Treatments That Work for Anxiety Disorders for Children and Adolescents

Parents ask me often, "Is there any way to know what actually works to treat my child's anxiety?" The simple answer is 'yes,' but the more complicated answer about how we arrive at 'yes' is a bit more interesting. To understand the more-complicated answer, it's important to know more about the term 'meta- analysis.' A meta-analysis is a large analysis of many studies or analyses - bringing a large amount of data together under strict requirements to look at conclusions more broadly. About 15 years ago, psychologists Ollendick and King conducted a very influential meta-analysis of evidence-based psychosocial treatments for child and adolescent (referred to as youth from this point forward) anxiety disorders. They concluded that psychosocial treatments (i.e., cognitive and behavior therapies) were likely effective but that better methods and further research were needed before stronger conclusions were reached. In the interim years, methods for evaluating treatments have improved dramatically and strong conclusions now support the effectiveness of cognitive behavior therapy (CBT). This is explained further below, but first let's look at the scope of the problem.

Anxiety disorders are one of the most common disorders in youth. Depending on the report, in the United States between 5%-10% of youth have an anxiety disorder with some studies reporting as high as 20% (ref Silverman). The same article cites, a study based on surveys in New Zealand and Australia reporting between 3% and 44% of youth have an anxiety disorder! In these studies, the anxiety disorders include separation anxiety/school refusal (sometimes called school phobia), social anxiety, specific phobias (e.g., needles, animals, heights, etc.), and overanxious/generalized anxiety. Three anxiety disorders together - social anxiety, separation anxiety, and generalized anxiety - make up what clinicians call the 'anxiety triad' and are highly prevalent among youth. Most youth who have symptoms of one of these disorders often have symptoms of the other two. Similar prevalence rates in the 3% to 10% range occur for OCD (ref March and Storch, Drew article).

In 1998, Ollendick's and King's meta-analysis showed that behavioral procedures like imaginal (using guided instruction to imagine a real-life event) and in vivo (real life) desensitization (exposure therapy that uses small steps to help the brain turn off alarms related to a specific trigger) were "probably efficacious " (such a cautious statement!) for childhood phobias and that these same procedures were similarly effective with and without family anxiety management training. In 1998, the authors concluded (as researchers are wont to do) - that more research with better methodology was needed. Thankfully, better studies with better methodologies occurred, producing the updated meta-analysis by Silverman and colleagues and numerous publications about separate, effective OCD treatment for youth by March, Storch, and many others.

Studies included in the meta-analysis by Silverman and her colleagues were categorized from the most rigorous - randomized prospective clinical trials (random assignment, blinded assessments, inclusion/exclusion, adequate sample, state-of-the-science diagnostics, well-established and sound measures with clearly defined interventions and adherence in implementing the intervention). These very 'tight' studies are Type 1 studies. Other studies included ranged from 2, to 6. As the number descended, criticism of methods increased. For example, studies designated Type 6 were case studies or opinion papers. The carefully designed studies, which contributed greatly to the conclusions reached, had qualities like strict inclusion/exclusion criteria (for example, youth with low IQ, psychotic disorder, unstable family life, co-occurring mental disorders, and similar characteristics that could affect the viability of a treatment were excluded).

Compared to the tentative conclusions of the 1998 analysis by Ollendick and King, Silverman and her colleagues concluded: "The considerable progress made shows that cognitive behavioral treatments, in individual or group formats, with and without parent involvement lead to positive treatment outcomes in children and adolescents with phobic and anxiety disorders." Similar conclusions by March and Storch for OCD, support CBT's effectiveness for all anxiety disorders in youth.

These strong improvements in methodology and treatment study outcomes that support CBT open the way for more-detailed questions about what works in CBT. Scientists want to further refine information about treatment (e.g., how much of a treatment is needed specifically, what is it about the treatment that works, what other factors affect whether the treatment works, whether medicine should be included in treatment, which aspects of treatment over what period of time make the most difference, and other similar questions). From studies of specific aspects of CBT, we know, for example, that it is important to reduce anxious self talk. Also, a parent's anxiety or depression can negatively affect treatment. Refining treatment questions (what works/what doesn't) is a good thing because it helps provide better answers for families and more specific direction for treatment providers. How much treatment, the role played by medications, how to measure precisely, and other methodological issues will occupy researchers for awhile, but it's great as a clinician to be able to offer effective, evidence-based CBT interventions for anxiety disorders in youth.

At NeuroScience, Inc., we contribute to research while we practice as clinicians. One of our current studies explores the effects of a novel medication on the disorders of the 'anxiety triad' mentioned above. To learn more about this study or consult with one or our experts about treating youth anxiety disorders, please contact us at 703-787-9090 or visit our Youth Anxiety Disorder website.

Keith E. Saylor, Ph.D., Sc.M., the President and CEO of NeuroScience, Inc., received his Ph.D. in Health Psychology from Stanford University and his Master's degree in Public Health from the School of Hygiene and Public Health, Johns Hopkins University. Dr. Saylor is a licensed clinical psychologist (Virginia) who maintains active research and private practices.

Original article

An Introduction to Anxiety Disorders and Attacks

Anxiety is an incredibly regularly and often overwhelming natural occurrence in one's mind that leads a lot of people to think that there is something severely wrong with them. As a sufferer from anxiety attacks, and having ended up in hospital after two of them, I will attempt to use my understanding to attempt to explain this to one who hasn't experienced it, or maybe even one who is going through it.

Every living being on this planet experiences anxiety, it is useful as a survival aid and our ancient ancestors undoubtedly had such successful genes through being cautious observant and cynical to all circumstances. In the 21st century, we're not in need of our survival instinct anymore, but there are tons of useless mental propensities left over in our brain from the phases of our evolution.

Anxiety or Depression issues trouble at least 1/3 people in their lifetimes, despite how common this is, sufferers genuinely think that they're the only one that feels this way, and there is something gravely wrong with them. This however is not the case, but despite whatever reassurance offered, the sufferer still genuinely holds the belief that something is seriously wrong with them.

Anxiety spawns from the fight or flight response evident in all of nature, when presented with a threat, we will either do one or the other, but our survival instinct that makes that subconscious decision is prone to getting confused and overworked. Anxiety attacks occur when this fight or flight response is ticked over and over in the sufferer's head, constantly setting them into a highly nervous and vulnerable state, often feeling as if their death is imminent, sometimes even having an outer body experience or passing out. Most sufferers are often shocked by the severity and unexpected nature of this, often taking them quite a few days before they feel normal after an attack.

These panic attacks can be a one off occurrence, or a precursor to a panic disorder. It's important to remember that anxiety is an incredibly common and treatable problem, and there are so many different solutions that can be offered by your GP, the odds are most definitely on your side. In addition, anyone who suffers from an anxiety attack should see their doctor as soon as possible afterwards, purely so you let him know what has happened, and you can have this on your file if you have one in the future.

I hope this has helped you understand anxiety a little better, as a long time sufferer myself I have always wanted to put into words how it feels.

Harry is a business consultant and has had the opportunity to work with several different companies. In his career, he has seen the various companies employed by a single firm to take care of tasks such as washroom services. For more information on the topics raised in this article visit City Healthcare.

Original article

Treatment of Anxiety Disorders Increases in Efficacy by the Combining of Individual Approaches

Anxiety disorder is a prevalent mental illness characterized by idiopathic fears, worries, impulsive behavior and many more. There are plenty of sub-types such as social phobia, OCD, generalized anxiety disorder and panic disorder, which manifest themselves in varying symptoms (with a considerable overlap), but all of them frequently respond to a common treatment. How does the brain exactly evoke anxiety and whether it originates from a common cause is left to discussion, however there have been proposed numerous theories upon which many forms of treatment are based:

1. Exercise - Performing aeorobic physical activities has been proposed to activate the endocannabinoid system resulting in a so called runner's high. Binding of anandamide to its corresponding receptor sites can bring about pain relief and mood enhancement. Additionally does exercise promote neuronal growth within the brain. This neurotrophic effect might be appreciated by many as anxiety/depression often result in increased cortisol levels (hypercortisolemia), which has a neurotoxic effect in excess.

2. Diet - Eating excess of sugars will result in rapid mood cycling: you might experience a short relief by eating something sweet, but know that it won't last long and likely emphasize depression because of the contrast it can induce. Drinking coffee is also something to consider avoiding as it activates adrenergic receptor sites (alpha 1 and 2), agonists at alpha 1 (such as coffee) have been shown to induce anxiogenic effects in subjects. Adhering to protein rich foods with an adequate carbohydrate intake is advised.

3. Supplements - It has been long thought that psychiatric disorders arise from the shortage of neurotransmitters/neuromodulators operating our brains. This and possible regional malfunctions (cingular cortex, amygdala, substantia nigra etc.) are the likely criminals implicated in a wide array of mental disorders. All of these require proper enzymes, proteins and other substances to operate correctly. Therefore supplementing yourself with vitamins (B and C mostly) and Zinc, Calcium, Magnesium, Omega-3, Lecithin and others might prove useful by eliminating possible deficiencies, which might be adding to or even be the sole cause of the disorder.

4. Medication - Prescription medication is a common accessory of many psychiatric patients. The spectrum of available anxiolytics is rather wide, offering different approaches involving different pharmacodynamics. The etiology of an anxiety disorder is not same among all sufferers, contrary to what many psychiatrists and physicians assume, making choosing the correct pill a matter of experimentation. The intricacy and heterogenity of our central nervous system do not enable for generalizations: e.g your anxiety might emanate from a vitamin deficiency while my anxiety ca be a result of receptor hyper-sensitivity. Therefore starting with an option presenting the best side effect to efficacy ratio is advised.

5. Meditation - Practices such as meditation have been revealed to support the growth of gray matter, structure associated with intelligence, and bring more order into a disorder by improving focusing and decision making skills. Meditating daily for 10-20 minutes will enable your mind to rest and make amends to the plaguing disorder. Furthermore a technique as such enables one to analyze the sources of distress and makes a disorder more accessible for corrections.

These are only few practices used by myriad anxiety sufferers to combat their symptoms. The efficiency of each of these approaches will vary among individuals mainly because of subjective reasons such as etiology of the disorder and personal psychology. However by combining several approaches (not by carrying them out simultaneously, but in a sequence and frequently) you will maximize the potential gains. Furthermore some techniques might work in a synergy such as exercise and supplementation: the exercise increases consumption and utilization of ions,minerals,vitamins and other bodily fuels so supplementation of these will enhance the effect of exercise.

To be concise: because of discrepant disorder etiologies the individual is advised to experiment with different techniques and if possible co-administer them to achieve a more significant symptom reduction.

A good site further elaborating on the topic of possible treatments of anxiety disorders: Alleviating anxiety - It provides all the information about the supplementation, medication and natural techniques that will help you reduce your anxiety and enter remission.

Paddy

Original article

Anxiety Disorders - Categories

Anxiety is a normal human emotion. It can be of good use in helping us to keep away from dangerous circumstances and provides us the motivation to deal with problems. However, when the feelings become too intense and blown out of proportion, it can increase the symptoms that obstruct with our day-to-day activities. Anxiety disorders are the most common of all the mental disorders.

An anxiety disorder varies from normal anxiety in these ways:

- Uneven to the severity and risks of the danger

- Persists even when the danger is absent

- Gets in the way with occupational, physical or social aspects of daily life

There are many different types of anxiety disorders. Here are some of them:

• Obsessive Compulsive Disorder

- Continuous thoughts, mental images or impulses (obsession) that keep coming back even though the person try to keep them out of the mind

- Performing a routine or ritual (compulsion), such as washing hands, repeating phrases, checking for completeness or hoarding to reduce the anxiety caused by the obsession

• Panic Attack

- Repeated attacks of severe anxiety

- Episodic and attack lasts for only minutes; climax of fear

• Social Phobia

- Very worried about being negatively seen by others

- Common fears such as meeting new people, public speaking, drinking or eating in front of others

- Always try to avoid other people

• Post Traumatic Stress Disorder (PTSD)

- Prolonged or delayed response to a traumatic event (1 month), such as physical or sexual assault, the unexpected death of a loved one, witnessing a death or a natural disaster

- Experience nightmares and flashbacks, emotional numbing, avoidance behaviour or physiological arousal (irritability, poor focus or difficulty sleeping)

• Specific Phobia

- Unreasonable and extreme powerful fear reaction to a specific situation or object such as heights, enclosed space, furry animals or spiders

• Generalised Anxiety Disorder (GAD)

- Too much and continuous worry that lasts 6 months or more

- Usually on issues such as career, finances, family or health

Different anxiety disorder cures work for different people and their bodies. It is vital to research all the choices, such as therapy, psychiatry sessions prescription drugs or natural remedies. Sometimes a mixture of two or three selections is the answer.

If you have a history of drug abuse in your family, it is essential to consider natural remedies, if you are usually against prescription drugs or if you are susceptible to the side effects of prescription drugs.

Afiqah Haidar is concern about the anxieties that can occur to anyone in this world be it young or old, rich or poor etc. All of the anxiety disorders should be treated by a physician who can prescribe the best medicines to relieve the disorders. Feel free to find out more about physicians in Singapore through http://psychiatrist.sg/.

Original article

Let's Bring Anxiety Disorders Out of the Closet

Many people suffer from an anxiety disorder and it seems the numbers are increasing daily. We live in uncertain times and have so many things to worry about. All of this stress can ultimately leave someone burned out and bring on an anxiety disorder. With that comes shame for a lot of sufferers and they try to hide it from the rest of the world. We have to bring this disorder out of the closet, so that sufferers can stop feeling embarrassed and shameful.

Anxiety disorders are hard to understand if you have never had one. I understand that people just don't always get what it's all about. I've dealt with this disorder, on and off, most of my life and just recently opened up to others about it. When I was younger, I hid it. I made up excuses why I couldn't do things or go places. Most people didn't have a clue what I was going through.

It became so bad in my twenties that I became agoraphobic for two years. For all of you who don't know what agoraphobia is, it's being afraid to leave your home. It turns into a vicious circle, because when you do leave the house, you usually have a panic attack, which, of course, drives you back to wanting to stay home.

Panic attacks are a terrifying experience. You can have trouble breathing, start shaking, feel terribly frightened and out of control, think you're having a heart attack, think you're going crazy, feel dizzy, and many other things. These are just some of the common reactions. They are also very embarrassing and hard to control because they aren't based on any real threat. You just panic for no reason.

Unfortunately, many people think that someone with this disorder are just weak- minded or not controlling their emotions. The worst opinion is that you are crazy. This is why so many people try to hide them. They are under enough stress without having the stress of knowing people are thinking horrible things about them. Now that I'm older, and anxiety problems are more in the news, I opened up and decided to quit hiding my problem.

It's very sad, but apparently people are still very uninformed about anxiety disorders. I recently had a friend ask me what I was afraid of and I told him that it wasn't anything tangible, just terrible anxiety and fear. He told me that didn't make any sense, to which I replied, "That's why it's called a DIS-order." I don't think he even got what that meant. That's why I say that we have to bring anxiety disorders out of the closet. We need to stop being ashamed of them, whether others understand or not.

While they don't have concrete answers as to what causes these disorders, it is generally accepted that several factors could be to blame. These include genetics, brain chemistry imbalance and stressful or traumatic situations. It is not because you are weak or crazy. I urge people who don't have this disorder to become more familiar with it, so that should they ever have to deal with a loved one having it, they will know how to help, and not hinder, their problem.

The main issue I wanted to bring out in this article was that anxiety disorders are a very debilitating problem and the last thing we need to do is feel like we have to hide our problem. No one would make us ashamed of a broken leg, but if it deals with the mind, it becomes something of a different nature. It becomes a shameful secret, an embarrassing problem that makes us feel abnormal.

Between sufferers talking openly about it, and non-sufferers learning the facts about it, I hope the world can finally let all of us come out of the closet. We need support and help, not criticism and shame. I, for one, will not tolerate being made to feel like a freak of nature about this anymore, and I hope others will learn to hold their heads up high and recognize they have a problem that doesn't need to be hidden.

As a lifelong sufferer of an anxiety disorder, I have learned many things along the way that I want to share with other sufferers. If anything I share about my personal experiences helps you with this problem, I feel I've accomplished something good. It's a common problem that needs to be addressed to help people overcome, or at least deal better, with anxiety problems.

Original article

Fixing Anxiety Disorders

In all their many forms, anxiety disorders are acknowledged to be the most frequent classification of mental illnesses with an estimated 20 million adults in the United States dealing with one type or another. Because anxiety disorders occur in many different forms it is important to understand their specific symptoms before being able to determine how to effectively treat them.

Three of the most prevalent forms of these disorders are:
• Panic Attacks
o A sudden extreme fear not in proportion to the cause of the fear. Symptoms include increased heart rate, sweating, dry mouth, and shortness of breath. Usually repetitive without warning.

• Generalized Anxiety Disorder
o Symptoms include constant worrying, being nervous, difficulty in controlling the thought process (over thinking).

• Post Traumatic Stress Disorder (PTSD)
o Most commonly associated with combat veterans, PTSD can also be caused by any type of physical or psychological trauma and is often a combination of both. Symptoms include recurring unpleasant dreams, vivid "flashback" memories, unable to remember significant events of the original trauma.

Treating Anxiety Disorder
Considering the three above examples, all are treated in very different ways because they have many different causes. A treatment program for someone dealing with occasional panic attacks will be much different that the treatment of PTSD. To receive the most effective treatment program an individual should discuss their symptoms and experiences with a medical professional who is trained and qualified in dealing with mental issues.

Therapy
A program of therapy over a period of time is very effective in identifying the specific issues causing a patient's symptoms. Many different research studies have confirmed the many advantages of one on one counseling in successful treatment.

Medicines
As anxiety disorders have become better understood pharmacological advances have provided a number of medicines that are very effective in treating a wide range of anxiety disorders. The downside is that many of these medications carry a high risk of addiction and must be used only when specifically prescribed by a trained medical professional.

Left untreated, anxiety disorders can destroy both lives and families. You are most responsible for your well being and that of your loved ones. If you are concerned that you may be suffering from an anxiety disorder, it is your responsibility to visit your medical professional and begin the process of determination. Both the causes and treatment of these problems are much better understood than in the past. What you are experiencing does not need to be a life sentence!

More information is as close as your keyboard. Stop by Control Stress for quite a lot more information on stress, anxiety, and sleep issues.

Original article

Childhood Anxiety Disorders

I know. It's a little strange to think of our kids as having anxiety. I mean, it seems more like the sort of thing characters in a Woody Allen film complain to their psychiatrists about than something your seven year old might be feeling. It's a complicated emotion after all. It requires a very developed imagination and a strong sense of possible futures.

But, yes, our kids - even our very young kids - have anxiety disorders too. This is especially likely if you suffer from anxiety disorders. Grade school is not too early to consider the possibility of childhood anxiety disorders.

Separation Anxiety

Typically, one of the earliest occurring childhood anxiety disorders is separation anxiety. Almost all young children feel a mild version of separation anxiety when they are separated from their parents for the first time. Most children will have fears and a bit of anxiety about going to school during the first week of kindergarten or pre-school.

When a child suffers from separation anxiety, however, these feelings of anxiousness and fear are on a whole new level. It is as if you have taken the mute off of your child as compared to the other children in his class. Separation anxiety children will typically cry and beg not to be left. They will have a longer more difficult adjustment period. And they will need more attention than the other children.

If the child's condition is very severe, they may even become violent or disruptive.

Adopted children are more likely to suffer from separation anxiety than most children since being left at an institution may remind the child of their original abandonment. Such children need to be constantly reassured that the parent will return. Sometimes some sort of a totem, like a rabbit's foot or picture of the parent, can help the child cope with the stress of the situation.

Phobias

As children begin to get older and develop their imaginations, those prone to anxiety may develop phobias. A phobia is an irrationally intense fear of a creature or object. Typically children will develop an intense fear of spiders or snakes or other creepy crawlers.

Although most children develop such fears, children suffering from phobias will have much more intense and prolonged reactions to the thing they fear. They may even suffer from panic attacks at the thought of such creatures. If the child fears spiders for example, they may come to see every spec as a potential spider. For such children, the bedtime ritual may be an especially trying time. The darkness will often make it easier for them to imagine their hobgoblins everywhere about them. For this reason it is important to observe regular rituals during bedtime.

Generalized Anxiety Disorder

Finally, if you suffer from generalized anxiety disorder, there is good chance your child will as well. Scientists believe this is both because of your genes and role modeling.

Children with GAD are constant worriers. Every opportunity for worry will be fully exploited. If you tell them about summer camp during Christmas break, you will hear their worries about it in January, in February, in March, etc.

GAD children often have headaches, stomachaches, nausea, and other minor afflictions. They will often feel physically ill on stress filled days. School is often the focus for this anxiety and so their symptoms more on school days than when they are just lounging around the house during the summer.

Later Anxiety Disorders

Although it is possible to have other anxiety disorders in early youth (like social anxiety disorder, for example) the three I've gone over are the most common childhood anxiety disorders. The good thing about detecting these anxieties in early childhood is that it gives your child a head start in dealing with his or her affliction. Many of us suffer for years before we finally seek the help we need for our anxiety disorders.

Tom Tait is focused on helping those with panic attacks. Here is more information on Anxiety and Depression disorders. There is even more information about Panic Attacks on the website Panic Attacks.

Original article