Over 60 percent of major depressions are accompanied by varying levels of anxious feelings and behavior. (During my illness, my extreme anxiety interfered with my recovery and increased the risk of suicide.) These symptoms may be diagnosed as generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, or post- traumatic stress disorder (PTSD). Here are some techniques that are commonly used to treat mild to severe anxiety.
1) Medications. The medications most often used to treat anxiety are a class of drugs known as benzodiazepines (also called “minor tranquilizers”). These include Xanax, Ativan and Klonopin. The main problem with these substances is their potential for tolerance, physical dependence, and the likely recurrence of panic and anxiety symptoms when the medication is stopped. Hence, they are best used for treating short-term anxiety and panic. Because anxiety is so often associated with depressive disorders, it is essential to treat the underlying depression along with the anxiety disorder. When the depression is healed, symptoms of anxiety often diminish.
2) Exercise and relaxation techniques. Because anxiety clearly has a physical component (especially when it manifests as a panic attack), techniques for relaxing the body are an important part of the treatment plan. These include abdominal breathing, progressive muscle relaxation (relaxing the body's muscle groups) and the Relaxation Response that we learned in Week 11. You can learn these practices from any mental health professional who teaches relaxation or stress reduction. Regular exercise also has a direct impact on several physiological conditions that underlie anxiety. Exercise reduces skeletal muscle tension, metabolizes excess adrenaline and thyroxin in the bloodstream (chemicals which keep one in a state of arousal) and discharges pent-up frustration and anger.
3) Cognitive-behavioral therapy. Cognitive-behavioral therapy is a psychotherapy that helps you to alter anxious self-talk and mistaken beliefs that give the body anxiety-producing messages. For example, saying to yourself, “What if I have an anxiety attack when I'm driving home?” will make it more likely that an attack will ensue. Overcoming negative self-talk involves creating positive counterstatements such as “I can feel anxious and still drive,” or “I can handle it.” What often underlies our negative self-talk is a set of negative beliefs about ourselves and the world. Examples of such mistaken beliefs are, “I am powerless,” “Life is dangerous,” and “It's not okay to show my feelings.” Replacing these beliefs with empowering truths can help to heal the roots of anxiety (see “cognitive distortions” sidebar on page 214).
4) Monitoring diet and nutrition. Stimulants such as caffeine and nicotine can aggravate anxiety and leave one more prone to anxiety and panic attacks. Other dietary factors such as sugar, certain food additives and food sensitivities can make some people feel anxious. Seeing a nutritionally oriented physician or therapist may help you to identify and eliminate possible offending substances from your diet. He or she can also help you to research supplements and herbs (e.g., GABA, kava, B vitamins, chamomile and valerian teas) that are known to calm the nervous system.
If you are suffering from a serious anxiety disorder, you may want to locate a clinic in your area that specializes in the treatment of anxiety. Your local hospital or mental health clinic can give you a referral. In addition, you may wish to call (800) 64-PANIC to receive helpful material from the National Institute of Mental Health. Books and Internet sites on anxiety disorders can be found in Appendix C and in the Recommended Reading section.