Common Questions

It is perfectly normal to feel anxious sometimes. It’s an important emotion to feel, because it lets us know how important the outcome of our activities is to us (i.e., if we don’t care, we won’t feel anxious) and it also lets us know when we’re in danger. A little bit of anxiety is a good thing and can enhance your performance on tasks (e.g., a little bit of anxiety about an exam makes you study harder, and thus, you could perform better). Alternatively, too much anxiety can affect our judgment and our ability to make simple decisions. Although there are occasions when high levels of anxiety are totally normal (like dangling off the ledge of a 10-story building), some people’s bodies send them mixed signals, making them think that they are in danger when they’re not (just looking out the window of a 10-story building). When this anxiety starts interfering with someone’s ability to live a normal life, it’s considered an anxiety disorder. Anxiety disorders cause substantial emotional, cognitive, and behavioral difficulties, and are one of the most common and most treatable mental disorders.

Agoraphobia is characterized by avoiding situations where escape might be difficult or embarrassing. The fear can be so intense that it leads some individuals to become completely housebound.

Panic Disorder is characterized by intense feelings of fear or terror, which come on for no apparent reason (i.e., panic attacks). Symptoms may include: dizziness, trembling, shortness of breath, heart racing, sweating, thoughts of death or dying, and chest pain. These attacks occur frequently and are associated with intense anxiety about getting another attack and avoidance of situations that may cause them.

Social Anxiety Disorder (a.k.a. Social Phobia) is characterized by avoidance of certain social or performance situations due to fear of being judged by or embarrassed in front of other people (e.g., fear of public speaking or eating in restaurants.)

Specific Phobia is characterized by intense fear of a specific situation or object, often leading to avoidance. (e.g., fear of heights or spiders.)

Obsessive-Compulsive Disorder (OCD) is characterized by recurring unwanted anxiety-producing thoughts (obsessions) and repetitive behaviors designed to reduce the anxiety caused by the obsessions (compulsions). The excessive amount of time given to these obsessive thoughts and compulsive actions often gets in the way of the person’s ability to function normally. For example: fear of contamination (obsession) and constant hand washing (compulsion). Although the obsession and compulsion are clearly linked in this example, often the compulsion has no obvious connection to the obsession it’s meant to alleviate.

Generalized Anxiety Disorder (GAD) is characterized by excessive worrying about a number of events or activities. People with GAD often experience restlessness, difficulty concentrating, irritability, muscle tension, headaches, fatigue, and sleep disturbance.

Post Traumatic Stress Disorder (PTSD) is characterized by repeated re-experiencing of a severely traumatic event (e.g., war, natural disaster, rape, assault, witnessing a murder) accompanied by increased arousal and avoidance of places and situations that remind the person of the event. For a diagnosis of PTSD, these symptoms need to last for at least one month. Most people exposed to a traumatic event will not develop PTSD.

Although not a substitute for treatment, the following tips can be helpful for people with an anxiety disorder and people experiencing regular anxiety.

Exercise – Exercise helps both physically and mentally.
Relax – Learn deep breathing techniques (such as Box Breathing); consider trying yoga or meditation.
Get enough Sleep – Try to get 8 to 9 hours of sleep each night.
Learn to laugh – Laughing decreases anxious feelings
No alcohol & drug consumption – Be careful not to use alcohol, nicotine, or other drugs to “self-treat” anxiety.
Reduce caffeine intake – Caffeine makes your heart race, which can make anxiety worse.
Eat a well-balanced diet – Eating healthy, well-balanced meals and avoiding junk food when possible keeps you in your best form, so you’re better able to cope with anxiety-provoking situations.
Create a support network – Talk to friends you can trust.
Learn to manage your time – Putting tasks off can become overwhelming. Get organized and review your daily tasks each morning. Break larger, more intimidating tasks down into smaller steps. Focus on one step at a time. Learn to do the most important things first.
Challenge your perfectionism – Chill out, praise yourself for trying.

For more information on how to help yourself be well, visit:
http://teenmentalhealth.org/toolbox/taking-charge-health-daily-checklist/

Anxiety Disorders require professional treatment, including psychotherapy and/or medication.

Medications: Selective Serotonin Reuptake-Inhibitors (SSRIs)

For many people, mild to moderately severe Anxiety Disorders can be effectively treated with psychological interventions. Medications generally are considered for use if psychotherapy alone is not producing the hoped for results.

Cognitive Behaviour Therapy (CBT)

CBT is a form of talk therapy, which teaches specific thinking and behavioural skills. The goal of CBT is to help people to challenge their current way of thinking, so they can learn to change their anxious negative thoughts and gain control over their anxiety. CBT also teaches people to relax, problem-solve, and gradually face their fears. Gradual and supported exposure to the frightening situation/object is the most effective way to treat anxiety.

Avoidance of anxiety producing situations is also discouraged in CBT, as it only serves to make anxiety worse.

More information on CBT

http://cogbtherapy.com/about-cbt/

DBT: Dialectical Behavioral Therapy is a cognitive behavioral treatment developed by Marsha Linehan, PhD, ABPP. It emphasizes individual psychotherapy and group skills training classes to help people learn and use new skills and strategies to develop a life that they experience as worth living. DBT skills include skills for mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness.

https://www.youtube.com/watch?v=Stz–d17ID4

https://behavioraltech.org/resources/faqs/what-is-dbt/

Depending on the person’s needs, therapy can last 6-8 weeks or longer, usually with weekly or twice-weekly meetings. Some people may be able to resolve their anxiety sooner, whereas others may need more time. Often, people benefit from “booster sessions” over time to help maintain their gains and prevent the anxiety disorder from returning. Medications can be used to help with specific situations (such as in a fear of getting on an airplane) or they can be used for longer periods of time (e.g., 3 – 6 months), in order to decrease anxiety to the point where the individual is able to actively work on their fears in therapy.

Having supportive and understanding friends is an essential component to recovering from an anxiety disorder. How can you help?

Educate yourself – Understanding  what your friend is going through will help you better support them. It will also help alleviate frustrations that you may have about his or her behaviour.
Be supportive – Encourage your friend when he or she is having a tough time and be empathetic to what he or she is going through. Be respectful but do not support avoidance of stressful situations.
Don’t try to change your friend – Modify your expectations of how you want your friend to be and accept your friend for who he or she is.
Communicate – Be sure to listen with a nonjudgmental attitude. Help him or her find treatment. Sometimes it’s hard to take the first step alone. Be a good support and encourage your friend to get help.
Encourage – Encourage your friend to confront stressful situations and support them through the experience, rather than avoiding anxiety-provoking situations. Avoidance can actually make the anxiety disorder worse.
Be fun – Sure it’s good to have someone to talk to, but your friends need you to keep the fun going. Help make them laugh and relax.


This resource is powered by TeenMentalHealth.org.

Be Specific:  Address your stress inducing thoughts and label them concretely.  Make a list at the end of each workday and evening (at home) with the labeled stressors and an action plan of completion.  Even if the items of stress are not task oriented in nature, it is beneficial to label them and write them down (for example, “Concerned about my daughter’s lack of interest in school. Plan – take her for a drive and begin a conversation.”)

Take a Break and Distract:  If you feel your thoughts becoming clustered and overly emotional, or the beginning stages of anxiety increasing, get up and move for 5-10 minutes.  Take your thoughts and body to a new location, even briefly, to grab a drink in the lounge, or to your car to listen to music for a moment. Distracting your thoughts will allow your brain to function in an organized and efficient manner.

Don’t Isolate (for long):  It can be helpful to distract your mind and give yourself some space for a short period, but prolonged isolation can lead to avoidance of anxiety producing situations, which reinforces the negative thought process.  Do what you fear, be it networking socials or assertively stating your idea in a meeting.

Model Emotional Honesty and Reach Out:  Let your coworkers and loved ones know if you are feeling stressed, create an environment where all emotions are labeled and acknowledged.  Address your needs.

Every child/situation is different, and that there is a lot of gray area. There is not always a right and wrong. There is a what works for this particular child, what have they been able to articulate as useful or helpful in decreasing their anxiety. Picking a child up from school is very different than allowing them to take a break from class – on a break they are still IN the school, but just using a coping tool so they can STAY in the school. Actually leaving the school could contribute to the anxiety, and if the parent is always picking up the child, they are unknowingly playing a role that may not be helping the situation.

-Answered by Cathy Cassani Adams, LCSW, Chicago/Zen Parenting Radio

The filmmakers explained that the people in the film didn’t mention medication. The core of the movie is really about that we are “built” to cope with the challenges of anxiety – that within the challenge of anxiety, we have innate coping tools that can help us manage what we are experiencing (breathing, breaks, counting, asking for help, even the use of ice cubes…). In some situations people are so deeply anxious and so in a “hole” that they need a “ladder” just to get to the point of finding these innate coping tools. In these situations, medication can be really helpful, because the med allows the person to climb out just enough to reach for an innate coping tool. And sometimes meds are used alongside coping tools to deepen a practice. There are times when clients ask for a med, but then chooses to not explore other ways to cope/manage what they are experiencing. In these cases the med can become a band-aid, because the core issues are not being addressed and innate coping tools are not being utilized. We are lucky to have meds available for when they are needed, and for some, they can be the difference between life and death. But for most, if used, they should be used as a tool to access what we already innately have available to us – they are a ladder to reach a solution rather than the entire solution.

-Answered by Cathy Cassani Adams, LCSW, Chicago/Zen Parenting Radio

The more we normalize words and not shy away from them, the more we are capable of having honest conversations about how we are feeling. But we should be careful of our tone/body language when we talk about anxiety, because if we are using the word and then looking/sounding afraid, we are doing the exact opposite of what we are hoping to do (normalize/validate). So it takes a lot of self-awareness on the part of the parent to become comfortable with anxiety, what it is, what it means, and how one can cope – so the conversation with our kids can be grounded and calm rather than filled with fear.

-Answered by Cathy Cassani Adams, LCSW, Chicago/Zen Parenting Radio

I am a mindfulness teacher, so I appreciated this question. I talked about meditation (but also used the words stillness, quiet, and calm as synonyms so people don’t get too caught up in the word “meditate”). Daily stillness/meditation can strengthen the mindfulness muscle, which means creating some space between stimulus (like a feeling of anxiety) and reaction (becoming more anxious about feeling anxious). A meditation/stillness practice can help us RESPOND, rather than REACT. We can practice noticing a feeling and then choosing to breathe through it, rather than react to it. Anxiety will still show up, that’s part of being human, but being mindful means we can decrease the pressure of the feeling, or sit with the feeling until it passes (rather than getting more anxious about feeling anxious).

-Answered by Cathy Cassani Adams, LCSW, Chicago/Zen Parenting Radio

Daily meditation/stillness is like “working out” this mindfulness muscle every day, so then we can use it in present time when something anxiety provoking actually occurs. Compare dealing with anxiety to running a marathon – to run a marathon, we need to exercise our bodies on a daily or weekly basis so we are ready to perform during the race. A meditation/stillness practice is exercising the brain by noticing and breathing through thoughts – then when an anxiety-provoking situation arrives, we can actually “perform” what we’ve been practicing. Other ways to practice mindfulness – breath work, yoga, walking meditations, visualizations. Anything that helps the brain “practice” calming down.

-Answered by Cathy Cassani Adams, LCSW, Chicago/Zen Parenting Radio

A little girl asked about how to manage her panic attacks. In front of the crowd I told her that the only thing she needs is her breath – that her thoughts feelings may not be clear, but if she can remember to breathe, she will slow down every part of her body and mind. It may not “stop” it immediately, but it will keep it from getting worse and help ground her. I talked with her (and her mom) for a long time after the movie – we talked more about things that preceded the panic attacks and how they could work together to decrease the anxiety before they took hold (the little girl admitted to being a perfectionist with homework, and this would make mom anxious and annoyed, and then it would just escalate, etc…).

-Answered by Cathy Cassani Adams, LCSW, Chicago/Zen Parenting Radio