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Anxiety Treatments

Anxiety Treatments

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arch 2007 Columnshttp://www.lightconnectiononline.com/colums.html1 of 53/30/2007 9:15 AM
Treating Anxiety Treating Anxiety Treating Anxiety Treating Anxiety 
By David Gersten, M.D.
Anxiety, worry, fear, and panic affect millions of Americans. Some of us are “professionalworriers” and some of us have a full-blown disorder, such as “panic disorder with agoraphobia.” Apanic attack is an overwhelming mental and physical experience in which one feels a sense ofimpending doom. Your heart pounds and races; it's hard to catch your breath; you think you'regoing to die and are pretty sure you're losing your mind. Panic disorder, if not identified andtreated, can cripple a person's life. There are a host of anxiety disorders, including anxiety causedby an “existential crisis,” a time when one has lost one's bearings, one's sense of purpose andconnectedness. It is important to explore all issues related to anxiety and panic before going forthe quick fix, whether that is a medication or a vitamin.
Standard Treatment 
How you deal with anxiety and panic reflects how you and your doctor conceptualize what youare struggling with. If your doctor believes that the problem is 100% biological, driven by problemswith brain chemistry, then your only treatment will come from approaches that improve brainchemistry.Regarding panic disorder, biological (medication) treatments were fairly well understood morethan 30 years ago, and included these components.1. Anti-depressants, like Elavil and Tofranil (early medications that raised brainnorepinephrine levels) were (and are) used to help stop panic attacks.2. While the effects of anti-depressant medication are waiting to kick in (about 2 weeks),minor tranquilizers (benzodiazepines), such as Valium, Xanax, Klonopin, and Ativan are used todecrease “anticipatory anxiety.” That's the anxiety a person feels in between panic attacks . . .when they are fearfully waiting for the next attack, which cannot be predicted. Largely for politicalreasons, minor tranquilizers fell into great disrepute, and so they are monitored quite closely bygovernmental agencies. The fact is that it is nearly impossible to commit suicide by overdosing onthis group of medications. On the other hand, the new generations of anti-depressants likeProzac, Paxil, Zoloft, Effexor, and Wellbutrin, are prescribed as if they are totally harmless. Theseare drugs that will kill you if you overdose. And if you increase them too quickly or suddenly stopthem, you may require psychiatric hospitalization.Why the stigma over benzodiazepines? They can and do cause tolerance, meaning that, ifyou take them every day, their effectiveness will drop from 100% to 75% to 50%, and you willrequire higher doses. For this reason, it is important, when using these medications, to “hold theline,” avoid increasing dosage, and avoid daily usage. Because people who are serious drugabusers have, among other drugs, abused benzodiazepines, this class of drugs began to belooked at as dangerous and evil in the mid-1980's.While many people prefer non-medical treatments, anti-depressant medications have a long,successful history of alleviating panic attacks, and should not be dismissed as a possible part ofthe solution.The anxiety experienced in between panic attacks, “anticipatory anxiety,” is qualitatively notdifferent from the anxiety of Generalized Anxiety Disorder, Social Anxiety Disorder, and otheranxieties with no name. Therefore, for virtually all forms of anxiety disorders, there are a numberof approaches that are universal. I do want to note that the pharmaceutical industry's attempt toportray SSRI anti-depressants as being helpful for most anxiety disorders is, in my opinion, adangerous marketing strategy. (Actually, it's a great marketing strategy, but dangerous, incorrectinformation). When I read on one web site that, “SSRI medications are a new class of anti-anxietydrugs,” I was concerned about how successful the drug companies have been in turning theiranti-depressant medications into broad-spectrum anti-anxiety drugs. The fact is that, for manypeople, SSRI's “cause” a great deal of anxiety, rather than curing it. However, they can be usefulfor panic attacks.
Mind-Body Approaches For Healing Anxiety 
1. First, determine if you are dealing with an existential crisis. Medication, or powerfulnutritional supplements, will not fill the void of a life in search of meaning.2. Explore, perhaps with professional help, any immediate causes of conflict. Extreme conflictcan precipitate panic and anxiety. Trouble shoot to see if there are practical ways to resolve theconflict in the “real world.” If not, then it is important to use hypnosis or guided mental imagery toquickly get down to core causes of unresolved conflict. You cannot “think your way” out of conflict,since the runaway, ruminating mind causes a great deal of conflict and is not capable of resolvingconflict or decreasing anxiety. 
 
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3. oo ac troug your entre e an reca any ncents o severe trauma. ave worewith countless people who “have already done the work” on their trauma issues. The fact is thatonly a couple of treatment modalities are capable of truly healing the wounds of trauma. SomaticExperiencing, or SE, (created by Dr. Peter Levine) is the most powerful modality for resolvingtrauma. In my work, I refer to this process as Body-Centered Trauma Resolution (BCTR).Hypnosis and Interactive Guided Imagery can also be quite helpful due to their power to go deepinto the subconscious mind, and because of their ability to work with the mind-body . . . and not just the mind.If you want to pursue SE, BCTR, Hypnosis, or Interactive Guided Imagery, do some research.Not all practitioners are created equal. In each of these modalities, you will find people in SanDiego (and most cities) with decades of experience. If trauma is the cause of your anxiety, youcan find a practitioner of Somatic Experiencing at www.traumahealing.com/. If you are drawn toInteractive Guided Imagery, you can search for a practitioner awww.academyforguidedimagery.com.Please understand that someone who spent only a weekend getting a certificate inhypnotherapy is not qualified to assist you in diagnosing your problem. Nor can they help youreconnect to Self, Nature, Others, and Higher Power, if you are dealing with an existential crisis.4. Various forms of meditation are powerful “anti-anxiety“ remedies. There IS a form ofmeditation that will work for you. Mantra meditation will work for almost everyone. Focusing on thebreath will also help most people, but is not quite as easy as mantra meditation. Mindfulness, bothas a meditation technique, and as a way of being in the world, will help bring you into your bodyand “out of your mind.” People with anxiety, especially Generalized Anxiety Disorder, are trappedin the prison of their mind. Their own mind drives them half crazy, and all attempts to stop themind prove futile. You need to “get out of your mind” in order to “tame your mind.” Mindfulnesstechniques help you focus on what is happening in the moment and on the sensations in yourbody. Mindfulness teaches you to become aware of your surroundings as much as possible,taking in the world through your five senses. The practice of yoga also helps take you into yourbody. Talk therapy keeps you in your head and is marginally useful and often detrimental.Anxiety and panic are caused by an autonomic nervous system that is in sympathetic nervoussystem overdrive. Meditation and yoga dampen the sympathetic (fight-or-flight) nervous systemand increase the activity of the parasympathetic nervous system, which aids healing andtranquility.
Working with Biochemistry 
1. Regardless of the cause of anxiety or panic, neurotransmitters are always involved. GABAchemistry is central to anxiety problems, and most of the anti-anxiety medications work at theGABA receptor site. You can increase GABA in your brain by taking 2,000 to 4,000 mg of GABAper day. Do not take higher doses. The amino acid L-glutamine easily enters the brain and muchof it converts into GABA. When you take pure GABA, only a small percentage gets into the brain.GABA combined with L-glutamine will help raise brain GABA levels, which will leave you calmer.2. Deficiency in the neurotransmitter, norepinephrine, often causes anxiety, as well asdepression and insomnia. If your anxiety includes problems with memory and concentration, youare probably dealing with a norepinephrine problem, which can be corrected by taking the aminoacid, L-tyrosine. Increasing norepinephrine will help depression and many kinds of anxiety. Manypeople suffer from both anxiety and depression. Those who have been anxious for months oryears, especially those with panic disorder with agoraphobia, often get depressed after awhile.So, it is not uncommon for people with chronic anxiety to also feel depressed, partly due to brainchemistry, and partly due to the fact that chronic anxiety can be debilitating and demoralizing.3. Brain chemistry requires a few important co-factors, which include: pyridoxal-5-phosphate(the active form of Vitamin B-6), magnesium, SAMe (S-adenosyl-methionine), B Vitamins(especially folic acid and Vitamin B-12), and the proper balance of Omega-3 and Omega-6 fattyacids.4. The amino acid, Taurine, stabilizes brain tissue, and slows the release of adrenaline,helping to stabilize fight-or-flight physiology.5. A variety of herbs help with anxiety: including kava kava, valerian, hops, passion flower,and lemon balm.
Healing the Body 
1. Do you suffer from hypoglycemia? If so, periodic drops in blood sugar can make youanxious.2. Part of a medical workup for anxiety should include blood testing for thyroid function. Toomuch thyroid will cause anxiety, along with heart palpitations. 
 
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3. ress arena exauston. rena uncton eps you staze oo sugar an asoproduces the hormones that help you cope with everyday, normal stress. With chronic adrenalexhaustion, people become overwhelmed with simple tasks that were once just part of theireveryday experience. If your anxiety picture includes hypersensitivity to loud noises, bright light, orsudden changes in movement, and you are also fighting fatigue, you are probably dealing withadrenal exhaustion.These bodily contributors to anxiety are too complex to allow for simple recommendations inthis article. Start by getting lab work done.
Healing Your Thoughts 
1. Cognitive Behavioral Therapy, or CBT, is the most-researched psychotherapy modality foranxiety and panic disorders. On average, 12 CBT sessions will dramatically improve anxietydisorders. Items 2 — 8 below are some of the techniques used by CBT:2. Pay attention to all-or-nothing statements, and use of the words “always,” and “never.”Replace these thoughts. A mantra is the easiest and most powerful replacement for incorrectthought patterns. Mantra meditation is an effective tool to help shift out of all-or-nothing, negativethinking.3. Determine where your negative self-talk comes from. Whose voice is it that speaks sonegatively through you and about you? (Mother, father, brother, sister, spouse). Begin to think,speak, and act for yourself, from your core power.4. Stop automatic negative thinking. CBT teaches techniques for temporarily stopping arunaway mind.5. Focus on what is calming and positive.6. Walk and talk slowly. That helps to slow down an overactive mind.7. Examine perfectionism. The drive for perfection causes anxiety, irritability, anger, anddepression. There is no such thing as perfection. Cognitive Behavioral Therapy helps peopleidentify the various facets of unconscious, repetitive, destructive thought patterns. When you learnto strive for excellence rather than perfection, you are freed from the prison your mind creates.8. Many anxious people are making comparisons all day long, comparing what they do, howthey look, how they perform, and what they own . . . to other people. The “comparing mind” isdoomed to misery. I have known several excellent musicians who got anxious and depressedbecause they were not as good as the very best players in the world. Some of these peoplecontinued to play their instrument, always making comparisons, and never living fully in themoment with “their own music.” For others the negative comparison was too great and they simplystopped playing their instrument forever. Once you recognize that your mind is makingcomparisons all day long, you can simply observe each comparison as it arises, and let it gowithout self-judgment. The “comparing mind” is related to the “perfectionistic mind.” There is nosuch thing as perfection. ”“The best that you can be” is all there is, and your personal best isdiminished by comparing yourself to the greats of the world. On the other hand, great people fromall walks of life can serve as role models or inspirations to you, and that is quite different fromcomparing yourself to them.9. Redefine setbacks. They are not failures. They are to be expected and accepted.
Pain, Anxiety, and Depression 
It is estimated that 15% — 33% of Americans suffer from chronic pain, and for many peoplethat pain is quite debilitating. Over time, people with chronic pain become depressed and anxious.They also develop sleep disorders, and adrenal exhaustion. If your doctor thinks that your mainproblem is anxiety, rather than physical pain, you will receive a treatment recommendation thatwill keep you locked into the vicious cycle of pain, anxiety, depression, and insomnia. Almost allpain is caused by inflammation, which is a process in which our immune system turns against usand attacks normal, healthy tissue. If you have chronic pain, you've spent years trying to cope withit. In the next issue of The Light Connection, I will be introducing you to a radical, revolutionarybreakthrough in pain reduction.
Spiritual Healing 
Many anxious people feel spiritually disconnected. They often don't feel connected tothemselves, others, the earth, God or a higher power. It is essential for people to focus theirattention on this issue, for without a sense of connectedness, however you define that, apervasive sense of anxiety is what people live with. Getting reconnected at all levels transformsfear and anxiety into peace and serenity.
 

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