October | 2010 | All About Anxiety

Archive for October, 2010

Cost-Effective Treatments for Panic and Anxiety Disorders

Today’s mental health community considers Cognitive Behavioral Therapy to be the best way to address disorders, both for its high rates of effectiveness and low rates of recidivism. Unfortunately, CBT is often tied to private clinics, which are extremely hard to afford for most families. This is a glaring problem, especially considering the fact that many insurance providers’ mental health offers are still far too meager to be of assistance to most mid- to low-income households or individuals. You don’t need to feel like you need to go without help, though. Low-cost alternatives, though far more sparse than they should be, are available, and in certain cases can be even more effective than high-priced treatments.

The first step in finding a low-cost mental health solution should be to check your local listings or search on the Internet for a nearby community mental health center. Community centers everywhere are struggling to secure funding and grants, which is especially difficult now given the economic climate and that, inexplicably, public health seems to be one of the first sectors on the chopping block for government spending cuts, but those that are still running give free or reduced cost diagnostic and educational services to anyone seeking their aid. Clinics that work with Medicare and Medicaid are also available, and are great sources of care for those who qualify. Check out the Substance Abuse and Mental Health Services Administration (SAMHSA) website to search for centers in your area.

Check to see if there are any universities in your area. Many psychology and psychiatry programs at universities across the nation offer sliding-scale fee treatment options, which can prove to be a lot cheaper than a private practice. You’re also receiving care straight from the source of academic progress in the mental health field, a research area that has exploded in the last decade. Individual and family therapy is available at countless universities. In fact, you can even participate in clinical trials for new methods of treatment, and sometimes get paid for it.

If someone were to tell you that the Internet is a quality source of treatment for anxiety and panic disorders, you would probably view that person with a healthy dose of skepticism. Getting any information from the Internet can often feel like a total crap shoot. Make no mistake, there is an alarming amount of misinformation on the Web, particularly in the field of mental health. That’s why it’s so surprising to hear that, if you look in the right places, you can find web-based therapies that are just as effective as therapy sessions with clinicians, if not more so. Studies performed around the world have shown that Cognitive Behavioral Therapy-based self-help programs on the Internet are just as effect as having regular face time with a clinician. Check out this article for more information about the efficacy and nature of online CBT treatments. The numbers are pretty staggering, but the gist is that Internet-based therapy seems to work for a majority of people who seek it, and work very well. Thanks to research like this, more time will be dedicated in the near future to further research and development toward making online therapies accessible and useful to more and more people.

Granted, the Internet being the Internet, always take precautions to make sure that the online-based CBT treatment you are using is actually legitimate. Seek out a community center or university for advice before using or choosing a certain website, or ask a local doctor or clinician. Once you’ve settled on a website, do some digging. Make sure the people behind the treatments are fully licensed clinicians with legitimate degrees. Send some emails and ask some questions. If you have any doubts, don’t go forward until they have been assuaged. Your mental health is far too important to leave in the hands of a website that is not fully trustworthy. This site is a good start, but still, perform your due diligence before going forward, no matter what option you choose to pursue.

Panic Disorder

You’re lying in bed at night, and all of a sudden, an overpowering, debilitating fear shivers through your body. Your extremities begin to tingle, and you feel lightheaded. Your heart starts banging against your ribcage, pain shooting through your chest and arms. It gets harder to breathe. The world, it seems, is spiraling out of control.

It sounds a lot like a heart attack, but for many people, incidents like these happen with great frequency, coming in weekly, or even daily, intervals. What was described above could very well be a heart attack, and if you experience these symptoms in an isolated and unexpected incident, you should not hesitate to seek emergency help immediately. These symptoms, however, are also characteristic of a panic attack.

A panic attack can last anywhere from 1 to 20 minutes, and in some cases can fade into new attacks. They are characterized by rapid heartbeat, heavy perspiration, dizziness, shortness of breath, trembling, fear, hyperventilation, tingling or numbness in extremities, feeling flushed, chills, nausea, chest pain or a feeling of doom or loss of control. The most telling symptom that indicates that the experience is likely a panic attack is an overwhelming sense of fear or dread.

A single panic attack does not necessarily indicate the presence of full blown panic disorder, though.
Panic disorder is defined by noticeable changes in behavior that persist for at least a month and the presence of anticipatory attacks, or panic attacks that arise out of fear of having another panic attack in the near future. These anticipatory attacks can also indicate the presence or contribute to the onset of agoraphobia, or social anxiety. Fear of having a panic attack in a public place, and incurring embarrassment, can cause some people to avoid social situations with greater frequency. However, do note that agoraphobia and panic disorder, though there is a high comorbidity rate between the two, are separate conditions that may require separate treatments.

Genetics has been useful in predicting who is more at risk to develop panic disorder than others. This just indicates a predisposition; panic disorders are usually touched off by one of two things: highly stressful life events or substance abuse. A death in the family, a move from one area of the country to another or a bad break-up can trigger panic disorder. Over long periods of time, alcohol abuse has been shown to worsen the symptoms of panic disorder, and excessive use of caffeine can easily trigger the disorder in and of itself.

Currently, cognitive behavioral therapy is the leading treatment for panic disorder. Drugs like SSRIs and Benzodiazepines have been shown to help in certain cases, but the former can actually trigger panic attacks if the individual is misdiagnosed, and the latter can lead to dependency and tolerance issues. As with many disorders, the most important part of the treatment might just be a strong support group and education. Learning about what the disorder entails, and sharing it with close family and friends, can allow a support group to form that can take sensible and positive action when the individual begins to have an attack.

Panic disorder is a frightening force to confront. Attacks can come without warning, and, if frequent, can prevent you from living life to the fullest. Untreated, it can have real effects on physical health, with correlations to myriad heart problems. It can also be costly financially; panic attacks can easily be misinterpreted as serious physical conditions, leading to unnecessary trips to the emergency room. For those that don’t have health insurance these days, money towards one emergency room trip is no small matter, let alone multiple trips.

Don’t feel alone. 2.4 million people in the United States have been diagnosed with panic disorder, with untold more still hesitating to seek help. If you are concerned that you or a loved one is struggling with panic disorder, find a mental health professional in your area, or consult your doctor, to do something about it.

Job Anxiety and Mindfulness

The idea of employment today means many different things to many different people. Unfortunately, anxiety is a common factor to almost all of those many different kinds of people. Some worry about needing to find a second or third job, while some worry about losing the one they have, with others still worrying about finding one in the first place. Over time, this anxiety can become pervasive. It becomes all-consuming, and the anxiety goes from being about being unable to find a job or about keeping your current one to being the very force that threatens to cause these fears to come to bear. Franklin Delano Roosevelt once said, “The only thing we have to fear is fear itself.” Whether or not that’s true is debatable, but what is certain is that fear itself is undoubtedly one of the greatest, if not the greatest, threats to human well-being ever encountered.

An article published a couple years ago in The Career Development Quarterly suggested mindfulness as a means to address this employment related anxiety. Mindfulness, as a whole, is the conscious practice of living and being in the present. Specifically, the article relates three parts of awareness through mindfulness that can be applied here, in order: stopping, observing and returning. When an anxiety-provoking cognition surfaces (e.g. “What if I lose my job?” or “How am I going to make ends meet?”), a good approach is to stop working on the task at hand and become aware of the thought as just that, a thought. Once you recognize it is a thought, something that is not actualized, you can observe this and other thoughts as they rise and fall. Rather than cling to them, and let them become sources of anxiety, recognize them as concerns, and let them pass. Once these fears have been seen for what they are, you can return to the task at hand, now without distraction.

The article wisely points out that mindfulness does not mean that one should strive to accept his or her lot without doing anything about it. Mindfulness, as a means of calming the mind, can allow many otherwise anxiety-wracked people to actually focus on creating a plan of action to address their own concerns, rather than have constant worry prevent cohesive action. Worrying by itself never solved anything; worries need to be put in their place, so to speak, so that we can be free to be constructive and positive within our daily lives.

A good way to introduce yourself to mindfulness is through breathing exercises. Simply sit in a quiet location, get comfortable, and begin to take full, but not overly deep, breaths, inhaling and exhaling regularly. Focus attention on only the breaths, but do not specifically try to clear your mind, or try to not think on purpose. You’ll find this to be counter-intuitive (read White Bears and Other Unwanted Thoughts, by Daniel Wegner, for more information). Keep your attention on the breath, and if a thought comes to mind, notice it, be aware of it, then let it go, calmly returning focus and attention to your breathing. If this exercise is made consistent practice, it can be a great way to promote familiarity with the idea of mindfulness, which makes it easily accessible whenever anxiety begins to take hold.

Anxiety is difficult to avoid today. The state of the economy isn’t great, and we live in a world that is constantly bombarded by news and media almost every second, both of which often tell us of things we simply wish didn’t need to be true. We need a revolution of optimism, a new positivity, in the face of today’s world, or as a people, our happiness will be horribly handicapped. The first step is to defeat our own anxiety by realizing that we are not powerless in the face of it.


Jacobs, S., & Blustein, D.. (2008). Mindfulness as a Coping Mechanism for Employment Uncertainty. The Career Development Quarterly, 57(2), 174-180.  Retrieved October 1, 2010, from Alumni – Research Library. (Document ID: 1613664271).