Understanding, an overview of the anxiety program
This is to understand the panic and phobic disorder. The various phobic programs provide detailed information on the problems. Re-education of the patient and family serves to remove many of the myths, fears and fantasies.
A number of treatment strategies are presented. Not all of them will suit everyone. Select those that help you and use them regularly. In time the fears, anticipation anxiety, panic attacks, phobias and avoidance habits will disappear or reduce to a minimal and bearable level.
Each person will need to work hard to change these fears and the faulty thinking habits. Changes are needed in the way people self-monitor the world and their internal world.
This (anxiety) disorder is associated with strong beliefs about danger, vulnerability, fears and sudden disasters. Not all thoughts are true or real. To return to the normal way of life requires considerable change. The person will require strong motivation to persist and move into positive ways of coping.
Anxiety and panic tend to freeze problem solving and make the person appear helpless to overcome the fears and phobias.
Self esteem and self condidence initially are low and devaluation is frequently used. To reduce anxiety and panic may require one or several of the follow: anxiety management, relaxation therapy, behavioural therapy, cognitive therapy and medication.
It is important to accept that self control is present and not lost.
Reduction in anxiety, depression and panic will then allow problem solving strategies to be used correctly. Many of the changes in beliefs and attitudes will strengthen the individual’s personality. The return of independence will be satisfying and the future will be promising.
From Frank Herbert’s DUNE:
“I must not fear. Fear is the mind-killer. Fear is the little death that brings total obliteration. I must face my fear. I will permit my fear to pass over and through me. And when it has gone past, I will turn the inner eye to see its path. Where fear has gone there will be nothing. Only I will remain.”
The start of the anxiety disorder
In most cases, anxiety disorder starts in the following way:
It commences with spontaneous panic attacks, after which patients become fearful of having panic attacks – this is anticipatory anxiety. There is then an association of the object or situation in which the panic attacks occurred. This may be, for example, in a shop. The person may be fearful of developing further panic attacks in the shop, being alone, being in situations where panic attacks have previously occurred, or where rapid exit, e.g. shop or train (or loss of control) is not possible.
So many phobic patients then develop avoidance of feared situations. They frequently get anticipation anxiety and, in the feared situation, may experience situation panic attacks.
Subsequent avoidance leads to a restricted life and problems. Sometimes the spontaneous panic attacks lessen and the major panic attack component is situational panic attack. In a number of cases a life threatening event or situation or stress can trigger off the sequence of events.
Reasons for medication
Not all patients require medication, but it is an effective way of reducing anxiety, depression and panic. Acceptance of medication should be positive. Following the selection of the appropriate drug, there are four areas to be assessed for response.
- Panic attacks: reduction in intensity, frequency and severity of panic attacks
- Anticipatory anxiety episodes: reduction in intensity, frequency and severity of episodes
- Residual anxiety: a lessening of features of chronic anxiety
- Depression: If severe, then it will need to be treated before the phobic patient can reap the full benefit of the program.
Once the medication is effective, the person can move out of the house and start to challenge phobias, i.e. following the procedure of graded exposure.
Other forms of treatment
- Educational
- Detailed explanations of certain items occur during sessions.
- Relaxation therapy
- Breathing
- Muscular
- Visual imagery
- Meditation
- Modified and self hypnosis
- Autogenic training (rapid and brief relaxation)
- Stress reduction strategies
- Self monitoring
- Diet
- Exercise
- Reduce the certain forms of excess or drug abuse
- Anxiety management techniques
- Review activities and interests
- Diversion, distraction
- Tiredness
- Reduce boredom
- Rubberband
- Thought control and stopping
- Coping skills
- Cognitive therapy
- Assertiveness training
- Behavioural therapy
- Time management
- Biofeedback
- Supportive discussions
- Marital therapy
- Hyperventilation control
Specific Techniques for Anxiety Control
Credit: This resource was handed during my dr sessions. It has been transcribed with approval from psychiatrist but remains the intellectual property of him.