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Anxiety

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Overview of Anxiety

Anxiety is the most common psychiatric disorder in the United States.  It affects 40 million American adults a year, or about 18% of the US adult population. This is an incredible number.  Work productivity and general happiness are lowered due to anxiety.  Anxiety can be mild or very severe.  Some people cannot leave their homes due to anxiety.  Some people cannot fly and thus limit attaining their dreams.  Some people cannot work and lose their jobs due to anxiety.  Anxiety may or may not have a trigger event (at least on the conscious level.)  The culture may joke about having anxiety, but true and significant anxiety should be considered a serious matter than needs treatment.

What are some non-medication ways to reduce anxiety?

Many people are unaware of their subtle triggers that cause anxiety. Basic human self-care is how we were designed to reduce anxiety and improve mood. Things like going outside, daily sunshine, good sleep, limiting screen time, yoga, healthy eating and avoiding junk food, taking vitamins, getting involved with other people in groups or hobbies, having something to look forward to (like a vacation), pursuing learning—all of these are important human components.  To neglect one for a long time will be stressful on one’s mental health, and build up anxiety. 

Social media in particular can be a culprit in causing people’s anxiety.  There is a small dopamine rush for every “like” or comment, or even seeing what is new on one’s feed.  This rush can be addictive and ending up wasting a lot of time.  When one finally looks up, nothing has been accomplished.  If there was negative news, or negative comments, this can increase worry.  If something was posted that cause the person to be upset, feel lonely, feel “less than,” then these can increase worry and lower mood.  In general, limiting screen time is sound advice from many mental health professionals.  If limiting it is hard, try limiting it until the evening time, or maybe on the weekends only.

The first line treatment for anxiety is psychotherapy, or talk therapy.  Anxiety disorders in particular respond well to therapy.  A trained therapist can notice patterns of anxiety and help one understand their faulty or irrational thinking, or create a more balanced view.  Ways people distort their thoughts include all-or-nothing thinking, overgeneralization, catastrophization, and many other subtle incorrect thoughts.  Many times, a good relationship with a skilled therapist can help people both understand their incorrect thinking, discovering the root cause, and also learn some coping skills to deal with present anxiety. 

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What about anxiety medication?

However, some people will still experience significant anxiety even with doing good self-care and in a therapeutic relationship.  This anxiety can disrupt relationships, work functioning, and general happiness.  At this point, medications should be considered as an adjunctive measure.  Medications such as SSRIs, SNRIs, buspirone, and other medications can help symptoms immensely.

What about Xanax?

Xanax and others in the benzodiazepene class (Ativan, Valium, Klonopin, Restoril, etc) are very useful medications, but they work in a different manner than the long term medications for anxiety, such as the SSRIs and the SNRIs.  They work quickly on the GABA receptor, stopping the next neuron from firing.  The net effect of this is that the anxiety circuits shut down, and sedation or sleepiness can ensure as well.  These medications are useful, but with daily use, the brain gets used to the benzodiazepine’s presence and begins to need the dose just to be at baseline.  This is called dependence.  It is different from addiction in that it is purely physiological.  Moreover, the brain starts to need more and more to get the same effect that a little bit used to give.  This is called tolerance.  Because of these two well known side effects, most medical professionals do not like to give benzodiazepenes long term.  However, with rare and sparing use, benzodiazepenes are a useful and sometimes necessary medication.

Dr. Kim treats people suffering from anxiety, including generalized anxiety disorder, social anxiety, specific phobia, OCD, postpartum anxiety, PTSD, and panic attacks and panic disorder.  For more information about her practice, click here.

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