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Anxiety, Anxiety Disorders and Anxiety Treatment


“Anxiety is ubiquitous.  Everyone experiences episodic or situational anxiety symptoms. Diagnosable anxiety disorders are the most common mental disorders, more prevalent than both affective and substance abuse disorders.  In the general population, 1-year prevalence for any criterion-based anxiety disorder is 16% [1], and lifetime prevalence is 28.8% [2].  Compared with median age of onset among mood disorders (age 30), median age of onset among anxiety disorders is much younger (age 11) [2].”


“Anxiety disorders can adversely affect quality of life, mobility, education, employment, social functioning, health care, and physical well being.  Although the directional sequence of co-morbidity varies, a primary anxiety disorder often contributes to secondary depression or substance abuse.  The presence of an anxiety disorder is significantly associated with thyroid disease, respiratory disease, gastrointestinal disease, arthritis, migraine headaches, and allergic conditions, and, this co-morbidity with physical conditions is significantly associated with poor quality of life and disability [3].”


“Anxiety disorders usually are chronic or recurrent disorders characterized by stress sensitivity and a fluctuating course.  Both psychopharmacologic and cognitive-behavioral approaches are well established, evidence-based treatments for panic disorder, social anxiety disorder, generalized anxiety disorder and OCD.  Exposure-based behavioral treatment is well established as evidence-based treatment for specific phobias.”


“…Specific CBT techniques, even exposure methods, are probably less important than the relationship in which they are embedded; different clinicians get different results using the same CBT techniques [1, 147].  The relationship with the physician prescriber may be just as critical to patients’ tolerance of adverse effects, perseverance with medication, eventual medication response and willingness to pursue other forms of treatment [24,25].” 


Full source for excerpts from ASDI's Dr. Shearer above



Philosophy of Treatment and Recovery


“The popular notion that CBT involves ‘changing the thought in order to change the feeling’ is fallacious.  A more accurate formulation of modern anxiety treatment stresses better tolerance of distressing feelings, focusing not on changing thoughts to change feelings, but on how patients tolerate and evaluate what they think and feel.  What matters most is not what they feel, but how they feel about how they feel.  This concept—sometimes called ‘anxiety sensitivity’—is at the foreground of contemporary anxiety treatment.  People with anxiety disorders are sensitive to and afraid of anxiety.  The goal is to change the relationship between the patient and anxiety symptoms, reducing distress, and promoting psychological flexibility.”


“Finally, it is primarily avoidance of all kinds—cognitive, behavioral, and emotional—that fuels and maintains anxiety. This means that exposure to the experience of anxiety is essential for effective therapy.”   


“Patients often wish there were some magic wand that would erase their anxieties quickly.  But erasing their anxiety doesn’t mean that they are recovered.  …Recovery requires that patients feel confident in their ability to manage anxiety whenever it shows up, and to be able to explore whatever aspects of their life they wish, free of the fear of anxiety.  The less bothered they are by whatever anxiety occurs, the closer they come to what we mean by recovery.”  


Full source for excerpts from ASDI's Dr. Winston above






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