Anxiety Disorder

Almost everyone gets nervous now and then. It’s normal to have knots in your stomach before a test. Or for your heart to beat fast on a first date. But an anxiety disorder is much more than a case of nerves. In fact, its symptoms may be overwhelming. But treatment can ease many of these symptoms. Talking with your healthcare provider is the first step.

An anxiety disorder causes very strong feelings of panic and fear. These feelings may occur for no clear reason. And they tend to happen again and again. They may prevent you from coping with life. They may cause you great distress. You may then stay away from anything that triggers your fear. In extreme cases, you may never leave the house. Anxiety disorders may cause other symptoms, such as:

• Obsessive thoughts that are unwanted and you can’t control.
• Constant nightmares or painful thoughts of the past.
• Upset stomach, sweating, and muscle tension.
• Trouble sleeping or focusing.

Anxiety disorders tend to run in families. For some people, childhood abuse or neglect may play a role. For others, stressful life events or trauma may trigger these disorders. Anxiety can trigger low self-esteem and poor coping skills.

• Panic disorder. This causes a very strong fear of being in danger.
• Phobias. These are extreme fears of certain things, places, or events.
• Obsessive-compulsive disorder (OCD). This makes you have unwanted thoughts and urges. You also may do certain things over and over.
• Posttraumatic stress disorder (PTSD). This occurs in people who have been through a terrible ordeal. It can cause nightmares and flashbacks about the event.
• Generalized anxiety disorder. This causes constant worry. It can greatly disrupt your life.

If you have an anxiety disorder, you don’t have to suffer anymore. Treatment is available. Therapy (also called counseling) is often a helpful treatment for anxiety disorders. With therapy, a specially trained professional (therapist) helps you face and learn to manage your anxiety. Therapy can be short-term or long-term depending on your needs. In some cases, medicine may also be prescribed with therapy. It may take time before you notice how much therapy is helping, but stick with it. With therapy, you can feel better.

Cognitive behavioral therapy (CBT) teaches you to manage anxiety. It does this by helping you understand how you think and act when you’re anxious. Research has shown CBT to be a very effective treatment for anxiety disorders. How CBT is run is almost like a class. It involves homework and activities to build skills that teach you to cope with anxiety step by step. It can be done in a group or one-on-one, and often takes place for a set number of sessions. CBT has two main parts:

• Cognitive therapy helps you identify the negative, irrational thoughts that occur with your anxiety. You’ll learn to replace these with more positive, realistic thoughts.
• Behavioral therapy helps you change how you react to anxiety. You’ll learn coping skills and methods for relaxing to help you better deal with anxiety.

Other therapy methods may work better for you than CBT. Or, you may move from CBT to another form of therapy as your treatment needs change. This may mean meeting with a therapist by yourself or in a group. Therapy can also help you work through problems in your life, such as drug or alcohol dependence, that may be making your anxiety worse.

Therapy will help you feel better and teach you skills to help manage anxiety long term. But change doesn’t happen right away. It takes a commitment from you. And treatment only works if you learn to face the causes of your anxiety. So, you might feel worse before you feel better. This can sometimes make it hard to stick with it. But remember: Therapy is a very effective treatment. The results will be well worth it.

If anxiety is wearing you down, here are some things you can do to cope:

• Check with your doctor and rule out any physical problems that may be causing the anxiety symptoms.
• If an anxiety disorder is diagnosed, seek mental healthcare. This is an illness and it can respond to treatment. Most types of anxiety disorders will respond to talk therapy and medicine.
• Educate yourself about anxiety disorders. Keep track of helpful online resources and books you can use during stressful periods.
• Try stress management techniques such as meditation.
• Consider online or in-person support groups.
• Don’t fight your feelings. Anxiety feeds itself. The more you worry about it, the worse it gets. Instead, try to identify what might have triggered your anxiety. Then try to put this threat in perspective.
• Keep in mind that you can’t control everything about a situation. Change what you can and let the rest take its course.
• Exercise — it’s a great way to relieve tension and help your body feel relaxed.
• Examine your life for stress, and try to find ways to reduce it.
• Avoid caffeine and nicotine, which can make anxiety symptoms worse.
• Fight the temptation to turn to alcohol or unprescribed drugs for relief. They only make things worse in the long run.

An anxiety disorder can make you feel nervous or apprehensive, even without a clear reason. In people age 65 and older, generalized anxiety disorder is one of the most commonly diagnosed anxiety disorders. Many times it occurs with depression. Certain anxiety disorders can cause intense feelings of fear or panic. You may even have physical symptoms such as a racing heartbeat, sweating, or dizziness. If you have these feelings, you don’t have to suffer anymore. Treatment to help you overcome your fears will likely include therapy (also called counseling). Medicine may also be prescribed to help control your symptoms.

Certain medicines may be prescribed to help control your symptoms. So you may feel less anxious. You may also feel able to move forward with therapy. At first, medicines and dosages may need to be adjusted to find what works best for you. Try to be patient. Tell your healthcare provider how a medicine makes you feel. This way, you can work together to find the treatment that’s best for you. Keep in mind that medicines can have side effects. Talk with your provider about any side effects that are bothering you. Changing the dose or type of medicine may help. Don’t stop taking medicine on your own. That can cause symptoms to come back or cause dangerous withdrawal symptoms.

• Anti-anxiety medicine. This medicine eases symptoms and helps you relax. Your healthcare provider will explain when and how to use it. It may be prescribed for use before situations that make you anxious. You may also be told to take medicine on a regular schedule. Anti-anxiety medicine may make you feel a little sleepy or “out of it.” Don’t drive a car or operate machinery while on this medicine, until you know how it affects you.

Never use alcohol or other drugs with anti-anxiety medicines. This could result in loss of muscular control, sedation, coma, or death. Also, use only the amount of medicine prescribed for you. If you think you may have taken too much, get emergency care right away. Never share your medications with others. Store these medications in a safe place that can't be accessed by children or visitors.

Never change your dosage, share or use another person's medicine or stop taking your medicines without talking to your healthcare provider first. Keep the following in mind:

• Some medicines must be taken on a schedule. Make this part of your daily routine. For instance, always take your pill before brushing your teeth. A pillbox can help you remember if you’ve taken your medicine each day.
• Medicines are often taken for 6 to 12 months. Your healthcare provider will then evaluate whether you need to stay on them. Many people who have also had therapy may no longer need medicine to manage anxiety.
• You may need to stop taking medicine slowly to give your body time to adjust. When it’s time to stop, your healthcare provider will tell you more. Remember: Never stop taking your medicine without talking to your provider first.
• If symptoms return, you may need to start taking medicines again. This isn’t your fault. It’s just the nature of your anxiety disorder.
• Side effects. Medicines may cause side effects. Ask your healthcare provider or pharmacist what you can expect. They may have ideas for avoiding some side effects.
• Sexual problems. Some antidepressants can affect your desire for sex or your ability to have an orgasm. A change in dosage or medicine often solves the problem. If you have a sexual side effect that concerns you, tell your healthcare provider.
• Addiction. If you’ve never had a problem with drugs or alcohol, you may not have a problem with medicines used to treat anxiety disorders. But always discuss the medicines with your healthcare provider before taking them. If you have a history of addiction, you may not be able to use certain medicines used to treat anxiety disorders.
• Medicine interactions. Always check with your pharmacist before using any over-the-counter medicines (OTCs), including herbal supplements. Some OTCs may interact with your anti-anxiety medications and increase or decrease their effectiveness.