Anxiety              Panic Attacks             Social Anxiety

anxiety

You may be someone who thinks that you're the only one in the whole wide world with horrible anxiety symptoms.

Without exaggerating, many millions of people throughout the world at this given moment are going through exactly the same trauma that you are experiencing.  It is helpful to know that you aren't the only one going through the painful anxiety that you currently experience.

It’s normal to feel anxious when facing a challenging situation, such as a job interview, a tough exam, or a blind date. But if your worries and fears seem overwhelming and interfere with your daily life, you may be suffering from an anxiety disorder. There are many different types of anxiety disorders—and many effective treatments and self-help strategies. Once you understand your anxiety disorder, there are steps you can take to reduce your symptoms and regain control of your life.

Understanding anxiety disorders

Anxiety is the body’s natural response to danger, an automatic alarm that goes off when you feel threatened, under pressure, or are facing a stressful situation.

In moderation, anxiety isn’t always a bad thing. In fact, anxiety can help you stay alert and focused, spur you to action, and motivate you to solve problems. But when anxiety is constant or overwhelming, when it interferes with your relationships and activities, it stops being functional—that’s when you’ve crossed the line from normal, productive anxiety into the territory of anxiety disorders.

Do your symptoms indicate an anxiety disorder?

If you identify with several of the following 7 signs and symptoms, and they just won’t go away, you may be suffering from an anxiety disorder:

1.    Are you constantly tense, worried, or on edge?

2.    Does your anxiety interfere with your work, school, or family responsibilities?

3.    Are you plagued by fears that you know are irrational, but can’t shake?

4.    Do you believe that something bad will happen if certain things aren’t done a certain way?

5.    Do you avoid everyday situations or activities because they cause you anxiety?

6.    Do you experience sudden, unexpected attacks of heart-pounding panic?

7.    Do you feel like danger and catastrophe are around every corner?

Signs and symptoms of anxiety disorders

Because anxiety disorders are a group of related conditions rather than a single disorder, they can look very different from person to person. One individual may suffer from intense anxiety attacks that strike without warning, while another gets panicky at the thought of mingling at a party. Someone else may struggle with a disabling fear of driving, or uncontrollable, intrusive thoughts. Yet another may live in a constant state of tension, worrying about anything and everything.

Despite their different forms, all anxiety disorders share one major symptom: persistent or severe fear or worry in situations where most people wouldn’t feel threatened.

Emotional symptoms of anxiety

In addition to the primary symptoms of irrational and excessive fear and worry, other common emotional symptoms include:

  • Feelings of apprehension or dread, watching for signs of danger, anticipating the worst
  • Restlessness, trouble concentrating
  • Feeling tense and jumpy, or irritable
  • Feeling like your mind's gone blank

Physical symptoms of anxiety

Anxiety is more than just a feeling. As a product of the body’s fight-or-flight response, anxiety involves a wide range of physical symptoms. Because of the numerous physical symptoms, anxiety sufferers often mistake their disorder for a medical illness. They may visit many doctors and make numerous trips to the hospital before their anxiety disorder is discovered.

Common physical symptoms of anxiety include:

  • Pounding heart, sweating
  • Headaches, stomach upset, or dizziness
  • Frequent urination or diarrhea
  • Shortness of breath
  • Muscle tension, tremors, and twitches
  • Fatigue or insomnia

The link between anxiety symptoms and depression

Many people with anxiety disorders also suffer from depression at some point. Anxiety and depression are believed to stem from the same biological vulnerability, which may explain why they so often go hand-in-hand. Since depression makes anxiety worse (and vice versa), it’s important to seek treatment for both conditions.

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Panic Attacks

Basic Facts About Panic Attacks

by Thomas A. Richards, Ph.D., Psychologist

"I’m losing control....."

"I feel like I’m going crazy....."

"I must be having a heart attack....."

"I’m smothering and I can’t breathe....."

"It came upon me by surprise. I began to feel wave after wave of fear and my stomach gave out on me. I could hear my heart pounding so loudly I thought it would come out of my chest. Pains were shooting down my legs. I became so afraid I couldn’t catch my breath. What was happening to me? Was I having a heart attack? Was I dying?"

Panic attacks are very real, very awful, and emotionally debilitating. Many people who experience their first panic attack find themselves at hospital emergency rooms......or at doctors’ offices -- prepared to hear the very worst news possible about their health.

When they don’t hear that they’ve had a life-threatening condition (such as a heart attack), this news may actually increase their anxiety and frustration: "...if I am physically OK, what happened to me? I experienced something so dreadful I can’t even explain it. So what’s happening to me?"

If a person with panic goes undiagnosed, they can bounce around from doctor to doctor for years on end without experiencing any relief.  Instead, it becomes more and more frustrating to the panic sufferer as no one is able to pinpoint the problem and provide any kind of help.

Because the symptoms of panic are very real, the anxiety is so traumatizing, and the whole experience is new and strange, a panic attack is one of the worst experiences a person can have.

On top of the attack, there is always the nagging fear, "When will this happen to me again?"

Some people become so frightened of having additional panic attacks, especially in public, that they withdraw to their "safe zones", usually their homes, and very rarely leave them.  This condition is known as agoraphobia.  Note that the person with agoraphobia does not enjoy having their life so restricted; it is a depressing and miserable existence. It is the fear of having further panic attacks in public, where they do not feel safe, that keeps them bound close to home.

Over four million Americans suffer from panic attacks, according to the National Institutes of Mental Health. That number is about 5% of the adult American population. Many researchers feel that even this number is a low estimate, because many people who experience panic attacks never receive the proper diagnosis and "live" with it, despite its horror and its constant terror.

What is a panic attack?

A panic attack can only be described as a comprehensive emotional nightmare. Some people with panic feel like they are in an escalating cycle of catastrophe and doom and that something bad is going to happen to them "right now this very moment."

Others feel as if they are having a heart attack as their heart races. The heart palpitations convince them that they are about to have an attack. Other people feel that they are going to "lose control" of themselves and will do something embarrassing in front of other people. Others breathe so quickly, taking rapid short breaths and gasping for air, that they hyperventilate and feel like they will suffocate from lack of oxygen.

Common symptoms of panic include:

  • a racing or pounding heartbeat
  • dizziness and lightheadedness
  • feeling that "I can’t catch my breath"
  • chest pains or a "heaviness" in the chest
  • flushes or chills
  • tingling in the hands, feet, legs, arms
  • jumpiness, trembling, twitching muscles
  • sweaty palms, flushed face
  • terror
  • fear of losing control
  • fear of a stroke that will lead to disability
  • fear of dying
  • fear of going crazy

A panic attack typically lasts several long minutes and is one of the most distressing conditions a person can experience. In some cases, panic attacks have been known to last for longer periods of time or to recur very quickly over and over again.

The aftermath of a panic attack is very painful. Feelings of depression and helplessness are usually experienced. The greatest fear is that the panic attack will come back again and again, making life too miserable to bear.

Panic is not necessarily brought on by a recognizable circumstance, and it may remain a mystery to the person involved. These attacks come "out of the blue". At other times, excessive stress or other negative life conditions can trigger an attack.

Sadly, many people do not seek help for panic attacks, agoraphobia, and other anxiety-related difficulties. This is especially tragic because panic and other anxiety disorders are treatable conditions that respond well to relatively short-term therapy. The National Institutes of Mental Health is currently conducting a nationwide campaign to educate the general public and health care practitioners that panic and the other anxiety disorders are some of the most successfully treated psychological problems. Clinical research provides us with a solid blueprint of cognitive, emotional and behavioral methods that can help us overcome anxiety disorders, such as panic and/or agoraphobia.

Today, panic attacks and agoraphobia can be treated successfully with a motivated client and a knowledgeable therapist. 

People who experience panic and agoraphobia, are not "crazy" and do not need to be in therapy for extended periods of time. Sessions depend on the severity and length of the problem and the willingness of the client to actively participate in treatment and change.

When a person with panic is motivated to practice and try new techniques, that person is literally changing the way their brain responds. When you change the way your brain responds, anxiety and panic will continue to shrink, the strategies you use against it will become stronger, and panic will cease to cause you problems. 

Overcoming panic disorder means you no longer have panic attacks, and you no longer have the initial symptoms that lead you to have a panic attack.  The underlying symptoms must be gone as well before we say that someone has "overcome" panic disorder


social anxiety

What is Social Anxiety/Social Phobia?

by Thomas A. Richards, Ph.D., Psychologist

 "It’s just easier to avoid social situations."

"I would freeze up every time I had to meet someone in authority...."

"I’m the only one in the world who has these terrible symptoms...."

The good news is that social anxiety is not only treatable, but the treatment is also successful.

Social phobia no longer needs to be a life-long, devastating condition.

Social anxiety is the third largest psychological problem in the United States today...very few people understand this.

A woman hates to stand in line in the grocery store because she’s afraid that everyone is watching her.  She knows that it’s not really true, but she can’t shake the feeling.  While she is shopping, she is conscious of the fact that people might be staring at her from the big mirrors on the inside front of the ceiling.  Now, she has to talk to the person who’s checking out the groceries.  She tries to smile, but her voice comes out weakly.  She’s sure she’s making a fool of herself.  Her self-consciousness and her anxiety rise to the roof.

A man finds it difficult to walk down the street because he’s self-conscious and feels that people are watching him from their windows.  Worse, he may run into a person on the sidewalk and be forced to say hello to them.  He’s not sure he can do that.  His voice will catch, his "hello" will sound weak, and the other person will know he’s frightened.  More than anything else, he doesn’t want anyone to know that he’s afraid.  He keeps his eyes safely away from anyone else’s gaze and prays he can make it home without having to talk to anyone.

There are seven miserable days of anxiety and worry ahead of her to think about it....over and over and over again.....

Another person sits in front of the telephone and agonizes because she’s afraid to pick up the receiver and make a call.  She’s even afraid to call an unknown person in a business office about the electric bill because she’s afraid she’ll be "putting someone out" and they will be upset with her.  It’s very hard for her to take rejection, even over the phone, even from someone she doesn’t know.  She’s especially afraid to call people she knows because she feels that she’ll be calling at the wrong time -- the other person will be busy — and they won’t want to talk with her.

She feels rejected even before she makes the call.  Once the call is made and over, she sits, analyzes, and ruminates about what was said, what tone it was said in, and how she was perceived by the other person....her anxiety and racing thoughts concerning the call prove to her that she "goofed" this conversation up, too, just like she always does.  Sometimes she gets embarrassed just thinking about the call.

A man hates to go to work because a meeting is scheduled the next day.  He knows that these meetings always involve co-workers talking with each other about their current projects.  Just the thought of speaking in front of co-workers raises his anxiety.  Sometimes he can’t sleep the night before because of the anticipatory anxiety that builds up.  Finally, the meeting is over.  A big wave of relief spills over him as he begins to relax.  But the memory of the meeting is still uppermost in his mind.  He is convinced he made a fool of himself and that everyone in the room saw how afraid he was when he spoke and how stupid he acted in their presence.  At next week’s meeting, the boss is going to be there.  Even though this meeting is seven days away, his stomach turns raw with anxiety and the the fear floods over him again.  He knows that in front of the boss he’ll stammer, hesitate, his face will turn red, he won’t remember what to say, and everyone will witness his embarrassment and humiliation.  He has seven miserable days of anxiety ahead of him, to think about it, ruminate over it, worry about it, over-exaggerate it in his mind...again and again and again...

A student won’t attend her university classes on the first day because she knows that in some classes the professor will instruct them to go around the room and introduce themselves.  Just thinking about sitting there, waiting to introduce herself to a roomful of strangers who will be staring at her makes her feel nauseous.  She knows she won’t be able to think clearly because her anxiety will be so high, and she is sure she will leave out important details.  Her voice might even quaver and she would sound scared and tentative.  The anxiety is just too much to bear -- so she skips the first day of class to avoid the possibility of having to introduce herself in public.

Another young man wants to go to parties and other social events -- indeed, he is very, very lonely -- but he never goes anywhere because he’s very nervous about meeting new people.  Too many people will be there and crowds only make things worse for him.  The thought of meeting new people scares him -- will he know what to say?  Will they stare at him and make him feel even more insignificant?  Will they reject him outright?  Even if they seem nice, they’re sure to notice his frozen look and his inability to fully smile.  They’ll sense his discomfort and tenseness and they won’t like him – there’s just no way to win – "I’m always going to be an outcast," he says.  And he spends the night alone, at home, watching television again.  He feels comfortable at home.  In fact, home is the only place he does feel comfortable.  He hasn’t gone anywhere in twelve years.

In public places, such as work, meetings, or shopping, people with social phobia feel that everyone is watching and staring at them (even though rationally they know this isn’t true).  The socially anxious person can’t relax, "take it easy", and enjoy themselves in public.  In fact, they can never relax when other people are around.  It always feels like others are evaluating them, being critical of them, or "judging" them in some way.  The person with social phobia knows that people don’t do this openly, of course, but they still feel the self-consciousness and the judgment while they are in the other person’s presence.  It’s sometimes impossible to let go, relax, and focus on anything else except the anxiety.  Because the anxiety is so very painful, it’s much easier just to stay away from social situations and avoid other people.

"More than anything, he doesn’t want anyone to know he’s afraid...."

Many times people with social anxiety simply must be alone -- closeted -- with the door closed behind them.  Even when they’re around familiar people, a person with social phobia may feel overwhelmed and have the feeling that others are noticing their every movement and critiquing their every thought.  They feel like they are being observed critically and that other people are making negative judgments about them.

One of the worst circumstances, though, is meeting people who are "authority figures".  Especially people such as bosses and supervisors at work, but including almost anyone who is seen as being "better" in some way.  People with social anxiety may get a lump in their throat and their facial muscles may freeze up when they meet this person.  The anxiety level is very high and they’re so focused on "not failing" and "giving themselves away" that they don’t even remember what was said.  But later on, they’re sure they must have said the wrong thing.....because they always do.

How is it ever possible to feel "comfortable" or "natural" under these circumstances?

To the person with social anxiety, going to a job interview is pure torture: you know your excessive anxiety will give you away.  You’ll look funny, you’ll be hesitant, maybe you’ll even blush, and you won’t be able to find the right words to answer all the questions.  Maybe this is the worst part of all: You know that you are going to say the wrong thing.  You just know it.  It is especially frustrating because you know you could do the job well if you could just get past this terrifying and intimidating interview.

Welcome to the world of the socially anxious.

Social anxiety is the third largest psychological problem in the United States today.  This type of anxiety affects 15 million Americans in any given year.  Unlike some other psychological problems, social phobia is not well understood by the general public or by medical and mental health care professionals, such as doctors, psychiatrists, psychologists, therapists, social workers, and counselors.  In fact, people with social phobia are misdiagnosed almost 90% of the time.  People coming to our anxiety clinic with diagnosable DSM-IV social phobia have been mislabeled "schizophrenic", "manic-depressive", "clinically depressed", "panic disordered", and "personality disordered", among other misdiagnoses.

Because few socially-anxious people have heard of their own problem, and have never seen it discussed on any of the television talk shows, they think they are the only ones in the whole world who have these terrible symptoms.  Therefore, they must keep quiet about them.  It would be awful if everyone realized how much anxiety they experienced in daily life.  Unfortunately, without some kind of education, knowledge and treatment, social anxiety continues to wreak havoc throughout their lives.  Adding to the dilemma, when a person with social phobia finally gets up the nerve to seek help, the chances that they can find it are very, very slim.

Making the situation more difficult is that social anxiety does not come and go like some other physical and psychological problems.  If you have social phobia one day...you have it every day for the rest of your life, unless you receive the appropriate therapy.

The feelings I described to you at the beginning of the article are those of people with "generalized" social phobia.  That is, these symptoms apply to most social events and functions in almost every area of life.  I suffered from social phobia myself for twenty years before I ever saw the term or read about its symptoms in a book.

As with all problems, everyone with social anxiety has slightly different symptoms.  Some people, for example, cannot write in public because they fear people are watching and their hand will shake.  Others are very introverted and they find it too difficult to hold down a job.  Still others have severe anxiety about eating or drinking in the presence of other people.  Blushing, sweating, and "freezing" are other physiological symptoms.  Some people with social anxiety feel that a certain part of their body (such as the face or neck) are particularly "strange looking" and vulnerable to being stared at.

One thing that all socially anxious people share is the knowledge that their thoughts and fears are basically irrational.  That is, people with social anxiety know that others are really not critically judging or evaluating them all the time.  They understand that people are not trying to embarrass or humiliate them.  They realize that their thoughts and feelings are somewhat irrational.  Yet, despite this rational knowledge, they still continue to feel that way.

It is these automatic "feelings" and thoughts that occur in social situations that must be met and conquered in therapy.  Usually these feelings are tied to thoughts that are entwined in a vicious cycle in the persons’ mind.

How can social anxiety be treated?  Many therapeutic methods have been studied, but cognitive-behavioral techniques have been shown to work the best.  In fact, treatment of social anxiety through these cognitive-behavioral methods produces long-lasting, permanent relief (link is external) from the anxiety-laden world of social anxiety.

A better life exists for all people who suffer from social anxiety...

Social anxiety responds to relatively short-term therapy, depending on the severity of the condition.   What socially-anxious people do not need is years and years of therapy.  In fact, socially anxious people who are taught to "analyze" and "ruminate" over their problems usually make their social anxiety worse.

There is a better life for all people with social anxiety.  Without treatment, social phobia is a torturous emotional problem; with treatment, its bark is worse than its bite.  Add to this that the current research is clear that cognitive-behavioral therapy is highly successful in the treatment of social anxiety.  In fact, people who are unsuccessful are the ones who are not persistent in their therapy and who won’t practice simple routines at home — they are the ones who give up.  If a person is motivated to end the years of crippling anxiety, then cognitive-behavioral treatment provides methods, techniques, and strategies that all combine to lessen anxiety and make the world a much more enjoyable place.  Many of us have been through the crippling fears and constant anxiety that social phobia produces -- and have come out healthier and happier on the other side