes, then an hour…
  
• Then try going to that same safe or bar and alone and staying for 10 minutes, then 20 minutes, then an hour
  
• Then try going to a café or bar with a group of friends and staying for 20 minutes…

As you challenge yourself with increasingly difficult but always manageable tasks you increase your confidence in your abilities to handle social situations and you lessen your anxiety at the thought of social tasks.¹

Don’t Suffer with Social Anxiety 

Don’t suffer through social anxiety and don’t let your anxieties limit what you can achieve and experience. If you aren’t able to break the negative cycle of social anxiety on your own, talk to a counselor or therapist about exposure therapy and other therapies that can help break the back of social anxiety.

You will likely also benefit from learning relaxation and breathing exercises that can be used to increase your tolerance to sensations of anxiety and from thinking modification exercises that can help you to correct unhelpful and inaccurate thinking.

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Chronic stress harms the body. Do you live under chronic stress? Is your body sending you a message?

Many of us become so accustomed to operating in environments of chronic stress that we become simply unaware of the effects stress has on our body. While acute stress, in some situations, can be beneficial, living under chronic, unrelenting stress is terribly harmful to health and well being.

Living under chronic stress, can lead to anxiety disorders, diabetes, weight gain and obesity, a decrease in immune system functioning, decreased cognitive performance, increased blood pressure, an increased risk of cardiac disease and others serious conditions. Chronic stress feels bad because it does harm.

Are you stressed? Do you show the physical warning signs of chronic stress?

According to the American Psychological Association (APA) here are some of the danger signs of chronic stress taking its toll:

• Feelings of anxiety
• Feelings of irritability (short fuse)
• Insomnia
• Tiredness
• Head-ache, muscle aches, back pain or other, tension related ills
• Feeling jittery
• Feeling scatterbrained, forgetful
• A lack of decisiveness
• Elevated heart rate
• Chest pains
• Comfort eating
• Cotton mouth (dryness)

If these symptoms sound familiar, and aren’t explained by another medical condition, then you may want to evaluate the impact stress has on your life and your health.

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Try a few of the following real-life tips from panic patients and therapists to prevent anxiety and panic and to retake control when panic strikes.

Here are 25 self-help tips and tricks to help you prevent and manage panic attacks. Some of these suggestion might sound kind of silly and you may not find research studies supporting their effectiveness - but all of them come from real-life panic patients or experts and any one of them might be just what you need to take back control.

So read on – because none of the ideas below will cost you a cent or cause unwanted side effects and you may even find something here that really helps.

Managing Panic - 25 Tips and Tricks to Try:

4. Get a little exercise each day. Make sure it’s strenuous enough to get your heart pumping a bit. Try to get used to the feeling of your heart beating and tell yourself that it is normal after exercise to feel this way.¹
5. When feeling anxious, make a conscious effort to relax your shoulders and drop your arms down
6. When panic hits, try to stay in the situation – do not run away from it. If you run away the environment becomes tinged with fear and you may feel a need to avoid it in the future. If you stay in place until you feel better, you weaken this fear-association.²
7. Hold your breath – when you notice the fear and feel your respiration rate spike you can avoid hyperventilation by holding your breath for 10 or 15 seconds, a few times in a row. After holding your breath, try to breathe very deeply right into the bottom of your lungs, breathing in for a count of 7 and out for a count of 11.  It is impossible to panic while breathing very slowly and deeply.
8. When feeling anxious, sing a song or hymn or recite a poem that you know all the words to
9. When panic or anxiety spikes, try not to fight it. Tell yourself it’s ‘just panic and it can’t hurt me and it will pass soon.”
10. Try to stay as motionless as you can. Slow your breathing and pretend like you’re trying to make yourself disappear
11. Or try the complete opposite – when panic hits do some very strenuous exercise right away – like running as fast and as far as you can. By the time you stop (once you’re completely out of breath and exhausted) you may notice your anxiety has simply disappeared.³
12. When you feel panic coming do anything that gets your brain thinking. Try counting backwards from 300 by 3’s or doing a Sudoku puzzle
13. Talk to someone who gets it and tell them how you’re feeling
14. When feeling anxious, make yourself laugh out loud (your brain apparently gets the same benefits from  manufactured laughs as authentic laughter)
15. Visualize yourself in a safe place
16. Don’t check your pulse
17. If you’re getting anxious while driving, focus on reading the license plates of cars around you until you get out of a difficult stretch of road.
18. Think of a coping sentence and repeat it during a panic attack…”I am fine, my heart is just pounding because I am panicking” ⁴
19. Make yourself smile
20. Take a shower
21. Breathe in for a count of 4, hold your breath for a count of 4 and then exhale for a count of 4 – gradually slow down your counting speed until you’re breathing very slowly and your heart rate has slowed to match your breathing (a good one for lying in bed).
22. Meditate
23. When you start feeling symptoms draw a picture of what you look like when in the midst of a panic attack
24. Read a children’s story out loud. Read it in a slow and relaxing voice, as if you were reading a bedtime story to a small child.
25. Try to find something positive to think about after a panic attack… (That was the shortest one ever!) and if you can’t find anything good to think about, just fake it until you can. By doing this you trick your mind into being less fearful of future panic attacks – which can help you to start breaking out of a bad cycle.
26. Avoid coffee and alcohol and try to avoid heavily processed foods. Eat meals on a regular schedule to avoid blood sugar spikes and falls.
27. Listen closely to some good music when feeling panicky – anything you can do to stop thinking about yourself will help.
28. Do writing exercises. Carry a notebook around with you and when you start to feel symptoms of anxiety or stress write down how you are feeling, where you are, what you’re thinking about and what you were thinking about before you started to feel panicky. This can help give you a better idea about what’s causing your panic attacks and it can also remove some of the power from the attack as it reminds you that your fears are artificial and are just symptoms that will pass in time.

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Find out why anxious breathing makes you feel bad and learn a simple, 30-second Deep Breathing Exercise that restores your inner calm.

Take a few slow breaths… it always makes you feel better, especially when you’re stressed. But why is this?

At a very basic level, controlling your mood is as easy as retaking conscious control over your respiration rate. Read on to learn...

1. Why the quickened breathing of anxiety, stress or anger leads to unpleasant feelings.
2. A simple exercise that can help calm anxiety breathing.

Why Anxious Breathing Makes Us Feel Bad

Our bodies produce carbon dioxide as a waste product when metabolizing oxygen. In a relaxed state, oxygen inhalation balances out carbon dioxide exhalation and carbon dioxide levels in the blood stay stable. As a result – we feel OK.

When we exercise, our muscles demand extra oxygen and produce extra carbon dioxide, so during exercise we breathe more rapidly - to deliver the extra needed oxygen and to expel the extra carbon dioxide. Carbon dioxide levels in the blood stay in balance, and as a result, we feel OK.

However...

When we get scared, stressed or anxious, respiration quickens and we take in extra oxygen and exhale extra carbon dioxide, however, since we don't use extra muscle energy, our muscles don’t produce extra carbon dioxide to match with this quicken depletion rate. When we're stressed, we push out more carbon dioxide than we create and levels in the bloodstream drop. With depleted carbon dioxide in the bloodstream, we can feel lightheaded, sweaty and tingly – we don’t feel OK!¹

So anxious breathing can cause unbalanced carbon dioxide/oxygen levels in the bloodstream, and this can lead to symptoms that actually worsen our stress or anxiety!

Fortunately, we can retake control of your mood as easily as retaking control of your breathing.

Our Nervous System is From Another Age

Our body has 2 essential regulatory systems (functioning largely below the level of consciousness):

(1) the parasympathetic nervous system and (2) the sympathetic nervous system

• The parasympathetic nervous system is the normal regulator for autonomic processes like breathing and heart rate.
• However, in moments of crisis, the sympathetic nervous system takes over and wrests control of these and other automatic processes. Unfortunately, our sympathetic nervous system can’t differentiate between everyday stress or anxiety and true crisis stress or fear. As a result, for example, as we feel anxious before a social situation – our body gets ready for a fight to the death or a full out sprint to safety!

This is obviously not ideal. Anxiety causes a sympathetic physiological response (pounding heart, sweating, etc.) and this makes your anxiety feel worse than it was to begin with.

Fortunately, we can trick our sympathetic nervous system into retreat by slowing our breathing. By the logic of our body – if the breathing slows then the crisis must be over, and there’s no longer any need to stay ready for the worst.

It doesn’t get any simpler than this!

Breathe Slowly

Here is a simple breathing exercise for you:

1. Breathe through your nose only*
2. Inhale for a slow count of 4
3. Exhale for a slow count of 4
4. Repeat until calm

* Breathing through the nose only creates resistance to air flow, which helps slow your respiration rate and contributes to relaxation