| Approximately 30-40 percent of people who receive | | | | philosophically opposed to them may hamper your |
| state-of-the-art treatment for their anxiety problems | | | | recovery if your situation is severe. |
| have limited recovery. They do not experience the | | | | 3. YOU SHOULD MODIFY YOUR LIFESTYLE IN A |
| relief they were hoping to find. | | | | WAY THAT SUPPORTS GREATER PEACE AND |
| Of those people who do initially derive benefit from | | | | EASE IN YOUR LIFE. |
| treatment, a significant percentage has a relapse | | | | Even if you've received cognitive-behavioral therapy |
| after a period of time. In some cases the relapse is a | | | | and have taken the proper medication(s), your |
| temporary response to increased stress and may be | | | | recovery may still be limited if your lifestyle is so |
| overcome; in other, less fortunate cases, it seems to | | | | complicated and busy that you continually keep |
| be enduring. | | | | yourself at a high level of stress. |
| Why do some persons not get better in spite of | | | | Anxiety disorders are caused by three factors: |
| good treatment? Why do others relapse? If | | | | heredity, personality based on childhood experience, |
| you´ve not gotten better because | | | | and cumulative stress. You can't do much about your |
| you´ve not received appropriate treatment i.e., | | | | genetic makeup or your early childhood, but you can |
| your therapist sat and just talked with you or tried | | | | do a lot to mitigate stress in your life. |
| some other form of treatment instead of | | | | If you reduce and manage your stress, you will |
| cognitive-behavioral therapy, you need to keep | | | | reduce your vulnerability to anxiety. It's that simple. |
| looking until you find effective help. | | | | Stress arises from both external and internal factors. |
| So keep in mind that the reasons that follow assume | | | | External stress factors include things like work |
| you've already had proper treatment but have not | | | | demands, rush-hour commuters, smog, food |
| improved as much as you would like. | | | | additives, negative relatives, and noise pollution. |
| 1. YOU SHOULD CONTINUE TO PRACTICE THE | | | | These types of stressors usually require external |
| BASIC TECHNIQUES AND STRATEGIES OF | | | | solutions. Internal stress factors have to do with your |
| COGNITIVE BEHAVIORAL THERAPY. | | | | own attitudes, such as overemphasizing success at |
| Recovery from panic, phobias, obsessions and | | | | the cost of everything else, or a tendency to cram |
| compulsions, or general anxiety requires consistent | | | | too many things into too short a time. They require |
| effort over a period of time. You need to make time | | | | internal solutions, basically shifting your attitudes and |
| each day to practice deep muscle relaxation, engage | | | | priorities. |
| in aerobic exercise, challenge and counter | | | | Many persons do not recover from panic or anxiety |
| anxiety-provoking self-talk, and incrementally face | | | | until they are willing to place as much importance on |
| internal anxiety sensations or avoided external | | | | their peace of mind and health as they do on career |
| situations. | | | | success and material accomplishment. |
| If you're unable or unwilling to make such an effort | | | | 4. YOU SHOULD NOT FAIL TO ADDRESS |
| during a course of cognitive-behavioral therapy, you | | | | PERSONALITY AND INTERPERSONAL ISSUES THAT |
| will probably not benefit much from it. And if you | | | | PERPETUATE ANXIETY. |
| don't keep up with the basic practices of relaxation, | | | | Cognitive therapy and exposure may help you to |
| exercise, and exposure following the completion of | | | | change panic-provoking thoughts and face your fears. |
| therapy, you increase your risk of relapse. | | | | However, they may not modify core personality |
| Recovery from an anxiety disorder requires a | | | | traits that predispose you to be anxious in the first |
| permanent change in lifestyle, with time allocated | | | | place. |
| each day for practicing skills that keep anxiety and | | | | If you grew up with perfectionist, overly controlling |
| phobias from recurring. If you find you're having | | | | parents, for example, you're likely to be |
| difficulty maintaining a commitment to the daily | | | | perfectionistic yourself. Nothing in yourself or your life |
| practices that can ensure your long-term recovery, | | | | ever quite meets your overdrawn standards, and so |
| there are a couple of things you might do. | | | | you set yourself up for continuous stress. |
| First, you might arrange with your therapist to have | | | | Or if your parents were highly critical of you, you |
| periodic "booster sessions", after you've finished | | | | may have grown up with an excessive need to |
| therapy, to help you stay on track with your | | | | please and win approval. If you spend your life trying |
| recovery program. | | | | to please others at the expense of your own |
| Second, if you live in a large metropolitan area, you | | | | personal needs, you're likely to harbor a lot of |
| can attend an anxiety disorders support group. Such | | | | unexpressed resentment and thus be more prone to |
| a group needs to be a place where the focus is on | | | | anxiety. |
| what everybody is doing to maintain or enhance | | | | Insecurity, over-dependency, over-cautiousness, and |
| recovery, not just venting about their problems. If | | | | the excessive need for control are additional |
| you don't have a support group in your area, you can | | | | personality issues common to people with anxiety |
| find support through message boards and chat | | | | disorders. Such core personality traits are often |
| rooms online. | | | | associated with interpersonal problems, i.e., perhaps |
| 2. YOU SHOULD TAKE MEDICATION WHEN IT'S | | | | you expect too much of your spouse (perfectionism) |
| NEEDED OR STOP TAKING IT BEFORE IT HAS | | | | or you don't ask enough (excessive need to please). |
| OFFERED ITS FULL BENEFIT. | | | | Or you may resent your parents' attempts to control |
| Often prescription medication is unnecessary. | | | | you, but you don't assert your needs with them. |
| However, if your problem is relatively severe, you | | | | 5. EXISTENTIAL ISSUES |
| may well need to combine medication with | | | | The problem at the root of your anxiety may lie still |
| cognitive-behavioral therapy to get the best results. | | | | deeper than personality. Anxiety may persist in spite |
| By "severe," I mean that your problem meets at | | | | of therapy and medication because you experience a |
| least one of the following criteria:o Your anxiety is | | | | sense of emptiness or meaninglessness about your |
| disruptive enough that it's difficult for you to get to | | | | life. |
| work and/or function on your job, or it has caused | | | | In present times, with so many conflicting values and |
| you to stop working.o Your anxiety interferes with | | | | a loss of traditional authorities such as the church or |
| your ability to maintain fulfilling and close relationships | | | | social mores, it's easy to feel adrift and confused. |
| with family members and/or significant others, or it | | | | The very pace of modern life can lead to feelings of |
| prevents you from establishing a relationship with any | | | | confusion, if not outright chaos. |
| significant other.o Your anxiety causes you significant | | | | What has been called "existential anxiety" does not |
| distress 50 percent of the time you're awake. It's not | | | | respond to cognitive-behavioral therapy and demands |
| just a major nuisance or irritation; you often feel | | | | a different kind of approach. |
| overwhelmed and find it hard to get through the day. | | | | If your life feels meaningless or without direction, |
| If you believe your anxiety problem meets any one | | | | perhaps you need to discover your own unique gifts |
| or more of these criteria, it's likely you may benefit | | | | and creativity, and then find a way to meaningfully |
| from a trial of medication subscribed by your doctor. | | | | express them in the world. I believe each of us has a |
| Not to try medications because you're afraid or | | | | unique gift to offer, a unique contribution to make. |