It is my hope that this book has helped to answer your questions about anxiety and panic disorder.  There are so many things that are important for sufferers and their loved ones to know that doctor’s just don’t seem to share.  When you have the best resources and all of the best information, it can be much easier to find a treatment that will be effective to you.

It is important to keep in mind that medication, which sometimes necessary for short term treatment of anxiety that is crippling or that leaves someone at risk of harming themselves or others, can be a risky treatment for long term anxiety.  Studies have proven that cognitive behavioral therapy offers a greater chance of recovery and symptom reduction without the risks of side effects and dependency.  We live in a society where it seems that everyone wants to push drugs as some sort of miracle cure when in truth no such miracle exists.

There are a number of different anxiety disorders, and in some cases, patients can exhibit symptoms of more than one disorder at a time.  Obtaining a proper diagnosis can be further complicated by depression and other mental and physical health issues.  If you or someone you love is experiencing symptoms of anxiety, but your doctor doesn’t seem willing to provide you a diagnosis so that you can get the treatment that you need, speak to someone new.  Anxiety is a very treatable condition, but first you need to find someone who can offer you the treatment that you require.

Treating anxiety and panic is about a number of things.  Therapy is a very important element of your recovery, but so is having a strong support system and finding coping techniques that you can employ at home.  You also have to be willing to practice therapeutic techniques whenever you experience symptoms so that these methods can be as effective as possible.

Anxiety doesn’t have to be disabling and it doesn’t have to control your life.  It is my hope that you will use the information learned within these pages to help you get the help that you deserve.  At the end of this book, you will find an appendix of resources that can help you find more information on panic and anxiety disorders as well as where you can turn in your state or online for the help you need.

Resources

In this appendix, you will find an array of websites that can offer you more information on anxiety and panic disorders as well as resources that can help you find help and support both online and where you live and books that can offer more information.

Learning More About Anxiety and Treatment

Information on Anxiety

The Anxiety Disorders Association of America

http://www.adaa.org/

The National Institute of Mental Health

http://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml

The National Alliance on Mental Illness

http://www.nami.org/template.cfm?section=anxiety_disorders

WebMD

http://www.webmd.com/anxiety-panic/guide/mental-health-anxiety-disorders

The Office of the Surgeon General

http://www.surgeongeneral.gov/library/mentalhealth/chapter4/sec2.html

The Mayo Clinic

http://www.mayoclinic.com/health/anxiety/DS01187/DSECTION=symptoms

General Anxiety Disorder

National Institute of Mental Health

http://www.nimh.nih.gov/health/topics/generalized-anxiety-disorder-gad/index.shtml

Mayo Clinic

http://www.mayoclinic.com/health/generalized-anxiety-disorder/DS00502

Social Phobia/Social Anxiety Disorder

The Social Anxiety Association

http://www.socialphobia.org/

Mayo Clinic

http://www.mayoclinic.com/health/social-anxiety-disorder/DS00595

Obsessive Compulsive Disorder

National Institute of Mental Health

http://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml

Mayo Clinic

http://www.mayoclinic.com/health/obsessive-compulsive-disorder/DS00189/DSECTION=symptoms

Post Traumatic Stress Disorder

National Institute of Mental Health

http://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml

PTSD Alliance

http://www.ptsdalliance.org/

Acute Stress Disorder

National Center for PTSD

http://www.ptsd.va.gov/public/pages/acute-stress-disorder.asp

Agoraphobia

Mayo Clinic

http://www.mayoclinic.com/health/agoraphobia/DS00894

Specific Phobia

National Institute of Mental Health

http://www.nimh.nih.gov/health/publications/anxiety-disorders/specific-phobias.shtml

WebMD

http://www.webmd.com/anxiety-panic/specific-phobias

Panic Attacks and Panic Disorder

National Institute of Mental Health

http://www.nimh.nih.gov/health/topics/panic-disorder/index.shtml

Mayo Clinic

http://www.mayoclinic.com/health/panic-attacks/DS00338

Anxiety in Children

Anxiety Disorders Association of America

http://www.adaa.org/living-with-anxiety/children

American Academy of Child and Adolescent Psychiatry

http://aacap.org/page.ww?name=The+Anxious+Child&section=Facts+for+Families

Anxiety in the Elderly

WebMD

http://www.webmd.com/anxiety-panic/guide/20061101/anxiety-missed-elderly

Health Central

http://www.healthcentral.com/anxiety/understanding-anxiety-279218-5.html

Cognitive Behavioral Therapy

Anxiety Network

http://www.anxietynetwork.com/hcbt.html

Health Central

http://www.healthcentral.com/anxiety/c/1950/17898/10-reasons-cbt

Brain Physics

http://www.brainphysics.com/anxiety-therapy.php

Interoceptive Exposure

About.com

http://ptsd.about.com/od/glossary/g/interoceptive.htm

Relaxation Techniques

Healthy Place

http://www.healthyplace.com/anxiety-panic/anxiety-self-help/relaxation-techniques-for-relief-of-anxiety-and-stress/menu-id-1216/

WebMD

http://www.webmd.com/anxiety-panic/guide/20061101/best-ways-to-ease-anxiety-disorders

Diet and Exercise

LiveStrong

http://www.livestrong.com/article/238386-diet-exercise-anxiety/

PsychCentral

http://psychcentral.com/news/2010/02/24/exercise-helps-to-reduce-anxiety/11681.html

Mayo Clinic

http://www.mayoclinic.com/health/coping-with-anxiety/AN01589

Finding Therapists and Support Groups Near You

Anxiety Disorders Association of America

https://community.adaa.org/eweb/DynamicPage.aspx?Site=adaa&WebKey=ce66a0ec-3e19-437d-836b-f180fcdf6814

Find a Therapist

http://www.find-a-therapist.com/

Psychology Today

http://therapists.psychologytoday.com/rms/

American Psychological Association

http://locator.apa.org/

GoodTherapy

http://www.goodtherapy.org/

TherapyTribe

http://www.therapytribe.com/

FindCounseling

http://www.findcounseling.com/

Anxiety Disorders of America Support Groups

http://www.adaa.org/supportgroups

Online Counseling, Support Groups, and Forums

AnxietyZone (forums for an array of disorders)

http://www.anxietyzone.com/

AnxietyHelp

http://www.anxietyhelp.org/forum/index.php

Yahoo Anxiety Support Groups

http://groups.yahoo.com/search?query=anxiety

WebMD

http://exchanges.webmd.com/anxiety-and-panic-disorders-exchange

Daily Strength

http://www.dailystrength.org/c/Anxiety/support-group

Find the Light

http://www.findthelight.net/

Therapy 24/7

http://www.therapy247.com/home/

iTherapy

http://www.itherapy.com/

Social Anxiety Forums

http://www.socialanxietyforums.com/

PsychCentral

http://forums.psychcentral.com/?Cat=&Board=depression

Anxiety Journey (Forum on natural and alternative treatments)

http://www.anxietypanicattack.com/forum/index.php

Books

The Anxiety and Phobia Workbook by Edmund J. Bourne

The Cognitive Behavioral Workbook for Anxiety by William J Knaus

Anxiety and Its Disorders by David H. Barlow

Anxiety Disorders and Phobias: A Cognitive Perspective by Aaron Beck, PhD, Gary Emery, and Ruth Greenberg

Cognitive Therapy of Anxiety Disorders by David A Clark PhD and Aaron Beck MD

What You Must Think of Me: A Firsthand Account of One Teenager’s Experience with Social Anxiety Disorder by Emily Ford, Michael Liebowitz, and Linda Wasmer Andrews

Anxiety Disorders in Children and Adolescents by Wendy Silverman and Andrew Field

If Your Adolescent Has an Anxiety Disorder by Edna B.Foa and Linda Wasmer Andrews

Mood Disorders in Later Life by James M Elison, Helen H Kyomen, and Sumer Verma

Phone Numbers

Alcohol and Drug Help Line

1-800-821-4357

Covenant House Nineline (help for youth and parents)

1-800-999-9999

Kid Help (immediate help for kids and teens with mental health crises)

1-800-543-7283

NAMI (National Alliance for the Mentally Ill

1-800-950-NAMI

National Mental Health Association (free info on anxiety and other disorders)

1-800-969-6642

National Institute of Mental Health (Info and literature on mental illness)

1-800-647-2642

National Suicide Prevention Hotline (for anyone in crisis or emotional distress)

1-800-273-TALK

Being Taken Advantage Of

While being supportive and helping your loved one with things they can no longer manage because of their symptoms is a wonderful thing, it can also lead to your loved one becoming overly dependent on you.  If your loved one is starting to rely on you to do things that they are capable of or if they are taking advantage of your desire to help them get well, it is important that you do something about it.

If you are constantly sacrificing your time and effort to help ensure that your friend or family member has all of their needs met but find that your loved one is not making an effort to get better or to seek help, you need to be able to stand up for yourself.  Don’t react with anger, but be certain that you say something.

Let your loved one know that you feel like you are being taken advantage of, and try to help them understand why you feel the way you do.  There is a good chance that your friend or family member did not mean to become so dependent on you and that they will be willing to make changes or compromises to start doing things for themselves again.  If this doesn’t work, however, you need to be willing to stand up for yourself and to put your foot down if need be.  If you are doing everything for your loved one, they have no reason to help themselves.

Being Controlled

For people living with someone who has agoraphobia, social anxiety, and other disorders, it can be easy to get caught in a cycle of controlling behavior.  Your loved one may start exhibiting fear or anxiety whenever you try to leave the home, and your initial instinct is to stay home so that they do not have to feel alone, anxious, or afraid.  Unfortunately, our social interactions are a strong part of our mental health, and this can have a severely negative impact on your own well-being.

Anxiety disorders can leave people feeling powerless, and it is not uncommon for people to start to exhibit controlling behavior over loved ones.  If your friend or family member has started telling you when you can leave the house, who you can spend time with, or what you are allowed to say or do, it is imperative that you take action.

Once again, rather than reacting with anger, try explaining how this behavior affects you and what it is doing to your happiness and well being.  Controlling behavior can be dangerous to your mental health and you need to let your loved one know that it is unacceptable.  If the behavior continues, you will need to either refuse to be controlled or, if need, be, leave the situation.

Being Abused

Abusive situations are never healthy and should never be endured, even when they are the result of an anxiety disorder.  If your loved one has become emotionally or mentally abusive, it is absolutely imperative that they receive treatment immediately.  You need to tell them that this behavior is absolutely unacceptable and that while you are willing to support them in any way possible while they are working to recover than taking anger, fear, or frustration out on you, your children, or other loved ones is simply not going to be tolerated.

If your loved one has become physically abusive, you may need to consider having them sent to a mental health treatment facility.  In most states, there are laws that allow people to be involuntarily admitted for treatment whenever they pose a threat to themselves or to other people.  You can try contacting your loved one’s therapist to determine the best course of action and they can often help you find a safe way to get your loved one the treatment they need to deal with their anxiety without engaging in abusive behaviors.

Paranoia

Paranoia is a rare but possible symptom of a number of anxiety disorders, and it is one that can have a severely negative impact on your relationship.  Your loved one may believe that you are planning to hurt them, that you are talking about them, or that they are the victim of plots and gossip from other people.  Paranoia can be one of the hardest symptoms to deal with, because it often seems so real that your loved one doesn’t realize that it is irrational.

Paranoia can also manifest in a belief that failure to complete certain actions will result in the injury or death of a loved one.  Knowing what to do in these situations can be difficult, and it is not uncommon for people to need to return home frequently whenever going to the store or trying to go on vacation because they become paranoid that they have left the door unlocked or left the stove turned on.  Reassurance doesn’t help, and failure to check for themselves can cause intense fear and panic.

When symptoms like this begin, it is crucial to seek treatment as soon as possible.  For many people, this type of paranoia can eventually make it impossible to leave the house.  This can not only be frustrating for you and your loved one, but it can put a great deal of strain on you.

Summary

The bottom line is that when the symptoms of a loved one’s anxiety disorder begin to have a negative impact on your life, it is important to take action.  You cannot sit by and let a loved one hurt you or disrupt your mental health, no matter how much you love them. Start by trying to show them how their actions are affecting you and encouraging them to seek treatment, but if this is unsuccessful, you have to be willing to do what it takes to protect yourself.

It is important to note, however, that you do want to be wary of enabling your friend’s anxious behavior.  While you don’t want to condemn, it is important that you don’t feed in to obsessive thoughts, compulsive actions, or social withdrawal.  Offering to go out every time something is needed because a loved one is developing anxiety about leaving the house can actually make anxiety worse.

Educate Both Of You

The importance of educating yourself and your loved ones has been stressed repeatedly throughout this book, and the simple fact is that it can truly be one of the best things for both of you and for others in your lives as well.  Anxiety can be frightening to experience, and it can be frightening to see a loved one go through.  When you take the time to educate yourselves on the situation, you can learn not only how common it is, but how treatable it is.

Educating yourself and your loved one on anxiety can also help them to understand that, while unsettling, their symptoms are not dangerous or life threatening.  In many cases, simply understanding anxiety and the symptoms that accompany it can help provide some relief from the symptoms.  Treatment is still necessary, but knowing that the disorder is not dangerous can certainly be helpful.

Provide Support

The notion of being supportive for someone who is dealing with an anxiety disorder can seem simple at first glance, but the truth of the matter is that it can get downright difficult.  Many people can experience severe symptoms before they are willing to seek help, and people with certain disorders may display strange behaviors, thought patterns, and mood changes.  It can also be very hard to watch someone you love suffer, but offering support is often an essential part of helping them to recover.

Studies show that people who have a strong support network are much more likely to see a resolution of their anxiety symptoms.  Sometimes being supportive just means offering a sympathetic ear whenever they need to explain what anxiety feels like or what it makes them think and do.  Other times it may mean struggling to get them to continue therapy or encouraging them to keep going out with friends when they feel as though they want to stay inside.  Being supportive isn’t always easy, but it is certainly the right thing to do.

Get Help

In the last chapter we talked about how important it is to help someone you love seek treatment for their anxiety, but the truth of the matter is that you may need to seek counseling of your own.  Dealing with someone’s anxiety, especially someone that you live with or share a strong bond with, can take a major toll on your emotional health.  Seeking the guidance and advice of a counselor can offer you a place where you can safely vent your feelings about the frustration and where you can talk about how their anxiety is affecting you.

Seeking therapy can also help you to avoid getting burned out.  Dealing with someone’s anxiety can be an emotional drain.  Talk to someone who can provide you with guidance and who can offer advice not only on how you can keep yourself protected but on what you can do to provide the right support for your loved one.

Try to Encourage Fun

While anxiety can be disabling and can create an array of negative emotions, there is plenty of evidence to show that having fun and laughing helps to greatly reduce anxiety.  Try to encourage your loved one to have games, to go out, and to just have fun.  Make certain that all of your conversations aren’t focused on their anxiety and that you are able to have lighthearted conversations as often as possible.

Consider Becoming Workout Partners

There is a great deal of evidence that supports the benefits of exercise on anxiety symptoms, so why not start working out together.  Encourage your friend to join a gym with you, start going for runs, or take a class.  Even if you just take a walk every couple of days or start learning how to dance, exercise is a great deal of fun and a great way to help improve your friend’s mood and boost endorphin production while helping improve both of your health.

Exercise helps to regulate hormones in the body, including those produced by the adrenal system.  It is the adrenal system that triggers symptoms of anxiety and panic, so exercise can certainly be quite beneficial.  Activities such as running and dancing also help to produce hormones that provide a general sense of well being while also helping to alleviate excess stress and muscle tension.  All in all, exercise is great for the mind, body, and soul, making it a perfect way to help your friend while also helping yourself.

Join a Support Group or Counseling Session

Part of helping your loved one is encouraging them to get help for their anxiety, so why not do the same?  Join a support group with your loved one or enroll in counseling with them.  This will show that you care about what they are going through and that you are willing to learn what you can do to help them on the road to recovery.  Whether you attend a single session or start making regular appointments, it will show that you, too, are dedicated to helping them relieve the symptoms of anxiety and panic that are disrupting their quality of life.

Avoid Judgment or Belittling

There is no doubt that for those who have never experienced anxiety firsthand, it can look strange.  Obsessive compulsive behaviors, phobias, and social anxiety can produce symptoms that are certainly outside of the realm of the types of behaviors we encounter on a daily basis.  It can be easy to make snap judgments about these behaviors, but one of the worst things you can do to someone with anxiety is to judge or belittle them.

If you have questions about their behaviors, try researching them on your own. Avoid asking them why they do strange things or accuse them of acting out for attention.  Anxiety symptoms are often very embarrassing for people who experience them, and fear of judgment is often one of the biggest barriers to getting treatment.  Ensuring that you are not judging your loved one is absolutely essential.

It is also important not to downplay or make a huge emphasis about someone’s anxiety symptoms.  This can be a hard balance to maintain, but it is a very important one.  Downplaying symptoms by pretending that they don’t exist or ignoring them can leave them feeling as though their feelings or symptoms are not worthy of mention, leaving them afraid to talk about them or seek help for them.

On the other hand, however, you don’t want to put the focus of every conversation on their symptoms or to make a big deal out of how they are acting.  This can be downright embarrassing and it can trigger more anxiety and panic symptoms.  The best thing that you can do is really just to acknowledge what is happening and to let your loved one share as much or as little about their symptoms as they want to.

Don’t Encourage Self Medication

If you saw your loved one buy illicit drugs, you would likely do whatever it takes to keep them from ingesting them, right?  For people with anxiety, even substances that many people ingest every day can be as detrimental to their symptoms as illicit drugs.  While you can’t force someone to give up things such as caffeine, nicotine, and alcohol, you can certainly work to not encourage the behavior.

Self-medicating is extremely common among people with anxiety disorder.  Nicotine is a stimulant that provides a short-term sensation of relief from anxiety but that can worsen the symptoms whenever withdrawals start to kick in.  Alcohol is a central nervous system depressant that serves to provide a fast acting sense of relaxation that can last as long as they are drinking.  Withdrawal symptoms often trigger significantly worse anxiety, and the amount of resources that the body needs in order to remove alcohol from the system can often exacerbate anxiety symptoms.

Keeping loved ones from ingesting these substances is not your job, but refraining from encouraging it can be very helpful. If nobody is offering to take or accompany your loved one to a place where alcohol is served, you can greatly decrease the chances that they will end up drinking.  Refusing to buy cigarettes or offering to quit along with your friend can be a great way to be supportive and to avoid enabling self-medicating behaviors.

Summary

There are many ways that you can help a loved one who is suffering from anxiety.  Sometimes simply being there and showing that you care and are interested in what is happening can make a significant difference.  Keep in mind, even when things get tough, that a supportive social network can be an essential element to recovery from anxiety disorders.  When you are able to provide your loved one with the support they need to get better, the road to recovery can be a much shorter and smoother one.

It is not uncommon for people to deny that they have a problem that requires psychiatric treatment.  After all, there is still a strong stigma that surrounds mental illness both here and around the world.  While a diagnosis of anxiety does not mean that your loved one is crazy, there is often a fear that other people will perceive them in this manner.  This often serves to make it harder for people to accept that they need treatment.

No matter how much your loved one wants to deny it, however, anxiety disorders require proper treatment in order to be resolved.  Left untreated, symptoms can become incredibly disabling.  In this chapter, we will help you look at ways that you can encourage your loved one to seek the treatment of a therapist.

Educate- Show Them the Benefits

There have been countless studies published that show that people who seek treatment for anxiety disorders can experience a significant reduction in symptoms, if not a complete recovery.  This can often offer significant hope for people with anxiety disorders.  Take the time to educate yourself on the benefits of different therapies and then make an effort to educate your loved one as well.

The image that many people have regarding psychiatric treatment is a very outdated one.  Movies and television shows have greatly contributed to the image many people have of psychiatric treatment as simply drugging patients until they are only a shell of their former selves or using methods of therapy that can produce dramatic and frightening results.  Do some research into cognitive behavior therapy and relaxation techniques and show your loved one what these therapies entail.  Sometimes simply letting them see what treatment is really like can be enough to help encourage them to seek the help that they need.

Let Them Know That Therapists Have Seen It Before

Many people with anxiety feel as though their symptoms are unique and strange or that nobody will understand the things that they are thinking or experiencing.  It can offer great benefit to explain to your loved one that their symptoms are common among people with anxiety disorders and that there are therapists who are trained in dealing specifically with symptoms such as theirs.  Knowing that they will not be thought of as strange, crazy, or weird can often be very helpful.

Explain What Their Anxiety Is Doing to Others

If your loved one still does not want to seek treatment for an anxiety disorder, it can help to sit down and explain to them what their anxiety is doing to you, their children, or other loved ones.  Sometimes when people are so overwhelmed by anxiety, it can be hard to see the effects that it has on other people.  Anxiety can have devastating effects on the people that we care about most, and it is important for people to know what effect they are having on others.

If you decide to talk with someone about the effect of their anxiety on loved ones, it is important not to judge or condemn them.  Many people with anxiety are already afraid that they are being judged, and it is important that you try to use positive language and that you help them see what is happening without condemning them.  Choose your words carefully, but let them know that their problem is an issue for more than just themselves.

If the person has children, it can be especially helpful to explain to them how parental anxiety affects children.  Explain that parental anxiety greatly increases the chances of children developing anxiety.  You can also explain that certain behaviors can make it harder for children to feel comfortable expressing themselves and that they are much more likely to develop the same fears and phobias of their parents.  The symptoms of anxiety can be crippling, and the fear of passing those symptoms down to their children can be enough to prompt many parents to seek treatment.

You can also explain what anxiety is doing to your relationship with your loved one.  If it is your spouse, explain how the symptoms are affecting your marriage.  Do you feel increased pressure to avoid time with your friends and loved ones to be with your spouse?  Do you feel as though parental duties or other jobs are falling to you more often as a result of their anxiety?  If your spouse’s anxiety is having a negative impact on your relationship, your self-esteem, or your emotions, it is important to both of you that you voice this.

If the loved one in question is a parent, try to learn what the source of their anxiety may be.  Are they afraid of getting sick or dying?  Have they experienced the loss of a spouse or a close friend?  Find out what is triggering the anxiety and let them know that therapy can be extremely effective.

Helping a friend with anxiety to seek treatment is important as well.  Anxiety can put great strains on a friendship, and it can appear in many ways.  It may start to feel as though your friend is no longer interested in spending time with you or you may feel that they are suddenly having a hard time being away from you.  Encouraging a friend to seek treatment can be particularly difficult, but if you let them know that you are coming from a place of love and caring, it can be much easier.

Let Them Know They Aren’t Alone

One of the biggest problems for many people with anxiety is that it makes you feel extremely different from everyone else.  Many people with anxiety feel as though they are the only person experiencing the symptoms that they are going through.  They may also worry that others will think that they are strange or that they are crazy.  Dispelling these myths can make it much easier to convince someone in your life to get the help that they need.

One thing that you can do is to look up some specific statistics regarding anxiety disorders. If you happen to know which anxiety disorder your loved one is suffering from, let them know how common it is.  Equally importantly, let them know how successful cognitive behavioral therapy can be for treating anxiety disorders.  Make certain that your friend or family member knows that anxiety is not a sign that they are going crazy, and make sure that they know that you realize this as well.

If your loved one is still reluctant to seek professional help, offer to accompany them.  Offer to attend a therapy appointment with them, to help them find a therapist that can offer them treatment, or to attend an anxiety support group.  Show that you are willing to be a part of their treatment and to do what it takes to ensure that they get better.

When Nothing Seems to Work- Be Frank

Sometimes, people just don’t want to get help.  When this happens, it can be difficult.  When you present a loved one with the effects of their anxiety and behavior on you and their loved ones and when you show them what they are doing to themselves and others, it feels like all you can do.  Explaining how effective therapy can be and what life can be like with treatment is a great idea, but it doesn’t always generate the results that we hope.

If your loved one simply won’t respond to your explanations about the benefits of therapy or your offers to attend a support group with them, it may be time to be frank.  Let your loved one know that their mood and their symptoms are damaging your relationship.  Don’t make idle threats or give an ultimatum, but if you feel that their anxiety may make it hard for the two of you to maintain a relationship, now is the time to be honest about it.  When confronted with the notion that they are destroying the relationships with the people closest to them, it can sometimes be enough to convince people to get the treatment they need.

Keep Your Own Well Being In Mind

The simple fact is that there may be people in our lives who simply refuse to get help for their anxiety or panic.  While it is our tendency to stick around until we simply can’t do it anymore, it is important to know that you need to keep your own safety and well being as a priority.  If your loved one has become irritable, controlling, or dependent on you and you feel that your own life is being spent trying to cater to their needs or protect their emotions, it may be time to consider what you want to do.

Walking away from someone with an illness is never easy, but in order for someone to get better, they have to want to get better.  Sticking around to help meet their needs and dealing with mood swings or negative behaviors is not only damaging to you, but it actually gives them reasons not to get help.  Ultimately, you have to be strong enough to know when your efforts to help are only enabling and when your own mental and emotional well being is at stake.

Summary

Convincing a loved one to get help isn’t usually an easy task, but it is a very important one.  There are many things that you can say or do to help show someone you care for that seeking therapy will be the best and most effective option for them and for the people who love them.  Try everything you can to show them that therapy can be effective and that it can even help their symptoms go away, but ensure that you do not put your own well being at risk if someone you love refuses to seek help for their anxiety.

If your spouse has started to display drastic personality changes, it is always cause for concern.  If you think that anxiety or panic is causing these changes, it may benefit you to suggest this to your spouse or to suggest the possibility of individual or couples counseling.  What follows are a few symptoms that may help make it easier to know if your spouse is developing an anxiety disorder.

• Excessive worry or anxiety symptoms more days than not for a significant period of time

• Sleep disturbances, such as trouble falling or staying asleep or recurrent nightmares

• Distancing from others via excessive criticism or withdrawal from social activities

• Constant fear or worry about developing a serious illness

• Paranoid thinking or excessively worrying that others are judging them

• Difficulty concentrating that interferes with career or family life

• Controlling behaviors

• A fear of being alone or behavior that keeps you from leaving without them or from engaging in social situations with your own friends or family members

• Constant criticism of your parenting skills

• Chronic fatigue, frequent headaches, or irritable bowel syndrome not explained by medical causes

• Withdrawal from other people and a tendency to spend a majority of time at home

• Restlessness and hyperactivity

• Panic attacks

• Obsessive, repetitive thought patterns or compulsive behaviors such as frequent hand washing or constantly checking things

When your spouse is suffering from anxiety, it is common to feel helpless, especially when you cannot offer an immediate solution to their problems.  When you spend every day with someone, recognizing that they are suffering from an anxiety problem can actually be more difficult, as symptoms can appear slowly.  If your loved one is suffering from anxiety, the best thing that you can do is to be supportive and to suggest that they seek help.

Recognizing Anxiety In the Elderly

Anxiety is surprisingly common in the elderly.  In fact, elderly people are actually in the highest risk demographic for depression and suicide.  As we get older, concerns about health, life, and finances tend to grow larger.  In addition, the older we get, the more likely we are to lose spouses and lifelong friends.  All of these things present viable reasons why anxiety develops, and watching out for signs of anxiety in elderly people is very important.

There are a wide number of reasons why older people develop anxiety, but studies show that therapy can still be very effective.  Looking for signs and symptoms is very important.  What follows are some signs that an older person in your life may be suffering from anxiety.

• Sudden loss of interest in once enjoyed activities

• Restlessness or irritability

• Avoiding social situations, spending more time at home, or suddenly changing their daily routine

• Sudden difficulty falling or staying asleep

• Physical symptoms such as chest pains or shortness of breath that arise or get worse when thinking about certain things

• Excessive worry or concern or a fixation on death or the possibility of sudden illness

Recent studies show that as many as one in five elderly people have anxiety that is significant enough to warrant therapeutic treatment.  There are many things that can make recognizing and diagnosing anxiety in the elderly difficult, but it is important that individuals seek treatment for their symptoms.

As we age, the likelihood of physical disability, illness, and death increases.  These things can be naturally anxiety provoking.  It can also be difficult for doctors to differentiate physical symptoms of anxiety from medical conditions, a problem that can often result in misdiagnosis or a delay in therapeutic treatment.  Diagnosis is further complicated by the frequent reluctance of elderly patients to discuss their emotional symptoms.

If you are concerned that your parent or another elderly loved one may be suffering from anxiety, try talking to them about their symptoms.  Anxiety can be treated in the elderly with great success.  By encouraging these individuals to get help, they can find relief from their symptoms, greatly improving their quality of life.  Let your loved one know that anxiety is common with aging, but that this does not mean that it must simply be accepted or dealt with.

Summary

Anxiety can and does happen to people of all ages.  Learning to recognize symptoms of anxiety in people close to us can be difficult, especially people that we see every day.  By learning how to recognize anxiety in different individuals, however, you increase the chances that you can encourage them to get the help they need and that they will be able to receive prompt treatment to help them resolve their symptoms.

When someone you love is diagnosed with a panic or anxiety disorder or when you suspect that their actions and behaviors may be symptoms of one, it is important for you to learn all that you can so that you can be an effective part of their treatment and recovery.  In this last section, we will work to help you learn the signs and symptoms of anxiety in people around you, including spouses, children, parents, and friends.  We will look at how signs of anxiety differ between age groups and what can cause anxiety disorders in people of different ages.

In addition to helping you recognize signs and symptoms of an anxiety disorder, we will help address the most common questions and concerns.  We will help you learn what you can do to encourage a loved one to seek treatment for an anxiety disorder as well as what you can do to help.  This includes joining support groups, being there where you are needed, and even communicating in a way that lets your loved one know that you are not judging them.

We will also help you learn when you may be doing too much or when someone’s anxiety may be affecting you negatively.  Ensuring that relationships are healthy is always important, and anxiety should not be a reason for someone to hurt you or take advantage of you.  Knowing how to recognize when a relationship is unhealthy for you both is an important part of caring for someone you love.

It is my hope that this section provides you with the tools you need to help your loved ones.  Anxiety is never easy, and it can be even harder when it is our loved ones who are suffering.  With the right knowledge and with the willingness of your loved one to seek help, you can both get through this together.

Recognizing the Signs and Symptoms

When you care for someone and spend a great deal of time with them, you might think that you would instantly recognize if they developed an anxiety disorder.  The truth of the matter, however, is that these disorders often happen so slowly and gradually that it can be hard to notice that something has changed until symptoms have become severe.  Because anxiety can present in so many ways, it is also common for people to think that their loved ones have just become moody.

In this chapter, we will take a deeper look at how you can recognize the signs and symptoms of anxiety in someone that you love.  Whether you suspect that your child, spouse, parent, or friend is suffering, identifying the warning signs can help you ensure that they are able to get the treatment that they need.  The faster someone is able to receive treatment for their anxiety, the more likely that they will be able to recover quickly before the condition becomes disabling or starts to severely affect their daily functioning.

Recognizing Anxiety in Children

Recognizing anxiety in children can be difficult.  Young children are just starting to develop their personalities and test their boundaries, and sometimes it can be hard to tell the difference between normal boundary establishment and moodiness and anxiety problems.  Anxiety is also a normal human response in certain situations, which can also make it harder to tell if your child’s symptoms are signs of a disorder or just a response to natural stresses at home or at school.

Another thing that can make it hard to recognize signs of anxiety in children is that they may be unable to properly express their feelings, symptoms, or emotions in a way that can convey to you that something may be amiss.  In many cases, they may not even realize that their thoughts or behaviors are not normal.  Because of this, it is up to you to notice when something may be wrong.

What follows are some symptoms that may indicate that you should talk with your child or consider speaking with a counselor or therapist:

• Excessive worry over school assignments

• Repeating the same assignment, task, or action over and over because it is not just right

• Childhood fears start to interfere with daily life or reach proportions that cause severe distress

• Panic attacks

• Clinging or whining behavior that displays a constant need for support and companionship

• Compulsive, repetitive actions, such as repeatedly checking under the bed, washing hands, or counting

• Recurrent nightmares, persistent insomnia, emotional disconnect, or intense fears following loss or another trauma

• Sudden decrease in concentration that disrupts school or home function

• Becoming unusually critical of themselves

• Unjustified but persistent worry

• Compulsive nail biting or hair pulling or nervous tics

• Self harming behaviors such as cutting

• Drug or alcohol use or other self medicating behaviors

• Withdrawal from social activities and situations

• Physical illnesses such as stomach upset and headaches that have no medical cause

All of these symptoms can be red flags for parents.  Recognizing anxiety symptoms in your children may not always be easy, but symptoms such as these should certainly prompt concern. It is common for parents to worry what others will think if their child is diagnosed with a mental illness, but studies show that children who receive prompt treatment for anxiety disorders are often able to recover fully.  Unlike adults, children and adolescents are still forming their personalities and behavior patterns, which makes it much easier for cognitive behavioral therapy to teach new thought patterns, behaviors, and techniques that will reduce or even eliminate symptoms of anxiety and panic.

Research shows that with proper treatment, assuming that a patient is compliant with treatment and makes a viable effort to recover, the long term prognosis for anxiety disorders is very good.  The prospects for recovery are often excellent, and even in the absence of total recovery, treatment can offer a significant reduction in symptoms.  Significant improvement is often seen in patients seeking treatment for even the most severe anxiety disorders, and most patients can see a vast improvement with only weeks or months of therapy.  With that said, however, longer term therapy is often recommended for people with chronic or long term anxiety disorders.

With this in mind, let’s close this section by taking a deeper look at the prognosis for each of the anxiety disorders discussed in the first part of this book.  Keep in mind that these are averages and that with treatment; you may see greater or lesser improvement in your symptoms.

Generalized Anxiety Disorder

The prognosis for patients with GAD is often very good.  About fifty percent of patients receiving appropriate therapeutic treatment start to respond positively within about three weeks of starting the treatment.  By about nine months, about eighty percent of patients experience improvement in their symptoms.  The prognosis can depend on the severity of the condition as well as the willingness of the patient to comply with all parts of treatment.

Social Phobia/Social Anxiety Disorder

The prognosis for patients with social phobia who undergo appropriate treatment and are compliant is excellent.  In fact, according to research done by the National Institute of Mental Health, about eighty percent of patients experience relief from symptoms or overcome their fears.  This is certainly a very good prognosis and one that serves to indicate how important it is for people with social anxiety to seek out appropriate treatment.

Obsessive Compulsive Disorder

Obsessive-compulsive disorder, or OCD, is a chronic condition, or one that can last for the patient’s lifetime.  With this in mind, however, it is important to note that therapy can be highly effective.  Studies show that about fifty percent of patients with OCD respond positively to therapy with a decrease in symptoms.  About ten percent of patients recover entirely from their symptoms, and only ten percent seem to see a worsening in symptoms despite therapy.  For patients with long-lasting OCD, long-term therapy can help offer greater benefit and symptom reduction or maintenance.

Post Traumatic Stress Disorder

The prognosis for posttraumatic stress disorder, or PTSD, depends on a large number of factors.  In general, the prognosis for this disorder is certainly positive, with about thirty percent of patients eventually recovering completely with appropriate therapeutic treatment.  Another forty percent of patients will recover almost fully, with only less intense symptoms still remaining.  Factors that can influence the overall prognosis of a patient include ongoing stress levels and coping skills, substance abuse or use, the presence of a social support network, and the willingness to comply with and stay in treatment.

Acute Stress Disorder

The prognosis for acute stress disorder is generally excellent.  In fact, a majority of people diagnosed with this condition recover completely.  Only about one in ten people with the diagnosis see no improvement in their condition or an increase in severity, and studies show that behavioral therapy offered as soon as possible after the trauma can decrease the likelihood of the patient developing PTSD as a result by as much as twenty percent.

Agoraphobia and Specific Phobia

According to the National Institute of Mental Health, the prognosis for people with agoraphobia (in the absence of panic disorder as an accompanying diagnosis) and specific phobias is excellent.  In fact, some seventy five percent of patients with one of these diagnoses overcome their fears through treatment with cognitive-behavioral therapy.

Panic Disorder

The prognosis for people with panic disorder is often good, presuming they receive appropriate treatment.  Between thirty and forty percent of patients become symptom free for extended periods of time, and another fifty percent of patients experience only mild symptoms that do not affect their daily lives in a significant manner.

Summary

Reading these prognoses should provide patients with anxiety and panic disorders with a good reason to seek treatment.  Therapy can be remarkably effective at reducing or eliminating symptoms of these disorders, and in many cases can even do so on a long term or permanent basis.  Recovery depends greatly on a willingness to comply with and continue treatment as long as needed as well as on treating any underlying or concurrent disorders.  With the proper treatment, the prognosis for anxiety disorders is indeed a good one, and that is something that should provide patients with a great deal of hope.

Overburdening or Under-communicating?

Trying to find a perfect balance in how much you rely on others can be very difficult for people who are fighting symptoms of anxiety and panic.  For some individuals, a fear of putting too much of a burden on someone leads them to try to fight and manage their symptoms almost entirely alone, while for others the willingness of other people to provide support can be relied upon too heavily, keeping loved ones from living their own lives.

It is important to try to strike a healthy balance.  Communicating with your loved ones about how you are feeling and asking for help when things are overwhelming is absolutely essential.  People who love you will want to support you and are willing to offer a hand when you need it.  Neglecting to tell others when symptoms are overwhelming can make them feel as though you do not trust them or that you do not need them.  If your loved ones do not know that your symptoms are creating problems for you, they may also misread signs of anxiety as signs that you are angry with them.

On the opposite side of the coin, it is important to ensure that you are not fully dependent on loved ones for your every need.  Social anxiety, for example, can often present with a fear of being alone.  For people who have this diagnosis, it is important to ensure that you are not so reliant on loved ones that you do not allow them to leave the house.  Asking for help when you need it is important, but it is equally important to ensure that you are not asking others to help you at the sake of their own mental and physical well being.

Maintaining Marital Bliss

For married people with anxiety, it is almost impossible for your symptoms not to impact your relationship.  After all, a healthy partnership is about communication from both sides.  What you can do, however, is ensure that your anxiety is not having a detrimental effect on your marriage or on your spouse.

Communication is essential in any marriage, but when you have anxiety, it is key.  You need to always keep lines of communication open and honest in both directions, sharing your anxiety and how you feel and allowing your spouse to tell you without judgment when they are feeling overwhelmed.  Let your partner know what you are experiencing and how you are dealing with it.  Understand that while being high strung or experiencing sudden mood changes may seem normal to you when you are experiencing them, your partner is not feeling the same things that you are.

A good idea is to make time to speak openly and honestly with your spouse whenever possible.  Remember that no matter how hard you try, your anxiety will certainly affect you both.  You need to be certain that both of your needs are being met.  If your spouse is a social person but you have developed anxiety about going out in public, you need to ensure that you still allow your loved one the ability to go out and enjoy the things that matter to them.

Couples cannot only survive one partner having an anxiety disorder, they can still manage to thrive.  Maintaining open lines of communication and working hard to ensure that everyone’s needs are met can go a long way.  Always tell your spouse how you are feeling and make sure you listen when they tell you how they are affected by your anxiety as well.  With good communication, you can ensure that your anxiety and panic does not have to spell disaster for your relationship.

What about the Kids?

Everyone who lives with someone who has anxiety is affected in some way, including your children.  Even if they do not understand what is happening or have the ability to communicate what they are feeling, the simple truth is that kids notice when things are different.  If you do not work hard to manage your symptoms, your anxiety can certainly have a negative impact on your children.  With that said, however, it is important to realize that parents with anxiety can still be fantastic parents.  It all comes down to managing your symptoms and ensuring that you are mindful of how your words and behaviors impact your kids.

As mentioned in earlier chapters in this book, in addition to genetic links, observed behaviors can also create anxiety disorders in children.  If your little ones observe that their going outside makes you fearful and anxious, it will begin to create a sense of fear and anxiety in them as well.  Likewise, if your children live in an environment where you are prone to explosive anger or outbursts of emotion, they are more likely to develop these traits.

There are a number of parental traits and behavior that can affect your children in a negative way and increase their likelihood of developing anxiety.  Studies show that children raised in a household with parents who have an anxiety disorder are about seven times more likely to develop one themselves, but staying aware of your actions, seeking treatment for your condition, and possibly even providing therapy for your children can all help to decrease this risk.  Studies show that cognitive behavioral therapy for children of parents with an anxiety disorder can be incredibly effective at helping to prevent the development of anxiety disorders.

What follows are a few behaviors common to parents with anxiety disorders that can increase your child’s chances of developing anxiety:

• Excessive or constant expression of fear or anxiety

• Infrequent expressions of affection

• Over-protectiveness or not allowing the child to engage in social behavior

• Possessiveness of the child

• Poor parent-child communication

• Excessive criticism of the child’s behavior

As more and more research is conducted about the link between parental anxiety and the development of anxiety disorders in children, more doctors than ever are recommending therapy for these children.  There is no way of knowing whether or not your child will develop an anxiety disorder, no matter how well you monitor your displays of anxiety in front of him or her.  Therapy offers the best chance at decreasing the odds, and seeking treatment of your own while working to keep from increasing your child’s anxiety can make a major difference.

What About Your Friends?

Anxiety affects every relationship in your life in some way, and friendships are no different.  In fact, if you have a number of very close friends, it may make one of the biggest impacts of all on this area of your life.  Your friends likely know you inside and out, and they have come to understand your habits, your likes and dislikes, and the way that you typically live your life.  So what happens when anxiety starts to take over?

For most people who develop anxiety or panic disorders, one of the ways that they manifest is in a decreased desire to attend social functions, whether out of social anxiety or a fear that they will experience a panic attack.  If you neglect to tell your friends about your symptoms, they will be left to make their own assumptions about why you keep changing plans or declining invitations.  They may start to think that you are no longer emotionally invested or interested in maintaining a friendship or that you are starting to feel that you are too good for them.

Even if you have informed your friends about your anxiety it is likely to affect the relationship.  It is important to ensure that you are able to talk to your friends about what you are feeling and experiencing and that you can rely on them when times get tough, but it is also important not to become too dependent on them.  Many people with anxiety end up relying on a close friend to start completing many of their tasks, such as shopping, so that they can avoid anxiety-provoking situations.  Not only can this make your friend feel as though you are taking advantage, but it enables your anxiety and can serve to make your symptoms worse.

It is important to strike a balance between what you take from your friends and what you contribute to the relationship.  Good friends will stick by you through thick and thin, but it is important that you seek the treatment you need to ensure that the relationship is healthy for everyone involved.  Your friends shouldn’t have to suffer for your anxiety.

When you are honest with your friends about what you are feeling, you will find that they can often help you to overcome your symptoms.  You may even want to consider asking a close friend to come to a therapy or support group session with you so that they might better understand what living with anxiety is like and what kind of skills you are learning to help you deal with anxiety.  Your friends will always want to see you get better, and you might be surprised how much your relationship can benefit from allowing them the chance to better understand your anxiety disorder.

Anxiety and Work Don’t Always Mix Well

While some people find that their careers offer a great way for them to get away from stress or to focus on things that help take their minds off of stress and anxiety, this is not always the case.  In fact, for some individuals, anxiety disorders can severely impact job performance.  There are a number of ways that anxiety disorders can affect your career, and it may take a great deal of work to help ensure that this is not the case.

One way that anxiety often starts to affect job performance is that it can create difficulty concentrating, which can mean more errors and reduced productivity.  Depending on your career, this can have a severe impact.  Anxiety also commonly causes mood disturbances, which can create conflicts between the sufferer and their coworkers or can even impact interactions with clients and customers.

Depending on the severity of your anxiety disorder and the type of disorder that you have, fears and phobias can also affect performance.  Social phobia can cause some employees to start missing meetings and conferences and to start missing more days of work than usual.  Phobias and panic disorders may cause employees to stop using elevators or to avoid certain assignments due to a fear of groups, of travel, or of getting on an airplane.  Fear of public speaking can also cause job difficulties.

If these symptoms are starting to impact your job, it might be time to be honest with your employer about what is going on.  Depending on your job, they might be able to help make certain accommodations for you.  Your employer might also be able to connect you with an employee assistance program, which many of today’s businesses are establishing to provide mental health counseling and treatment for employees who are experiencing problems that affect their ability to do their job.

Speaking openly and honestly with your employer about your anxiety disorder can certainly be a frightening experience.  Many people worry that they will lose their jobs or that their employers will lose faith in them.  It is up to you to determine if you might benefit from speaking to your employer, but if your anxiety is impacting your performance, it is safe to assume that your employer has noticed.

Letting your employer know that there is an explanation for the change and that you are seeking help for your symptoms will let them know that you haven’t just stopped trying or that you haven’t lost interest in the job.  It is often said that honesty is the best policy, and this is certainly a good time to employ that rule.  It is up to you whether or not you also choose to inform your coworkers about your anxiety, and you may wish to consider whether this knowledge would help or harm your relationship as coworkers.

Summary

If you suffer from an anxiety disorder, it is important for you to realize that it definitely impacts those closest to you.  No matter how hard you strive to protect your loved ones from your anxiety, your symptoms will make a difference in their lives.  With this said, however, the impact does not have to be a negative one.

Take the time to let those closest to you know what is happening with you.  If they are interested, allow family members or friends to attend a therapy or support group session with you so that they may better understand your condition.  Consider the idea of allowing your children to attend therapy sessions of their own so that their risk of anxiety disorders is not increased.  It may be difficult to limit the impact that your anxiety has on others, but with the right actions, you can help ensure that the impact is not a  negative one.  Friends and family members care about you and will want to do whatever they can to help.  Allowing them to understand your illness and ensuring that you are working to maintain a healthy relationship can ensure that your relationships are beneficial for everyone involved.

One thing that is important to understand is that feeling anxiety in and of itself is not wrong.  While the goal of treatment for anxiety disorder is to help alleviate feeling of anxiety and panic in the absence of a cause, this does not mean that anxiety is always a bad thing.  In fact, it is a natural part of your body’s stress response system and it can help motivate you in a crisis to be able to function when your emotions threaten to overwhelm you.

Bad things happen to all of us.  Losing a loved one, finding yourself without a job or a home, or enduring trauma can occur.  If this happens to you, understand that it is okay to feel anxious.  Anxiety is never pleasant, but it can be an important part of handling a crisis.  What matters is that you do not let anxiety or panic take control of you.

Remember Therapeutic Techniques

While the techniques you learn in therapy are typically taught to help you manage anxiety in times when it is unnecessary, it is important to realize that your brain doesn’t only respond to them in these times.  Relaxation techniques and cognitive behavioral therapies can be equally effective at helping to relieve anxiety and panic whenever you are dealing with a real life crisis.  If your symptoms are becoming unmanageable or if they are affecting your functioning and making it hard for you to deal with the crisis at hand, don’t hesitate to employ the things that you have learned in therapy to help you better cope with the situation.

Controlling your breathing and working to avoid negative thought patterns is an important part of dealing with necessary anxiety as well as anxiety that occurs without provocation.  Taking the time to slow your heart rate or to remind yourself that your anxiety and panic are not permanent and not dangerous can help you keep a level head so that you can deal with whatever the situation at hand may be.

Put Yourself First

When a crisis occurs that involves loved ones, it can be easy to put your own needs on the back burner.  Part of properly dealing with anxiety and panic is putting your own needs first.  Focus on what it takes to stop your own panic and anxiety before you start trying to help others cope with their feelings and emotions.  Much as airlines remind you to secure your own oxygen mask before helping other people with theirs, you need to ensure that you are safe and that your emotions are under control before you can worry about helping others through a crisis.  If you are overwhelmed by panic and anxiety, you are going to find that you are unable to help others and that you may even create panic for other people.  Take the time to do what it takes to help yourself first.

Stay In the Moment

In times of crisis, panic and anxiety can always seem like they are just on the verge of erupting.  One of the best things that you can do in times like this is to work hard to stay in the moment and to just focus on what is happening in the present.  With a crisis, it is common to worry about what the long-term effects will be or what the future will hold, but this sense of worry and anxiety about things to come is not helpful to you.  You can’t change the future right now, and staying mindful of the present can help you prevent excessive anxiety and panic.

When dealing with times of crisis, ensure that you are trying to be mindful of what is happening in the moment.  Remind yourself that you may be feeling worry or stress right now, but that you are okay.  Instead of looking to the future, try to be mindful of what is happening right now, in this very moment.  Respond to symptoms of anxiety rather than reacting to them.  If you feel your heartbeat starting to race, instead of reacting by worrying, choose instead to respond by changing your pattern of breathing.

If you are having a hard time focusing on the present, practice mindfulness techniques that can help you get back into the here and now.  A great idea can be to use your senses to help you stay in the present.  Make an effort to find and name five things that you can see in that moment.  Name things that you can physically feel in the moment, such as your feet touching the floor or your legs touching the chair, or name things that you can hear in the moment.  This will help keep you aware of where you are and keep you from worrying or focusing on the future.

Know Your Limits

In times of family crisis and other emergencies, it is common for people to reach out to others for help.  Ensuring that your loved ones are okay is instinctive, but it is important for us to know our own limits.  You need to recognize when you are capable of offering support and guidance and when you are too emotionally or physically overwhelmed to do so without causing yourself emotional harm.

Understand that telling your loved ones that you are unable to provide support is not mean.  It is a matter of self-preservation.  Giving more than you can afford emotionally or physically can make symptoms of anxiety and panic significantly worse.

Don’t Be Afraid to Reach Out

If a crisis is causing you to become too overwhelmed and you find that symptoms of anxiety and panic are not resolving from coping strategies that you have learned or practiced in therapy, don’t hesitate to reach out.  Tell a family member or friend that you are feeling overwhelmed, call your therapist, or contact the after-hours number for your therapist’s practice if one is available.  You don’t have to deal with a crisis alone, and you shouldn’t stay in a situation that is causing you severe symptoms without any way to help manage them.  If you need help, don’t be afraid to seek it.

There is no shame in reaching out to others, and it can show your loved ones that you are serious about recovering from your anxiety.  It can be a wonderful idea to build a contact list of people you can contact in case of an emergency.  This list should include friends and family members, your therapist and their crisis number, and anyone else that you trust in times of crisis.  Your minister or clergy can be wonderful additions to this list, as well as local and national anxiety and crisis hotlines.

Summary

As much as we would like to think that we will never encounter a crisis, the simple truth is that they can and do happen.  Another very important truth to keep in mind, however, is that you can deal with them.  A crisis is a temporary situation and it is something that you can overcome.  Even when the worst things imaginable happen, such as losing someone close to you, you can move beyond it.  Feelings are always valid, but you need to be certain that you do not let anxiety and panic take over when trying to deal with an emotional situation.

One of the most popular methods of stopping hyperventilation is paper bag breathing.  This method is designed to help regulate the levels of oxygen and carbon dioxide in your blood.  To stop hyperventilation with the paper bag method, follow these simple steps:

• Hold the paper bag over your nose and mouth using your hand

• Take between six and twelve normal breaths while holding the bag in place, breathing in and out of the bag

• Take the bag away when your breathing starts to feel normal again

Diaphragm breathing is another popular method of stopping hyperventilation, and it is slowly gaining favor over the paper bag method with doctors and health professionals who worry that the paper bag method can allow too much carbon dioxide to accumulate in the blood.  To use diaphragm breathing, follow these easy steps:

• While standing up or lying on the floor with both knees bent, put one hand on your chest and one on your stomach just below your ribs

• Take a deep inward breath, allowing the air to push your stomach outward while keeping your chest still

• Count to seven slowly while inhaling

• Now, purse your lips like you would if you were whistling and slowly exhale through your mouth, allowing your stomach to deflate

• Count to twelve while you exhale

• Repeat five to ten times or until symptoms subside and breathing returns to normal

Calming Racing Thoughts

Racing thoughts are characteristic of anxiety and panic disorders.  This can be a very disturbing symptom, and it is one that can occur at almost any time.  When your thoughts are racing, it can be hard to focus on a single idea or to express what is on your mind.  Learning how to calm racing thoughts can help alleviate anxiety.

One great tip to help prevent racing thoughts from occurring is to actually start and end each day with goal setting and reflection.  When you get up each morning, take the time to set a list of goals for your day.  Decide what you want to accomplish, set up an order for your tasks, and work to stick as closely to your schedule as possible.  When you already know what you have to do, you are less likely to suddenly find yourself bombarded with thoughts about everything that needs to be done.

At the end of the day, spend a few minutes reflecting on the occurrences of the day.  Examine whether your goals were accomplished and spend time thinking about anything unusual or significant that happened.  By setting aside a specific time for this, you can help prevent racing thoughts while you are trying to go to sleep.

Practicing positive affirmations can be another excellent way to help stop racing thoughts.  You will find that more often than not, racing thoughts are negative.  You will likely find yourself with a racing list of things you haven’t accomplished, things that could go wrong, or other negative thoughts.  By starting and ending each day with positive affirmations and saying them whenever you start to feel stressed, you help to change your overall cycle of thought.

Easing Muscle Tension

Muscle tension is a very common symptom for people with anxiety, and it is one that can be very bothersome.  Whether you are trying to do your job, trying to relax, or trying to go to sleep, muscle tension can be very disruptive. It can also create headaches, backaches, and other pains.  Alleviating muscle tension is a great way to reduce anxiety, and there are a number of different ways that you can achieve it.

Staying hydrated is a surprisingly effective way to help reduce muscle tension.  Everything that we do requires our bodies to consume water, and studies show that most people aren’t taking in a sufficient amount of it.  Whenever we are dehydrated, our muscles become tense.  Anxiety also causes muscle tension, and dehydration causes anxiety.  These three things are very strongly connected, and hydration is the easiest of the three to treat in order to help break the cycle.

Exercise can also be very effective.  Whenever you exercise, you are stretching your muscles and alleviating excess tension.  Exercise also gets rid of stress and produces natural mood improving hormones.  The link between exercise and anxiety relief has been well proven, and it is generally a good idea to get some exercise every day.

Progressive muscle relaxation can be a simple way to relieve muscle tension when you are at work or in bed.  In order to do this, simply start at your toes, tightening the muscles while you slowly count to five and then relaxing them.  Next, move to the muscles in your feet, then your calves, then your thighs, and so on, until you make it all the way to your head.  When you have tensed and relaxed each muscle group, you will likely feel a great deal more relaxed.

Last, consider meditation or yoga as a means of easing muscle tension.  Both of these practices are designed to help you let go of excess stress and tension, both in your mind and your body.  Learning these practices can also be incredibly helpful at combating other symptoms of anxiety and panic.

Stopping or Easing Fatigue

Fatigue can be a particularly troublesome symptom for people with anxiety and panic disorders for a number of reasons.  When you are fatigued, it can be harder to concentrate on tasks at work, school or home.  Fatigue can make driving and operating machinery dangerous and it can also make you considerably more vulnerable to panic attacks.  But what can you do to stop it?  There are actually a number of things that can help anxiety sufferers reduce fatigue.

One thing that can help stop fatigue is to cut any stimulants out of your diet.  While caffeine may provide the sensation of being more awake and alert, it also causes significant crashing over the course of the day, creating a great deal of fatigue.  Eliminating caffeine and nicotine can help prevent symptoms of fatigue.  Cutting alcohol out of your diet can also be very effective, as your body consumes a great deal of resources trying to eliminate the toxin from your system, leading to increased fatigue that can last for days.

In addition to cutting certain things out of your diet, you will find that adding certain things to your diet can be helpful as well.  B Vitamins are excellent at helping to improve energy levels in a safe way.  Gingko Biloba is excellent for memory and concentration, and Omega 3 fish oils can also help to greatly improve focus and concentration.

Another effective means of combating fatigue is to exercise.  Vigorous exercise such as running or using an exercise bike will increase blood flow and circulation, helping to improve energy and boost your metabolism.  It can also ease muscle tension and help get rid of excess hormones that can cause anxiety and other mood problems.  This will help keep your body going throughout the day and will also make it easier for you to get a good night’s sleep, which is another essential part of fighting fatigue.

Using techniques to help improve sleep is also important.  As mentioned elsewhere in this book, try to keep a regular sleep schedule so that your body gets more rest.  Eliminate unnecessary distractions to help make your sleep more beneficial.  Make certain that your room is used only for sleep, as using it to surf the web, watch television, or perform other tasks can take away your mental image of your bedroom as a place of peace and respite.  If you are feeling overly anxious or overwhelmed by emotion, consider going into another room or walking around for a moment.  You want to associate your bedroom only with sleep and relaxation, and when you can do this it can help make sleeping much easier and more restful, which can have great benefit on your anxiety symptoms.

Last, if your fatigue is caused by stress and worry, set aside fifteen to thirty minutes each day to allow yourself to focus on the things that cause these symptoms.  Spend this time each day worrying, fretting, or thinking about the things that cause you concern and forget about them for the rest of the day.  This can take a bit of work and mindfulness, but it can be done.  If you experience a stressful or worrisome thought outside of this thirty-minute period, simply acknowledge it and let it go.  Don’t give these thoughts any merit until it is time to think about them, and when the thirty minutes is over, move on to something else.

Summary

Anxiety can produce a wide variety of symptoms that, when individually managed, can make living with anxiety or panic disorders much more manageable.  Learning how to deal with individual symptoms can take some practice, but you will find that it can be very helpful.  By working to treat or eliminate symptoms one by one, you can help to create a chain reaction that reduces other symptoms as well.  When you experience fewer symptoms, anxiety becomes more manageable and treatment can be more effective.