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Anxiety Disorders:
The Role of Psychotherapy in Effective Treatment
Everyone feels anxious and under stress from time to time. Situations such as
meeting tight
deadlines, important social obligations or driving in heavy traffic, often bring
about anxious
feelings. Such mild anxiety may help make you alert and focused on facing
threatening or challenging
circumstances. On the other hand, anxiety disorders cause severe distress over a
period of time and
disrupt the lives of individuals suffering from them. The frequency and
intensity of anxiety involved
in these disorders is often debilitating. But fortunately, with proper and
effective treatment,
people suffering from anxiety disorders can lead normal lives.
What are the major kinds of anxiety disorders?
There are several major types of anxiety disorders, each with its own
characteristics.
People with generalized anxiety disorder have recurring fears or worries, such
as about health
or finances, and they often have a persistent sense that something bad is just
about to happen.
The reason for the intense feelings of anxiety may be difficult to identify. But
the fears and
worries are very real and often keep individuals from concentrating on daily
tasks. Panic disorder
involves sudden, intense and unprovoked feelings of terror and dread. People who
suffer from this
disorder generally develop strong fears about when and where their next panic
attack will occur,
and they often restrict their activities as a result. A related disorder
involves phobias, or
intense fears, about certain objects or situations. Specific phobias may involve
things such as
encountering certain animals or flying in airplanes, whereas social phobias
involve fear of social
settings or public places. Obsessive-compulsive disorder is characterized by
persistent, uncontrollable
and unwanted feelings or thoughts (obsessions) and routines or rituals in which
individuals engage
to try to prevent or rid themselves of these thoughts (compulsions). Examples of
common compulsions
include washing hands or cleaning house excessively for fear of germs, or
checking over something
repeatedly for errors. Someone who suffers severe physical or emotional trauma
such as from a natural
disaster or serious accident or crime may experience post-traumatic stress
disorder. Thoughts, feelings
and behavior patterns become seriously affected by reminders of the event,
sometimes months or even years after the traumatic experience. Symptoms such as
shortness of breath, racing heartbeat, trembling and dizziness often accompany
certain anxiety disorders such as panic and generalized anxiety disorders.
Although they may begin at any time, anxiety disorders often surface in
adolescence or early adulthood. There is some evidence of a genetic or family
predisposition to certain anxiety disorders.
Why is it important to seek treatment for these disorders?
If left untreated, anxiety disorders can have severe consequences. For example,
some people who
suffer from recurring panic attacks avoid at all costs putting themselves in a
situation that
they fear may trigger an attack. Such avoidance behavior may create problems by
conflicting with
job requirements, family obligations or other basic activities of daily living.
Many people who
suffer from an untreated anxiety disorder are prone to other psychological
disorders, such as
depression, and they have a greater tendency to abuse alcohol and other drugs.
Their relationships
with family members, friends and coworkers may become very strained. And their
job performance
may falter.
Are there effective treatments available for anxiety disorders?
Absolutely. Most cases of anxiety disorder can be treated successfully by
appropriately trained
health and mental health care professionals. According to the National Institute
of Mental Health,
research has demonstrated that both 'behavioral therapy' and 'cognitive therapy'
can be highly
effective in treating anxiety disorders. Behavioral therapy involves using
techniques to reduce or
stop the undesired behavior associated with these disorders. For example, one
approach involves
training patients in relaxation and deep breathing techniques to counteract the
agitation and
hyperventilation (rapid, shallow breathing) that accompany certain anxiety
disorders.
Through cognitive therapy, patients learn to understand how their thoughts
contribute to the
symptoms of anxiety disorders, and how to change those thought patterns to
reduce the likelihood
of occurrence and the intensity of reaction. The patient's increased cognitive
awareness is often
combined with behavioral techniques to help the individual gradually confront
and tolerate fearful
situations in a controlled, safe environment.
Proper and effective medications may have a role in treatment along with
psychotherapy. In cases
where medications are used, the patient's care may be managed collaboratively by
a therapist and
physician. It is important for patients to realize that there are side effects
to any drugs, which
must be monitored closely by the prescribing physician.
How can a qualified therapist help someone suffering from an anxiety
disorder?
Licensed psychologists are highly qualified to diagnose and treat anxiety
disorders. Individuals
suffering from these disorders should seek a provider who is competent in
cognitive and behavioral
therapies. Experienced mental health professionals have the added benefit of
having helped other
patients recover from anxiety disorders.
Family psychotherapy and group psychotherapy (typically involving individuals
who are not related
to one another) offer helpful approaches to treatment for some patients with
anxiety disorders. In
addition, mental health clinics or other specialized treatment programs dealing
with specific disorders
such as panic or phobias may also be available nearby.
How long does psychological treatment take?
It is very important to understand that treatments for anxiety disorders do not
work instantly.
The patient should be comfortable from the outset with the general treatment
being proposed and
with the therapist with whom he or she is working. The patient's cooperation is
crucial, and there
must be a strong sense that the patient and therapist are collaborating as a
team to remedy the
anxiety disorder.
No one plan works well for all patients. Treatment needs to be tailored to the
needs of the patient
and to the type of disorder, or disorders, from which the individual suffers. A
therapist and patient
should work together to assess whether a treatment plan seems to be on track.
Adjustments to the plan
sometimes are necessary, since patients respond differently to treatment.
Many patients will begin to improve noticeably within eight to ten sessions,
especially those who
carefully follow the outlined treatment plan.
There is no question that the various kinds of anxiety disorders can severely
impair a person's functioning in work, family and social environments. But the
prospects for long-term recovery for most individuals who seek appropriate
professional help are very good. Those who suffer from anxiety disorders can
work with a qualified and experienced therapist such as a licensed psychologist
to help them regain control of their feelings and thoughts -- and their lives.
October 1998
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Wilmes-Reitz Psychological
23945 Calabasas Rd., Suite 202
Calabasas, California 91302
(818) 591-8270
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