Some disturbances of mood result in excessive anxiety. Many people seek treatment for generalized anxiety disorder, characterized by vague worries and anxiety that persist throughout the day, may attach itself to many different thoughts and occurrences without any apparent rationale, and often can disturb sleep. If you suffer from generalized anxiety, you may have fearful responses to a large number of things, and the issues that preoccupy you may change from day to day or even minute to minute. On the other hand, if you suffer from panic attacks you may feel fine most of the day, but have dramatic episodes of anxiety that can include shortness of breath, a feeling of suffocation, rapid heartbeat and pulse, and chest pains. In fact, panic attacks can be so frightening many people seek treatment in hospital emergency rooms, thinking they are having a heart attack- only to be told that there is no physical cause for these symptoms. Attacks can occur regularly, and may or may not have clear “triggers”.
Obsessive-compulsive disorder (OCD) is characterized by intrusive, fearful thoughts, and compulsive, ritualistic behaviors designed to “ward off” harm. Someone suffering from OCD may feel compelled to perform elaborate rituals, like repeatedly washing their hands, or ordering everything in a very specific way, to feel safe. Other rituals may be much more subtle, involving only tiny movements or even thoughts summoned up to counteract the fear. Eventually, the OCD sufferer may severely limit their life in order to avoid fear-provoking situations. Phobias are fears of specific things or activities; the most common are fear of public speaking and fear of flying. Both OCD and certain phobias can lead to agoraphobia, a disorder in which the agoraphobic restricts their activities in order to avoid anxiety producing places, objects, or activities, until eventually they cannot leave home.
The first-line psychotherapy treatments for anxiety – those techniques with proven success – usually involve cognitive-behavioral counseling. This therapy focuses less on your past – the reasons why the anxiety started – than it does on here-and-now methods to conquer fear. For example, if you suffer from Generalized Anxiety Disorder you may learn to combat worrisome thoughts by “rebutting” them in your head, and you may be taught special breathing techniques that calm your body. If you have a specific phobia, you will be gradually “desensitized” to the phobia both through visualization exercises in the office and real-life exposure. Obsessive-compulsive disorder is treated with a regimen that includes gradual exposure to feared objects while preventing enactment of the ritual. No matter what form your anxiety takes, you will probably be helped to identify “triggers” to anxiety so that you can manage these situations appropriately, and undergo some relaxation training so you can maintain freedom from your problem long after treatment has ended. Medication is often helpful in conjunction with psychotherapy, and often the same drugs that are used for depression work for some types of anxiety disorder. If we think medication will help you, we will recommend one of our colleagues or work with your own medication specialist.