This book is designed to give you ideas on how to beat anxiety. Beware the following things, which make anxiety worse:
Avoidance: Avoiding what scares you makes anxiety worse. For example, if you're afraid of driving on a freeway and only use side streets, your fear of driving on crowded, fast roads will get worse.
Whining and complaining: People love to do this, but it only makes things worse.
Seeking reassurance: When people give you reassurance, it feels good. But the effects are short-lived, and reassurance can actually make anxiety worse.
Seeking quick fixes: The Internet is full of quick fixes, but we don't know of any that have really been proven to work.
Psychoanalysis: This approach to therapy works for some problems, but it hasn't collected much support in alleviating anxiety.
Drinking or illegal drugs: Substances may relieve anxiety for a short while, but they actually increase anxiety in the long run.
Trying too hard: If you push yourself too hard and feel anxious about your progress, you're just going to make things worse. Slow down a little.
Sipping herbal drinks: There's nothing wrong with using these as a short-term crutch, but don't count on them to cure your problem.
Hoping for miracles: Hope is good — miracles do happen — but it's not a good idea to sit around and wait for one to come along.
Taking medication as a sole solution: Some medications help some people with some anxiety problems, some of the time. But the strategies and therapies described in this book have proven to be more reliable and effective in the long run.
When people feel unusually anxious and worried, they almost inevitably distort the way they think about these things. That distortion actually causes much of their anxiety. In the following example, Luann has both physical symptoms and cognitive symptoms of anxiety. Her therapist chooses a cognitive approach to help her.
Luann, a junior in college, gets physically ill before every exam. She throws up, has diarrhea, and her heart races. She fantasizes that she will fail each and every test she takes and that eventually, the college will dismiss her. Yet, her lowest grade to date has been a B-.
The cognitive approach her therapist uses helps her capture the negative predictions and catastrophic outcomes that run through her mind. It then guides her to search for evidence about her true performance and a more realistic appraisal of the chances of her actually failing.
As simple as this approach sounds, hundreds of studies have found that it works well to reduce anxiety. Part II of this book describes various cognitive or thinking therapy techniques.
Behaving therapies
Another highly effective type of therapy is known as behavior therapy. As the name suggests, this approach deals with actions you can take and behaviors you can incorporate to alleviate your anxiety. Some actions are fairly straightforward, like getting more exercise and sleep and managing your responsibilities. You can get good ideas on those actions in Chapter 10.
On the other hand, one type of action that targets anxiety and can feel a little scary is exposure — breaking your fears down into small steps and facing them one at a time. We cover exposure in Chapter 8.
Some people, with the advice of their doctor, choose to take medications for their anxiety. If you're considering that option, be sure to see Chapter 9 to help you make an informed decision.
Feeling therapies — soothing the inner storm
Anxiety sets off a storm of distressing physical symptoms, such as a racing heartbeat, upset stomach, muscle tension, sweating, dizziness, and so on. We have a variety of suggestions, including breathing and relaxation techniques, for helping quell this turmoil. You may choose to make changes in your lifestyle (see Chapter 10), give the relaxation strategies we cover in Chapters 11 and 12 a try, or employ mindfulness, an approach that teaches you to connect with present moment experiences (see Chapter 13).
Choosing where to start
We organize this book so you can start anywhere you want, but you may wonder whether one set of strategies would work better for you than another. Although we can't predict with certainty what will work best for you, we do have a guide for helping you choose the approach that may feel most compatible for your initial efforts. On the other hand, if you just want to read the book from front to back, that's fine, too.
In the following anxiety quiz, check all the items that apply to you. If you check off more items in one category than the others, you may consider starting with the part of this book that applies to it. For example, Chapters 5, 6, and 7 are designed especially for thinkers and present the thinking therapies, also known as cognitive therapy; Chapter 8 is aimed at doers and provides the essentials of behavior therapy. Part III focuses on feelers who may profit most by starting with strategies for quelling troubling bodily sensations and feelings through relaxation, diet, exercise, meditation, better sleep habits, and mindfulness. If you check an equal number of items in two or more categories, ask yourself which one seems most like you and start there.
Thinkers (see Chapters 5, 6, and 7)
I like to analyze problems.
I like to carefully consider pros and cons.
I enjoy dealing with facts.
I like to be logical.
I like to plan things in advance.
Doers (see Chapter 8)
If I have a problem, I take action right away.
I love getting things done.
I'm energetic.
I'm an active person.
I hate sitting still with nothing to do.
Feelers (see Part III)
I am always aware of every discomfort in my body.
I hate the feeling of anxiety.
I love to immerse myself in the arts.
Music speaks to me.
I love the feeling of a massage or a hot bath.
Finding the right help
We suppose it's not too presumptuous to assume that because you're reading this book, you or someone you know suffers from anxiety. And you'd probably like to tackle anxiety on your own. This is a self-help book, after all.
The good news is that self-help does work. A number of studies support the idea that people can deal with important, difficult problems without seeking the services of a professional. People clearly benefit from self-help. They get better and stay better.
Then again, sometimes self-help efforts fall short. Chapter 23 provides ten critical signs that indicate a likely need for professional help. See Chapter 4 for information about finding the right professional for you.
If you do need professional consultation, many qualified therapists will work with you on the ideas contained in this book. That's because most mental-health professionals will appreciate the comprehensive nature of the material and the fact that most of the strategies are based on well-proven methods. If research has yet to support the value of a particular approach, we take care to let you know that. We happen to think you're much better off sticking with strategies known to work and avoiding those that don't.
In Chapters 18, 19, and 20, we discuss how to help a child or an adult loved one who has anxiety. If you're working with a friend or family member, you both may want to read Part V, and possibly more, of this book. Sometimes, friends and family can help those who are also working with a professional and making their own efforts.
Whichever sources, techniques, or strategies you select, overcoming anxiety will be one of the most rewarding challenges that you ever undertake. The endeavor may scare you at first, and the going may start slow and have its ups and downs. But if you stick with it, we believe that you'll find a way out of the quicksand of anxiety and onto the solid ground of serenity.
Chapter 2: Examining Anxiety: What's Normal, What's Not
In This Chapter
Determining whether you have an anxiety disorder
Looking at types of anxiety
Uncovering anxiety copycats
Anxious feelings sprout up for most folks here and there and are complete
ly normal. In certain situations, anxiety is a perfectly understandable reaction. For example, if you're driving in a snowstorm and your car starts to spin out of control, feeling anxious makes sense. But sometimes anxiety signals something more serious.
To get a feel for the difference between something as serious as an anxiety disorder and a normal reaction, read the following description and imagine ten minutes in the life of Tiffany.
Tiffany feels restless and shifts her weight from foot to foot. Walking forward a little, she notices a slight tightening in her chest. Her breathing quickens. She feels an odd mixture of excitement and mounting tension. She sits down and does her best to relax, but the anxiety continues to intensify. Her body suddenly jerks forward; she grips the sides of her seat and clenches her teeth to choke back a scream. Her stomach feels like it might come up through her throat. She feels her heart race and her face flush. Tiffany's emotions run wild. Dizziness, fear, and a rushing sensation overtake her. The feelings all come in waves — one after the other.
You may wonder what's wrong with poor Tiffany. Maybe she has an anxiety disorder. Or possibly she's suffering a nervous breakdown. Perhaps she's going crazy. No, Tiffany actually wanted to feel scared and anxious!
You see, she was at an amusement park. She handed her ticket to the attendant and buckled herself into a roller coaster. After that, you probably understand the rest of her experience. Tiffany doesn't have an anxiety disorder, she isn't suffering a nervous breakdown, and she isn't going crazy. As her story illustrates, the symptoms of anxiety can be ordinary reactions to life.
In this chapter, we help you figure out whether you're suffering from an anxiety disorder, everyday anxiety, or something else. We take a close look at all the different forms and symptoms of anxiety. Then we discuss some of the other emotional disorders that often accompany anxiety.
Knowing When Anxiety Is a Help and When It's a Hindrance
Imagine a life with no anxiety at all. How wonderful! You awaken every morning anticipating nothing but pleasant experiences. You fear nothing. The future holds only sweet security and joy.
Think again. With no anxiety, when the guy in the car in front of you slams on the brakes, your response will be slower and you'll crash. With no worries about the future, your retirement may end up bleak. The total absence of anxiety may cause you to walk into a work presentation unprepared.
Anxiety is good for you! It prepares you to take action. It mobilizes your body for emergencies. It warns you about danger. Be glad you have some anxiety. Your anxiety helps you stay out of trouble.
Anxiety poses a problem for you when
It lasts uncomfortably long or occurs too often. For example, if you have anxiety most days for more than a few weeks, you have reason for concern.
It interferes with doing what you want to do. Thus, if anxiety wakes you up at night, causes you to make mistakes at work, or keeps you from going where you want to go, it's getting in the way.
It exceeds the level of actual danger or risk. For example, if your body and mind feel like an avalanche is about to bury you but all you're doing is taking a test for school, your anxiety has gone too far.
You struggle to control your worries, but they keep on coming. Regardless of what you do, anxious thoughts pop up over and over.
Presenting the Seven Types of Anxiety
Anxiety comes in various forms. The word "anxious" is a derivative of the Latin word angere, meaning to strangle or choke. A sense of choking or tightening in the throat or chest is a common symptom of anxiety. However, anxiety also involves other symptoms, such as sweating, trembling, nausea, and a racing heartbeat. Anxiety may also involve fears — fear of losing control and fear of illness or dying. In addition, people with excessive anxiety avoid various situations, people, animals, or objects to an unnecessary degree.
Psychologists and psychiatrists have compiled a list of seven major categories of anxiety disorders as follows:
Generalized anxiety disorder (GAD)
Social phobia
Panic disorder
Agoraphobia
Specific phobias
Post-traumatic stress disorder (PTSD)
Obsessive-compulsive disorder (OCD)
You don't need a full-blown diagnosis to feel that you have some trouble with anxiety. Many people have more anxiety than they want but don't completely fit the category of having an official anxiety disorder.
Only a mental-health professional can tell you for certain what type of anxiety you have, because various other disorders can look similar.
Generalized anxiety disorder: The common cold of anxiety
Some people refer to generalized anxiety disorder (GAD) as the common cold of anxiety disorders because it afflicts more people throughout the world than any other anxiety disorder. GAD involves a long-lasting, almost constant state of tension and worry. Realistic worries don't mean you have GAD. For example, if you worry about money and you've just lost your job, that's not GAD; it's a real-life problem. But if you constantly worry about money and your name is Bill Gates or Warren Buffet, you just may have GAD!
You may have GAD if your anxiety has shown up almost every day for the last six months. You try to stop worrying but you just can't, and you frequently experience a number of the following problems:
You feel restless, often irritable, on edge, fidgety, or keyed up.
You get tired easily.
Your muscles feel tense, especially in your back, neck, or shoulders.
You have difficulty concentrating, falling asleep, or staying asleep.
Not everyone experiences anxiety in exactly the same way. Some people complain about other problems — such as twitching, trembling, shortness of breath, sweating, dry mouth, stomach upset, feeling shaky, being easily startled, and having difficulty swallowing — and fail to realize that they actually suffer from GAD.
The following profile offers an example of what GAD is all about.
In a subway, Brian taps his foot nervously. He slept only a few hours last night, tossing, turning, and ruminating about the economy. He's sure that he's next in line to lose his job. Even though his boss says that he's safe, Brian can't stop worrying. He believes that he may end up broke and homeless.
His back is killing him; he shrugs his shoulders trying to loosen up his tight muscles. He struggles to concentrate on the blog that he's looking at and realizes that he can't remember what he just read. He notices his shirt feels damp. He thinks he might be sick. He is sick — with worry.
Brian has worked steadily at the same company since graduating from college six years ago. His work is highly technical. Most of the senior executives depend on his technology know-how. He has stashed away a nice amount of money for emergencies. Nevertheless, his anxiety has increased over the last year to the point that he notices that he's making mistakes. He can't think; he feels horrible and is in a constant state of distress. Brian suffers from GAD.
The economy can make anyone anxious at times. But Brian's worries seem out of proportion to his real situation. It seems unlikely that he's in danger of losing his job. However, his extreme anxiety may, in fact, cause him to get in trouble at work. People with overwhelming anxiety often make careless mistakes because of problems with attention and concentration. GAD takes everyday worries and turns up the volume to full blast.
Social phobia: Avoiding people
Those with social phobia fear exposure to public scrutiny. They frequently dread performing, speaking, going to parties, meeting new people, entering groups, using the telephone, writing a check in front of others, eating in public, and/or interacting with those in authority. They see these situations as painful because they expect to receive humiliating or shameful judgments from others. Social phobics believe they're somehow defective and inadequate; they assume they'll bungle their lines, spill their drinks, shake hands with clammy palms, or commit any number of social faux pas and thus embarrass themselves. They also worry about what others are thinking about them —
so much that they don't listen well enough to keep a conversation going.
Everyone feels uncomfortable or nervous from time to time, especially in new situations. For example, if you've been experiencing social fears for less than six months, you may not have social phobia. A short-term fear of socializing may be a temporary reaction to a new stress such as moving to a new neighborhood or getting a new job. However, you may have social phobia if you experience the following symptoms for a prolonged period:
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