Cognitive, Behavior, & Schema Therapy Clinic


Cognitive-Behavioral Therapy (CBT) is one of the most effective therapies today. Most effective for Depression & Anxiety Disorders.

Coping With Anxiety


What is Anxiety?
Anxiety is one of the most powerful emotions we have for survival. Without fear and anxiety we would not exist for one minute. However, anxiety becomes a serious problem when it’s in excess. Meaning, we become anxious for no apparent reason, or, we worry and become anxious about things that don’t commonly require that much worry or anxiety. Symptoms of Anxiety affect thoughts, feelings, the body, and behavior. Without treatment, the symptoms can last for months, years, or a lifetime.
How Does Anxiety Differ from Fear?
In the simplest definitions, fear is dealing with the immediate danger or threat before us, whilst anxiety is preparing for the unexpected or anticipated events that may be perceived as dangerous or threatening. Everyone feels both at some point in life. We become fearful when an earthquake hits, and we become anxious anticipating aftershocks. But, when these feelings occur out of the blue, or, we find ourselves worrying excessively about things and the symptoms lasting for a prolonged period of time, the person may be suffering from Anxiety that requires treatment.
What Causes Anxiety
Anxiety is often caused by a combination of factors. Some might be genetic in nature, others might be environmental. Stressful life evens, sudden changes, exposure to threatening events, a family history of Anxiety, and chemical imbalances in the body all contribute to the illness. Certain drugs and medical conditions can also cause a person to feel anxious.
What are the Emotional Signs?
Persistently feelings of dread, worry, apprehension, unrealistic fears of dying, losing control, or going crazy, having recurring thoughts of doom and catastrophe, and/or exaggerated fears about physical disease or physical harm are all emotional signs of Anxiety.
What are the Physical Signs?
Physical signs include increased heart rate, increased breathing, sweating, numbing, tingling sensations, light-headedness, dizziness, chocking sensations, low energy, fatigue, and muscle tension. Other symptoms may include early insomnia, digestive problems, and difficulty concentrating.
What are the Social Signs?
Social signs of Anxiety include avoidance of social situations, avoidance of things perceived as threatening, avoidance of public places, crowds, some activities, problems with drugs or alcohol; compulsive spending; irritability and/or agitation.

How Many Types of Anxiety Disorders are there?
There are several types of anxiety disorders. Sometimes occurring individually and others co-occurring with other anxiety disorders or other mental problems such as depression, which is most common. Anxiety disorders are: Post traumatic Stress Disorders (PTSD); Acute Stress Disorder (ASD); Generalized Anxiety Disorder (GAD); Obsessive-Compulsive Disorder (OCD); Panic Disorder (PD); Agoraphobia; Social Phobia (SP); Specific Phobia; and Anxiety Not Otherwise Specified (ANOS). See below for symptoms for each.
Can Anxiety be Cured?
Nearly all people with anxiety disorders who receive proper treatment do recover. People with mild Anxiety respond very well to “talk therapy”, and most effective is Cognitive-Behavioral Therapy. 90% of all anxious people are successfully treated with anti-depressant drugs and some anxiolytics. The combination of therapy and medication can be most effective. See later for more facts on the treatment of Anxiety and for a preliminary self-awareness test.
Self-Assessment
What Kind of Anxiety Disorder do I Have?
Acute Stress Disorder: is characterized by symptoms similar to those of PTSD that occur immediately in the aftermath of an extremely traumatic event. The major difference between the two is that ASD should only last for no more than 30 days. See PTSD for complete symptoms list.
Post Traumatic Stress Disorder (PTSD): is characterized by the person re-experiencing the initial event or trauma (defined as witnessing or confronted by an event that threatened death or injury to self, or others, accompanied by the following summarized symptoms:
- The person felt intense fear, terror or helplessness.
- The traumatic event is recurrent in recollections, including images or perceptions
- Recurrent distressing dreams of the event.
- Acting or feeling as if the trauma is recurring now.
- Intense psychological distress in reacting t internal or external cues of the event.
- Physiological reactivity on exposure to internal or external cues of the event.
- Persistent avoidance of stimuli associated with the trauma
- Persistent symptoms of increased arousal.


Generalized Anxiety Disorder (GAD): is characterized by at least 6 months of persistent and excessive anxiety and worry with the following summarized symptoms:
- Difficulty to control worry.
- Restlessness or feeling on edge
- Difficulty concentrating
- Irritability
- Muscle tension
- Sleep disturbance
- The above symptoms are felt in more days than not for at least 6 months.


• Obsessive-Compulsive Disorder (OCD): is characterized by obsessions, which cause excessive anxiety and distress, and compulsions which serve to neutralize anxiety. OCD also includes the following summarized symptoms:
- Obsessions are defined by recurrent thoughts, images and impulses.
- The thoughts are not necessarily excessive thoughts about real life problems.
- The person tries to neutralize the obsessions by other thoughts or actions.
- The person is aware of the unreality of their thoughts lack of rationale.
- Repetitive behaviors or mental acts that the person feels compelled to do (hand washing, checking etc.)
- The behaviors are aimed to neutralize the obsessions.

• Panic Disorder (PD) with/or without Agoraphobia: is characterized by recurrent unexpected panic attacks, which the person gets concerned with. When Agoraphobia is present, the person avoids places and situations where the panic attacks occurred. Without Agoraphobia is when the panic disorder is not impacted by it. The symptoms of panic disorder are the same symptoms listed above under the Fight/Flight response. In addition, the person experiences panic attacks out of the blue, and continues to worry about having another one in the future.

• Social Anxiety Disorder (SAD) also known as Social Phobia: is characterized by anxiety due to exposure to social settings and situations where the person performs to others and often leading to avoiding the situation all together. The major symptoms are summarized as follows:
- Marked and persistent fear of social situations or performances
- Exposure to social situations would invoke fear or anxiety
- The person recognizes that the fear is excessive and unreasonable
- The situations are avoided due to the fear or anxiety
- This avoidance or anxiety interferes with the person’s normal daily functioning


• Specific Phobias (SP): is characterized by fear or anxiety due to exposure to specific feared objects or situation, leading to avoidance behaviors. The following summarized symptoms may include:
- Marked and/or persistent fear that is excessive or unreasonable when exposed to specific feared objects or situations.
- The person recognizes that the fear is excessive or unreasonable.
- The phobic object or situation maybe avoided or endured with excessive.
- The fear or anxiety interferes with normal daily functioning.
- Types are: Animals (Dogs, Snakes, Spiders…), Natural Environment (Heights, Storms, Water…), Blood-Injection-Injury Type, Situational (Airplane, Elevators, Enclosed Places…), and Other Types (Vomiting, Chocking, Contracting Disease…).


• Agoraphobia: is anxiety about, or avoidance of, places or situations from which escape might be difficult, or embarrassing in the event of having a panic attack or similar anxiety symptoms.


• Anxiety Disorder Not Otherwise Specified (NOS): This is applied when the person suffers from anxiety or fear but does not have enough symptoms to meet any of the above diagnostic disorders.


• Anxiety Disorder due to Medications or Drugs: The anxiety is present and due to the intake of medications and/or drugs whether prescribed or not.



HOW IS ANXIETY TREATED?


Professional Evaluation: Some medicine and medical conditions can cause a person to feel anxious. Before any treatment program begins, a medical evaluation is essential for an accurate diagnosis. A good evaluation involves complete physical checkup and family history of health problems.


Therapy: People with severe Anxiety respond more rapidly if given prescribed medication, such as bipolar illness, may need to stay on medication to prevent or lessen further episodes. Medication is often combined with therapy for effective treatment. Cognitive-Behavioral Therapy, according to research, yields the best results thus far.


Seeking Support: Dealing with Anxiety can be frightening and disturbing, not only for the person with the illness, but for family members, friends and co-workers. Support groups provide an opportunity for sharing, voicing concerns, learning about the illness, understanding how to help the anxious person, and receiving emotional support.


COMMONLY ASKED QUESTIONS


Who Suffers from Anxiety? Over 10 million Americans, of all ages, nationalities, backgrounds, and life styles, suffer from Anxiety. One in four women and one in 10 men either have, or will develop, Anxiety. Episodes can occur once, twice, or several times in a lifetime.


Do Children Suffer from Anxiety? Anxiety is more widespread among children and adolescents than is generally thought. Anxious youngsters may exhibit a wide range of symptoms, from “acting out,” in rowdy ways to withdrawal, negative self-esteem, quilt, sadness, and thoughts of self-destruction. Anxiety in teenagers frequently leads to suicide.


Can Anxiety Go Away by Itself? People who have Anxiety cannot merely pull themselves together and get better. A combination of professional therapy and medication is needed for recovery. Without treatment, symptoms can last for weeks, months, or years. Yet, Anxiety is one of the most treatable diseases. When the right steps are taken, people do recover.


Will Talking About Anxiety Make it Worse? Talking can help open the door to recovery from Anxiety. Understanding and concern can be very healing. Engage the anxious person in conversation and listen carefully. Be reassuring that, with time and help, things will get better. DO not ignore any remarks about suicide.
How Can I Help People Who are Anxious? Give emotional support and encouragement to seek help. Offer invitations to participate in outings or things they used to enjoy doing, such as hobbies, sports, religious or cultural activities. Don not push for too much too soon. A anxious person needs diversion and company, but, too many demands can increase feelings of failure.


Is Suicide a Possibility? Talk of suicide should always be taken seriously. Left untreated, a severely anxious person may carry out suicide. If a person has a specific, detailed plan for committing suicide, get professional help immediately. Suicide is the eighth leading cause of death in America; doctors think Anxiety causes the majority of suicide. Approximately, 30,000 Americans commit suicide annually.


For more information, please call:
Gabi L. Deak, LCSW
(310) 666-3097


or email us at:
gabi.deak@cbstclinic.com