Anxiety attacks usually come without warning, and although the fear is generally irrational, the perceived danger is very real. Symptoms of anxiety and panic attacks / anxiety attacks include racing heart, hyperventilation or breathing difficulties, as well as chest pain, nausea or dizziness, headaches, shaking and trembling, and many more. Anxiety can also exacerbate many pre-existing medical conditions, such as ulcers, hypertension, and respiratory conditions including asthma and chronic obstructive pulmonary disease. Furthermore, anxiety is associated with mitral valve prolapse, chronic fatigue syndrome, sleep apnea, irritable bowel syndrome, and chronic tension headaches. Behavioural therapy - performed with a mental health professional to help gain control over unwanted behaviour. Cognitive therapy - similar to behavioural therapy but dealing with unhelpful and unproductive thoughts patterns.Anxiety medications can be habit forming and may have unwanted side effects, so be sure to research your options.

Medication - A short prescription of benzodiazepine tablets, such as diazepam, may be helpful in relieving short-term stress-related anxieties. Beta blockers are the best drug class to control physical symptoms of anxiety & panic attack and are normaly prescribed to prevent rapid heartbeat, shaking and trembling related symptoms. Buspirone is another medicine that is prescribed in the short-term to relieve anxiety. Antidepressants such as paroxetine may be prescribed for certain anxiety disorders such as generalised anxiety disorder, social phobia and OCD, and when anxiety is associated with depression. Group therapy - with one or two specialised therapists, particularly helpfully for certain conditions such as difficultly relating to others or being scrutinised by others. Psychoeducation - recognition by the patient that they have a treatable medical condition, and self-education through books and websites, and mental health professionals.

Anxiety and Anxiety Attacks Treatment Tips

1. Cognitive-behavior therapy (CBT) is very effective in the treatment of anxiety disorders.

2. Medication is sometimes used in the short-term to alleviate severe symptoms so that other forms of therapy can be pursued.

3. Relaxation techniques – Relaxation techniques such as progressive muscle relaxation, controlled breathing, and guided imagery may reduce anxiety.

4. Biofeedback – Using sensors that measure physiological arousal brought on by anxiety.

5. Hypnotherapy – Hypnosis for anxiety is conducted by a clinical hypnotherapist.

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If you are a person that is dealing with anxiety attacks, finding information about what the cause of anxiety attack is can be frustrating. There are many different ideas about the causes of anxiety attacks and some of them are wrong. When a person is having regular anxiety attacks they can feel depressed and bad about themselves because they feel it is their fault. Many people feel they are the cause of the anxiety attack and that if they just had greater control over themselves that they would not have them.

Suffererss who have knowledge about the cause of anxiety attacks are the individuals who are most likely to succeed and breakthrough and having this is one of the greatest tools to use to stop them. It is knowledge, not control that is the key to overcoming anxiety attacks.

One of the more common myths about the cause of anxiety attacks is that a person is going crazy, more specifically, that they have some form of schizophrenia. Schizophrenia is a genetic disorder that is not caused by anxiety. It may contain anxiety components, but is much different than anxiety attacks. People with schizophrenia usually have disjointed thoughts, speech babbling and are plagued with delusions and hallucinations. People with anxiety attacks usually do not suffer from these symptoms.

Schizophrenia usually begins in a persons teen age years and is diagnosable by age 25. Schizophrenia is not a disorder than suddenly appears; it is a gradual debilitating disease that a person is born with. So unless you have a strong family history of schizophrenia it is not something you should worry about nor should you think that it is a cause of your anxiety attack.

Another belief about the cause of anxiety attacks is that it is about losing control. People believe that they will die, lose organ function or lose their grip on reality. People believe that you might go on killing spree or pass out in a car and run into a shopping mall.

These are all fallacies of the mind. You are not going to do any of those things. Anxiety is the bodies natural response to feeling that it is in danger. Anxiety is not dangerous and neither are you.

A lot of people with panic attacks believe they are going to lose total control of themselves. The fact is that most of the anxiety attack occurs in the mind. People around the person having the attack rarely notice they are having a problem. The fear of embarrassing yourself can actually make the anxiety worse. It is the feeling of losing control in front of others that can trigger the anxiety attack. It becomes a self fulfilling prophecy except that people usually never lose control of themselves during an anxiety attack.

Some people feel that when an anxiety attack occurs that they will pass out in a public place. They imagine that they will be in the middle of a grocery store lying prone and unconscious in the floor. Worse than that some people believe that they will have an attack and no one will be around. They worry that they will be strewn in some ditch somewhere.

The fact is the fainting is not common with people having a panic attack. Fainting is usually the result of not enough oxygen going to the brain. When a person is having an anxiety attack their heart is usually pumping hard to circulate oxygen rich blood through out the body. A person may feel light headed because they may be hyperventilating but this usually does not lead to a fainting spell.

Another myth about anxiety attacks is that they are somehow caused by the heart. People believe they are having a heart attack. They feel tightness or pain in their chest, their heart is beating fast, they may be sweating and their respirations have increased. It is easy to see where the myth came from but the heart is not the cause of an anxiety attack not does an anxiety attack result in a heart attack.

Heart attacks usually occur when the heart is under stress that is during physical exertion. Panic attacks occur at anytime. Heart attacks are usually abated by resting and reducing the stress on the heart. A panic attack usually goes on and a person must calm themselves mentally before it really begins to subside. It is not a matter of control; it is more a matter of relinquishing control.

If you were to hook a person up to an EKG that is having a heart attack you would see unusual heart beats. A person having an anxiety attack usually only has an elevated heart rate.

The best way to reduce your anxiety of your heart is to see your doctor and have an EKG. Once you realize there is nothing to worry about it should reduce your anxiety over having a heart attack.

As you can see people worry about symptoms of anxiety attacks and misdiagnose themselves. They believe that the cause of an anxiety attack is mental or physical disease. Once they realize that it is not they can learn to overcome anxiety attacks for good.

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The first thing you need to do is determining the type of anxiety disorder you suffer from. There are five main types of anxiety disorders: generalized anxiety disorder, obsessive compulsive disorder, panic disorder, post-traumatic stress disorder, and social anxiety disorder. Effective treatments for each anxiety disorder are accessible, and new and enhanced treatments are always becoming available.

Non-medication treatments

Once you have found out the type of anxiety that you are suffering from you will be able to find the suitable anxiety disorder treatment. Mild anxiety disorders can often be treated relatively simple with relaxation and breathing techniques. Yoga, for instance, is a great type of exercise that can really help with anxiety and related health conditions. This is definitely something that should be tried prior to more serious forms of anxiety disorder treatment.

If your anxiety is more severe or constant, then therapy or counseling may become the best option. Cognitive behavioral therapy for one has been confirmed to be very effective in the treatment of all types of anxiety disorder. In this therapy you work one on one with an experienced and qualified mental health professional, who will assist you to deal with your fears in a safe and controlled environment. Over time you will be able to find out the root of your anxiety and from there work towards developing a treatment plan that will lead you to your normal life.

You can also select an anxiety disorder treatment plan that involves natural and herbal treatments. Herbal remedies such as valerian root and kava kava have over and over again proven to be effective at treating anxiety disorders and depression. You do need to keep in mind that just because these herbal remedies are natural it does not indicate that you do not still have to be careful. If taken inappropriately, these remedies can actually worsen your anxiety.

Hypnotherapy, biofeedback, and acupuncture are other options for anxiety disorder treatment. In order to determine which one is going to work best for you, you need to talk to your doctor. You may need to try a few different methods before you find the one that works best for you and your particular anxiety condition.

Medications for anxiety disorder

Generally, most treatments for anxiety disorders include at least one prescription medication. If you start taking medication as a treatment for anxiety disorder, it is important to understand that this should not be a long-term solution and you should keep working with a certified mental health professional in order to determine the root cause of your anxiety.

There are several common medications for anxiety disorder and one of them is selective serotonin reuptake inhibitors. Serotonin is known as the brain’s all-natural happy drug. Scientists believe that a lack of serotonin is the source of depression, anxiety, and panic attacks and therefore the purpose of selective serotonin reuptake inhibitors is to increase the levels of serotonin in the brain. Some familiar brands that use selective serotonin reuptake inhibitors are Prozac and Zoloft.

Benzodiazepines are another choice of medication, which act like minor tranquilizers. They decelerate the body’s nervous system, giving it an all-over calm. These types of medications can be addictive, so they should only be taken as prescribed. Some well-known brand names are Xanax and Valium.

Another medication that is used to treat anxiety disorder is antidepressants, which affect the neurotransmitters in the brain. Effexor is a good example of this type of anxiety disorder medication. Monoamine oxidase inhibitors (MAOIs) are very strong antidepressant drugs that should only be taken as a last resort after all other treatments have been tried. These drugs can be lethal when combined with certain other drugs and foods. One thing that need to be noted, anyone who takes antidepressants may become more susceptible to suicide, especially when they first begin to take them or when the dosage is changed.

Last important remark

Taking time to find the right treatment for your anxiety disorder is going to be vital to your success and you are going to want to work with a professional, especially if you have little knowledge on anxiety disorders in general. Remember that treatment for anxiety disorder is as different as the individuals who use them, and what works well for one person may not be effective for you. You may find relief from various sources of treatment including medication, therapy, self-help, alternative medicine or another form of treatment, and it may take some time and some trial and error in order to discover what works best for you.

One thing to remember is that support from family and friends are also very important. Many communities have organized support groups for people with different difficulties and you should be able to find a support group dedicated to anxiety disorder. These groups are typically made up of people with similar problems. Most patients find it reassuring to realize that they are not alone. Others in the group will be able to share advices, failures, and successes.

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It is also well-known that many anti-anxiety medications have a wide variety of side effects, ranging from weight gain to sexual dysfunction; and in some circumstances, the medications can even make the patient’s anxiety worse. Fortunately there are alternative methods of restoring balance and eliminating anxiety, without the use of prescription medications. Let’s take a look at a few of the most common methods of controlling and even eliminating anxiety without resorting to potentially dangerous drugs.

Anxiety is not a disease; it is an imbalance of the emotions. In other words, anxiety is a problem that is most commonly caused by our habitual way of thinking and reacting to the world–it’s a type of “thinking problem.” Therefore, the ideal way to alleviate anxiety and panic attacks is by addressing the root cause, not just the symptoms, and this can best be done by using exercises and techniques to reduce stress and improve feelings of well-being on a daily basis.

Relaxation exercises have been clinically proven to significantly reduce anxiety symptoms. Techniques such as tai chi and yoga benefit many anxiety sufferers, and can be practiced by virtually anyone of any age (assuming they are physically healthy and capable of mild to moderate exertion). Both tai chi and yoga are exercises which help to calm the mind, and can improve our mental focus and clarity by “slowing down” our thought processes, and concentrating on breath and movement.

In fact, focused breathing exercises are themselves a useful tool to reduce stress. Meditation is a similar practice that has also been proven to have a positive effect on restoring balance to the emotions, and even improve the functioning of the immune system and our overall physical health. All of these techniques are great alternatives to using anxiety medications, and best of all they are all natural, and have no known side effects or withdrawal symptoms.

But along with all of these stress reduction techniques, it is also important to eat a balanced diet, and limit our intake of stimulants such as caffeine and nicotine, both of which have been shown to aggravate anxiety symptoms. Cutting out (or at least cutting down on) coffee and soft drinks is important for anxiety sufferers. Reducing sugar intake is also helpful to avoid the “wired” feelings that can sometimes bring on anxiety or panic attacks.

Another aspect of your diet that can affect anxiety is food allergies. While there are many different types of food allergies that can cause emotional imbalances like anxiety, one commonly undiagnosed food allergy is dairy products. Some anxiety sufferers report immediate reduction in their overall feelings of stress and anxiety by simply eliminating dairy from their diet.

And last but certainly not least, anxiety sufferers should consider their overall attitude and state of mind. Because anxiety is a thinking problem, and not a disease, our habitual thoughts play a great role in its development. Positive thinking is not just for motivational speakers or the blissfully ignorant among us — is also an extremely useful tool in restoring balance to our lives, and eliminating chronic anxiety. In fact, there is no anti-anxiety medication on the market that is as powerful as your mind!

Refusing to be a victim and assuming responsibility for your state of mind is empowering, and can have very real, measurable results in improving anxiety situations. After all, anxiety and panic attacks begin with thoughts, which just prove how powerful our thoughts can be.

This is great news for anxiety sufferers, because if our thoughts are powerful enough to generate an anxiety attack in the first place, they are also powerful enough to eliminate anxiety problems, and bring us back into a balanced emotional state. When anxiety medications do not provide relief from the problem, using a combination of the all-natural methods listed in this article is a great alternative to overcoming anxiety and panic attacks once and for all.

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People with GAD cannot get rid of their concerns, even though they usually realize that their anxiety is more intense than the situation warrants. They are unable relax, startle easily and have difficulty concentrating.

Physical symptoms that often accompany the anxiety include, but are not limited to, fatigue, headaches, muscle tension, muscle aches, difficulty swallowing, trembling, twitching, irritability, sweating, nausea, lightheadedness, having to go to the bathroom frequently, feeling out of breath and hot flashes.

GAD affects about 6.8 million Americans and about twice as many women as men. It comes on gradually and can begin across the life cycle, though the risk is highest between childhood and middle age.

It is diagnosed when someone spends at least 6 months worrying excessively about a number of everyday problems. There is evidence that genes play a modest role in GAD.

Other anxiety disorders, depression, or substance abuse often accompany GAD, which rarely occurs alone. It is commonly treated with medication an/or cognitive-behavioral therapy.

Treatment of Anxiety Disorders

Anxiety disorders are typically treated with medication, specific types of psychotherapy, or both. Treatment choices depend on the problem and the persons preference.

Before treatment, a doctor must conduct a careful diagnostic evaluation to determine whether the symptoms are caused by an anxiety disorder or a physical problem. If an anxiety disorder is diagnosed, the type of disorder must be identified, as well as any coexisting conditions, such as depression or substance abuse.

Sometimes alcoholism, depression or other coexisting conditions have such a strong effect on the individual that treating the anxiety disorder must wait until the coexisting conditions are brought under control.
People with anxiety disorders who have already received treatment should tell their current doctor about that treatment.

If they received medication, they should tell their doctor what medication was used, what the dosage was at the beginning of treatment, whether it was ever increased or decreased, what side effects occurred and whether the treatment helped them significantly. If they received psychotherapy, they should describe the type of therapy, how often they attended sessions and how much the therapy helped.

Often people believe that they have failed at treatment or that the treatment did not work for them when, in fact, it was not given for an adequate length of time or was administered incorrectly. Sometimes people must try several different treatments or combinations before they find the one that works for them.

Medications

Medication will not cure anxiety disorders, but it can keep them under control while the person receives psychotherapy, often from a psychologist. The principal medications used to treat anxiety disorders are antidepressants, anti-anxiety drugs and beta-blockers which control some of the physical symptoms.

With proper treatment, many people with anxiety disorders can lead normal, fulfilling lives.

Antidepressants

Antidepressants were developed to treat depression but are also effective for anxiety disorders. Although these medications begin to alter brain chemistry after the very first dose, their full effect requires about 4 to 6 weeks before symptoms start to fade. It is important to continue taking these medications long enough to let them work.

SSRIs

Some of the newest antidepressants are called selective serotonin reuptake inhibitors, or SSRIs. SSRIs alter the levels of the neurotransmitter serotonin in the brain, which, like other neurotransmitters, helps brain cells communicate with one another.

Fluoxetine (Prozac), sertraline (Zoloft), escitalopram (Lexapro), paroxetine (Paxil) and citalopram (Celexa) are some of the SSRIs commonly prescribed for panic disorder, OCD, PTSD, and social phobia. These drugs are also used to treat panic disorder when it occurs in combination with OCD, social phobia or depression.

Venlafaxine (Effexor), a drug closely related to the SSRIs, is also used to treat GAD. These medications are started at low doses and gradually increased until they cause side effects or produce a beneficial effect.

SSRIs have fewer side effects than older antidepressants, but they sometimes produce slight nausea or jitters when people first start to take them. These symptoms fade with time, however.

Some people also experience sexual dysfunction with SSRIs, which may be helped by adjusting the dosage or switching to another medication.

Tricyclics

Tricyclics are older than SSRIs and work as well as SSRIs for anxiety disorders other than OCD. They are also started at low doses that are gradually increased.

They sometimes cause dizziness, drowsiness, dry mouth and weight gain, which can usually be corrected by changing the dosage or switching to another medication.
Tricyclics include imipramine (Tofranil), which is prescribed for panic disorder and GAD and clomipramine (Anafranil), which is the only tricyclic antidepressant useful for treating OCD.

MAOIs

Monoamine oxidase inhibitors (MAOIs) are the oldest class of antidepressant medications and the ones most commonly prescribed for anxiety are phenelzine (Nardil), followed by tranylcypromine (Parnate) and isocarboxazid (Marplan), which are useful in treating panic disorder and social phobia.

People who take MAOIs cannot eat a variety of foods and beverages (including cheese and red wine) that contain tyramine or take certain medications, including some types of birth control pills, pain relievers (such as Advil, Motrin and Tylenol, cold and allergy medications and herbal supplements; these substances can interact with MAOIs to cause dangerous increases in blood pressure.

MAOIs can also react with SSRIs to produce a serious condition called serotonin syndrome, which can cause confusion, hallucinations, increased sweating, muscle stiffness, seizures, changes in blood pressure or heart rhythm and other potentially life-threatening conditions.

Anti-Anxiety Drugs

High-potency benzodiazepines combat anxiety and have few side effects other than drowsiness. Because people can develop a tolerance to them and may need higher and higher doses to get the same effect, benzodiazepines are generally prescribed for short periods of time, especially for people who have abused drugs or alcohol or who become dependent on medication easily.

One exception to this rule, however, is people with panic disorder, who can take benzodiazepines for up to a year without harm. Clonazepam (Klonopin) is used for social phobia and GAD, lorazepam (Ativan) is helpful for panic disorder and alprazolam (Xanax) is useful for both panic disorder and GAD.

Some people experience withdrawal symptoms if they stop taking benzodiazepines abruptly instead of tapering off, and anxiety can return once the medication is stopped. These potential problems have led some physicians to shy away from using these drugs or to use them in inadequate doses.

Buspirone (Buspar), an azapirone, is a newer anti-anxiety medication used to treat GAD. Possible side effects include dizziness, headaches, and nausea. Unlike benzodiazepines, buspirone must be taken consistently for at least 2 weeks to achieve an anti-anxiety effect.

Psychotherapy

Psychotherapy involves talking with a trained mental health professional, such as a psychologist, social worker, or counselor, to discover what caused an anxiety disorder and how to deal with its symptoms.

Cognitive-Behavioral Therapy

Cognitive-Behavioral Therapy (CBT) is very useful in treating anxiety disorders. The cognitive part helps people change the thinking patterns that support their fears and the behavioral part helps people change the way they react to anxiety-provoking situations.

For example, CBT can help people with panic disorder learn that their panic attacks are not really heart attacks and help people with social phobia learn how to overcome the belief that others are always watching and judging them. When people are ready to confront their fears, they are shown how to use exposure techniques to desensitize themselves to situations that trigger their anxieties.

People with OCD who fear dirt and germs are encouraged to get their hands dirty and wait increasing amounts of time before washing them. The therapist helps the person cope with the anxiety that waiting produces; after the exercise has been repeated a number of times, the anxiety diminishes.

People with social phobia may be encouraged to spend time in feared social situations without giving in to the temptation to flee and to make small social blunders and observe how people respond to them. Since the response is usually far less harsh than the person fears, these anxieties are lessened.

People with PTSD may be supported through recalling their traumatic event in a safe situation, which helps reduce the fear it produces. CBT therapists also teach deep breathing and other types of exercises to relieve anxiety and encourage relaxation.

Exposure-based behavioral therapy has been used for many years to treat specific phobias. The person gradually encounters the object or situation that is feared, perhaps at first only through pictures or tapes, then later face-to-face.

Group therapy is particularly effective for social phobia. Often homework is assigned for participants to complete between sessions.

There is some evidence that the benefits of CBT last longer than those of medication for people with panic disorder, and the same may be true for OCD, PTSD, and social phobia. If a disorder recurs at a later date, the same therapy can be used to treat it successfully a second time.

Medication can be combined with psychotherapy for specific anxiety disorders, and this is the best treatment approach for many people.

Taking Medications

Before taking medication for an anxiety disorder:

1. Ask your doctor to tell you about the effects and side effects of the drug.

2. Tell your doctor about any alternative therapies or over-the-counter medications you are using.

3. Ask your doctor when and how the medication should be stopped. Some drugs cannot be stopped abruptly but must be tapered off slowly under a doctors supervision.

4. Work with your doctor to determine which medication is right for you and what dosage is best.

5. Be aware that some medications are effective only if they are taken regularly and that symptoms may recur if the medication is stopped.

How to Get Help for Anxiety Disorders

If you think you have an anxiety disorder, the first person you should see is a psychologist, psychiatrist or your family doctor. It must be determined whether the symptoms that alarm you are due to an anxiety disorder, another medical condition or both.

If an anxiety disorder is diagnosed, the next step is usually contracting with a mental health professional to provide treatment. The practitioners who are most helpful with anxiety disorders are psychologists and therapists who have training in cognitive-behavioral therapy and/or behavioral therapy and who are open to using medication if it is needed.

You should feel comfortable talking with the mental health professional you choose. If you do not, you should seek help elsewhere.

Once you find a mental health professional with whom you are comfortable, the two of you should work as a team and make a plan to treat your anxiety disorder.
Remember that once you start on medication, it is important not to stop taking it abruptly.

Certain drugs must be tapered off under the supervision of a doctor or bad reactions can occur. Make sure you talk to the doctor who prescribed your medication before you stop taking it.

If you are having trouble with side effects, it is possible that they can be eliminated by adjusting how much medication you take and when you take it.
Most insurance plans, including health maintenance organizations (HMOs), will cover treatment for anxiety disorders. Check with your insurance company and find out.

If you do not have insurance, the Health and Human Services division of your county government may offer mental health care at a public mental health center that charges people according to how much they are able to pay. If you are on public assistance, you may be able to get care through your state Medicaid plan.

Ways to Make Treatment More Effective

Many people with anxiety disorders benefit from joining a self-help or support group and sharing their problems and achievements with others. Internet chat rooms can also be useful in this regard, but any advice received over the Internet should be used with caution, as Internet acquaintances have usually never seen each other and false identities are common.

Talking with a trusted friend or member of the clergy can also provide support, but it is not a substitute for care from a psychologist or other mental health professional. Stress management techniques and meditation can help people with anxiety disorders calm themselves and may enhance the effects of their therapy.

There is preliminary evidence that aerobic exercise may have a calming effect. Since caffeine, certain illicit drugs and even some over-the-counter cold medications can aggravate anxiety disorders, they should be avoided.

Check with your physician or pharmacist before taking any additional medications. Also, the family is very important in ones recovery. Ideally, the family should be supportive and should not trivialize the disorder or demand improvement without treatment.

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Anxiety and fear causes crisis. One must understand fear and anxiety, how fear and anxiety work, to control anxiety, manage fear. Can be overcome anxiety and fear.

Managing fear, overcoming anxiety can be without expensive books, courses. Overcoming children’s fears, anxieties, controlling, managing adult fear and anxiety is possible. Here is, whether in child or adult, how to control, manage, overcome fear and anxiety.

Fear and anxiety, being afraid and anxious, begin when we are, or feel, vulnerable. We experience uneasiness and concern which frightens, makes fearful. This causes timidity, and timidity gives rise to a state of alarm which sometimes involves such hesitation that shrinks us from dealing with a matter or situation that needs to be resolved. The pain and emotion, the tension and stress of fear and anxiety is accompanied by a feeling of helplessness which is negative thought which so affects the functioning of the nervous system in dealing with fear and anxiety.

Fright, fear, anxiety, can cause crises, neurosis; the dread, terror, horror of phobia is fear. Worrying, most worries, are fear; but, often, we can’t cope with worry. Positive thinking helps but is not coping with fear, controlling fear, dealing with worry; to control fear, anxiety, we must know how fear and anxiety work.

Fear and anxiety effect automatically. Our autonomic nervous system regulates how body organs work. Chiefly a part of the autonomic nervous system, called ’sympathetic’, automatically interacts with our mind when we worry, experience anxiety, fear.

When fear is felt the mind signals a threat, danger, or emergency physically (e.g. a hand raised in anger) or psychologically (e.g. distrust); the sympathetic nervous system immediately comes into action to help protect or defend ourselves to our best possible advantage. Suddenly automatically we breath more oxygen which, with cyclic biochemical reactions, energises our ‘electron transport chain’ and synthesises with other substances in our body, upon that fear signal. This synthesising upon that fear signal urgently turns on electrical impulses which fire from cell to cell at very high speeds communicating that fear to the control centre in the brain.

In our fear and anxiety, the brain instantly issues commands to the organs to take action. Our organs immediately divert and concentrate energies from other organs to those relevant to our fear and anxiety. The pupils of our eyes grow bigger to see better, the blood vessels expand to more and faster supply, to enable our muscles to react. In aid of that the body produces adrenaline to enhance alertness and our actions for ‘flight’ or ‘fight’, as our values dictate, and as we feel directed by our fear, anxiety.

Anxiety and fear are not cured by medication. Drugs only help coping with worry; only help cope with fear or anxiety. It is generally agreed by expert that if we know how to, we can better control fear, manage anxiety. Panic confuses and causes worry; but, except for phobias (when one must consult a doctor), it isn’t complicated to manage fear, control anxiety.

Adult fear and anxiety is mostly due to problems; e.g., worry over debt, disapproval, separation, failure.

Children have no adult problems; child fear or anxiety is feeling inadequate about the frightening unknown.

Adults cope with both, whether it is fear or anxiety arising from adult problems or child fear and anxiety over inability to protect or defend as adults can.

In child fear control, managing child fear and anxiety it often suffices to ensure an “I am protected” feeling for the child. A child’s fear, e.g., of the dark is over anxiety that something may go wrong or be hurtful; e.g. a dim light helps ease that fear, anxiety, but the child needs assurance that you are nearby and can protect from or defend against what is causing the child’s fear and anxiety. If fear of the unknown is, e.g., anxiety over a new environment, accompany the child until it is realised that there is nothing to fear.

In adults fear and anxiety does not go away because of their being fear and anxiety with good reason. Adult fear and anxiety involve not unreasonable worry but possible significant consequences. But an adult can control worry, even overcome fear, anxiety.

Coping with, overcoming fear and anxiety begins with realising that problems are solvable, consequences avoidable. This enables to cope with fear and anxiety.

Adults suffer fear and anxiety for two reasons. They do not know how to solve the problem; and, it never occurs to most to find out because panic causes confusion. Panic prevents rational thinking, they can not think how to, e.g., reason arguments, acceptably put a hurt right; they, e.g., forget or never find out that an offer to pay by instalments may not be lawfully refused. The problem seems unsolvable, panic becomes fear, anxiety; worry makes fear worse.

Anxiety and fear often result from failure to clearly identify the problem. That is the cause of panic, a problem’s becoming worse, of the fear and anxiety.

Problem solving involves rational though, and that necessitates calmness. If angry, do ‘count to ten’.

Avoiding panic is avoiding fear and anxiety. If feeling panicky, take a deep breath: inhale, hold it to the count of three, exhale slowly; this is regarded as regulating oxygen intake and avoiding the above-mentioned body functions and chemical reactions which substitute to normal body and mind functions the limited, concentrated, emergency, urgent functioning. You will feel less urgency, less rushed, less panicky and less likely to suffer fear and anxiety.

Similarly easy it becomes then to replace the reduced likelihood of fear, anxiety with rational thought. One only needs to know how to do so.

One cannot apply rational thought to a problem if one is confused. The panic was due to not knowing what to do, confusion. One needs to clear one’s head in order to think and substitute to avoided panic, and reduced fear and anxiety, rational thought.

One’s bodily functions and mental functions interact. Adrenaline enhances what the brain signals. If it signals an emergency, it enhances urgency; if it signals calm though, then it enhances that. This is the basis of ‘positive thinking’. Such automatic biological, electrochemical, functioning of the nervous system enhances mental functions, confusion is rid of. Then can be clearly seen the problem and properly explored the ways of solving it without panic worsening it, causing fear and anxiety.

Then you can identify your fear. What is it that you fear, why? What part or parts of the problem is it that is causing you the worry, the anxiety, the fear? Think of what exactly it is you fear, are afraid of. ‘Know your enemy’ to easier mange anxiety, overcome fear.

One can learn to control one’s fear and, in the verses of Orhan Seyfi Ari in his Mystic Man (translated), one can enjoy the feeling that…

“Neither anxiety has he, nor fear,

The World’s like a rubber ball under his feet rather,

The Sun in one hand, and the Moon in the other.”

Calmness helps solution, managing fear and anxiety.

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* These symptoms must cause clinically important distress, or impair work, social or personal functioning, and they should not fulfil the criteria for Mixed Episode.

* The symptoms are not due to the direct physiological effects of a substance (e.g., abuse of a drug or medication) or a general medical condition (e.g., hypothyroidism).[1]

* Other than in the case of severe symptoms (severely impaired functioning, severe preoccupation with worthlessness, ideas of suicide, delusions or hallucinations or psychomotor retardation), the episode should not have begun within two months of the loss of a loved one. (See Bereavement)

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• Major depressive episode (0)
• Karen Horney (0)

Over a two week period, the patient has consistently experienced five or more of the following symptoms, and these behaviours must be outside the parameters of the patient’s normal behaviour. Either depressed mood or decreased interest or pleasure must be one of the five (although both are frequently concomitant).

Mood

* For the better part of nearly every day, the patient reports a depressed mood or appears depressed to others.[3]
o The patient may state that he or she has been feeling sad, depressed, blue, empty, “down in the dumps,” hopeless, etc. If the patient is in denial about these feelings, yet appears to be on the verge of tearfulness, manifests a depressed facial expression and disposition, or appears to be overly irritable, these may also indicate the presence of depressed mood. NOTE: Some people may be more likely to report physical complaints (i.e., aches, pains, headaches) rather than depressed mood, however physical symptoms without physical cause are often indicators of depression. See Myalgia and Neuralgia [4]

Anhedonia and loss of interest

* For most of nearly every day, interest or pleasure is markedly decreased in nearly all activities (noted by the patient or by others). (See Anhedonia)[3]
o People suffering with depression tend to lose interest in things they once found enjoyable. Activities are no longer enjoyable and there is often a loss of interest in or desire for sex. People who are depressed may say, “I just don’t care anymore,” or “nothing matters anymore.” Friends and family of the depressed person may notice that he/she has withdrawn from friends, or has neglected or quit doing activities that were once a source of enjoyment.[4]

Eating disorders and weight gain/loss

* Although not dieting, there is a marked loss or gain of weight (such as five percent in one month) or appetite is markedly decreased or increased nearly every day.[3]
o Changes in appetite take on two manifestations: under- or over-eating. In the first instance, some people never feel hungry, can go long periods of time without wanting to eat, may forget to eat, or if they do eat a small amount of food may be sufficient. A reduction in weight is often associated with a melancholic type of depression.
o In the second instance, some people tend toward an increase in appetite and may gain significant amounts of weight. They may tend to crave certain types of food such as sweets or carbohydrates. People with seasonal affective disorder (SAD) often crave foods high in carbohydrates. Weight gain is often associated with atypical depression.[4]

Sleep

* Nearly every day the patient sleeps excessively, known as hypersomnia, or not enough, known as insomnia.[3]
o Insomnia is the most common type of sleep disturbance for people who are clinically depressed. Waking in the middle of the night and being unable to go back to sleep is known as “middle insomnia”; waking too early as “terminal insomnia”, and; having difficulty falling asleep at night as insomnia. Insomnia is often associated with a melancholic type of depression.
o A less frequent sleeping problem is oversleeping (called “hypersomnia”). This may occur in the form of sleeping for prolonged periods at night or increased sleeping during the daytime. Even with excess sleep, a person may still feel tired and sluggish during the day. People with seasonal affective disorder (SAD) may sleep longer during the winter months. Hypersomnia is often associated with an atypical depression.[4]

Motor activity

* Nearly every day others can see that the patient’s activity is agitated or slow.[3]
o People suffering from depression may be either quite agitated (psychomotor agitation), or very lethargic (psychomotor retardation) in their mannerisms and behavior. If a person is agitated, he or she may find it difficult to sit still, may pace the room, wring his/her hands, or fidget with clothes or objects. Someone with psychomotor retardation will tend to move sluggishly, may move across a room very slowly, avert his/her eyes, sit slumped in a chair and speak slowly, saying little.
o In terms of diagnosis, the agitation or slowing down of one’s demeanor must be to the degree that it can be observed by others.[4]

Fatigue

* Nearly every day the person experiences extreme fatigue.[3]
o A decrease in energy and feeling fatigued are very common symptoms for those who are clinically depressed. A person may feel tired without having engaged in any physical activity, and day-to-day tasks become difficult, including getting washed and dressed in the morning. Job tasks or housework become very tiring, and the person finds his/her work at home, school, or on the job suffers.[4]

Self-worth

* Nearly every day the patient feels worthless or inappropriately guilty. These feelings are not just about being depressed, they may be delusional.[3]
o Depressed people may think of themselves in very negative, unrealistic ways such as manifesting a preoccupation with past “failures”, personalisation of trivial events, or believing that minor mistakes prove their inadequacy. They also may have an unrealistic sense of personal responsibility and see things beyond their control as being their fault. Additionally, self-loathing is common in clinical depression, and can lead to a downward spiral when combined with other symptoms. [4]

Concentration

* Noted by the patient or by others, nearly every day the patient is indecisive or has trouble thinking or concentrating.[3]
o A person with depression frequently experiences negative and pessimistic thoughts, and reports that his/her ability to think, concentrate, or make decisions becomes impaired. Memory and distraction problems are common. This problem can be notably pronounced, causing significant difficulty in functioning for those involved in intellectually demanding activities.[4]

Thoughts of death

* The patient has had repeated thoughts about death (other than the fear of dying), suicide (with or without a plan) or has made a suicide attempt.[3]
o The frequency and intensity of thoughts about suicide can range from believing that friends and family would be better off if one were dead, to frequent thoughts about committing suicide (generally related to wishing to stop the emotional pain), to detailed plans about how the suicide would be carried out. Less severely suicidal people may have regular thoughts of suicide, while those who are more severely suicidal may have made specific plans and decided upon a day and location for the suicide attempt.

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In addition to the emotional pain endured by those suffering from depression, significant economic costs are associated with depression. In fact, American and Canadian studies have indicated that the costs associated with depression are greater than those associated with hypertension, and equal to those of heart disease, diabetes, and back problems.[2]

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