You are on page 1of 56

A.

Pengertian Neurosis Neurosis kadang-kadang disebut psikoneurosis dan gangguan jiwa (untuk membedakannya dengan psikosis atau penyakit jiwa. Menurut inggih !irgagunarsa ("#$% : "&'() neurosis adalah gangguan yang terjadi hanya pada sebagian dari kepribadian) sehingga orang yang mengalaminya masih bisa melakukan pekerjaan-pekerjaan biasa sehari-hari atau masih bisa belajar) dan jarang memerlukan perawatan khusus di rumah sakit. !ali *ulo ("#%+ : "$#() berpendapat bahwa neurosis adalah suatu kelainan mental) hanya memberi pengaruh pada sebagaian kepribadian) lebih ringan dari psikosis) dan seringkali ditandai dengan : keadaan ,emas yang kronis) gangguangangguan pada indera dan motorik) hambatan emosi) kurang perhatian terhadap lingkungan) dan kurang memiliki energi -isik) dst. Nurosis) menurut ../. Maramis ("#%0 : #$() adalah suatu kesalahan penyesuaian diri se,ara emosional karena tidak diselesaikan suatu kon-lik tidak sadar. 1erdasarkan pendapat mengenai neurosis dari para ahli tersebut dapat diidenti-ikasi pokok-pokok pengertian mengenai neurosis sebagai berikut: a. Neurosis merupakan gangguan jiwa pada tara- ringan. b. Neurosis terjadi pada sebagian ke,il aspek kepribadian. ,. Neurosis dapat dikenali berdasarkan gejala yang paling menonjol yaitu ke,emasan. d. Penderita neurosis masih mampu menyesuaikan diri dan mampu melakukan akti2itas sehari-hari. e. Penderita neurosis tidak memerlukan perawatan khusus di rumah sakit jiwa. 1. Ma,am-ma,am neurosis Kelainan jiwa yang disebut neurosis ditandai dengan berma,am-ma,am gejala. !an berdasarkan gejala yang paling menonjol) sebutan atau nama untuk jenis neurosis diberikan. !engan demikian pada setiap jenis neurosis terdapat ,iri-,iri dari jenis neurosis yang lain) bahkan kadang-kadang ada pasien yang menunjukkan begitu banyak gejala sehingga gangguan jiwa yang dideritanya sukar untuk dimasukkan pada jenis neurosis tertentu (../. Maramis) "#%0 : +3%(. 1ahwa nama atau sebutan untuk neurosis diberikan berdasarkan gejala yang paling menjonjol atau paling kuat. Atas

Oleh: Kuntjojo

dasar kriteria ini para ahli mengemukakan jenis-jenis neurosis sebagai berikut (../. Maramis) "#%0 : +3$-+3%(. ". Neurosis cemas (an4iety neurosis atau an4iety state( a. *ejala-gejala neurosis ,emas 5idak ada rangsang yang spesi-ik yang menyebabkan ke,emasan) tetapi bersi-at mengambang bebas) apa saja dapat menyebabkan gejala tersebut. 1ila ke,amasan yang dialami sangat hebat maka terjadi kepanikan. "( *ejala somatis dapat berupa sesak na-as) dada tertekan) kepala ringan seperti mengambang) lekas lelah) keringat dingan) dst. +( *ejala psikologis berupa ke,emasan) ketegangan) panik) depresi) perasaan tidak mampu) dst. b. /aktor penyeban neurosis ,emas Menurut Maramis ("##% : +6"() -aktor pen,etus neurosis ,emas sering jelas dan se,ara psikodinamik berhubungan dengan -aktor--aktor yang menahun seperti kemarahan yang dipendam. ,. 5erapi untuk penderita neurosis ,emas 5erapi untuk penederita neurosis ,emas dilakukan dengan menemukan sumber ketakutan atau kekuatiran dan men,ari penyesuaian yang lebih baik terhadap permasalahan. Mudah tidaknya upaya ini pada umumnya dipengaruhi oleh kepribadian penderita. Ada beberapa jenis terapi yang dapat dipilih untuk menyembuhkan neurosis ,emas) yaitu : "( psikoterapi indi2idual) +( psikoterapi kelompok) '( psikoterapi analitik) &( sosioterapi) 3( terapi seni kreati-) 6( terapi kerja) $( terapi perilaku) dan %( -armakoterapi. +. Histeria a. *ejala-gejala histeria 7isteria merupakan neurosis yang ditandai dengan reaksi-reaksi emosional yang tidak terkendali sebagai ,ara untuk mempertahankan diri dari kepekaannya terhadap rangsang-rangsang emosional. Pada neurosis jenis ini -ungsi mental dan jasmaniah dapat hilang tanpa dikehendaki oleh penderita. *ejala-gejala sering timbul dan hilang se,ara tiba-tiba) teruma bila penderita menghadapi situasi yang menimbulkan reaksi emosional yang hebat.

b. 8enis-jenis histeria 7isteria digolongkan menjadi +) yaitu reaksi kon2ersi atau histeria minor dan reaksi disosiasi atau histeria mayor. "( Histeria minor atau reaksi konversi Pada histeria minor ke,emasan diubah atau dikon2ersikan (sehingga disebut reaksi kon2ersi( menjadi gangguan -ungsional susunan sarasomatomotorik atau somatosensorik) dengan gejala : lumpuh) kejang-kejang) mati raba) buta) tuli) dst. +( 7isteria mayor atau reaksi disosiasi 7isteria jenis ini dapat terjadi bila ke,emasan yang yang alami penderita demikian hebat) sehingga dapat memisahkan beberapa -ungsi kepribadian satu dengan lainnya sehingga bagian yang terpisah tersebut ber-ungsi se,ara otonom) sehingga timbul gejala-gejala : amnesia) somnabulisme) -ugue) dan kepribadian ganda. ,. /aktor penyebab histeria Menurut igmund /reud) histeria terjadi karena pengalaman traumatis (pengalaman menyakitkan( yang kemudian direpresi atau ditekan ke dalam alam tidak sadar. Maksudnya adalah untuk melupakan atau menghilangkan pengalaman tersebut. Namun pengalaman traumatis tersebut tidak dapat dihilangkan begitu saja) melainkan ada dalam alam tidak sadar (un,o,iousness( dan suatu saat mun,ul kedalam sadar tetapi dalam bentuk gannguan jiwa. d. 5erapi terhadap penderita histeria Ada beberapa teknik terapi yang dapat dilakukan untuk menyembuhkan hysteria yaitu : "( 5eknik hipnosis (pernah diterapkan oleh dr. 8oseph 1reuer(9 +( 5eknik asosiasi bebas (dikembangkan oleh igmund /reud(9 '( Psikoterapi suporti-. &( /armakoterapi. '. Neurosis fobik a. Gejala-gejala neurosis fobik Neurosis -obik merupakan gangguang jiwa dengan gejala utamanya -obia) yaitu rasa takut yang hebat yang bersi-at irasional) terhadap suatu benda atau

keadaan. /obia dapat menyebabkan timbulnya perasaan seperti akan pingsan) rasa lelah) mual) panik) berkeringat) dst. Ada berma,am-ma,am -obia yang nama atau sebutannya menurut -aktor yang menyebabkan ketakutan tersebut) misalnya : "( Hematophobia: takut melihat darah +( Hydrophobia: takut pada air '( Pyrophibia: takut pada api &( Acrophobia: takut berada di tempat yang tinggi b. Faktor penyebab neurosis fobik Neurosis -obik terjadi karena penderita pernah mengalami ketakutan dan sho,k hebat berkenaan dengan situasi atau benda tertentu) yang disertai perasaan malu dan bersalah. Pengalaman traumastis ini kemudian direpresi (ditekan ke dalam ketidak sadarannya(. Namun pengalaman tersebut tidak bisa hilang dan akan mun,ul bila ada rangsangan serupa. c. erapi untuk penderita neurosis fobik Menurut Maramis) neurosa -obik sulit untuk dihilangkan sama sekali bila gangguan tersebut telah lama diderita atau berdasarkan -obi pada masa kanak-kanak. Namun bila gangguan tersebut relati- baru dialami proses penyembuhannya lebih mudah. 5eknik terapi yang dapat dilakukan untuk penderita neurosis -obik adalah : "( Psikoterapi suporti-) upaya untuk mengajar penderita memahami apa yang sebenarnya dia alami beserta psikodinamikanya. +( 5erapi perilaku dengandeconditioning) yaitu setiap kali penderita merasa takut dia diberi rangsang yang tidak menyenagkan. '( 5erapi kelompok. &( Manipulasi lingkungan. &. Neurosis obsesif-kompulsif a. Gejala-gejala neurosis obsesif-kompulsif :stilah obsesi menunjuk pada suatu ide yang mendesak ke dalam pikiran atau menguasai kesadaran dan istilah kompulsi menunjuk pada dorongan atau impuls yang tidak dapat ditahan untuk tidak dilakukan) meskipun sebenarnya perbuatan tersebut tidak perlu dilakukan. ;ontoh obsesi--kompulsi- antara lain 9

"( !leptomania : keinginan yang kuat untuk men,uri meskipun dia tidak membutuhkan barang yang ia ,uri. +( Pyromania : keinginan yang tidak bisa ditekan untuk membakar sesuatu. '( "anderlust : keinginan yang tidak bisa ditahan untuk bepergian. &( #ania cuci tangan : keinginan untuk men,u,i tangan se,ara terus menerus. b.Faktor penyebab neurosis obsesif-kompulsif Neurosis jenis ini dapat terjadi karena -aktor--aktor sebagai berikut (<ulia!.) +000 : ""6-""$(. "( Kon-lik antara keinginan-keinginan yang ditekan atau dialihkan. +( 5rauma mental emosional) yaitu represi pengalaman masa lalu (masa ke,il(. c. erapi untuk penderita neurosis obsesif-kompulsif "( psikoterapi suporti-9 +( penjelasan dan pendidikan9 '( terapi perilaku. 3. Neurosis depresif a. Gejala-gejala neurosis depresif Neurosis depresi- merupakan neurosis dengan gangguang utama pada perasaan dengan ,iri-,iri : kurang atau tidak bersemangat) rasa harga diri rendah) dan ,enderung menyalahkan diri sendiri. *ejala-gejala utama gangguan jiwa ini adalah : "( gejala jasmaniah : senantiasa lelah. +( gejala psikologis : sedih) putus asa) ,epat lupa) insomnia) anoreksia) ingin mengakhiri hidupnya) dst. c. Faktor penyebab neurosis depresif Menurut hasil riset mutakhir sebagaimana dilakukan oleh !a2id !. 1urns ("#%% : 6() bahwa depresi tidak didasarkan pada persepsi akurat tentang kenyataan) tetapi merupakan produk =keterpelesetan> mental) bahwa depresi bukanlah suatu gangguan emosional sama sekali) melainkan akibat dari adanya distorsi kogniti- atau pemikiran yang negati-) yang kemudian men,iptakan suasana jiwa) terutama perasaan yang negati- pula.

'( ering gagal dalam menghadapi persainganpersaingan c.ara membetulkan pikiran yang salah) yang telah menyebabkan terjadinya keka. d. erapi untuk penderita neurosis depresif ?ntukmenyembukan depresi) 1urns ("#%% : 3( telah mengembang-kan teknik terapi dengan prinsip yang disebut terapi kognitif) yang dilakukan dengan prinsip sebagai berikut. "( 1ahwa semua rasa murung disebabkan oleh kesadaran atau pemikiran ang bersangkutan.auan emosional. "( 5erlalu lama menekan perasaan) pertentangan batin) ke. '( 1ahwa pemikiran negati2e menyebabkan keka. +( 5erhalanginya keinginan-keinginan. 5erapi kogniti.auan emosional.dilakukan dengan . b. 6. Neurasthenia a. elain terapi kogniti-) bisa pula pendrita depresi mendapatkan farmakoterapi. *ejala utama gangguan ini adalah tidak bersemangat) .1urns berpendapat bahwa persepsi indi2idu terhadap realitas tidak selalu bersi-at objekti-.epat lelah meskipun hanya mengeluarkan tenaga yang sedikit) emosi labil) dan kemampuan berpikir menurun. Faktor penyebab neurasthenia Neurasthenia dapat terjadi karena beberapa -aktor (@akiah !aradjat) "#%' : '&() yaitu sebagai berikut. erapi untuk penderita neurasthenia .emasan. Gejala-gejala neurasthenia Neurasthenia disebutjuga penyakit payah. +( 8ika depresi sedang terjadi maka berarti pemikiran telah dikuasai oleh kekeliruan yang mendalam. !an pena-siran ini bisa keliru bahkan bertentangan dengan realitas sebenarnya.am-ma. :ndi2idu memahami realitas bukan bagaimana sebenarnya realitas tersebut) melainkan bagaimana realitas tersebut dita-sirkan. !i samping gejala-gejala utama tersebut juga terdapat gejala-gejala tambahan) yaitu insomnia) kepala pusing) sering merasa dihinggapi berma.am penyakit) dst.

(Alih 1ahasa : antosa( 8akarta : Brlangga. Krisis situasional atau krisis maturasional Aiwayat kon-lik keluarga dan system pendukung yang tidak adekuat tress internal yang berat dari banyak perubahan kehidupan Kerentanan herediter Aiwayat prolaps pada katup mitral atau tirotoksikosis 1atasan karakteristik : ". Ketidak e-ekti-an koping indi2idu Kemungkinan penyebab : ". Menggunakan Cat psikoakti. ("#%%( Pengantar Psikologi. urabaya : Airlangga ?ni2ersity.a) Albert A. . 1urns) !a2id !. !irgagunarsa) inggih.ontoh diagnosa keperawatan ". Ae-erensi 1ran. ("#%0( (lmu !edokteran )i*a. +. 8akarta : 1PK *unung Mulia.?paya membantu penyembuahn penderita neurasthenia dapat dilakukan dengan teknik terapi sebagai berikut./.. '. ("#63( Psychology $ he %cience of &ehavior. +. 3.ara 2erbal ketakutannya yang besar akan serangan lainnya. Maramis) . "( Psikoterapi supporti-9 +( 5erapi olah raga9 '( /armakoterapi. Menyatakan se.on) in.. . &.untuk bersosialisasi atau untuk menoleransi ketakutan dari serangan panik 3. *ejala -isik yang dialami selama serangan Perlaku menghindar 5idak mampu menyelesaikan masalah &. ("##%( erapi !ognitif $ Pendekatan &aru &agi Penanganan 'epresi. '. 1oston : Allyn and 1a.

Aasional : Klien perlu mengetahui metode koping lain yang dapat digunakan untuk mengatasi ansietas yang tidak dapat ditoleransi akibat serangan panik. Aasional : ebelum klien dapat memperoleh kendali terhadap serangan) stressor yang berhubungan dengan pani.ara 2erbal perasaan yang begitu kuat) tidak nyaman) khususnya ansietas) rasa bersalah dan -rustasi. !orong klien untuk mengungkapkan se. membantu klien mengantisipasi dan pada akhirnya mengontrol serangan. 5ujuan jangka pendek " Klien ber. Aasional : Analisa stimulus eksternal yang menyertai pani. !iskusikan mekanisme koping) seperti gerakan -isik dan latihan napas dalam yang lambat dan bagaimana mekansme ini dapat panik. dimasa lalu. &. . '. dengan klien) ber-okus pada stimulus eksternal yang merangsang serangan. !iskusikan dan analisa situasi pani.erita tentang stressor kehidupan) terutama yang berhubungan dengan serangan pani. 1antu klien mengidenti-ikasi stressor internal yang umumnya terjadi sebelum serangan. Aasional : Perasaan sakit yang tidak diakui adalah stressor) mengungkapkan perasan yang tidak nyaman membantu meredakan stress. harus diidenti-ikasi. +.5ujuan jangka panjang : Klien menunjukkan kemampuan untuk mengatasi panik dengan mengurangi perilaku yang disebabkan oleh keadaan panik. :nter2ensi dan rasional ".

Ketakutan Kemungkinan penyebab : . Ajari klien tentang .ul. +.ara alternati2e untuk menangani stress akan meningkatkan kendali perilaku. Aasional : Memiliki pengetahuan tentang .ari bantuan ketika tanda dan gejala ansietas mun. 1antu klien memodi-ikasi pikiran spontan yang enyertai gejala -isik ketika ansietas mulai timbul.. Aasional : Keterampilan ini memampukan klien untuk melepaskan ansietas melalui -o. !iskusikan hubungan antara ansietas dengan respons -isiologis yang se. &.. '. Aasional : 5indakan ini mem-asilitasi daya tolak klien kedalam hubungan antara ansietas dan gejala -isik akibat serangan pani. Aasional : Klien perlu mengetahui bahwa gejala -isiologis ansietas diikuti oleh pikiran spontan yang mengganggu penilaian tentang apa yang sedang terjadi. +. Aasional : Mengembangkan dan menggunakan system pendukung meningkatkan tanggung jawab pribadi dan pengakuan pribadi tentang kebutuhan memperoleh bantuan pada saat stress.5ujuan jangka pendek + Klien menunjukkan perilaku yang membantu mengontrol keadaan pani. 3.ara khas di tunjukkan dalam serangan pani.ara berpindah dari keadaan internal ke keadaan eksternal untuk mengalihkan perhatian klien dari dirinya sendiri.us keluar. !orong klien membentuk system pendukung dan men. :nter2ensi dan rasional ". Ajari klien strategi untuk mengatasi stressor internal) seperti ketakutan atau perasaan tidak menentu.

&. '. &.ara untuk tetap ber-ungsi dengan baik ketika menghadapi stimulus -obia tanpa mengalami ansietas hebat atau membuat ia tidak mampu. 5ujuan jangka pendek " Klien megungkapkan rasa takut dan mengidenti-ikasi ansietas yang timbul akibat -obia. 1ersama klien berupaya mengidenti-ikasi kon-lik dasar yang menimbulkan -obia. Mengungkapkan rasa tidak nyaman terhadap objek atau situasi yang menakutkan '. +. Mani-estasi -isik dan emosi yang disebabkan oleh ansietas berat +. . 5idak mampu melaksanakan akti2itas hidup sehari-hari Menarik diri dari akti2itas yang biasa ketika rasa takutnya berlebihan erangan panik. 5ujuan angka panjang : Klien mempelajari . Aasional : !skusi tentang bagaimana klien mempersepsikan -obia memberi dasar untuk membuat program terapi. !orong klien untuk mendiskusikan obek atau situasi yang menakutkan. Kon-lik emosional yang tidak disadari alah menempatkan ansietas Pengalaman hidup di masa lalu Kurang engetahuan Kesalahan persepsi sensori 1atasan karakeristik : ". Aasional : !engan megidenti-ikasi kon-lik dasar dan ansietas yang ditimbulkan) klien dapat menghubungkan pengalaman ansietas dalam diri dengan -obianya. 3. +. :nter2ensi dan rasonal ".". 3.

&.emasan membantu klien untuk tidak berhubungan dengan respon -obik dan mem-okuskan perhatian pada masalah yang menyebabkan ansieas.ara sadar mematikan kesadarannya( atau belum terselesaikan. Aasional : Pengungkapan pikiran dan perasaan memungkinkan klien untuk menggali isu-isu yang mungkin ditekan (se.ara-. Minta klien mempelajari dan mempraktekkan latihan relaksasi dan imajinasikan terpimpin. Ajari klien bahwa -obia adalah sebuah gambaran simbolik dari ansietas. :denti-ikasi apakah klien mengalami depresi dan atasi Aasional : Klien depresi sulit berkonsentrasi dan tidak mampu ber-okus pada strategi untuk mengatasi respon -obia.ara mendetil) ajarkan keterampilan koping seperti asertitekhnik berhenti ber-ikir dan teknik menyelesaikan masalah Aasional : !apat mebentuk koping e-ekti'. +. . 5ujuan jangka pendek + Klien berpartisipasi dalam program densitiasi ( pengurangan sensiti2itas( dan memperagakan . :nter2ensi dan rasional ". 3. Aasional : Kesadaran bahwa -obia timbul dari ke. !iskusikan -obia se.ara koping untuk mengatasi -obia. 1antu klien mengidenti-ikasikan dan mendiskusikan pikiran dan perasaan yang turut menimbulkan rasa takut. ebelum program desentitisasi dimulai) yakinkan klien bahwa keamanannya terjamin Aasional : Klien perlu merasa terlindungi dan aman untuk meneruskan program.'.

(Hans & Cassidy.etuskan respons -obik. particularly psychoanalysts 'psychiatrists who follow a psychoanalytical model of treatment. Gale Group." and was first coined in the late eighteenth century by William Cullen.) "sychiatric Association s Diagnostic and Statistical Manual of Mental Disorders in #$%& with the publication of the third edition 'it last appeared as a diagnostic category in DSM-II(. A term generally used to describe a nonpsychotic mental illness that triggers feelings of distress and anxiety and impairs functioning. 1ersama klien) esplorasi pikiran) perasaan atau peristiwa yang dapat men. Some professionals use the term to describe anxious symptoms and associated behavior. Cullen s concept of neurosis encompassed those nervous disorders and symptoms that do not have a clear organic cause.. Origins The word neurosis means "nerve disorder. delusional disorder(. or to describe the range of mental illnesses outside of the psychotic disorders 'e.g. Reproduced with permission. )thers. !t is not generally used as a diagnostic category by American psychologists and psychiatrists any longer. use the term to describe the internal process itself 'called .Aasional : trategi ini membantu mengurangi tingkat ansietas klien. as populari*ed by +reud and Carl Jung(. and was removed from the American The features of a typical neuron. Sigmund Freud later used the term anxiety neurosis to describemental illness or distress with extreme anxiety as a defining feature.ara alternati2e untuk menangani ansietas. Aasional : Kesadaran akan apa yang men. a Scottish physician. There is a difference of opinion over the clinical use of the term neurosis today. Neurosis adalah gangguan emosional relatif ringan (seperti depresi ringan dan fobia). &. schizophrenia.etuskan reaksi -obik dapat memampukan klien untuk mempelajari .

• • • • Causes !n #$$1. The persistent and distressing recurrence of intrusive thoughts or images 'obsessions( and repetitive behaviors or mental acts 'compulsions(.an unconscious conflict( that triggers the anxiety characteristic of the neurosis. The identified gene and its allele pair help to control the amount of serotonin 'a central nervous system neuro-transmitter( released into the body through the production of a protein /nown as a transporter. Somatization (formerly called ysterical neurosis!. 0ot a true neurosis. chest pain.or traditional categories of psychological neuroses. or feigning psychological symptoms for monetary or other personal gain. These include• • Anxiety neurosis. sometimes involving panic attac/s and manifesting itself in physical symptoms such as tremor. Categories The neurotic disorders are distinct from psychotic disorders in that the individual with neurotic symptoms has a firm grip on reality. but a form of malingering. Obsessive-compulsive neurosis. sweating. There are several ma. and nausea. but are instead a manifestation of anxiety or other mental distress. a specific human gene and its corresponding alleles 'two components of a gene which are responsible for encoding the gene( were lin/ed to neuroticism. and the psychotic patient does not. The presence of real and significant physical symptoms that cannot be explained by a medical condition. This transporter protein. which helps to carry the serotonin across the synaptic . "ost-traumatic stress disorder (also called #ar or combat neurosis!.ental illness defined by excessive anxiety and worry. A mental illness characteri*ed by a profound feeling of sadness or despair and a lac/ of interest in things that were once pleasurable.ury. Depressive neurosis. Severe stress and functional disability caused by witnessing a traumatic event such as war combat or any other event that involved death or serious in. . $ompensation neurosis.

!t is possible that genetic factors predispose an individual to anxiety and neurosis. Diagnosis "atients with symptoms of mental illness should undergo a thorough physical examination and detailed patient history to rule out organic causes 'such as brain tumor or head in.ustment Schedule. and the serotonin will continue to stimulate surrounding nerve cells. also assists the cell in reabsorbing the serotonin 'a process /nown as "reupta/e"(. or other mental healthcare professional.( scale. and the other 'named l for long(. to evaluate mental status. a significantly large amount. !n the case of the "neurosis gene. a psychologist or psychiatrist will usually conduct an interview with the patient and administer clinical assessments 'also called scales. This finding is consistent with a study published the same year that found that women in 45 different countries scored consistently higher on measurements of neuroticism than men. an excessive amount of serotonin must remain in the synaptic gap while the protein "catches up" with reupta/e. A corresponding study of 3&& patients showed that patients who were assessed as having neuroticpersonality traits usually possessed the shorter allele pair 'or a combination of one short and one long( that produced insufficient transporter protein. psychologist. Tests which may be administered for the diagnosis and assessment of neurosis include the 0euroticism 9xtraversion and )penness '09):." one possible version of its corresponding alleles 'called s for their short length( was found to produce an insufficient amount of this transporter protein. Treatment for a neurotic disorder depends on the presenting symptoms and the level of discomfort they . !f a neurotic disorder is suspected.3&& 7nited 8ingdom residents found that those with a lower standard of living had a higher prevalence of neurotic disorders. resulting in neurosis or neurotic symptoms.space 'the gap between nerve cells( to stimulate nerve cells. Treatment 0eurosis should be treated by a counselor. inventories. and the Social .ury(. !f the amount of transporter protein produced is inade2uate. the Sixteen "ersonality +actor <uestionnaire '#1"+(. The fact that such high scores were found across a variety of socioeconomic classes and cultures but specific to one gender seems to support a genetic basis for the disorder. or tests(. 6owever. and outside factors such as socioeconomic status trigger the symptoms. psychiatrist.alad. a #$$% study of over $. therapist.

!nc. Washington. and .adaa. Diagnostic and Statistical Manual of Mental Disorders ?th ed..W. Categories.org.@..are causing the patient. http-CCwww. Treatment : "ersonality !nventories. ." F . Suite #&&.W.. @C.aw#s. 0orton > Son.ead more. . . . Further Information Anxiety @isorders Association of America 'A@AA(.orgCpagesC?3&C0eurosis.ran/.American "sychiatric "ress. "aula +ord:.ental : D.g.. fax. )tto . A&%3A. American "sychiatric Association. 4&#:A4#:$43&. Causes. creative therapies 'e. art or music therapy(. psychoactive drugs. and relaxation exercises. @iagnosis.artin Further Reading +enichel.Anx@isBadaa.htmlEix**A. 0ew =or/.org. 7SA.an/ Articles http-CCpsychology.oc/ville.odes of treatment are similar to that of other mental disorders. 9mail. % e "syc oanalytic % eory of &eurosis' ()t Anniversary *dition. and can include psychotherapy. ##$&& "ar/lawn @rive. #$$?.0eurosis : )rigins. Theory )f "ersonality. cognitive:behavioral therapy. #$$3.4&#:A4#:54$A.

lude the -ollowing: • • • • • • • mus. worry about e2eryday things."E o. Symptoms People with generaliCed an4iety disorder (*A!( e4perien.on.tors) -amily ba.ulty sleeping irritability edginess gastrointestinal dis. ometimes just the thought o.onstant) .ross the li-e .al -a. Although the e4a.om-ort or diarrhea Treatment .e2eryday problems -or at least 6 months.kground) and li-e e4perien.ial a.hen their an4iety le2el is mild) people with *A! . *A! a--e.arrying out the simplest daily a.es an4iety.essi2ely about a 2ariety o. 5hey anti. .omes on gradually and .le and -eel it is beyond their .e that biologi.an ha2e di--i.e as likely to be a--e.t .ulty .omen are twi.% million adults) or '.erned about money) health) -amily) work) or other issues.GeneralizedAnxietyDisorder(GAD) *eneraliCed an4iety disorder is .y.teriCed by persistent) e4.e e4aggerated worry and tension) o-ten e4pe.an -un.*A! is unknown) there is e2iden. 5his worrying goes on e2ery day) possibly all day. Physi.hroni. population) in any gi2en year.*A! in.the ?. People with the disorder) whi.e .es) parti. 5he disorder . :t disrupts so.ause o.) and unsubstantiated worry) o-ten about health) -amily) money) or work.essi2e) and unrealisti. *A! is diagnosed when a person worries e4.ularly stress-ul ones) play a role.ted.hara.ting the worst) e2en when there is no apparent reason -or .al symptoms o.on.ti2ities when their an4iety is se2ere.hool) or -amily.le) though the risk is highest between .ern. .y. Although they may a2oid some situations be.hildhood and middle age.an begin a. .le tension -atigue restlessness di--i.ially and be gain-ully employed.ipate disaster and are o2erly .ti2ities and inter-eres with work) s. Dearn more symptoms.ts 6.tion so.ontrol) e2en though they usually realiCe that their an4iety is more intense than the situation warrants.getting through the day produ.h is also re-erred to as *A!) e4perien. 5hey don>t know how to stop the worry .ause they ha2e the disorder) some people .

hing your retirement sa2ings shrink) -retting about how to pay -or .ashington Post-A1.h deep stress and worry about their bank balan. horiCon) you might -eel as i. *A! is not triggered by a spe.ial -ree -all) does that mean they all ha2e an an4iety disorderI !oes it mean an4iety disorders are on the riseI 5he answer: no.H 5hey ha2e good reason to -eel stress. Anxiety: A Normal Reaction .ei2ing unemployment bene-its rea.on-irms that sentiment: Nearly $$ per. downturn has .e o.ti2e -or many people) helping them to identi-y) understand) and modi-y -aulty thinking and beha2ior patterns. General Anxiety About the Economy Dooking o2er today>s dismal e.o-o.urring .ontrol their worry.ation. B2en in the best o.ord high.h rarely o. worry about issues like money) health) -amily) or work -or si4 months or longer.H :.the ?."E o. Diagnosis: Generalized Anxiety Disorder 7owe2er) you may ha2e generaliCed an4iety disorder i.hen asked what stressed people the most in a re. . 5he -ollowing month a .es than they did be-ore this -inan. An4iety is a normal rea. .ans say they are stressed out o2er the nation>s troubled e.onsult a trusted -inan.an4iety -or Ameri.ase to wat. B2en among those who -eel the e.ollege) or worrying about a possible layo--Gor e2en i.hniFues) meditation) yoga) e4er.t yoursel-) in this .essi2e) and unrealisti. :t>s your body telling you to stay alert and prote.a treatment plan.ans.people re.e abuse o-ten a. population) in any gi2en year) and women are twi. 5he world doesn>t need to e4perien.tion to stress-ul and un.Dike other an4iety disorders) *A! is treatable.e an e.ted.y) work to keep your job) or .an4iety disorder di--ers greatly -rom the normal an4iety we may -eel about the e.you worry about the e.% million adults) or '.ts 6.orries about -inan.onomy or any other stress-ul e2ent.es ha2e long been a leading .ial e4pert.h +00# that the number o.urs alone9 .onomy or your -inan.times) *A! a--e. Also known as *A!) this type o. Other an4iety disorders) depression) or substan.onomy) one-third reporting serious stress. People with generaliCed an4iety disorder e4perien...aused a moderate amount to =a lot o.es -or many hours e2ery day) you .ause o. down-all -or someone to ha2e *A!. Aela4ation te. Another A!AA online poll . 5hey don>t know how to stop the .you>re happily employed but ner2ously -ollowing the news) these are an4iety-pro2oking times.their stress.ise) and other alternati2e treatments may also be.onomi.stress. .there>s no end in sight. .onditions must also be treated with appropriate therapies. !epartment o.e persistent) e4.hether you>re wat.ent A!AA online poll) &3 per.onomi.onomi.so many people share su. Generalized Anxiety Disorder vs.onomy is impro2ing) a majority still named it as a sour.es.. .hed a re.ent responded =personal -inan.ome part o. ome people with *A! also take medi.h your spending) try to sa2e -or an emergen. 5he ?. situation.ompany *A!) whi.an>t sleep or per-orm your usual tasks) and you>re aware that your -ears are irrational.e as likely to be a--e.Dabor reported in Mar. News poll reported that more than si4 in "0 Ameri.ent said the e. 5his enables people with *A! learn to .ogniti2e-beha2ioral therapy is e--e.ertain situations.i-i.

using on obsessi2e thoughts and per-orming seemingly senseless rituals.essi2e.! .ti2ities.anJt seem to get out o.li-e.hes skills -or handling an4iety) whi.! are aware that their obsessions and .on. Dearn more about . B4.ation) or a . 5rying to . Preo.hotherapy) medi.worry .ome thoughts) -eelings) or images. beha2iors and routines (.hniFues) meditation) yoga) or e4er. !istaste-ul religious and se4ual thoughts or images.ontrol their worry on their own.ts with little or no 2alue.*A!.onstant) irrational worry about dirt) germs) or .le) whi. 1e.on.others. /orty million adults in the ?.on.an be e--e.ts o. Good News: GAD Is Treatable Dike other an4iety disorders) *A! .ated rituals in2ol2ing hand-washing) .ompulsi2e disorder (O.hoolwork) job) -amily) or so. ome people -ind that medi.hanged re.an) too. .y. ome spend hours at a time per-orming . <ou may also want to talk to your do.ause the disorder -reFuently .urs with other an4iety disorders) depression) or a sleep disorder) it>s wise to raise .essi2e .Dearn more symptoms.king to ward o-.ti2ities may be di--i. !oubting that is irrational or e4. e2eral hours e2ery day may be spent -o. /eeling o2erly responsible -or the sa-ety o. ObsessiveCompulsiveDisorder(OCD) . .! may not realiCe that their obsessions and .ogniti2e-beha2ioral therapy) or .o-o.on.ently. Dearn more symptoms.essi2e.an inter-ere with all aspe.ern with order) arrangement) or symmetry.ompulsions are e4.he.their heads (obsessions() o-ten .ompulsions are irrational) yet they -eel powerless to stop them..ontamination.. . B4.ation is help-ul9 the ?.tor about other symptoms.ombination.tor about adding alternati2e treatments) su.ounting) or . Symptoms Obsessions — unwanted intrusive thoughts • • • • • • • • .h as rela4ation te.15) tea.ti2ely treated with psy.15.hildren with O.persistent) unwel.!( su--er -rom unwanted and intrusi2e thoughts that they .h helps those with *A! learn to .essi2e .an inter-ere with a personJs normal routine) s. /ear that negati2e or aggressi2e thoughts or impulses will .hildren and adults with obsessi2e-.entrate on daily a. su--er -rom an an4iety disorder. 5hese .ise) as part oyour o2erall treatment plan. Most people who ha2e O. 1ut an4iety disorders are real) serious) and treatable) and like many people who ha2e o2er. 5hat>s one number that hasn>t .identally or purpose-ully injuring another person.ompli..erns with your do.ern about a.ial a.ompulsions( to try and ease their an4iety. /ood and !rug Administration has appro2ed se2eral antidepressants -or the treatment o.ult. ?nlike adults) howe2er) .upation with losing or throwing away obje.h they -eel is beyond their .ompelling them to repeatedly per-orm ritualisti. De-t untreated) O.hildren su--er -rom O.ontrol.!. . .ome them) you .ause personal harm or harm to a lo2ed one.

Ask Fuestions and learn where you . 5rust your instin. Treatment O.ompatible do. <our responses will help your therapist or do.on.urs with depression and other an4iety disorders.h o--i.h e4perien.e 2isit.the therapy to the best o.h to treating O. :.ation whene2er ne.ome disabling.hat is your su.e do you ha2e treating O.tor.losely with a health .you>re . 5hen .king se2eral to hundreds o.on.hat is your basi.leaning G Aepeatedly washing one>s hands) bathing) or .all between appointments i.erns about your sa-ety.alling up =goodH thoughts to neutraliCe =badH thoughts or obsessions9 or e4.. !o all homework assigned to you as part o.tor or therapist. Getting Help 1e prepared to make the most o.hing and arranging Mental rituals G Bndless re2iewing o. ..king and re-. .aps) or rubber bands.ked) the sto2e is turned o--) the hairdryer is unplugged) et.erned about symptoms o. <ou ha2e a right to know.e signi-i.ti2e treatment plan. 7oarding G !i--i. approa.ea.on.your ability.king G . *i2e honest -eedba. /ollow the tips below to make sure your .ounting9 repetiti2ely . Ask -or .h as going through a doorway o2er and o2er(.he.!) make an appointment with a therapist or your do. 5ou.ulty throwing away useless items su.an -ind more in-ormation.essI .. Questions for the Therapist or Doctor Before Making an Appointment • • • • • • .ial words or phrases to neutraliCe obsessions. :.oming and persistent about issues that .essary.O.he.lari-i.ts in your sear. Aepeating G :nability to stop repeating a name) phrase) or simple a.erns are addressed and your Fuestions are answered. During Treatment • • • • • • • • • • Keep your s.are pro-essional to determine the best option.distress) or ha2e .ess rate with O.!I 7ow do you de-ine su..ted le2els o. 1e -orth. Most people who seek treatment e4perien.rite your Fuestions ahead o.tor or therapist.leaning household items) o-ten -or hours at a time. 1e honest and open with your do.not treated properly) it may be. 5ake notes during the appointment to make sure you understand what you are hearing.omplete the sel--test on this site.time and bring them with you.k on how the treatment is working.ern you.e une4pe.times a day that the doors are lo.tor make a proper diagnosis and determine an e--e.!I 7ow o-ten are my appointmentsI 7ow long is treatment likely to lastI .Compulsions — ritualistic behaviors and routines to ease anxiety or distress • • • • • • .! is a serious) yet treatable an4iety disorder that o-ten o.h to -ind a .ant impro2ement and enjoy an impro2ed Fuality oli-e.he.heduled appointments.ti2ity (su..h as old newspapers or magaCines) bottle . .you ha2e Fuestions about treatment) e4perien.on. :t is important to work .on2ersations) .essi2e praying and using spe.!I 7ow mu.

h do you think is best -or my problemI .hat i.ting -lyers() or the .old clothes.!I !oes it run in -amiliesI .15 best -or meI 7ow long do you e4pe.an be related to .-ree items (su. #aga.ation and .ardboard bo4es) photographs) household supplies) -ood) and . #y husband is upset and embarrassed.!I .their .olle. &ut ( get so an0ious *hen ( try to thro* anything a*ay.hat i.and *e get into horrible fights.h -or per-e.: ha2e a relapseI u.luding the di--eren.and ( feel guilty that the clutter makes them cry.tsGemotional) physi. Dearn more about treating O.hat .hat is . • • • • • • • • • • • • • Hoarding: The Basics (+ve al*ays had trouble thro*ing things a*ay.t treatment to lastI .medi.ation. Aead on to learn more) in.hat i.ompulsi2e buying (su.hat kind o.h may not appear to others as uniFue) su.es between hoarding and .arding or parting with possessions) regardless o.ial) and e2en legalG-or a hoarder and -amily members.ess-ul treatment o-ten in.lothing.olle.ombination o. he large piles of stuff in our house keep gro*ing so it+s difficult to move around and sit or eat together as a family.ompulsi2e sear.ogniti2e-beha2ioral therapy or e4posure therapy) and medi.ontainer(.! and an4iety disorders..ategoriCing or organiCing possessions :nde. bags) .t to see resultsI :s a .ulty .ted at the time o.al) so.someone who su--ers -rom hoarding.hat are the side e--e.ommonly hoarded items may be newspapers) magaCines) paper and plasti.ompulsi2e a. 5his e4ample is typi.: also ha2e other an4iety disorders or depressionI .their a.h as -eeling o2erwhelmed or embarrassed by possessions .ines. Understanding Hoarding 7oarding is the persistent di--i.eI :s payment e4pe. Symptoms and Behavior omeone who hoards may e4hibit the -ollowing: • • • • • :nability to throw away possessions e2ere an4iety when attempting to dis.ting.olle. "hat if ( need them one day/ ( don+t *ant to risk thro*ing something out that might be valuable.beha2ior therapy) su.ationI .h as .the medi.ial) -inan.ation doesn>t workI .and ( don+t kno* *hat to do.ted items sets them apart -rom other people. /or those who hoard) the Fuantity o.ludes a .h as ne2er passing up a bargain() the .Fuisition o.ts o. 5he beha2ior usually has deleterious e--e.ne*spapers.auses O. /ind out all about animal hoarding.ombination o.hen .medi.Are you a pro2ider -or my insuran.tual 2alue.!I .ard items *reat di--i.al o.h as an old .my treatmentI At the First Session 7ow did you diagnose that : ha2e O.h as . ( don+t kno* *hat+s *rong *ith me.treatment approa.ision about what to keep or where to put things !istress) su.ulty dis.15I 7ow well does it work -or O. 7oarding . . #y children *on+t invite friends over.an : e4pe. (+m scared *hen he threatens to leave me.t or uniFue items (whi.

running out o.ause they belie2e that an item will be use-ul or 2aluable in the -uture.a re.a (eating non--ood materials() Prader-.e) -eel sad or ashamed a-ter a. Or be.e spontaneous seemingly out-o--the-blue pani.ope with mal-un.tors and lo2ed ones) about what they e4perien.!() attention-de-i. disorder is diagnosed in people who e4perien..ally de2eloping in early adulthood) women are twi.iated with an eating disorder) pi.k) also known as an an4iety atta.li2able spa. Diminished Quality of Life A la.lutter) o-ten at the e4pense o. :n general) .other people tou.an adults e4perien.tors ha2e a sense o.he..es and without heat or other ne.auses anger) resentment) and depression among -amily members) and it .hild . 7oarding also . 7oarding may be present on its own or as a symptom o. ?nli2able .tions: -ear o.ord) -inan.illi syndrome (a geneti.P!() obsessi2e-.ti2ity disorder (A!7!() and depression.om-orts. atta.ial de2elopment o.king the trash -or a.e pani. 7oarders o-ten li2e with broken applian.needing it in the -uture9 . ome are a-raid or embarrassed to tell anyone) in. Hoarding vs.ide where something belongs) it>s better just to keep it.luding loss o.ompulsi2e disorder (O.e -or .hing items Obsessi2e thoughts and a.e is .ur une4pe.ial problems) as well.k.onditions.tor o. Dearn about staging an inter2ention.e) e2i.ts /un.onsider an item a reminder that will jog their memory) thinking that without it they won>t remember an important person or e2ent.hosis) or dementia.ks and are preo.upied with the -ear o.an a--e.identally dis. disorder() psy.luding their do.eable) or too big a bargain to throw away.essary .k) New <ork Panic Disorder & Agoraphobia Pani. Dearn the symptoms o. Collecting 7oarding is not the same as .ustody. 5hey ha2e . 5hey usually keep their .the 1io-1eha2ioral :nstitute) in *reat Ne.tional li2ing spa.an>t de.k o.an item or o.urring atta.a pani.om-ortable when others see them. disorder.k.e joy in displaying and talking about them.tional impairments) in.ks o. 5hey may also . 5hose who hoard usually e4perien.ting. 5ypi.ompulsi2e personality disorder (O. disorder in a gi2en year. /ugen NeCiroglu) Ph!) A11P) A1PP) is !ire.Fuiring additional items) and they are o-ten in debt. About si4 million Ameri.ause they . Although less o-ten) hoarding may be asso.hildren. 5hey ..• • • uspi. Many people donJt know that their disorder is real and highly responsi2e to treatment.itKhypera.e embarrassment about their possessions and -eel un. atta.e as likely as men to ha2e pani.pride about their possessions and they e4perien.. 5hose most o-ten asso..tedly) sometimes e2en during sleep.olle. 7oarding may lead to serious -inan.ial di--i.t the so.tion when adding to it) and budget their time and money.ulties) health haCards Reasons for Hoarding People hoard be.onditions may lead to separation or di2or.e) so.another disorder.tion) and e2en loss o.olle.li2ing spa.tion organiCed) -eel satis-a.olle.tioning systems rather than allow a Fuali-ied person into their home to -i4 a problem. Or they -eel it has sentimental 2alue) is uniFue and irrepla. Pani.iated with hoarding are obsessi2e-.ion o.arded obje.ial isolation) -amily or marital dis. atta.ommon among hoarders) who may also li2e in unhealthy or dangerous .-un.

ipation o.hart .alming kills Pra. 5his may .t diagnosis.ult) su. About one in three people with pani.ti.hart .e .onstantly on guard) waiting -or the ne4t pani..hart .ould be help-ul or supporti2e. :nstead they su--er in silen. ome people de2elop a -i4ed route or territory) and it may be. atta.ome your pani. !ownload the .om-ort diCCiness or lightheadedness . 5hese people ha2e agoraphobia) and they typi.hes a peak within a -ew minutes and in.ti.e .luding other an4iety disorders) depression) irritable bowel syndrome) asthma) or substan. pla. Agoraphobia ome people stop going into situations or pla.intense -ear that rea. transportation) or large sports arenas.ludes at least -our o.hondria.ti.al disorders) in..om-ort nausea or abdominal dis.ti.harts -ound in Facing Panic) %elf-Help for People *ith Panic Attacks to help you pra.es in whi.ti.orre.k the skills you learn to o2er.hart .es where they -eel immediate es. atta.being .hoking .e 5he disorder o-ten o.h theyJ2e pre2iously had a pani.ape heart palpitations sweating trembling shortness o..h as shopping malls) publi.k in anti.hest pain or dis.-ear o.k is de-ined as the abrupt onset o.getting a . 5heir world may be.ally a2oid publi.ing the .ome impossible -or them to tra2el beyond their sa-ety Cones without su--ering se2ere an4iety.reating ymptoms Disting L Aanking My /eared ituations !etails o.it happening again.k.e and tra.ate o.e abuse. atta.e Dearning -rom Pra.hart ": +: ': &: 3: 6: $: Pra.onsidered a hypo.ape might be di--i.e) distan.hart .My /eared ituations Preparing to Pra. disorder de2elops agoraphobia..imminent danger or doom the need to es.urs with other mental and physi.reating ymptoms Pra.ing themsel2es -rom -riends) -amily) and others who .ompli.breath or a smothering -eeling a -eeling o.ome smaller as they are . Symptoms A pani.the -ollowing symptoms: • • • • • • • • • • a -eeling o.hart . .ti.

are..ti2e.torsJ o--i. • • • • • Treatment Dike other an4iety disorders) pani.dying tingling sensation .orre.hart +: Pra.es) . disorder and other an4iety disorders. atta. 5reatment su.harts -ound in this book to help you pra.an be .e Posttraumatic Stress Disorder (PTSD) .ome your pani.things being unreal) depersonaliCation a -ear o.ed they ha2e a li-e-threatening illness.hart &: Distening L Aanking My /eared ituations .e .ks donJt know they ha2e a real and treatable disorder.reen yoursel. disorder o-ten make many 2isits to emergen.e and tra.e .ti.My /eared ituations . .ant impro2ement with pro-essional . Self-help Dearn se2en steps to break the . .hart 6: Preparing to Pra.le o. !ownload the .the two. 5herapists will use therapy) medi.losing .ess 2aries among people.ing the .on2in.reating ymptoms .reating ymptoms .y. those o.illnesses su.hart 3: !etails o. ome may respond to treatment a-ter a -ew months) while other people may need more than a year.ontrol or Mgoing .h is why it must be tailored to the indi2idual. disorder mimi.ti. Most people -ind signi-i.the symptoms o.ompli.or a -amily member -or pani.alming kills . Many people su--ering -rom pani.hart ": Pra.-rustration be-ore re. 5reatment .hart $: Dearning -rom Pra.pani.t diagnosis.ti.hills or heat -lush in.e abuse) whi.a person has more than one an4iety disorder or su--ers -rom depression or substan.h as heart disease) thyroid problems) and breathing disorders) people with pani.. :t o-ten takes months or years and a great deal o. Although treatment is indi2idualiCed) se2eral standard approa.ti.e many o.ti.k the skills you learn to o2er.ti. in Facing Panic$ %elf-Help for People "ith Panic Attacks.ombination o. disorder and agoraphobia .raCyM a -ear o.ated i.y rooms or do.e .ei2ing the .ation) or a . disorder. Dearn more about treating pani.pani.an be treated.a sense o.hart ': Pra.hes ha2e pro2ed e--e.

ents) and .ontinue to be se2erely depressed and an4ious -or months or e2en years -ollowing the e2ent. !iagnosis . Posttraumatic stress disorder. • :n.ommuni.ondition that .the military: .hara.traumati.ed pre2ious traumati.h e2ents re. e2ent. Most people who e4perien.t the way the sur2i2or a.tion. B2ents Relationships.h as di--i. ee how she got help.an also de2elop it. PTSD Facts • • • • $.h as rape) or other li-ethreatening e2ents.ed P5 !.ident) terrorist in.Reacting to a Traumatic Event :t>s not unusual -or people who ha2e e4perien.ts the trauma sur2i2or.de2eloping P5 !.on.reased arousal su.o2er -rom them) but people with P5 ! . stress disorder as men) and .ed or witnessed a natural disaster) serious a.ohol.an also a--e. A .ks) and nightmares.$ million Ameri.tions o.ing the trauma through intrusi2e distressing re.ti2ities or outside in nature) and a2oid al. ta. .ould harm relationships.lose -amily relationships or -riendships. Trauma.es) people) and a.the trauma.ause problems with trust) .luding how to help . e2ents.ur in people who ha2e e4perien.an o.ts with others.pla..people e4posed to mass 2iolen. 5heir symptoms .ident) sudden death o. Aead more -rom the National Center for PTSD..the e2ent) -lashba.es symptoms -or at least one month -ollowing a traumati.ans age "% and older ha2e P5 !. 5ry not to get hooked to news reports) whi.ed traumati.e abuse) or other an4iety disorders.entrating) -eeling jumpy) and being easily irritated and angered.teriCed by three main types o. pend time with lo2ed ones in -a2orite a.ompelling. Dearn more below) in.omen are twi.ombat photographer who e4perien.tual or threatened death) serious injury) or se4ual 2iolation: • .gt.ation) and problem sol2ing) whi.hildren older than si4 in. • Bmotional numbness and a2oidan.e as likely to de2elop posttraumati.ular pattern may de2elop that .t .lude those below.a lo2ed one) war) 2iolent personal assault su.ulty sleeping and .riteria that apply to adults) adoles.e o.h may seem parti.at.e su.ir.ks) nightmares) or intrusi2e memories when something terrible happens -. P5 ! . Dearn about P5 ! symptoms.symptoms: Ae-e4perien.e ha2e been shown to de2elop P5 !) a higher rate than those e4posed to natural disasters or other types o. or PTSD. and PTSD 5rauma sur2i2ors who ha2e P5 ! may ha2e trouble with their .h may a--e.loseness) . Aead more details here. e2ents run a higher risk o.hildren and members o..ularly .h a 2ideo about ta-. :n turn) the way a lo2ed one responds to him or her a--e.olle. is a serious potentially debilitating .your ner2ous system: :t>s ha2ing a normal rea. • 7elp <our .hildren.y Pearsall) a . 7owe2er symptoms may not appear until se2eral months or e2en years later.hild Manage 5raumati. e2ents to ha2e -lashba.ti2ities that are reminders o.an . Symptoms P5 ! is diagnosed a-ter a person e4perien.urs with depression) substan. 6$ per.like the e4plosions at the 1oston Marathon.hildren . P5 ! o-ten o.ent o. B4posure to a. 1e tolerant o. 5he disorder is . People who ha2e e4perien.

unless e0posure is *ork-related.deta.upational) or other important areas o-un.distressing memories) thoughts) or -eelings about or .tions in whi. • persistent) distorted blame o.2 • re. Dearn about P5 ! symptoms in .g.idental • e4perien. Note$ his does not apply to e0posure through electronic mediatelevision.the traumati.hanges in arousal and rea.ers repeatedly e4posed to details o.urred to a .on2ersations) a.tual or threatened death must ha2e been 2iolent or a.the traumati.the traumati.h the . e2ents or o.e positi2e emotions 5wo or more o.ti2e beha2ior hyper2igilan.t o.ing the traumati.e e4aggerated startle response problems with .losely asso.ases oa. e2ents learning that the traumati.h as traumati. .tioning not attributed to the dire.the -ollowing: inability to remember an important aspe.ant a.or a -amily member -or P5 !.ause or . e2ents • persistent -ear) horror) anger) guilt) or shame • markedly diminished interest or parti. !epartment o.the traumati.hildren age si4 and younger.ti2ities) obje.ondition) su.the traumati.ts) situations( 5wo or more o. e2ents are re. e2ents witnessing) in person) the traumati.hment or estrangement -rom others • persistent inability to e4perien.he.hologi.ohol or another medi.ting human remains9 poli.al distress at e4posure to internal or e4ternal .2 • intense or prolonged psy.2 • -lashba.ti2ities • -eelings o.ts as i.ues that symboliCe or resemble an aspe.ts o.the -ollowing marked .onseFuen.sel.ohol) or drugs( • persistent and e4aggerated negati2e belie-s or e4pe.) people) pla. 5he presen.entration di--i.ompletely dangerousM(. -eeling( o.tations about onesel-) others) or the world (e. brain injury.the -ollowing: spontaneous or .or pictures.e.tly e4perien.urrent) in2oluntary) and intrusi2e distressing memories o.the dream is related to the e2ents 1Note$ (n children there may be frightening dreams *ithout recogni. • • • • • • • • • • • Treatment .iati2e rea.ulty -alling or staying asleep or restless sleep Also) .e o.ant distress or impairment in so. e2ents (not due to head injury) al.ing repeated or e4treme e4posure to a2ersi2e details o..Neterans A--airs.lini.ti2ity: irritable or aggressi2e beha2ior re.) =: am bad)H =No one .urring 1Note$ (n children trauma-specific reenactment may occur in play.h) -rom the ?.es) .lose -riend9 . e2ents 1Note$ (n children repetitive play may occur in *hich themes or aspects of the traumatic events are e0pressed.e4ternal reminders (i.ontent or a--e.al e--e.h the indi2idual -eels or a.the traumati.ipation in signi-i.ally signi-i.tions to reminders o.on.dire. e2ents • physiologi.iated with the traumati.t physiologi.kless or sel--destru.t o. e2ents (B4amples are -irst responders .es o.ation) drugs) or al..e.al .able content.k out the mobile app P5 ! .the traumati.al rea.olle.oa.reen yoursel.movies. .ued re. e2ents o..lose -amily member or .urrent distressing dreams in whi..t (i. e2ents Persistent a2oidan. .or others about the .one or more o.ks or other disso.hild abuse(.e o.ial) o.an be trusted)H M5he world is .e o--i.medi.

ial an4iety disorder report symptoms -or "0 or more years be-ore seeking help Although they re.alled talk therapy() medi. 5hey are terri-ied they will humiliate or embarrass themsel2es.ial or per-orman.taking the patient into the a. $%posure therap#.ial phobia) may ha2e -ew or no so. situation.hotherapy (o-ten . 5he an4iety .people with so.e and .an wreak ha2o..ope with their -eelings.e.ial li-e) making it di--i.ript o.rutiniCed and judged by others in so.15I Disten to this pod.essi2e and unreasonable) people with so. 5he therapist uses these tools to help people with P5 ! .e where the e2ent happened. way.ogniti2e restru.a therapistJs o--i. • • • .ontrol their -ear by e4posing them to the trauma they e4perien.antly with daily routines) o.e P5 ! symptoms by tea.ed with P5 !. 5hey may -eel guilt or shame about what is not their -ault.being s.a dis. on the li2es o.hat is .ult to .e) or so.ial or romanti. 5his therapy helps people make sense o.omplete s.upational per-orman.are-ully designed to support e4posure therapy o.ations) or both.those who su--er -rom it.an4iety disorders. :t uses mental imagery) writing) or 2isits to the pla.e.are pro-essional who is e4perien. People with this disorder) also .turing) this treatment helps people look at their memories in a healthy way. 5his therapy tries to redu..ed in a sa-e way.ustom 2irtual en2ironments that ha2e been .al age o. relationships) making them -eel powerless) alone) or e2en ashamed.ogniCe that the -ear is e4.aliCed: Aead about the di--eren.ontains the -eared situation) instead o.ast. Dike . ome people will need to try di--erent treatments to -ind what works -or their symptoms.ial an4iety disorder -eel powerless against their an4iety.alled so.an inter-ere signi-i.5he main treatments -or people with P5 ! are psy.hing a person how to redu. Social Anxiety Disorder :t>s the e4treme -ear o. 5his therapy helps people -a.omputer keyboard) ensuring -ull . ymptoms may be so e4treme that they disrupt daily li-e. &irtual realit# treatment .an adults ha2e so. B2eryone is di--erent) so a treatment that works -or one person may not work -or another. 5his disorder is not simply shyness that has been inappropriately medi. 5he treatment in2ol2es e4posing the person with P5 ! to a 2irtual en2ironment that .onset: "' years old '6 per.ent o.15) . Stress inoculation training. Cogniti e restructuring. :t is important -or anyone with P5 ! to be treated by a mental health . About "3 million Ameri.ial an4iety disorder 5ypi. .ussion with e4perts: 5reating An4iety with Nirtual Aeality B4posure /ind out more about treatment.an be help-ul.on-ines o. 5he therapist helps people with P5 ! look at what happened in a realisti.ontrol othe e4posure and the ability manipulate situations to best suit the person within the . ometimes people remember the e2ent di--erently than how it happened.hool) inter2iew and get a job) and ha2e -riendships and romanti.tual en2ironment or ha2ing the patient imagine the traumati. • Aead a trans.e situations: o. relationships.onsists o. 5he therapist . Cogniti e!"eha ioral therap#) or .ial an4iety disorder .e an4iety.the bad memories.ontrols the 2irtual en2ironment through a .

are.al symptoms o.ial an4iety disorder.ial an4iety disorder.hile this may be an e4aggeration) many would agree.ant impro2ement with pro-essional .sel--.ts so.deta.ti2e. /ind out more about treatment.om-ortable in other similar settings.talking to a salesperson or gi2ing a spee. ome literally -eel si.ome an4ious during routine a. Most people -ind signi-i.ti.topping flyingfinancial ruin.ontrol.ess 2aries among people.k -rom -ear in seemingly nonthreatening situations.hment and loss o.ial an4iety disorder) how it impa.so. 1ut those with so.al symptoms o. ?sing humor) warmth) and language that is easy to understand) authors Murray tein) M!) MP7) and 8ohn . relationships) and what treatments work. ome may respond to treatment a-ter a -ew months) while other people may need more than a year.h is why it must be tailored to the indi2idual.so.ial an4iety disorder e4perien. Second Edition B4.ompli. Triumph Over Shyness: Conquering Social Anxiety Disorder.e your stage -right.an be .ial or per-orman. 5he disorder is o-ten sele. .and even death. Conquering Stage Fright Public speaking is said to be the biggest fear reported by many American adults.opy today. ..ial an4iety disorder . Order your .these therapies.ipating in meetings or . Other people may be.ial an4iety disorder usually begins in .al tips) help-ul te.lasses) or dating and attending parties.e abuse) whi.ial and romanti.e) and .hes) and -eelings o.h) but they may be .rutiniCed and negati2ely e2aluated by others in so.being s. B2eryone .an be treated. 5reatment .breath) diCCiness or lightheadedness) heada.on2ersation with a stranger or a person in authority) parti.sickness.ti2ities su.ti2e. 5reatment su.erpt o.a person has more than one an4iety disorder or su--ers -rom depression or substan.h as starting a .auses so. Symptoms Physi.reen yoursel.riumph 3ver %hyness$ 4on5uering %ocial An0iety 'isorder .ial an4iety disorder may in.hildren are prone to .o.e an intense -ear o.pra.en.e situations. Dook inside: Aead an e4. <ou may ha2e heard the joke that some people would pre-er to be in their own .hildhood or adoles.linging beha2ior) tantrums) and e2en mutism. Treatment Dike other an4iety disorders) so.ombination o. .o--ins than gi2e a eulogy at a -uneral.hes ha2e pro2ed e--e.lusi2ely -rom A!AA) this book is -ull o. Although treatment is indi2idualiCed) se2eral standard approa.hniFues) and more to help manage an4ious thoughts and physi.ated i. ome people may ha2e an intense -ear o.lude blushing) pro-use sweating) trembling) nausea or other abdominal distress) rapid heartbeat) shortness o.alker) Ph!) e4plain what . *et "0 tips to redu. 5herapists will use one or a .an relate to -eeling an4ious be-ore gi2ing a presentation or asking someone out on a date.or a -amily member -or so.

A.e) impa.ept yoursel.ti. Pra.e an4iety. Scientific *eferences tein) M.e other health-ul li-estyle habits. Taking Steps to Overcome Your Fear Dearning to impro2e your speaking or per-orman. ("##6(.us on your strength and ability to handle .1.e) o-ten .ation or natural remedies to help redu. speaking and per-orming.to others is at the root o.t.3') "6#-"$&. 6. %.A. top s.enter o.us your attention on thoughts and images that are .us -eel a degree o.ess: Always -o.alker) 8. '.publi. And be.ial phobia: . :n -a. Tr# these '( tips to reduce #our stage fright) ".lassi-i. Aemain warm and open and make eye .h a situationGor anywhere the person might be . 5alk with your physi. Dearning to a. 8anet Bsposito) M . ("##&(.ommended that you learn skills to redu.e. tein) M.ohol as mu.a--eine) sugar) and al.onne.onsidered less than per-e.h as possible. Publi.alled stage -right) e4a.ret) e2en -rom a spouse or other . tand or sit in a sel--assured) .e.hoose medi.them as -riends rather than enemies.se2eral books about resol2ing -ears o.al to learn .1. <ou must address and re2ise any negati2e per.ing your -ear) it be.tions related to publi.ial phobia(. 5ry to limit . 3. 1e natural) be yoursel-.reate sel--doubt and low .hallenging situations.ation.A.ial an4iety disorder (also known as so.aring yoursel.omes possible to o2er. thresholds -or so.ner2ous apprehension when preparing to speak up or per-orm in -ront o. Prepare your material in ad2an.ame her own terror o.e may gi2e you immediate relie-) but it rein-or.ome per-orman.e and sel--esteem and .auses some people to lea2e s.ogniti2e-beha2ioral methods to stop the . Ae-use to think thoughts that . A2oidan. NisualiCe your su.eptions) belie-s) thoughts) images) and predi.) .t on -un. :nstead) -o. speaking -ears in the .e ways to .riti.on-ident posture. 1ut those who are -illed with -eelings o.alker) 8. :t>s also .ises) yoga) and meditation.om-ort and ease in e4pressing yoursel.e: mile and greet people) thinking o.e their symptoms oper-orman. ome people also .alm and rela4 your mind and body) su. Make . 5he -ear o.on-iden.dread and pani.e. . hi-t the -o.ts a huge toll on sel-.ause they -eel embarrassed) people try to keep their -ear a se.Most o.us -rom yoursel.. speaking or per-orming. speaking) is the author o.and not -eeling that you ha2e to pro2e yoursel.es your -ear in the long run.and your -ear to your true purposeG.ation or natural produ. Archives of General Psychiatry.ise) eat well) and pra. in su.onta. etting diagnosti.o2er the deeper -ears related to being seen and heard by others) showing 2ulnerability) and being . $.e and manage them) you will de2elop an empowering belie.ts alone.le o.ontributing something o2alue to your audien. *i2e up trying to be per-e.e and read it aloud to hear your 2oi.in -ront o.tioning) and diagnosti. :.A.) .with thoughts about what might go wrong.) who o2er.you are willing stop a2oiding your -ears and learn new skills to redu.publi.ti.t. speaking or per-orman. And it>s o-ten help-ul to un.and trust in yoursel-.a2oiding -ear-ul situations. Many) in.luding seasoned pro-essional per-ormers) su--er in silent terror.ian to -ind the most appropriate treatment -or you. B4er.ommunity: Pre2alen.e and manage your -ear and an4iety and not resort to using medi.hool or a job or pass up a promotion. #.) L /orde) !. "0.attentionGmay be su--ering -rom a -orm o-so.tions with your audien..e your -ear.alming and reassuring.a group.e an4iety and -ind . +.lose -amily members or -riends. &.others.h as deep breathing) rela4ation e4er.publi.y.healing.on-iden.) L /orde) !.t and know that it is OK to make mistakes.e skills is good) but it>s generally not enough to substantially redu. :t is re.

ompany o.tor e4press . adults) or $ per.on.ohol -our or more times a week 7a2e -i2e or more drinks .ontaining al..h as al.people with so. ( had no skills to use to interact socially *ith my peers.-riends) and she started drinking to alle2iate her an4iety around her peers. ( did *hat *as e0pected as a 9good: girl.ultiesH su..ut down . Murray tein) M!) MP7) and 8ohn . Order your .so.ope with symptoms or try to es. ( felt intense social an0iety.ial an4iety disorder.any group o.an temporarily redu. ( *as 5uiet and blended into the *alls.ho* ( felt.ial an4iety disorder.pra.%econd 6dition is -ull o.an a--e. ( didn+t trust my perceptions and it took many years before ( could admit. :. About "3 million ?.ynthia>s tumultuous .oupled with so.ial an4iety disorder =-reFuently tra2els in the .ial an4iety led to di--i. he didn>t -eel part o.ial an4iety disorder) how it impa.ial an4iety disorder in any gi2en year.rease an4iety) irritability) or depression a -ew hours later or the ne4t day.much less say aloud.auses so.o-worker) or do. Self-Help riumph 3ver %hyness$ 4on5uering %ocial An0iety 'isorder.ent o.ial and romanti.al symptoms o.ohol or drug abuse) depression) and other an4iety disorders.other emotional di--i.so.ent study -ound that the two disorders ha2e a stronger . Although al.ial an4iety disorder O or other an4iety disorders O to drink e4.ynthia Kipp) who has so.going /eel guilty or remorse-ul a-ter drinking 7eard a relati2e) -riend) .ern about your drinking or suggest you .ial an4iety O whi.alker note that al.the -ollowing) you may su--er -rom al. ?sing humor) warmth) and language that is easy to understand) authors Murray tein) M!) MP7) and 8ohn .hniFues) and more to help manage an4ious thoughts and physi.so.hildhood O her -ather was abusi2e and su--ered -rom s.alker) Ph!) write in riumph 3ver %hyness$ 4on5uering %ocial An0iety 'isorder that so.ts so. Symptoms #y drinking *as self-destructive.( became a*are that ( *as different. B2en moderate amounts o. relationships) and what treatments work.ame as big o.oholism: • • • • • • !rink al. .tion among women.an also in.ult teenage years."3") &0%&"+.not bigger. American )ournal of Psychiatry. And it isn>t unusual -or people with so.ial an4iety disorder also su--er -rom al.e you>2e started Need a drink in the morning to get yoursel.alker) Ph!) e4plain what .ommunity sur2ey o.a problem as her an4iety) i.ohol .you do at least one o.ohol in one day Not be able to stop drinking on.the population) ha2e so.t one>s mood and an4iety le2el.ial an4iety. #y family didn+t seem to pay too much attention to my phobia.opy today.and that compounded my lo* self-esteem.ohol abuse or dependen. 5hese are the words o.e symptoms o.onne.ent o.al. . Social Anxiety Disorder and Alcohol Abuse At around the age of 78.ohol .e) and a re.ti.hiCophrenia O .ohol .essi2ely to . 1ut her drinking soon be.al tips) help-ul te.h is the reason many turn to it O tein and .ape them.onsiderations -rom a . About +0 per.

ess-ully parti.ial an4iety) howe2er) -ind AA meetings and other support groups to be too an4iety-pro2oking. obje.us a bit uneasy or e2en -rightened.al symptoms o.e a strain on relationships be.es) situations) or obje. phobia.ial an4iety. phobias) or strong irrational -ear rea.ogniti2e-beha2ioral therapy (.ation on.s Recommended books riumph 3ver %hyness$ 4on5uering %ocial An0iety 'isorder O A!AA publi.ould -o.ident.ipation o.ause people will do whate2er they .t) pla.15( and moti2ational enhan..( started attending AA meetings. 5he -ear may not make any sense) but they -eel powerless to stop it..hildhood) most seem to arise une4pe.tion and delay the desire to seek treatment and inter-ere with the e--e.lini.hile some phobias de2elop in . 1ut people with spe.ial an4iety disorder symptoms through therapy.essi2e and unreasonable -ears in the presen.om-ortable and o-tenterri-ying -eelings o.ohol treatment program at a later time. Treatment 3n the verge of losing everything. 5heir onset is usually sudden) and they may o.urring so.e sel--esteem) and pla.i-i.an lead to addi. Finally.e o.ommon pla.om-ortable speaking be-ore other people) and on.hange into .e in treating an4iety disorders may be best and .om-ort or an4iety.us on -urther redu.. .or in anti.ti.essi2e drinking .ial an4iety disorder Specific Phobias New pla. /ind an AA meeting near you.arry out daily a.oming her so. People who e4perien.an to a2oid the un.oholi.oholi.on. .B4.al tips) help-ul te.hniFues) and more to help manage an4ious thoughts and physi.tions) work hard to a2oid .redits Al. ome people with so.y) redu.e these seemingly e4.phobi.ohol abuse.al study also -ound that a .ombination o.ti2ities without in.e or early adulthood. an4iety. Moti2ational enhan.ement therapy is used in drug abuse .h the A!AA dire.a spe.es) high bridges) old ele2ators may make all o.rete goals to do so.ial an4iety disorder and al.therapy or medi.ode or .s Anonymous O -or people with drinking Al-Anon and Alateen O -or -riends and -amily o/ind a 5herapist O sear.s Anonymous meetings -or not only helping her with her al.ohol problem) but -or putting her on the path to o2er.ynthia .ur in situations that pre2iously did not .ts e2en though they know thereJs no threat or danger.en.i-i.ipate in an al.an disrupt daily routines) limit work e--i. .i-i. For the first year ( couldn+t speak.ent .pra. /ind a therapist near you.e she be.ome .e on a treatment plan.ien.ation -ull o. A re.tory using your Cip .an help one prepare to su. . .e) or situation ha2e a spe.ontrol their -ears and .tor or therapist with e4perien. Resources Al. %peaking at meetings slo*ly gave me confidence to speak in front of others.ti2eness o.ement therapy (MB5( may be su.ourages patients to turn their desire to .ounseling and en. 5he meetings allowed her to gradually be.oholi.and not really kno*ing myself.orking one-on-one with a do.ing her so. 7a2ing phobias .ynthia .tedly) usually during adoles.so.( shared my story.o-o.ity and state problems al.ame sober) .e might try to a2oid things that make us un.ause any dis.ess-ul in treating ..om-ortable) but most people generally manage to ..

transportation) -lying) dental or medi.an o-ten .ause it>s on the +3th -loor o.limbing a tall ladder .ape heart palpitations sweating trembling shortness o.hills or heat -lush .raCyH a -ear o.an4iety: a -eeling o.in an airplane during a lightning storm /eeling an4ious around your neighbor>s pit bull Pho"ia Ae-using to attend your best -riend>s wedding be.people with an an4iety disorder .ha2ing a spe.reen yoursel..breath or a smothering -eeling a -eeling o.losing .us on animals) inse.imminent danger or doom the need to es.lude un.i-i. Symptoms ymptoms o.hest pain or dis.hoking . phobias .dying tingling sensation .an be helped with pro-essional .orrying about taking o-.e between e2eryday an4iety and a phobia: • • • • • • • • • • • • • • • $ er#da# An%iet# /eeling Fueasy while .ause it in2ol2es air tra2el A2oiding 2isiting your neighbors -or -ear oseeing a dog Treatment 5he 2ast majority o.ontrol or =going .or a -amily member -or a spe.ommonly -o. phobia.om-ort nausea or abdominal dis.ause e4treme an4iety. phobia o-ten in.a hotel 5urning down a big promotion be.pe.are.i-i.om-ort -eeling -aint) diCCy or lightheaded a sense o.al pro. Although people with phobias realiCe that their -ear is irrational) e2en thinking about it .ts) germs) heights) thunder) dri2ing) publi. .om-ortable and terri-ying -eelings o.things being unreal) depersonaliCation a -ear o.edures) and ele2ators. :t>s important to note the di--eren.i-i.

Dosing a lo2ed one) getting -ired -rom a job) going through a di2or.an work -or those with spe. 5his is why treatment must be tailored to the indi2idual..orre.ularly .ommon -or someone with an an4iety disorder to also su--er -rom depression or 2i. /irst the therapist helps the patient understand in.eekly treatment with homework assignments usually su.h as taking . ome may respond to treatment a-ter a -ew months) while others may need more than a year. 5he therapist and patient would go into a house and stand near a window) learning to take a.h would not mean holding up a metal bat in a storm.ared) ner2ous) or an4ious.e 2ersa. Depression Most people -eel an4ious or depressed at times.hool) itJs likely a major depressi2e episode.e abuse.hes) parti.atastrophiCe9 they immediately jump to the worst-.an4iety and depression ")+ and how they .people ha2e more than one an4iety disorder or su--er -rom depression or substan.these therapies.ouple o.ase oMthe blues.. 5he good news is that these disorders are both treatable) separately and together. Aead on to -ind out more about the . People are unlikely to be hit by lightening) -or e4ample) and their house will probably not .t assumptions and then gradually e4poses him or her to the phobia sour.arry on with normal) e2eryday -un.o-o.eeds in "+ to"6 sessions. .ombination o. . Nearly one-hal. . People with phobias .h as going with a therapist and getting . 5hese -eelings are normal rea. 5hese people may ha2e an an4iety disorder) depression) or both. Depression !epression is a .an lead a person to -eel sad) lonely) s.treatment 2aries among people.time) it may be a .e o.ult to . .tioning.-amily) spending time with -riends) or going to work or s.sessions is help people identi-y mistaken belie-s.o.ase s.at.urren.are o. 5herapists help them realiCe they are making those mistakes) and they talk about realisti. 5reatment may be .M 1ut when su.e o.enario) and they o2erestimate the probability that it will happen.ondly .eptable risks that are relati2ely sa-e. :t is not un.those diagnosed with depression are also diagnosed with an an4iety disorder.. Dearn more about treatment.omes e4posure) or . risks.ompli.an be treated.e these -eelings daily or nearly daily -or no apparent reason) making it di--i..h -eelings last -or more than two weeks and when the -eelings inter-ere with daily a.15( . 1ut some people e4perien. e.ouraged) sad) hopeless) unmoti2ated) or disinterested in li-e in general.h -ire) -or e4ample. phobia.h a person -eels dis.h a personal story about the importan. 5herapists will use one or a .e) and other di--i.loser to dogs. Although treatment is indi2idualiCed) se2eral standard approa.on-ronting the -eared situation) su. Another e4ample is a thunderstorm) whi.ogniti2e-beha2ioral therapy (.ogniti2e-beha2ioral therapy) ha2e pro2ed e--e.u.ondition in whi.ated i. Cognitive-Behavioral Therapy :n general) .hen these -eelings last -or a short period o.hat a therapist usually does in the -irst .tions to li-eJs stressors.i-i. .ess o.ti2e.e.ti2ities su.at.ult situations .seeking help.

omorbidity with mood and addi.e spontaneously) during or a-ter the death o.or a lo2ed one -or depression. Many people who de2elop depression ha2e a history o.ing thoughts) in.hroni. ("##%(. phase) a person may e4perien.reased talking) ra.y.ur with any o. %upplement..'&: +&O+%. B.seeking help.Major depression is a treatable illness that a--e. !uring the mani. A. 1arbee) 8..ent o..h an episode is disabling and will inter-ere with the ability to work) study) eat) and sleep.empty.an o. -orm o. *.) prognosti.) Kaelber) . ome people with major depression may -eel that li-e is not worth li2ing and some will attempt to end their li2es. Symptoms A major depressi2e episode may in.ti2ities.-depression) is . People with dysthymia might be thought o.lude these symptoms: .) Aae) !.ent..essi2e elation) irritability) a de.an an4iety disorder) su.entrating.people su--er -rom major depression9 the li-etime risk is about "$ per.e that many people su--er -rom both disorders. Ma+or depression in2ol2es at least -i2e o. 5hey may also take pla. . issues.reased energy) poor judgment) and inappropriate so. :t . on.reased need -or sleep) grandiose notions) in. Major depressi2e episodes may o.e abnormal or e4. 5here is no e2iden. Mi4ed symptoms and syndromes o. Annals of 4linical Psychiatry.on. Mood swings -rom mani.reen yoursel. +.h is the inability to deri2e pleasure -rom most a.major depression.as always seeing the glass as hal.. Pre2alen.an o. . /.Mental 7ealth.alled mani.teriCed by a mood . :t in2ol2es the samesymptoms as major depression) mainly low energy) poor appetite or o2ereating) and insomnia or o2ersleeping.a lo2ed one) a romanti.reased se4ual desire) markedly in.tions.at. 5. breakup) a medi.these symptoms -or a two-week period.e o.h disorder has its own .ial beha2ior. u.es the same symptoms as would a su--erer o."0:"3O+#. to depressi2e are o-ten gradual) although o.the an4iety disorders. ".ur -reFuently. D#sth#mia is a less se2ere) long-term) and .) and etiologi.e or twi.depression. Types of depression 5hree main types o..an4iety and depression: !iagnosti. !uring the depressi2e phase) a person e4perien. Aegier) !. Aead more in-ormation about depression -rom the National :nstitute o. 1ut ea.e one disorder .ur on.ts the way a person thinks) -eels) beha2es) and -un.asionally they .ur abruptly.auses and its own emotional and beha2ioral symptoms.e symptoms similar to those o.le that shi-ts -rom se2ere highs (mania( or mild highs (hypomania( to se2ere lows (depression(.h as ner2ousness) irritability) and problems sleeping and .ti2e disorders. ("##%(. Dearn more about bipolar disorder.al illness) or other li-e e2ent.lear e2iden.an mani-est as stress) irritability) and mild anhedonia) whi.depressi2e disordersGmajor depression) dysthymia) and bipolar disorderG. Depression and anxiety disorders: not the same !epression and an4iety disorders are di--erent) but people with depression o-ten e4perien.auses the other) but there is . . At any point in time) ' to 3 per.h a personal story about the importan.e in a li-etime) or they may re-o.an an4iety disorder earlier in li-e.e ..e oan4iety disorders and their .hara.hatCberg) A.) L . &ritish )ournal of Psychiatry.) Narrow) . Bipolar disorder.

ti2e.h set o.h reFuires high moti2ation and energy) it may be ne.these) .h no other . <our therapist may re.an be help-ul.ti2e thought patterns with more realisti. ymptoms o. :n many .ations.an A: or NA: does not pro2ide adeFuate impro2ement.luding se4 !e.ause .ur together) and resear.medi.essary to treat the depression -irst. 5alk with -amily members and -riends and e4plain how they .hes) digesti2e disorders and pain -or whi.ing one>s -ears as part o.15( works to repla. 5reatment o-ten in2ol2es -a. . e2eral -orms o.ult to tell whi.guilt) worthlessness) helplessness Doss o.hopelessness) pessimism /eelings o.a person who is highly depressed is unable to begin treatment -or an an4iety disorder) whi. Treatment As with any illness) treatment should be tailored to a spe.ti2ities) in.ide) sui.are ystem: .ans take antidepressants) the number one type o.entrating) remembering) making de. /or people with se2ere symptoms or -un.i-i.symptoms is predominant) so treatment o.both may start at the same time. ome people may ha2e a disorder that .ation treatment may be .h shows that both respond to treatment with sele.ombined.hniFues) meditation) and breathing e4er.an be diagnosed.on. /ind out more about treatment. diagnosis. Taking Other Steps • • • • .ulty . steps to o2er. /or e4ample) i.the pathway to re.us on taking spe.ome an4iety and depression.isions :nsomnia) early-morning awakening) or o2ersleeping Dow appetite and weight loss or o2ereating and weight gain 5houghts o. Medications . A treatment plan -or a diagnosis o.ation used by people ages "% to &&.hotherapy and medi.tional limitations) psy.ises.an be treated similarly.al symptoms that do not respond to treatment) su.an be tailored to an indi2idual so that it works to redu.ps#chotherap# are e--e.ases) therapy .e negati2e and unprodu. 5hese treatments -o. and use-ul ones.depression and an an4iety disorder should be designed to help a person manage and redu.both disorders.ommend sel--help materials.reased energy) -atigue) -eeling Mslowed downM !i--i..o2ery.e the symptoms o.al 5reatments -or Antidepressants More than one in "0 Ameri. :nterpersonal therapy and problemsol2ing therapy are also e--e. Treating Depression and Anxiety Disorders O-ten depression and an an4iety disorder . 5ry rela4ation te.death or sui.an also be use-ul. Other medi.ogniti2e-beha2ioral therapy (. Dearn more about how these drugs work.ti2e serotonin reuptake inhibitor ( A:( and serotonin norepinephrine reuptake inhibitor ( NA:( medi. O-ten) howe2er it is di--i.onsider joining a support group.auses most o. O.interest or pleasure in hobbies and a.• • • • • • • • • • • Persistent sad) an4ious or MemptyM mood /eelings o.ti2e.depression and an4iety disorders o-ten o.both disorders) o-ten at the same time.ide attempts Aestlessness) irritability Persistent physi.ations may be used i.the distress) and it is reasonable to address it -irst.omparing Medi. Dearn more about antidepressants in Na2igating the 7ealth .h as heada.e the symptoms o.i-i.

o-o. Related Illnesses Many people with an an4iety disorder also ha2e a .ine.ti2ity is a pro2en way to redu.omplementary and alternati2e medi. Aela4ation te.the An4iety !isorders Asso.• Aegular e4er.es o. /ind out more about .o-o.an make their symptoms worse and re.ti.hest pain to heart palpitations) skin rashes) and loss o.stress) the e--e. 5he di--eren.hes) high blood pressure) and .t on your health) and how to manage it. 5his -a.rease o2erall le2els o.ise .t sheet -rom the National :nstitute o.. Dearn the news and re.ise has been shown to de.stress and manage your symptoms.urs.breathing e4er.e between them is that stress is a response to a threat in a situation.depression and an4iety.o2ery more di--i.ipation in aerobi. 5ry these tips when youJre -eeling stressed or an4ious.ti. Other e--e.riptions o.sleep. An4iety is a rea.hange or an4iety le2el to rise when a stress-ul or di--i. Physi.lude mind-body pra..es in -ind a therapist.urring disorder or physi..t o.hroni. e4er. .es stress and an4iety at one time or another. :t is natural -or a mood to .ult e2ent o.onditions Bipolar Disorder Most people -eel an4ious at times and ha2e their ups and downs.e o. Aead on to learn more about the . Stress B2eryone e4perien.t your health) .ti2e methods in.Mental 7ealth e4plains the di--erent types o.e the impa.iation o.tion to the stress. .tension) ele2ate and stabiliCe mood) and impro2e sleep and sel-esteem.an learn how to redu.-or people in stress-ul situations.ent resear.e abuse Other related .ises) yoga) and meditation. stress .h . Aegular parti.hes :rritable bowel syndrome (:1 ( leep disorders ubstan.ausing symptoms -rom heada.their pra.ult.an4iety and these disorders: • • • • • • • 1ipolar disorder Bating disorders 7eada.al a. 1ut you .Ameri. Choosing a Therapist Members o.an redu.hniFues ha2e been used to assist in the treatment o.hether in good times or bad) most people say that stress inter-eres at least moderately with their li2es.e symptoms o.al illness) whi. .a who spe. :t>s essential to be treated -or both disorders.urren.an a--e.ialiCe in an4iety disorders ha2e pro2ided des. disorder) and depression) as well as pro2iding relie.phobias) pani.h about stress.e stress.

auses unusual shi-ts in a personJs mood) energy) and ability to -un.the day) nearly e2ery day) -or at least one week.an in.alled episodes o.e periods onormal mood in between mood episodes.tioning.ulty .an ele2ated mood o. :t is not un.drugs) parti.persistent sadness and hopelessness.urs with three or more primary symptoms most o.isions Aestlessness or irritability .lude the -ollowing: :n.on. episode .ti2ities on.) with periods o.ations Pro2o. 5he mood episodes asso.ti2ity) and restlessness B4. Bipolar Disorder 1ipolar disorder) also known as mani.ommon -or someone with an an4iety disorder to also su--er -rom bipolar disorder.hanges.two weeks or longer.being o2erly high andKor irritable to periods o.the day) nearly e2ery day) -or a period o. 5hese people may be su--ering -rom an an4iety disorder) bipolar disorder) or both. O-ten people with bipolar disorder e4perien.ati2e) intrusi2e) or aggressi2e beha2ior !enial that anything is wrong A depressi e episode is diagnosed i.a mani.being Mslowed downM !i--i.an in.reased energy) a.entrate well Dittle sleep needed ?nrealisti.tion. igns and symptoms o.reased se4ual dri2e Abuse o.ohol) and sleeping medi. 5he good news is that the disorders are treatable separately and together.a depressi2e episode . A manic episode is diagnosed i.entrating) remembering) making de. belie-s in oneJs abilities and powers Poor judgment pending sprees A lasting period o.-i2e or more primary depressi2e symptoms last most o.e enjoyed) in.interest or pleasure in a.-atigue or o.highs and lows) .an4iety or depression or su--er mood swings that are so se2ere and o2erwhelming that they inter-ere with personal relationships) job responsibilities) and daily -un.ularly .t episodes o-ten re..lude the -ollowing: • • • • • • • • • • • • • • • • • • • • • Dasting sad or empty mood /eelings o.on.1ut some people e4perien.an be distin.hopelessness or pessimism /eelings o.aine) al.iated with the disorder persist -rom days to weeks or longer) and .o.alled mi4ed state.tibility) inability to . . e2ere .e -eelings o. Many people with bipolar disorder will su--er -rom at least one an4iety disorder at some point in their li2es.reased energy) a -eeling o.beha2ior that is di--erent -rom usual :n.ur together in a so-. igns and symptoms o.-depressi2e illness) is a brain disorder that .ing thoughts and talking 2ery -ast) jumping -rom one idea to another !istra.guilt) worthlessness) or helplessness Doss o.mania and depression) .an be dramati..luding se4 !e.essi2ely high) o2erly good) euphori.hanges in beha2ior go along with the mood .urring o2er time) or they may o. 5hese periods o.ith an irritable mood) -our additional symptoms must be present -or a diagnosis. mood B4treme irritability Aa.

h .hosis.iate !ire.h people with both disorders are more likely to report. state) and la.e oa.hild or young adult) whi. "eople with bipolar II disorder ne!er de!elop se!ere mania# instead they e perience episodes of hypomania that alternate with depression.enter -or An4iety and 5raumati.lude hallu.k o. u--ering -rom an an4iety disorder and bipolar disorder has been asso. • 5he de2elopment o.iated with de. or e!en within a single day.pani.ant .tor o. $hen four or more episodes of illness occur within a twel!e-month period. A person may ha2e a 2ery sad hopeless mood e2en while -eeling e4tremely energiCed. atta.and less se2ere() and then se2ere mania) whi. imon says) a -ew .moods. • :n.ks) signi-i.ording to Naomi M. ymptoms o-ten in.husetts *eneral 7ospital and Assistant Pro-essor in psy.trum o.inations) delusions) or other symptoms o.mania and depression together in what is .an in.death or sui.e symptoms o.h) or ha2ing trouble sleeping . imon) M!) Asso. which in!ol!es recurrent episodes of mania and depression. ome people may e4perien.response to initial treatment. At one end is se2ere depression) abo2e whi.ommon an4iety disorder symptom) is a signi-i.on-using) and it is best to seek help -rom a mental health pro-essional.e o. most people with bipolar disorder are free of symptoms.medi. • The Course of Bipolar Disorder Episodes of mania and depression typically recur across the life span.e abuse and sui.the .substan.leeping too mu.tioning and Fuality o.e o.ed mood) then hypomania (mild mania that may -eel good and be relati2ely brie. 'apid cycling tends to de!elop later in the course of illness and is more common among women than among men.reased -un.li-e and an in.ts o. a person is said to ha!e rapid-cycling bipolar disorder.ant problems with sleep and persistent an4iety e2en when not in a mani.reased likelihood o. Aead more about bipolar disorder in adults and -ind out about the illness in .alled the blues when it is short-li2ed and dysthymia when it is .bipolar disorder as a spe.hiatry at 7ar2ard Medi.idal thinking.ation) and sometimes a longer time -rame -or -inding the right medi.ant trigger -or mani.both an an4iety disorder and bipolar disorder: 5he presen. %ome people e perience multiple episodes within a single wee&.h may be .reased sensiti2ity to initial side e--e.ide) or ui.ant an4iety) ner2ousness) worry) or -ear-ul a2oidan.ation .hange in appetite) psy.lude agitation) trouble sleeping) signi-i. tress !isorders at Massa.an be help-ul to think o.an be . 1ut) !r.ide attempts :t . • igni-i. but as many as one-third find that some linger.hange in appetite or unintended weight loss or gain 5houghts o.psy.ide attempts.depression and mania or hypomania.al .ombination and dosing..hosis) and sui.ti2ities in addition to periods o. :nsomnia) a . episodes.an an4iety disorder plus bipolar disorder .hool) making a diagnosis o.hildren and teens. Ne4t is normal or balan.h is moderate depression) and then mild low mood) whi. Between episodes. . Bipolar I disorder is the classic form of the illness..lues may suggest the presen.hroni.alled a mi4ed bipolar state. A small percentage e perience chronic unremitting symptoms despite treatment. • • • • Co-Occurring Anxiety Disorder and Bipolar Disorder A.symptoms as a .

Many therapists use .psy. 1reathing re-training) progressi2e mus.h is a short-term -orm o.le rela4ation) and e4er.hniFues. the disorder tends to worsen.ti2ities and stability in personal relationships.ope more e--e.ise) eat) . they may cause side effects. or a combination. :nterpersonal and o.distress within a -amily that may either .ial rhythms (when to sleep) e4er. $ith proper treatment. an iety disorders and bipolar disorder can be o!ercome. howe!er.(ost people with bipolar disorder can lead healthy and producti!e li!es when the illness is properly treated. Patients re. medication. 'is& for suicide appears to be greater earlier in the course of the illness.ti2ities) moods) and le2els o.a need for more medication o!er time/. Aela4ation 5e. e!en while ta&ing a mood stabili-er. particularly those who ha!e e perienced alcohol or substance abuse.CB+/ or another e!idence-based psychotherapy instead of medication for an an iety disorder addresses concerns about side effects from ta&ing mood stabili-ers with anti-an iety medications. Because ben-odia-epines . 1sing cogniti!e-beha!ioral therapy . therapy.so. Below are forms of therapy with !arying le!els of research e!idence for an iety disorders. it is essential that people recei!e treatment for a co-occurring an iety disorder and bipolar disorder.ial stimulation. and there is some ris& of abuse among people suffering from bipolar disorder. an antidepressant can trigger manic episodes.hniFues may help people de2elop the ability to .ial Ahythm 5herapy.ontribute to an4iety and mood) as well as with any asso. Howe!er.ord the timing o.a common medication approach for an iety disorders/ before mood stabili-ation is achie!ed may worsen the bipolar disorder symptoms.ti2ely with the stresses that . 0or this reason. or anyone thin&ing about committing suicide.ise are among the te.15. Treatment +o achie!e wellness.hedule o.ogniti2e-1eha2ioral 5herapy. "eople may need to try a few different combinations to find the most effecti!e medications. As treatment progresses) they work to keep stable so.iated physi.e the le2el o. Types of Therapy "eople with bipolar disorder should recei!e medication for mood stabili-ation.a class of drugs often used to treat an iety disorders/ do not appear to ha!e negati!e effects on bipolar disorder. Howe!er. most doctors first prescribe a mood stabili-er to address the bipolar disorder.hotherapy. including physical dependence and tolerance . Dearn more about . 5hese te. is more comple than treatment for one.ti2e -or bipolar disorder) this treatment program stresses maintaining a regular s. howe!er.15) whi. and they monitor carefully any patients who are ta&ing a mood stabili-er and an antidepressant. )!er time a person may suffer more fre*uent and more se!ere manic and depressi!e episodes than when the illness first appeared. +reatment for both. • • • • . Carefully consider all treatment options with your doctor or mental health pro!ider. $ithout treatment.therapy uses strategies to redu. doctors sometimes a!oid prescribing antidepressants or prescribe them at a low dose for patients with co-occurring disorders. Medications $hen treating a co-occurring an iety and bipolar disorder with medi. /amily 5herapy. But therapy also plays an important role. %ome people with bipolar disorder become suicidal. A person with bipolar disorder.hniFues.their a. 5his -orm o. %tarting an antidepressant . they may be used for an iety in patients with co-occurring bipolar disorder.ation.ogniti2e and beha2ior therapies) o-ten re-erred to as .al symptoms.ontribute to an ill person>s symptoms or result -rom them. B--e. needs immediate attention from a mental health professional or a physician.daily a.

• • • • • • • • • • • .e (!1 A( website. As noted abo!e. wal&..an you pres.ularly when they are not -eeling well. bipolar disorder.hanges may help sta2e o-. 1e aware that it may take awhile to -ind the best indi2idual treatment plan.e do you a. and worsen episodes of mood disorders. bi&e. or dance.umstan. insomnia can be a trigger for manic episodes.hedule) and do you ha2e a sliding s.lude -amily members in therapyI .ome ne. Children With Co-Occurring Anxiety and Bipolar Disorders (any children with bipolar disorder also suffer from at least one co-occurring an iety disorder.essary. E ercise can ha!e a beneficial effect on an iety.ontinued mood and so.an emergen.. %et a goal of 34 minutes of acti!ity three to fi!e times a wee&. +a&ing these steps can help a lo2ed one.esI .onsistently take their medi.e do you ha2e in treating an4iety disorders and bipolar disorderI .risisI .tations during stress-ul periods.ipate e2ents that . • Pro2ide ongoing en.h -or one here.ial .a se2ere episode.ill it be possible to rea.y situations should symptoms be. #et a good night$s sleep. • Keep tra. Consider as&ing the following *uestions during your initial consultation. • Make a .ould disrupt rhythms) and de2elop plans -or . 5ry to build a support network o. • Ae. • Dearn about the disorders.() anti. 0ind out more aboutan4iety disorders and substan.anI 7ow long is the .o2ery pro.ation or re-er me to someone who .indi2idual impro2ement) not against some absolute standard.ommend treating the an4iety -irst or the bipolar disorderI 7ow do you manage treatment i.ial rhythm stability.ouragement during the treatment pro.lear plan -or emergen. 2earn about other self-help groups at the!epression and 1ipolar upport Allian.hat is your basi.ation and keep therapy appointments) parti.essary.ation based on these .torKtherapist -or treatment as wellI . trigger panic attac&s. !"ercise regularly.h you a-ter hours in the e2ent o.y or .ome se2ere or hospitaliCation be. and depression because chemicals released during e ercise ha!e a stabili-ing effect on mood. .e abuse. %&oid alcohol and drugs. ear. • Measure progress on the basis o.omplishments.ess is stress-ul -or -amily and -riends. Getting Help /ind a therapist who treats an4iety disorders . %leep depri!ation is ne!er beneficial. • Keep in mind that the re.eptI More Steps to Reduce Anxiety and Regulate Mood oin a support group. • Modi-y e4pe. approa.ribe medi.relati2es) -riends) and therapists) i.ne.symptoms.ess) and help your lo2ed ones . Alcohol and drugs that ha!e not been prescribed can aggra!ate an iety.et. Do2ed ones may noti.e a .hat is your -ee s..treatmentI 7ow -reFuent are treatment sessions and how long do they lastI !o you in.hat kinds o. • 1e -le4ible and try to maintain a normal routine. Helping Others +he support of family and friends is important to the reco!ery process for anyone diagnosed with co-occurring an iety and bipolar disorders.health insuran.hange in beha2ior or symptoms be-ore the person su--ering -rom them does) and treatment modi-i.: am seeing another do.ourse o.h to treatmentI !o you re.hat training and e4perien.ir. 2earn more about an iety and sleep disorders62789 to new page:. 5og.k o.ogniCe and praise small a.ale -or 2arying -inan.

an .ommon among women and girls) but men and boys a.ent o.harm.oming -at.es.an -ind something they don>t like about their body) and many take steps to eat more health-ully or start an e4er. ?sually appearing during adoles.h more .alories) e4er.h as intense and .h as a2oiding -ood and meals) pi.tions to pre2ent any weight gain.. e treme irritability.be.h .omes an obsession.eating be.ontrol their weight) su. so it. 7t.ise -or hours on end ea.ult.ount -or about 3 to "3 per. :t>s essential to be treated -or both disorders..urring eating disorder may make their symptoms worse and re.o-o.o-o.ommonly . 5he pro.es in eating beha2ior) su.+he age of onset for an an iety disorder often precedes the age of onset for bipolar disorder.ause a great deal o. ?nusual eating habits de2elop) su.nor to the family members or friends of individuals *ith psychiatric conditions.s.an also de2elop during .-ood intake or e4treme o2ereating) or -eelings o.ent o.t their .e or young adulthood) eating disorders .alled anore4ia ner2osa see themsel2es as o2erweight e2en though they are dangerously thin.onseFuen. Helping Your Child Consult a mental health pro!ider or physician as soon as possible if your child e hibits symptoms of an an iety or bipolar disorder.s recommended that children with bipolar disorder are also assessed for an an iety disorder. /or those who ha2e an an4iety disorder) a .ompulsi2e e4er. An eating disorder is present when a person e4perien. and other pronounced symptoms of bipolar disorder mas& underlying obsessi!e thoughts.es se2ere disturban.o2ery more di--i.ise plan to impro2e their appearan. 5hose with eating disorders de2elop habits that . N3 6$ his information is not intended to provide a diagnosis or specific clinical advice to individuals about their psychiatric condition. 5hey are mu. 5hey may repeatedly . including suggestions to find the right mental health professional.hild.those with anore4ia or bulimia and about '3 per.an ha2e li-e-threatening or e2en -atal .ern about body weight or shape.are-ully weighing and portioning -ood. worries.tion o.s essential that both are treated. compulsions. Anyone seeking to rule out or establish a diagnosis or anyone seeking immediate help for a psychiatric condition should contact a mental health professional. +he co-occurrence of an an iety disorder with bipolar disorder can worsen the symptoms and course of each disorder. A person with an eating disorder may diet) e4er.en. 0ind out more information about helping your .ess o.2omiting and abuse ola4ati2es) enemas) and diureti. . or other an iety symptoms.ise) or purging by means o.ur with an4iety disorders.hildhood or later in adulthood.ed Mind /oundation website pro!ides information about finding a therapist. Eating Disorders Most people .he.those with binge eating disorder. %ometimes se!ere mood episodes.king out a -ew -oods and eating these in small Fuantities) or . B2en though they are o-ten underweight) they ha2e an intense -ear o.h as e4treme redu. 5he 1alan.k their body weight or engage in other te. Bating disorders .h day) or take other a.essi2ely) whi.ise) or eats e4..e.e4treme distress or . 5hey may -ast or se2erely restri.hniFues to . Anorexia Nervosa People with the eating disorder .on.

Many people with anore4ia also ha2e .hologi.B!NO .the bones brittle hair and nails dry and yellowish skin growth o. abuse se2ere dehydration -rom purging o.ausing a person to -eel .ontrol o2er the eating. People with binge-eating disorder e4perien. .essi2e e4er.luding ele.e4.trolyte imbalan. Many physi. 5hey e4perien. And like those with anore4ia) people with bulimia o-ten ha2e . and physi. 5his binge-eating is -ollowed by purging (2omiting) e4.ess .onditions also result -rom their beha2ior) in.hologi.e -reFuent episodes o.oe4isting psy.luding an4iety) depression) and personality disorders.s() -asting) or e4.ludes se2eral 2ariations o.oe4isting psy.ise.ardio2as.le o.h in.out-o--.e abuse) .ids gastroesophageal re-lu4 disorder (*BA!( intestinal distress and irritation -rom la4ati2e abuse kidney problems -rom diureti.h a.eating unusually large amounts o.ardio2as.hroni.al .these disorders are similar to anore4ia or bulimia but with slightly di--erent .e4posure to stoma.old all the time lethargy in-reFuent or absent menstrual periods Bulimia Nervosa 1ulimia ner2osa is . 1inge eating disorder is one type o. :n addition) obesity is asso.es) gastrointestinal problems) and oral and tooth-related problems.hiatri.-ine hair o2er body mild anemia and mus.y. 1ut they do not purge their bodies o.al .e abuse problems.-luids Binge Eating Disorder and EDNOS Another .guilt) shame) or distress) o-ten leading to another .hara.le weakness and loss se2ere .h as depression) an4iety) or substan.onstipation low blood pressure) slowed breathing and pulse drop in internal body temperature) .ations) and impaired physi.ular disease and hypertension.aying teeth as a result o.k and below the jaw worn tooth enamel and in.la4ati2es or diureti.hara.i-ied)H or B!NO ) whi.ular and neurologi.k o. Other symptoms may de2elop o2er time: • • • • • • • • • • thinning o.al illnesses su.ally in-lamed and sore throat swollen glands in the ne.teristi.al illnesses) in. People with bulimia usually weigh within a normal range) but like those who ha2e anore4ia) they -ear gaining weight) wish to lose weight) and -eel intensely dissatis-ied with their bodies.eating disorders.alories) and many people with this disorder are o2erweight or obese.ompli.ontrol eating..s.-ood and -eeling a la.al de2elopment. Obese people with binge eating disorder o-ten ha2e other psy.ategory is Meating disorders not otherwise spe.binge eating.luding depression) an4iety) obsessi2e beha2ior) substan. Most o.e -eelings o.reasingly sensiti2e and de. Other symptoms: • • • • • • • .urrent and -reFuent episodes o.iated with .al illnesses) too) in.essi2e use o.teriCed by re.

o2ery -rom another) so it is ne. . stress disorder(P5 !( and so.he pain) sometimes se2ere) may be all too -amiliar. B2en so) re. atta. A migraine may also . disorder o-ten -ollows.hes .essary to seek help -or both.. 1ut you .ommon in people who su--er -rom an4iety disorders.ularly generaliCed an4iety disorder) or *A!. disorder) substan. Other studies also .ti2e) and lasting treatment is .tor>s super2ision and joining a support group are also sound treatment options.ommon migraine may .urs around the temples or behind one eye or ear.ial an4iety disorder is also .-ood or .auses an aura) or 2isual symptoms su.ause nausea and 2omiting and sensiti2ity to light and sound.ede the onset o.an last -rom a -ew hours to se2eral days. A well-established) highly e--e..ent had de2eloped an an4iety disorder during . 5he odds o.hroni.ounseling.ur with an eating disorder..hroni. 5aking medi.o2ery -rom one disorder does not ensure re.e se2ere symptoms may reFuire hospitaliCation to help restore them to a sa-e and healthy weight.ommon an4iety disorder to . daily heada.!( is the most . Migraines and .uses on identi-ying) understanding) and .hanging thinking and beha2ior patterns.h pain to lead a -ull and produ.h as -lashing lights "0 to '0 minutes be-ore an atta. Migraine heada.ipants in the study had migraines and a 2ariety odisorders: major depression) general an4iety disorder (*A!() dysthymia) bipolar disorder) pani..ator G o.ks) pani.de2eloping bulimia are greater -or women with posttraumati.ommonly -ound among people with an eating disorder.ause nausea) 2omiting) or other symptoms) but no aura.utting it into tiny pie.Anxiety or Eating Disorder: Which Comes First? A +00& study -ound that two-thirds o.ording to a +00# study.ations under a do.on-irm that an an4iety disorder usually the onset o.an manage an4iety disorders and su. 5hose who e4perien. Treatment An4iety and eating disorders may be treated at the same time and in the same manner.onne. A . 5reatment -or eating disorders also in.the head.urring heada.k or losing 2ision. 5he pain .their eating disorder.an pre.hes .hes are . 5hose who ha2e both disorders o-ten de2elop .ommon symptom G and sometimes a good indi.an make -un.lassi.hes .ult -or someone with an an4iety disorder.ogniti2e-beha2ioral therapy) or .an an4iety disorder) parti.o-o. A .o-o.ompulsi2e rituals .mental disorders) a. 5he pain normally o.ent o.tioning e2en more di--i.an be a .an eating disorder) but pani.ommon predisposition to an4iety disorders) depression) and migraines may e4ist.parti.hildhood) well be-ore the onset o. migraine usually . 7eada. Obsessi2e-. Headaches /or some people with an4iety disorders) heada.es) or e2en binge eating.e abuse disorders) agoraphobia) and simple phobia.h -o.ti2e li-e.ludes nutritional management and nutritional . . 1ene-its are usually seen in "+ to "6 weeks) depending on the indi2idual. Migraine Headache A migraine is se2ere pain -elt on one or both sides o.h as weighing e2ery bit o.15) whi.hers -ound that "" per. Migraine and Anxiety Disorders Aesear.hers ha2e suggested that a .people with eating disorders su--er -rom an an4iety disorder at some point in their li2es and that around &+ per. And .ted to -ood) su.ompulsi2e disorder (O. Aesear.

And people with a .ause the .onstipation) and diarrhea.o-o. Irritable bowel syndrome Also .an worsen symptoms. Irritable Bowel Syndrome (IBS) People -eel the e--e. 5he do.ations may be used to treat an an4iety disorder alone) too.ontrolled by the ner2ous system) whi.teriCed by abdominal pain) .o-o. Aead on to learn more about :1 and its .an4iety usually pre.onne.olon.h usually begin in late adoles. disorder in parti. B2iden.ramping) bloating) gas) .en.antly higher in migraine su--erers than in the general population) as are epilepsy and stroke. Appro4imately one in -i2e adults in the ?nited tates has :1 .onsidered -or those who ha2e migraines and P5 !.omen are more likely to e4perien. heada.h.ause it is e--e.eded migraine) but -ollowed major depression.ogniti2e-beha2ioral therapy (.hara.e also suggests that the immune system) also responding to stress) plays a role.es o2er a li-etime o.15( be . A do.ti2e -or an an4iety disorder as well as heada.an also make you -eel more an4ious and depressed.h suggests that .e or early adulthood.tor treating a person with a .hes worse or 2i.hallenges e4ist -or a do.i-i.hroni.ts o.ause) but some e4perts suggest people who su--er -rom :1 ha2e a . 1ut when is it more than just an upset stoma. tudies show that the o.ial treatment .abdominal .depression) an4iety disorders) and bipolar disorder are signi-i.h responds to stress. :n addition) resear.h as some an4iolyti. 5hat>s be.luding irritable bowel syndrome. 5here is no known spe..urren..patients with migraine also e4perien.e depression.hes. and episodi.h also suggests that people with .heada.he pain.olon that is more sensiti2e and rea.ha.an be pain-ul and un. :1 .olon is in part .stress and an4iety in many ways. .an worsen symptoms o.ation be.hroni. antidepressants) and monoamine o4idase inhibitors (MAO:s(. Treatment pe.( Although :1 .hI Millions su--er -rom gastrointestinal problems) in.alled :1 ) this disorder is . An4iety .tor may sele.ti2e to .om-ortable) it is not permanently damaging to the intestines) nor does it .s) tri.urring an4iety disorder and .ertain -oods and stress.reased likelihood oe4perien.tor will .ommon symptom is stoma. New resear.ause other gastrointestinal diseases.li. :n those who su--er -rom major depression and an an4iety disorder) the onset o. . .losely monitor any side e--e.h .e migraines or other types o.he pain) su.tion to stress and an4iety..e symptoms) whi.Many studies ha2e -ound that people with *A! and pani. One .ts to make sure that the an4iety medi. migraine are more likely to ha2e posttraumati.ramps and pain and make you literally -eel si. 5hese medi.ing major depression9 as many as &0E o. .y. People with :1 -reFuently su--er -rom an4iety and depression) whi. (5he disorder is also known as spasti.t a medi.hes.urring an4iety disorder and migraines ha2e an in.k to your stoma.ular e4perien.ation is not making the heada.e 2ersa. stress disorder (P5 !( than the general population.

onstipation.e stress.lini. Sleep Disorders Many o.an .ent o. tress and an4iety may .hanges.ation to .hloride (brand name is Dotrone4( spe.e both an4iety and :1 symptoms in some patients.le spasms in the . Anxiety Disorder or Sleep Disorder: Which Comes First? Bither one. 5he National !igesti2e !iseases :n-ormation .h suggests sleep depri2ation .ks) or depression.aused by an obstru. 5here are no /!A-appro2ed medi. 5his medi. medi.ation and therapy are not e--e.lude sleep apnea (loud snoring .an4iety and depression.ogniti2e-beha2ioral therapy to learn how to .ei2ing treatment. An4iety .an manage the symptoms and dis. /ood and !rug Administration (/!A( -or women.*astroenterology re.ure -or :1 ) treatments .ans su--er -rom .an .those who do seek treatment) resear.ollege o*astroenterology also re.tor may re.ause an an4iety disorder. Dubiprostone (brand name is AmitiCa( is also appro2ed by the /!A but only -or adult women with :1 and .hile there is no .iety o.an>t sleep -or a night or two.al therapy as the -irst-line treatment -or :1 when the patient has a history o. 1ut -or some) a restless night is routine. More than &0 million Ameri. leep disorders are .auses sleeping problems) and new resear.h the . tress or an4iety .lo.7ealth.reased blood -low to the .h .h has -ound that 30 to #0 per.ation is re.olon and se2ere .two or three large meals) whi.i-i.the teeth while sleeping( are .hiatri.ombination o.om-ort. /or others) that may mean in.ommends therapy and says it .teriCed by abnormal sleep patterns that inter-ere with physi.ause sleeping problems or make e4isting problems worse.h as an an4iety disorder or depression.k when we .ti2e) and when the primary symptom is diarrhea. And ha2ing an an4iety disorder e4a.ommends psy. Antispasmodi. Antidepressants to help minimiCe symptoms o.ording to the National :nstitutes o. :nsomnia is the . disorder su. 5he Ameri.ally treats :1 and has been appro2ed by the ?.ts .reasing dietary -iber) whi..an aggra2ate symptoms.lude de.onstipation) or eating smaller meals more o-ten instead o.onditions that also may .onstipation.hroni.ope with an4iety and depression.hara.tioning.onstipation. ide e--e.us toss and turn or wat. /or some) that may mean a2oiding dairy produ. .ontribute to sleep disorders.ause a serious night without sleep) as do a 2ariety oother problems.an relie2e .an be serious and in.:1 .ounter medi.lude nausea) diarrhea) and abdominal pain.ts or . Aela4ation te.h .ommend one or a .ommended only when o2er-the-.al) mental) and emotional -un.ulty staying asleep) waking too early in the morning) or waking up -eeling unre-reshed.ramping.learinghouse estimates that up to $0 per.an .an4iety) pani.the -ollowing treatments: • • • • • • • /iber supplements or la4ati2es to de.Treatment .e abdominal pain.an redu.erbates the problem.) long-term sleep disorders) and an additional +0 million report sleeping problems o.olon and redu. ide e--e.arbonated be2erages) whi.an .olepsy (-alling asleep spontaneously(. .ted airway() sleepwalking) and nar. 5he 1ritish o.ts in.ontrol mus. Other . Alosetrin hydro.al term -or people who ha2e trouble -alling asleep) di--i. <our do..h .rease . O. !iet .ent ha2e a psy.people with :1 are not re.hniFues to redu. .ations -or men -or the treatment o.ommon sleep disorders in.asionally) a. atta.ause . /ind a therapist near you. Aestless leg syndrome and bru4ism (grinding o.hologi.

are physi. o-t) . insomnia are at high risk o. disorders.hniFues) and medi. 5alk to your do. Dend a hand to a relati2e or neighbor) or 2olunteer in your . Aegular e4er. 5urn the .harges your brain and impro2es your -o.an be parti.otine be-ore going to sleep) and ne2er wat.h as a deserted bea.hing 5N or doing work G and get into bed only when you are tired. $%ercise. Bstablish a regular) rela4ing bedtime routine.ing endorphins. Pla# music. Sleep Soundly 5o redu. 5reatment options -or an an4iety disorder also in. Det -riends and -amily know how they .luding weekends. :t pro2ides an outlet -or -rustrations and releases mood-enhan.the night.ool) dark) and Fuiet.hool) in.h or grassy hill.hiatri.ription or herbal sleep remedy.ine and. 5his .ise is good -or your physi.h also shows that some -orm o.e #our to!do list.k away -rom you.alming musi. 7elping others will take your mind o-.o--ee) . tudies also show that people with . Dearn more about treatment options. Treatment :.ti2e at redu.tor i. pend your time and energy on the tasks that are truly important) and break up large proje.ts into smaller) more easily managed tasks.on. :n addition to an4iety and mood disorders) those with sleep disorders are risk -or heart disease) heart -ailure) irregular heartbeat) heart atta.k.e at work or s. Prioriti. <our do.k out se2en to nine hours -or a -ull night ouninterrupted sleep) and try to wake up at the same time e2ery day) in.h 5N) use the .al and mental health.h tea.k) high blood pressure) stroke) diabetes) and obesity.you still ha2e problems -alling asleep.hes how to identi-y and modi-y beha2iors that perpetuate sleeping problems.hroni.ogniti2e-beha2ior therapy) as well as rela4ation te.Aesear.t you ha2e a sleep disorder) 2isit a primary . A2oid stimulants like .an make you an4ious in the middle o. :.ise will help you sleep better) but limit your workouts to mornings and a-ternoons.omputer) or pay bills be-ore going to bed. <oga .lini.ian) mental health pro-essional) or sleep disorders . -et an ade.these treatments. leeping re. 1lo.sleep disruption is present in nearly all psy.lude .an help) and .ess noise) and make sure your mattress and pillows are . Aead a book) listen to so-t musi. 5reatment options in. Make sure your bedroom is .o.ing an4iety and stress. . Aegular e4er.us) .ommunity. Reduce Anxiety.lude sleep medi. !elegate when you .onsider seeing a do.ommend one or a .an lead to poor per-orman. ?se your bedroom as a bedroom G not -or wat..lo. sleep more soundly: Make getting a good night>s sleep a priority.an lower your blood pressure and rela4 your mind and body. leeplessness . Talk to someone.om-ortable.ation.entration) and mood.an.you don>t -all asleep within "3 minutes) go to another room and do something rela4ing.inadeFuate sleep e4tend way beyond tiredness. Health Risks 5he risks o. <ou may need a pres.injury) and health problems.your own an4iety and -ears.ombination o.onsider using a -an to drown out e4.ho.tor or therapist.de2eloping an an4iety disorder.ogniti2e-beha2ior therapy) whi.ularly e--e.tor or therapist may re. • • • • • • • .e an4iety and stress: • • • • • • • 5o Meditate.us on your breath G breathe in and out slowly and deeply G and 2isualiCe a serene en2ironment su.olate) and ni.reased risk o.lo. A2oid looking at the . Direct stress and an%iet# else/here. . /o.uate amount of sleep.) or meditate instead.you suspe.

ks) and ha2ing pani.Substance Abuse Moderate al. Panic disorder Al.ation always depends on a person>s indi2idual .e them independently) but ha2ing both .e o.ohol or other substan.ribe medi.ent o.ohol abuse .ur. Al.ern -or many people.reased risk -or abuse as well as potentially dangerous intera. People with this disorder report that al.h as depression ha2e an al.tors pres.es .. Al.this disorder.15) whi.uses on identi-ying) understanding) and . 5he .ohol abuse usually de2elops a-ter the onset o.medi.e abuse together be.. People su--ering -rom this disorder o-ten use al.ohol abuse. atta.e abuse .hoi.e o. disorder symptoms.an be a 2i.e abuse disorder also ha2e an an4iety or mood disorder. disorder is a risk -a.Ameri. Comor"idit# Dearn more about . 8oining asupport group may be a good additional treatment option.ohol or substan.ur in the same person) either at the same time or one a-ter the other.e abuse relapse.an .e abuse) parti.essary to treat both together) parti.on.wine with dinner or a -ew drinks at a partyGis no .ohol or other substan.ent o.e( . .o-o.tor -or a relapse among people with a substan.e abuse disorders are at an in. People with an4iety and substan.e abuse and an an4iety disorder e4perien. Many mental health pro-essionals treat P5 ! and substan.ohol abuse) is . 5he symptoms o.han. And they are two to three times more likely to ha2e an al.an make the symptoms another worse9 an an4iety disorder may lead to using al.le.es.e abuse .ription medi.ause -or .ti2e) and lasting treatment is ..ause a substan. Aead more about so.an e4a.ation.ohol or drugs o-ten .ommonly o. Many therapists will use therapy -or people with both an4iety and substan.ohol or substan. Social an%iet# disorder 5he .ious .ohol or other substan.ial an4iety) although it o-ten makes it worse.those with an al.e abuse disorder.ur together.relapse.ohol or drugs to try to ease their an4iety) but substan.y.e abuse will not eliminate an an4iety disorder) so it>s usually ne. A well-established) highly e--e. 1ene-its are usually seen in "+ to "6 weeks) depending on the indi2idual.onsumptionGa glass o.urren.ause pani..ans with an an4iety or mood disorder su.es to sel--medi.an make their an4iety symptoms worse.ogniti2e-beha2ioral therapy) or .ations with low abuse potential that are .ause symptoms oP5 ! (intrusi2e thoughts and sleep disturban.ommonly begins be-ore or at the same time as pani.tions when they use pres. Anxiety Disorder or Substance Abuse: Which Comes First? Most people with al. !o.substan.e o.erbate P5 ! symptoms.ohol or other substan.onsidered sa-e should a relapse o. Posttraumatic stress disorder 0PTSD1 P5 ! and substan.hanging thinking and beha2ior patterns.e abuse disorders. Treatment 5reating substan. About +0 per.ate or alle2iate an4iety symptoms.e abuse disorder at some point in their li2es than the general population.one disorder .ularly al.ommon among people who ha2e so.ial an4iety disorder and al.ohol helps lessen their so.umstan.omorbidity) or when two or more disorders or illnesses o.e abuse disorder) and about +0 per. 7owe2er those with an4iety disorders may -ind that al.ohol .ir.ularly to lessen the .h -o.ial an4iety disorder.

onditions .hara.se2erity) ranging -rom mild to signi-i.ti2e disorder) or A!7!) is a . Aead on -or more in-ormation about these .those adults seek help.itKhypera.ondition .ent o. Adult A!7! symptoms that . 5hought to be biologi.hroni.itKhypera. Symptoms A!7! symptoms o-ten in. disorder( .oe4ist with an an4iety disorder or other disorders may signi-i.lini.lude adult A!7! (attention de-i. About 60 per. Dess than +0 per.itKhypera.omorbid psy.ant impairment.ti2ity) impulsi2eness) or a .ount personal history) sel--reported symptoms) and mental-status testing) as well as early de2elopment problems and symptoms o. .h .onditions.teriCed by inattention) hypera. (5he term =.e 2ery early in brain de2elopment.omprehensi2e .al and most o-ten geneti. disorder.e them at di--erent le2els o..ommonly e4perien. ADHD and mental health disorders Adults with A!7! are likely to ha2e an an4iety disorder) depression) bipolar disorder) or other . pain /ibromyalgia Adult ADHD (Attention Deficit/Hyperactive Disorder) Attention-de-i.hiatri.ombination.ed by people who ha2e an an4iety disorder in.the adult population) or % million adults. People who ha2e A!7! may e4hibit di--erent symptoms) and they may e4perien.t their relationships at home) s. Adults with A!7! may e4hibit the same symptoms they had as .( About 30 per.inattention) distra.lude an inability to -o.tion.hool) and work.tions) remembering details) or di--i.ome adults with A!7!9 that>s about & per.omorbidH re-ers to a .hroni.ent o.) A!7! takes pla.an a--e.Other Related Conditions .adults with A!7! also su--er -rom an an4iety disorder.hildren with A!7! in the ?nited tates be.us) disorganiCation) and restlessness.ent o.hildren) and although hypera.ent o.al e2aluation by a health pro-essional) who will take into a. pain) and -ibromyalgia. Adults with A!7! may ha2e a hard time organiCing things) listening to instru.. disorder() .antly impair the ability to -un. As with other illnesses and disorders) it>s important to -ind treatment.ompleting tasks) whi.ti2e disorder( 1!! (body dysmorphi.ondition that e4ists with another.adults with A!7! ha2e been diagnosed or treated) and only about one-Fuarter o.tibility) impulsi2ity) and emotional instability. • • • • Adult A!7! (attention de-i.ulty . Diagnosis Proper diagnosis relies on a .ti2ity o-ten diminishes by adulthood) inattenti2eness and impulsi2ity may persist.ti2e disorder() 1!! (body dysmorphi.

ornerstone o.e their -laws.impairment (su.ational) and .omorbid an4iety.anJt .ti2ityI !o you ha2e a hard time keeping your temper or staying in a good moodI !o these problems happen to you at work and at homeI !o -amily members and -riends see that you ha2e these problemsI 7a2e you had these problems sin.hool) a2oid so.t the most -a2orable treatment option.tions) ne2er -inding satis-a.tions) they don>t inter-ere with our daily li2es.ation -or A!7!) a health pro-essional may re.onditions simultaneously.ate getting an a.an4iety) treating the A!7! may redu.ei2ed imper-e. One health pro-essional may de.tioning. 5hey may e2en undergo unne. A health pro-essional will ask Fuestions like these during a . ome stimulant-drug treatments -or A!7! may worsen an4iety symptoms in patients with .essary plasti.upations with an imagined or slight de-e.us on the disorder asso.omorbid .al) edu. :n addition to pres.tion with the results.ti2ity !isorder(. .omorbid an4iety disorder .hara. :A!7! is the ..ontrol their impulses.ation is a .h day. Most people also bene-it -rom beha2ioral) psy.an4iety is independent oA!7!) howe2er) a do.hologi.an impro2e the symptoms o.h has shown that stimulants and some nonstimulants .ribing medi.ial situations and isolate themsel2es) e2en -rom -amily and -riends) be.onditions o-ten . A help-ul resour. An4iety disorders and other . 5heir thoughts may .ogniti2ebeha2ior therapy( -or . 5hey may miss work or s. disorder (1!!( think about their real or per. ..itK7ypera.al or mental health problems that might a--e.ompli.t in oneJs appearan.an make treatment more .t per.us ha2e something we donJt like about our appearan. Body Dysmorphic Disorder (BDD) Most o.h as problems relating to attention or impulsi2ity at work or s.oa. 1ut people who ha2e body dysmorphi.O2erlapping symptoms o.e G a . Aesear.orre.e you were a .hiatri.ause they -ear others will noti.omorbid an4iety disorders. Characteristics of BDD 1!! is a body-image disorder .ontrol their negati2e thoughts and donJt belie2e people who tell them that they look -ine.hildI !o you ha2e any physi.ause o.15 (.. surgeries to .hing inter2entions.7A!! (.hildren and Adults with Attention !e-i.ei2ed -laws -or hours ea. And though we may -ret about our imper-e.treatment -or adults with A!7!.onditions may .ause se2ere emotional distress and inter-ere with their daily -un.e.entrate) and .hool) sleeping) or -amily li-e( and help sele.rooked nose) an une2en smile) or eyes that are too large or too small.teriCed by persistent and intrusi2e preo.omorbid psy.li2ing with A!7!.onsultation: • • • • • • !o your beha2iors and -eelings show that you ha2e problems with attention and hypera.ide to treat the an4iety -irst9 another may treat both .ome about as a result o.ating support groups or pro-essionals with appropriate e4pertise is . A health pro-essional will de-ine the areas o.tor will determine the proper medi.ommend .urate diagnosis. 7a2ing a . A health pro-essional should -o. 5hey .e -or lo.e the an4iety. :.on.ated.A!7!) helping people pay attention) .t your beha2iorI Treatment Medi.impairment.ompli.iated with the highest degree o.ation.

some people with so.an take a sel--test that .tion or none4istent. 1ut -or someone with 1!!) the -law is signi-i.( .1!! are un.amou-laging (with body position) .essi2e grooming e4.their body) although they o-ten -ind -ault with their hair) skin) nose) .tioning oserotonin in the brain) personality traits) and li-e e4perien.. Symptoms People with 1!! su--er -rom obsessions about their appearan. :n reality) a per.ial situations is similar to the beha2ior o.!.tioning.luding geneti. A trained .h shows that it a--e.t may be only a slight imper-e.1!! is present) but it will not o--er a de-initi2e diagnosis. 1!! su--erers may per-orm some type o. • • .lothes e4.ontribute to its de2elopment) in.ausing se2ere emotional distress and di--i. B4amples are listed below: • • • • • • • • • .ial situations) and problems at work or s.ts men and women almost eFually.essi2ely BDD and Other Mental Health Disorders People with 1!! .hool.hild is preo.hool or ibeha2iors listed abo2e appear) talk to a mental health pro-essional.tors su.us on anything but their imper-e.ent o.e that . About one per.al and en2ironmental -a.an dislike any part o.tions.auses o.an lead to low sel--esteem) a2oidan.ial an4iety disorder. el--test -or adults el--test -or adoles.ise .king in a mirror a2oiding mirrors skin pi..ial an4iety disorder) as well as depression and eating disorders.he.ontrol) these obsessions make it di--i.ompulsi2e or repetiti2e beha2ior to try to hide or impro2e their -laws although these beha2iors usually gi2e only temporary relie-.entration in s. .O..e seeking surgery .omparing body part to othersJ appearan.urate diagnosis and appropriate treatment) people must mention spe.an help suggest i.these disorders be.e when they talk to a do.lear) but .your . Diagnosis and Treatment 5o get an a.lini.e o.the ?.ult -or people with 1!! to -o. 1!! .ian should diagnose 1!!.ertain biologi.on. population has 1!!.an last -or hours or up to an entire day..ause they share similar symptoms.ide or make a sui.ents :.ally their .erns with their appearan.on.king e4.ents and teens) and resear. 5he .ompulsi2e disorder (O.ommonly also su--er -rom the an4iety disorders obsessi2e-.!( or so. 7ard to resist or .al -a. 5his .hest) or stoma.ompulsions o.ide attempt. 7owe2er) you .essi2e e4er.e so that it inter-eres with .es.h.an also be misdiagnosed as one o.lothing) makeup) hair) hats) et.ant and prominent) o-ten . People with se2ere 1!! may a2oid lea2ing their homes altogether and may e2en ha2e thoughts osui. 5he intrusi2e thoughts and repetiti2e beha2iors e4hibited in 1!! are similar to the obsessions and .upied with appearan.so.tor or mental health pro-essional. predisposition) neurobiologi.ei2ed de-e.People with 1!! . And a2oiding so.h as mal-un.i-i.hanging .ulties in daily -un. 1!! most o-ten de2elops in adoles.tors may .

• Antidepressant medi. pain and ha2e an an4iety disorder may ha2e a lower toleran.an make -un. Fi"rom#algia is a .arthritis ..treatments -or best results.tors re. And a . /or people with an4iety disorders) pain like this may be all too -amiliar. a. Patients learn to identi-y unhealthy ways o.ribes a group o.idents) and in-e. Back pain is more . .ause damage to 2irtually any bodily organ or system.ially a-ter sitting or standing -or e4tended periods.al .hroni. Chronic Pain and Anxiety Disorders Many . Dearn more.hroni. -orms o.an help relie2e the obsessi2e and .hroni. pain disease .hes.ularly generaliCed an4iety disorder (*A!(. .tor to determine the best indi2idual approa.hes and pains) some people will also su--er a diagnosed .ommon symptom G and sometimes a good indi.luding sele.B--e.ult to treat.more than "00 medi.urring around the temples or behind one eye or ear. Many do. ymptoms in.side e--e.ts than) and they may also be more -ear-ul o.an . People with an an4iety disorder may be more sensiti2e to medi. 1ut people . Complications An an4iety disorder along with .ombination o. ystemi.ommon in people with an4iety and mood disorders than those without them.an a--e.ti2ity9 and . Pain .tioning e2en more di--i. Migraine is se2ere pain -elt on one or both sides o. pain to lead -ull and produ.urring .lude persistent a.he in the middle or lower ba.h. /ind out about A.the head) normally o.ogniti2e-beha2ioral therapy (.le pain and -atigue.an lead to joint weakness) instability) and de-ormities that . 1eyond e2eryday a..ult -or someone with an an4iety disorder. pain disorders are .k pain.an inter-ere with basi.an an4iety disorder) parti.o-o.15. ymptoms in. pain .ba.ti2e li2es.ations) in. daily tasks.h patient so it is important to talk with a do.hroni.hes or sti--ness anywhere along the spine9 sharp) lo. 5reatment is tailored to ea.ation side e--e. medi.ommend using a .thinking and beha2ing and repla.uloskeletal system) spe. • Chronic Pain Mus.15( tea. pain disease su..an manage an4iety disorders and .ompulsi2e symptoms o.hroni.ts or more -ear-ul o.t the mus.h as arthritis or -ibromyalgia. !amage .ially a-ter li-ting hea2y obje.ts or engaging in strenuous a.lude pain) sti--ness) in-lammation) and damage to joint .hroni. Arthritis is a wide-ranging term that des. :llness) a.artilage and surrounding stru.e -or pain.es pain without an4iety.aliCed pain in the ne.i-i.k) or lower ba.auses widespread mus.ommon in people with an4iety disorders.e them with positi2e ones.5 with .ator G o.an be a .ally the joints.k) espe.pain than someone who e4perien.1!!.al .le tension) body soreness) heada.auses o.hroni.an be di--i.ondition that . An4iety) depression) and other mood disorders are .hange negati2e thinking patterns.ti2e treatments are a2ailable to help 1!! su--erers li2e -ull) produ.k) espe.ti2e serotonin reuptake inhibitors ( A:s() . 5hose who su--er -rom .hroni. Dearn more.k) upper ba.tures.ommon among people who ha2e arthritis) and 2ery o-ten in younger arthritis su--erers.ti2e li2es.onditions that a--e.t the whole body and .ogniCe irrational thoughts and .hes patients to re.tions are among the .

k with your do.hroni. .ti2ely with the stresses that .ulties and numbness or tingling in arms and legs. <oga) a.ause in-lammation at the joints or mus.hroni.onditions.ent who li2e with this .hroni. Symptoms /ibromyalgia is .hniFues in.ondition that impairs the joints and .an help promote rest-ul sleep.a--eine late in the day and at night . :t is one type o.s) tri. disorder that .auses widespread mus. atta.Treatment Many treatments -or an4iety disorders may also impro2e .ommon te.uloskeletal .h .both types o.ause people to e4perien. Lifestyle Many li-estyle .an trigger pani.ation -or the symptoms o. pain may be able to take one medi.les.an -eel similar to arthritis) it does not .le pain and -atigue. . /ibromyalgia may .ope more e--e.e their intake o. People with -ibromyalgia ha2e tender points on their bodies that hurt in response to e2en slight pressure.le rela4ation) and e4er.an an4iety disorder also help the symptoms o.es sti--ness) impro2es -le4ibility) and boosts mood and sel--esteem.id--orming -oods.ks and worsen an4iety symptoms.hroni. Sleep.ture) and massage are among the .upun. A health pro-essional .o(.ontribute to an4iety and pain.hes) and temperature sensiti2ity) as well as memory di--i.auses .hroni.omplementary and alternati2e te.an4iety disorders as well as .h as treating -ibromyalgia with a sele. Nutrition.e .ti2e therapy. pain .lude breathing retraining) progressi2e mus.tion to an4iety disorders should not be ignored. Cogniti e!Beha ioral Therap# 0CBT1 is used to treat an4iety disorders as well as . Complementar# and Alternati e Treatment.tions() and a2oiding .onsistent sleep and wake times) a good sleep en2ironment (.ts) gluten (-ound in wheat) oats) barley) and rye() .ti2e -or heada. pain.onne.onditions) in. /ibromyalgia and its . Fibromyalgia /ibromyalgia is a .y.hroni.hniFues that relie2e the symptoms o..luding dairy produ. pain symptoms. ome people with an an4iety disorder and .ondition) or a medi.e about health-ul -oods and whi. ome types o. /ind a mental health pro-essional who treats an4iety disorders in your area. Aegular e4er.e--e.the nightshade -amily (potatoes) tomatoes) eggplant) peppers) and toba.an pain redu.ohol) whi.onditions) su. pain.ues help people de2elop the ability to .ohol) red meat) and a. pain also su--er -rom an an4iety disorder or depression.tors be-ore beginning an e4er.ise regimen. pain .h to a2oid.an pro2ide more guidan.ome worse without enough sleep.al .ise strengthens mus.orn) sugar) and members o. *ela%ation techni..hroni.he. A good night>s sleep is key -or an4iety disorders and . . 5hough the symptoms .he pain.onditions.both . pain. .ise. About +0 per.e sleep problems) heada.li.om-ortable room temperature) no 5N or other distra.hroni.a--eine and al. People with an4iety should limit or a2oid .tea) .ti2e serotonin reuptake inhibitor ( A:( and some an4iolyti.o--ee) al. Always .hroni.hanges that impro2e the symptoms o. ymptoms o.onditions o-ten be.-ood may aggra2ate some mus. Medications. $%ercise. 5hose who e4perien.onsidered a rheumati.les) redu. antidepressants) and monoamine o4idase inhibitors (MAO:s( that are e--e.

an be di--i.ult to diagnose be.ti2ity) and -le4ibility training reported -eeling better physi.ian about all the medi. !o.e.pain.ause not all do.h physi. !o.an properly diagnose the . DSM-5: Changes to the Diagnostic and Statistical Manual of Mental Disorders . 1ut diagnosis .an make an immediate di--eren.ause its symptoms o.ombination o.al and o.ts ' to 6 million Ameri.ise9 e2en moderate e4er.Aesear.hroni.onditions.ations you>re taking) or ask that all your health pro-essionals work together in your treatment.ans G as many as one in 30.A(. 5here is no .tors also re. .ult be.o2ered that women who engaged in strength training) aerobi. ..ases .tors are -amiliar with the . A 7ar2ard Medi.tors must take the patient>s word about the amount o.an redu.al .upational therapy and antidepressants) whi.lassi-ied by the Ameri.treatments and therapies) su.tor -or -ibromyalgia and another -or an an4iety disorder.al pro-essional who .an . pain and an an4iety disorder should see a medi. a. Getting Help Anyone su--ering -rom .e pain in people who ha2e -ibromyalgia.hile symptoms .Aheumatology (A.the brain that regulates pain. /ood and !rug Administration has appro2ed the -irst drug to treat -ibromyalgia. /ibromyalgia is also di--i. .ise . /ibromyalgia appears to run in -amilies) but s. O-ten misunderstood) -ibromyalgia a--e.ondition is not progressi2e or -atal.onditions and de2elop a treatment plan.h suggests that people with -ibromyalgia are hypersensiti2e to stimuli that are not pain-ul to others) perhaps due to a redu.antly more likely to be diagnosed with the disorder) and most are diagnosed during middle age.ondition that .an impro2e with treatment) -ibromyalgia is a .al . 5hat may mean seeing one do.ure) but the .ase) be sure to in-orm ea.h as physi.ollege o.al .ondition) and there is no lab test to dete.-atigue and disturbed sleep des.ribe se2eral medi. Diagnosis A person must ha2e widespread pain lasting -or more than three months and at least "" o. :n this . Treatment 5he ?.ally and mentally a-ter -our months. gene.hroni. People with rheumatoid arthritis) lupus) and spinal arthritis are also more likely to de2elop -ibromyalgia. 1ut like other medi.an last a li-etime.ed blood -low to the portion o.h in some ."% designated tender point sites on the body) as .t it.onditions) -ibromyalgia o-ten reFuires a . .hool study dis.omen are signi-i.ientists ha2en>t pinpointed a spe.ommend getting ample sleep and e4er.i-i.

• !ownload -a. Anxiety and Depression Refinements Mu. !isorder Pani.ategories -or an4iety disorders ha2e .ate about the disorders.i-ied An4iety !isorder 2"sessi e!Compulsi e and *elated Disorders .ti2e Mutism pe.the .lini.luding .ategory o. ome disorders in.ation o.t your ability to -ind treatment or your .teriCe symptoms and assess se2erity.hapters: An4iety !isorders) Obsessi2e-.ed An4iety !isorder An4iety !isorder !ue to Another Medi.eKMedi.orporates signi-i.and tressor-Aelated !isorders.an4iety disorders are now in three seFuential .an Psy. ome o. • /ind a 5herapist • Dearn more about treatments -or an4iety and depression.an4iety and depression) with re-inements o.ross the li-espan.hanges will not a--e.ation-:ndu. 5he '%#-. disorder re.k ( pe. Asso.treatments -or patients and their lo2ed ones.the 'iagnostic and %tatistical #anual of #ental 'isorders.riteria may pro2ide a more a.hildren and older adults. pro2ides a . ad2an. Atta.riteria and symptoms a.are system. Others ha2e been split apart into distin.onditions are grouped together as syndromes be.hara.tor about how the new . Asso.urrent health insuran.hiatri.lassi-i.h and e4amination o.isely identi-ying and diagnosing mental disorders. ( ee list below.( One signi-i.hiatri. Ask your therapist or do.the new edition o.h .i-ied An4iety !isorder ?nspe.ial Phobia( Pani.disorders a. :t .ause the symptoms are not su--i.ommon language -or patients) .in. DSM ! Disorders An%iet# Disorders eparation An4iety !isorder ele.al . .iation.t to separate the disorders.ti2eness o.mental disorders used by mental health pro-essionals in the ?nited tates.ienti-i.es in more pre. ome .e.ant . health .ea..iently distin.diagnosti.ontains a listing o.ategory while signaling their inter. Revisions Published in 2013 5he Ameri.hanged.ross the li-espan) in..ial An4iety !isorder ( o.i-i.'iagnostic and %tatistical #anual of #ental 'isorders 1'%#2 is the standard . 5his mo2e emphasiCes the distin.iation has announ.ondition Other pe.hange is the de2elopmental approa. 5hese .t sheets about the disorders -rom the Ameri.hiatri.onne. .an Psy.h has remained the same in the areas o.riteria -or e2ery psy. is not a treatment guide) and it will not a--e.ant s.ed that '%#-.t the a2ailability o.ommuni.urate way to .tedness..ogniCed by the ?.t groups.luded in the broad .ians to . '%#-.ompulsi2e and Aelated !isorders) and 5rauma.i-ier( Agoraphobia *eneraliCed An4iety !isorder ubstan. Phobia o.aregi2ers) and .

. 1ut how .ompulsi2e and Aelated !isorder Trauma! and Stressor!*elated Disorders Aea.hotillomania (7air-Pulling !isorder( B4.oriation ( kin-Pi.ed !epressi2e !isorder !epressi2e !isorder !ue to Another Medi.i-ied !epressi2e !isorder Somatic S#mptom and *elated Disorders :llness An4iety !isorder 1additional disorders not listed2 “Myth-Conceptions.Fui.eKMedi.and tressor-Aelated !isorder Depressi e Disorders !isrupti2e Mood !ysregulation !isorder Major !epressi2e !isorder) ingle and Ae.i-ied Obsessi2e-.luding promises o.and tressor-Aelated !isorder ?nspe.hment !isorder !isinhibited o.urrent Bpisodes Persistent !epressi2e !isorder (!ysthymia( Premenstrual !ysphori.an you learn what>s trustworthyI And how . and Folklore About Anxiety 5he :nternet abounds in in-ormation and misin-ormation about pani.i-ied Obsessi2e-. an4iety disrupts your li-e) you may be willing to try anything.k .hen .ondition Other pe.ommon an4iety myths.ures that reFuire up--ront payment.i-ied !epressi2e !isorder ?nspe.ed Obsessi2e-.ompulsi2e and Aelated !isorder !ue to Another Medi.ks) phobias) and other an4iety disorders G in.al .ompulsi2e !isorder 1ody !ysmorphi.ial Bngagement !isorder Posttraumati.ute tress !isorder Adjustment !isorders Other pe. tress !isorder A.ompulsi2e and Aelated !isorder ?nspe.an you -ind help that will work -or youI Aead on.i-ied 5rauma.hroni.Obsessi2e-. !isorder ubstan. atta.ondition Other pe.ompulsi2e and Aelated !isorder Obsessi2e-. Fibs. !isorder 7oarding !isorder 5ri.ti2e Atta.ation-:ndu.i-ied 5rauma.king( !isorder ubstan.” or Common Fabrications.ation-:ndu.eKMedi. <ou may ha2e heard these: . /irst) take a look at the reality behind some .al .

k gets too bad) you .h is .an really make any di--eren.losing . ome people are just worrywarts or neuroti. . !uring a pani.ti2e therapy must -o.ienti-i. 5herapy . 5he .h shows that e--e. :.ation .ontrol.om-orts) and beha2ior. Dearn about li2ing with an4iety. :t>s 2ery unlikely you will -aint) whi.an pass out or lose . A2oiding an4iety tends to rein-or. Medi.ti2e so they should be taken only i.ogniti2e-beha2ioral therapy) or .H Always . *et answers to -reFuently asked Fuestions about an4iety disorders.bad or disturbing thoughts is to snap a rubber band on your wrist e2ery time you ha2e the thought.ation( -or most people) espe.your an4iety might go away) your :.essary.) and there is nothing that ..ombination oheredity and personal e4perien.arry a paper bag in .tually rises slightly.you ha2e an an4iety disorder) it is important to a2oid stress and situations that make you -eel =stressed.ations( are sa-ety .luding new skills to manage thoughts) emotions) dis. 1enCodiaCepines might be help-ul in the short term) but they .15.15) may be just as or more e--e. Medi.e popular as a beha2ioral inter2ention) more re.e and dependen. Dearn more about therapy.hildhood) so e--e. Medi.ations.hile some o.ontrol do not pre. atta.an be an4ious and still do whate2er you ha2e to do. 7yper2entilation) while un.ede loss o.ti2e.you are -ragile and a2oiding risk leads to -eeling demoraliCed.ations -or an4iety are addi.e a-ter long-term use. Paper bags (like as-needed medi.e it. atta.as i.an be e--e. resear.ation is the only treatment -or an4iety disorders.absolutely ne.aused by a sudden drop in blood pressure.ent studies ha2e shown that suppressing your thoughts makes them stronger and more -reFuent. <ou .your temperament and how long neuroti. Also) thoughts and images o. habits ha2e been in your li-e.ation (or a .auses o.e worry and su--ering and learn a di--erent relationship to your own thoughts) regardless o.hile this was on. . Dearn about .an lead to in.ontrol.Myth One way to get rid o. . 1ut s.ti2e than medi. /irst-line medi.e.ially in the long run.ti2e.h shows that .us on that time period.ations -or an4iety disorders (the A: and NA: antidepressants( are not addi.hate2er the .ti2e treatment -o.auses (usually a . 5hink o. Facing Panic$ %elf-Help for People "ith Panic Attacks 5reating yoursel. Dearn how people li2ing with an4iety disorders ha2e triumphed.ase you hyper2entilate.15 and medi. Dearn more about medi. Reality Check .es() resear.reased toleran.an4iety disorders are usually rooted in your .k your blood pressure does not -all9 it a.om-ortable) is not dangerous.hes that keep you an4ious about being an4ious..an help you redu.a pani.it this way: 5he thoughts you resist persist.rut.ombination o.uses on the here and now) in.

1eware o.ipate in a -orum) message board) or .h are treatments that . 1e. !isorder .hat room) be aware that while it>s easy to get in-ormation -rom other people that appears help-ul) it may work against your re. &.A!AA.e4perien.hotillomania Dearning .o2ery.iation -or 1eha2ior and . Also) 2isit the National :nstitute o.e on Mental :llness (NAM:(.hologist !a2id . 7ere are the top -i2e ways: ".e o.es) whi. • .ne2er again ha2ing an4iety symptoms) re2olutionary -ormulas) =naturalH or uniFue methods or te.ogniti2e 5herapy) 5he 5ri.he.asional e-mails.it>s reliable or .h has shown to be e--e. +. A =leading e4pertH or -ellow pani.lini.any website.ts =e4..redentials.treatment that are re.ti.al resear. • .e with a mental health pro-essional.these re.h as :nternational Obsessi2e .redibleI Dook -or e2iden. Dearn more about :nternet an4iety s.ause it says =s.onta.enses) asso. 3.ams by psy.ei2e 5riumph) the A!AA monthly e-newsletter and other o.Finding Information Online 5he :nternet o--ers lots o. Dook -or .ures) guaranteed results o.enter) Asso.k out other national organiCations su.t A!AA -or more in-ormation. Ae2iew A!AA Aesour.in-ormation about an4iety) so how .ti2e.ome an in-ormed . Dook -or a.e-based pra. Many uni2ersity health .e4tra2agant .ademi.Mental 7ealth (N:M7( website to -ind the types o.ommended organiCations)learn about treatment options) and .he.H 8ust be.laims G instant . degrees) pro-essional and state li.enter) and National Allian. .hniFues that reFuire payment G and produ. Peers may o--er 2aluable insight) but be sure to .enters o--er treatment) too.arbonell) Ph!) an e4pert on an4iety disorders and a member o.ally pro2enH doesn>t mean it>s true.es: Nisit the websites o.ti2e treatment -or you.onsumer to -ind the most e--e.iation memberships) and other e2iden.ompulsi2e !isorder /oundation) National Bating !isorders /oundation) 1ody !ysmorphi. su--erer might not o--er the treatment that>s best -or you.ommended.an you tell i.hen you parti.lusi2ely a2ailable -rom this website. ign up to re.k any ad2i. '.e -or the authors o.ienti-i.