Getting Help For Anxiety
Managing anxiety often involves learning more about whats causing it.
While addressing anxiety early can make treatment easier, strategies exist to help you cope with anxiety however long youve had it.
Therapy is highly effective for learning to manage anxiety. A therapist can help you by taking a closer look at your beliefs, thoughts, and behaviors.
No matter the cause of your anxiety, theres a coping strategy out there that fits your needs and goals. Learn more about treatment options for anxiety.
How Does Medication Treat Anxiety Disorders
Medications cant cure an anxiety disorder. But they can improve symptoms and help you function better. Medications for anxiety disorders often include:
- Anti-anxiety medications, such as benzodiazepines, may decrease your anxiety, panic and worry. They work quickly, but you can build up a tolerance to them. That makes them less effective over time. Your healthcare provider may prescribe an anti-anxiety medication for the short-term, then taper you off or the provider may add an antidepressant to the mix.
- Antidepressants can also help with anxiety disorders. They tweak how your brain uses certain chemicals to improve mood and reduce stress. Antidepressants may take some time to work, so be patient. If you feel like youre ready to stop taking antidepressants, talk to your provider first.
- Beta-blockers, usually used for high blood pressure, can help reduce some of the physical symptoms of anxiety disorders. They can relieve rapid heartbeat, shaking and trembling.
Your healthcare provider will work with you to find the right medication combination and dosage. Dont change the dose without consulting your provider. Theyll monitor you to make sure the medicines are working without causing negative side effects.
Anatomical And Neuroimaging Findings In Posttraumatic Stress Disorder
Activation of the amygdala is important for the fear learning associated with PTSD symptoms and with extinction learning associated with PTSD treatment. Amygdala hyperresponsiveness has been identified in numerous studies of patients who have PTSD . Greater activation of the amygdala in response to viewing fearful faces corresponded with poor prognosis in CBT other studies have shown that severity of PTSD symptoms predicts the magnitude of amygdala activation when encoding memories unrelated to the traumatic event.
A recent study examined the neural correlates of responsiveness to CBT in Iraq war veterans who had PTSD. Avoidance symptoms of PTSD are thought to result from conditioned fear-like encoding of the environment surrounding a traumatic event. CBT in PTSD attempts to override the conditioned fear with extinction learning. In patients who had recently diagnosed PTSD, rostral ACC volume predicted a successful CBT response. It is possible that decreased rostral ACC volume results in a decreased ability for extinction learning. Thus, patients who have PTSD and who have a smaller ACC volume may be less able to regulate fear during therapy, rendering the CBT process less effective. Functional imaging studies have shown that greater activation of the ventral ACC in response to viewing fearful faces corresponded with a poorer response to CBT.
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Biological Causes Of Anxiety Disorders
Genetics and biology play a role in the creation of anxiety disorders. Not only does anxiety appear to run in families – if you take two people with similar experiences, one may have an anxiety disorder, one may not, and the only difference between them may be genetic, or at least influenced by the body more than the mind. Biological causes include:
Genetic Contribution To Social Anxiety Disorder
The Neurobiology of Anxiety Disorders Unfortunately, there are very few studies specifically examining the genetic underpinnings of SAD. Available data suggest that SAD has a high degree of familial aggregation. In a recent meta-analysis in which SAD was grouped with specific phobia and agoraphobia, an association between phobia in probands and their first-degree relatives was identified.
Twin studies in social phobics suggest that additive genetics is responsible for increased incidence of SAD in monozygotic compared with dizigotic twins and suggest no role for common environmental experiences. Adult twin studies of combined phobia diagnoses suggest that the additive genetics accounts for 20% to 40% of the variance in diagnosis. This result corresponds with a population-based twin study of adolescents diagnosed with social phobia, MDD, and alcoholism, in which genetics accounted for 28% of the risk variance for SAD. Again, the remaining risk was derived from non-shared environmental experiences. Unlike MDD and PTSD, there is little evidence that early-life trauma influences the risk for developing SAD in adulthood.
Genes associated with high behavioral inhibition include CRF and SERT. Internalizing neuroticism is associated with the gene encoding glutamic acid decarboxylase, the rate-limiting enzyme in the synthesis of GABA from glutamate .
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What Stress And Anxiety Do To The Brain Over Time
This survival response is helpful and necessary when we encounter a real threat, but in excess, can cause long-term damage to our bodies. The effects of chronic stress have been linked to a weakened immune system, weight gain, and heart disease, among other issues.
But new research is finding a possible correlation between prolonged stress and anxiety, and structural degeneration of the hippocampus,
and impaired functioning of the prefrontal cortex. This means that the wear and tear caused to the brain by chronic stress or anxiety could be tied to an increased risk of depression and dementia.
The good news is that some of the damage incurred from chronic stress and anxiety is not completely irreversible, according to some experts. It was long believed that once a brain lost volume, it was gone forever, but we now know thats not entirely true. Our brains are plastic, meaning theyre capable of change. This plasticity allows our brains some degree of regrowth and regeneration.
The best way, however, to protect your brain and body from the effects of chronic stress and anxiety is to find a way to manage it before it begins to affect your health. Luckily, there are many different options for managing these conditions.
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Anatomical And Neuroimaging Findings In Patients Who Have Generalized Anxiety Disorder
Structural imaging studies have shown high ratios of gray matter to white matter in the upper temporal lobe of pediatric patients who have generalized anxiety disorder . Pediatric patients who have GAD also exhibit increased amygdala volume, which may correspond to the stress-induced amygdalar hypertrophy observed in laboratory animal studies .
In functional imaging studies of adolescent patients who have GAD, resting vlPFC activity is elevated relative to healthy control subjects. Because the vlPFC activity correlates negatively with symptom severity, the elevation in vlPFC metabolism is interpreted as a compensatory response rather than an underlying cause of GAD. Because of observed hypermetabolism in the PFC of patients who have GAD, neuronal viability has been assessed in this region as measured by the ratio of N-ace-tylasparate to creatine using proton MRS. For patients who had GAD, neuronal viability was increased in the right dorsolateral PFC in those without early-life stress but was decreased in those who self-reported early-life trauma.
Interconnectivity with brain regions responsible for interpreting social behavior may be one mechanism by which the amygdala plays a substantial role in anxiety disorders. The brain regions responsible for interpreting social behavior include the superior temporal gyrus, thalamus, and PFC. Amygdala hyperactivity may mediate the inaccurate interpretations of social behavior in patients who have GAD.
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Why Are Rates Of Anxiety Increasing
Anxiety in its several forms, including phobias and social anxiety, is the most common mental health disorder in the U.S. Population-based surveys indicate that about a third of adults in the U.S. will grapple with disabling anxiety at some point.
High as the number is, there is someand sometimes conflictingevidence that the prevalence of anxiety is increasing, especially among the young. Several factors are thought to be responsible for a rise in prevalence. In general, as the middle class erodes, there is growing economic uncertainty for much of the population. The high cost of health care also creates a burden of chronic worry about getting sick. In addition, a lack of coping skills, emotion regulation skills notably among them, is said to be making younger people vulnerable to a number of mental health disorders, particularly anxiety and depression.
Social media are singled out for their especially pernicious effect on young teens, because they introduce a means of constant social comparison and, through it, self-doubtand that self-doubt drives further social media use, with compounding negative effects. In addition, dating and mating practices are far less structured than in past eras, and digital forms of communication create so much ambiguity that young people are often clueless about where they stand in romantic relationships. Ambiguity typically breeds anxiety.
Environmental Causes Of Anxiety Disorders
We have spent a lot of time on CalmClinic discussing the biological and genetic components of anxiety. But for most people, anxiety is going to be largely environmental. For some, it may be difficult to find the cause at all, because not all anxiety is as simple as pointing to a specific moment.
Even if you have a genetic predisposition to anxiety , your environment is going to play a key role in whether you develop an anxiety disorder. Most believe that environment plays a triggering role in anxiety disorders, and in some cases may cause anxiety disorders by themselves.
In this case, environment includes everything that is not genetic – every experience you have, every place you go, and everything youve been taught.
According to a study of monozygotic twins and dizygotic twins , monozygotic twins – who both share the same DNA – were twice as likely to develop anxiety disorders than fraternal twins, but in each of these cases their genetics did not guarantee an anxiety disorder, which indicates that environment still plays a role.
Its also strongly believed that people can develop anxiety disorders from the environment alone. This is supported by the idea that anxiety can be treated without any medicine or surgery, indicating that a great deal of mental health is forged by life experiences.
Common environmental causes of anxiety include:
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Diagnosing Generalized Anxiety Disorder
Several approaches are usually needed to diagnose generalized anxiety disorder:
Medical history. Your answers to questions about how you are feeling, your habits and lifestyle, and your medical history may offer important clues.
Physical exam. Sometimes generalized anxiety disorder is linked to an underlying medical condition such as an overactive thyroid gland.
Psychological evaluation. Your answers to questionnaires can help make the diagnosis.
The standard criteria for generalized anxiety disorder include:
- feeling anxious and worried most days of the week for at least six months
- having trouble controlling feelings of anxiety
- at least three of these symptoms in adults: restlessness, fatigue, trouble concentrating, feeling irritated, muscle tension, or sleep problems
- anxiety or worry that causes distress or interferes with daily life
- anxiety that isn’t related to another mental health condition
Many people with generalized anxiety disorder have another psychiatric disorder, most often depression or dysthymia, a less severe form of depression. They are also more likely to abuse alcohol or other drug. The effects of these drugs or the symptoms of withdrawal from them can raise the level of anxiety.
Physiological Effects Of Stress On The Brain
Stress is a chain reaction. When someone experiences a stressful event, the amygdala, an area of the brain that contributes to emotional processing, sends a distress signal to the hypothalamus, Harvard Health Publications of Harvard Medical School explains. This area of the brain functions like a command center, communicating with the rest of the body through the nervous system so that the person has the energy to fight or flee.
This fight-or-flight response is responsible for the outward physical reactions most people associate with stress including increased heart rate, heightened senses, a deeper intake of oxygen and the rush of adrenaline. Finally, a hormone called cortisol is released, which helps to restore the energy lost in the response. When the stressful event is over, cortisol levels fall and the body returns to stasis.
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The Best Nutrition For Anxiety Sane Foods
Focusing on whole foods, the SANE eating plan provides all the nutrition you need to reduce your anxiety. The 4 main SANE food groups are non-starchy vegetables, nutrient-dense protein, whole-food fats, and low-fructose fruits.
The addition of these foods plus the reduction of heavily processed foods and sugars will soothe your anxiety like nothing else. Wouldnt you rather be SANE than filled with anxiety?
Effects Of Chronic Stress On The Brain
While stress itself is not necessarily problematic, the buildup of cortisol in the brain can have long-term effects. Thus, chronic stress can lead to health problems.
Cortisols functions are part of the natural process of the body. In moderation, the hormone is perfectly normal and healthy. Its functions are multiple, explains the Dartmouth Undergraduate Journal of Science. In addition to restoring balance to the body after a stress event, cortisol helps regulate blood sugar levels in cells and has utilitarian value in the hippocampus, where memories are stored and processed.
But when chronic stress is experienced, the body makes more cortisol than it has a chance to release. This is when cortisol and stress can lead to trouble. High levels of cortisol can wear down the brains ability to function properly. According to several studies, chronic stress impairs brain function in multiple ways. It can disrupt synapse regulation, resulting in the loss of sociability and the avoidance of interactions with others. Stress can kill brain cells and even reduce the size of the brain. Chronic stress has a shrinking effect on the prefrontal cortex, the area of the brain responsible for memory and learning.
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What Is Separation Anxiety Disorder
This condition mostly happens to children or teens, who may worry about being away from their parents. Children with separation anxiety disorder may fear that their parents will be hurt in some way or not come back as promised. It happens a lot in preschoolers. But older children and adults who experience a stressful event may have separation anxiety disorder as well.
Anatomical And Neuroimaging Findings In Social Anxiety Disorder
As with PD and PTSD, amygdala activation has been implicated in symptoms of SAD. Social-cue tasks, such as the viewing of harsh faces, were associated with hyperreactivity in the amygdala and other limbic areas in patients who had SAD. Similarly, in response to viewing negative affective faces, patients who have SAD exhibited bilateral amygdala activation, which positively correlated with symptom severity and which reversed upon successful treatment. In anticipation of public speaking, subcortical, limbic, and lateral paralimbic activity is increased in patients who have SAD, suggesting elevations in automatic emotional processing. Decreased activity in the ACC and PFC in these subjects suggests a decreased ability for cognitive processing .
The combined results of imaging analysis in subjects who have SAD suggest dysfunction of a cortico-striato-thalamic network: hyperactivity in the right PFC, striatal dysfunction, and increased hippocampal and amygdala activity with left lateralization. It has been suggested that hyperactivity in the frontolimbic system, including the ACC, which processes negative emotional information and anticipation of aversive stimuli, could result in misinterpretation of social cues .
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Can Uncertainty Cause Anxiety
Uncertainty doesnt cause anxiety but it creates breeding grounds for anxiety, and the rise of uncertainty in much of public and private life may be one reason why anxiety has become the most prevalent mental health condition today. Worry, the cognitive component of anxiety, is activated by the mere possibility of a bad outcomeand for many modern concerns, possibility can almost never be ruled out entirely. But of course, possibility does not equal probability. Anxiety with its payload of worry can be seen as an attempt to avoid uncertaintyto dispel the discomfort it creates. The better approach, say experts, is to learn to tolerate some uncertainty and recognize that most of life is not black or white but shades of gray.
What Is The Difference Between Fear And Anxiety
Anxiety differs from fear in several important ways. Fear is a response to present danger it is usually highly focused, attached to a very specific thing or circumstance, and meant to mobilize fast action. Anxiety doesnt require an external stimulus it is a response to real or imagined future threat, and it is typically more diffuse, setting in motion the need for constant vigilance in anticipation of some calamity. Fear is contagious, marked by characteristic featureswidened pupils, pale skin that signal others to be afraid. Anxiety is highly subjective. While anxiety shares some of the physiological signs of fearheightened awareness and fast heart rate, similarly set off by the hormones of the stress responseit carries a heavy cognitive load of worry, a form of rumination about what might possibly go wrong in the future.
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Risk Factors For Anxiety Disorder
Some things also make you more likely to develop an anxiety disorder. These are called risk factors. Some risk factors you canât change, but others you can.
Risk factors for anxiety disorders include:
- History of mental health disorder. Having another mental health disorder, like depression, raises your risk for anxiety disorder.
- Childhood sexual abuse. Emotional, physical, and sexual abuse or neglect during childhood is linked to anxiety disorders later in life.
- Trauma. Living through a traumatic event increases the risk of posttraumatic stress disorder , which can cause panic attacks.
- Negative life events. Stressful or negative life events, like losing a parent in early childhood, increase your risk for anxiety disorder.
- Severe illness or chronic health condition. Constant worry about your health or the health of a loved one, or caring for someone who is sick, can cause you to feel overwhelmed and anxious.
- Substance abuse. The use of alcohol and illegal drugs makes you more likely to get an anxiety disorder. Some people also use these substances to hide or ease anxiety symptoms.
- Being shy as a child. Shyness and withdrawal from unfamiliar people and places during childhood is linked to social anxiety in teens and adults.
- Low self-esteem. Negative perceptions about yourself may lead to social anxiety disorder.