You have a fear of spiders, or of flying, or of crowds. Are you just sitting there suffering? It’s time to try Exposure Therapy!

Exposure therapy is a type of Behavioral Therapy used to help the patient confront a feared situation, object, thought, or memory and dispel its power to produce fear and anxiety. It involves reliving a traumatic experience in a controlled, therapeutic environment.

The Anxiety Disorders can paralyze the sufferer with ever-mounting avoidance behaviors. While successful for the moment, avoidance just sets aside the fear and anxiety triggered by a situation. They are sure to come back, stronger than ever.

Exposure therapy has been shown to be effective with many of the Anxiety Disorders, including Social Phobia (SAD), Generalized Anxiety Disorder (GAD), panic attacks and Panic Disorder, Agoraphobia, Adult Separation Anxiety Disorder (ASAD), Post Traumatic Stress Disorder (PTSD), and specific phobias.

This is the second of a two-part series of articles on Exposure Therapy. It focuses on tips to make your Exposure Therapy successful. Today’s installment has these headings:

• Exposure Therapy: Better in real life or in imagination?
• Tips for successful Exposure Therapy experiences

Yesterday’s Part 1 describes Exposure Therapy and what goes into a typical Exposure Therapy plan:

• Exposure Therapy is based on habituation
• Exposure Therapy counteracts Anxiety Disorders’ avoidance
• Exposure Therapy is a part of Cognitive Behavioral Therapy
• Characteristics of a typical Exposure Therapy plan

Exposure Therapy: Better in real life or in imagination?

Exposure Therapy in the thoughts or imagination is more difficult

Exposure Therapy may be done in vivo (in real life) or in the thoughts or imagination. In vivo exposure is more effective than exposure using the imagination. While anxiety or other discomfort may get worse in the first few minutes of in vivo exposure, it is important to continue the experience until the discomfort has diminished.

Examples of exposure in vivo are resuming driving after being in a traumatizing accident, or returning to a now-safe location where an assault once occurred.

Exposure in imagination or in thoughts involves the person recounting traumatic memories in their mind until they lose their sting. While treating exposure in imagination is sometimes unavoidable, it is harder for you and the therapist to create an exposure plan, and more difficult for both of you to evaluate your progress. Your therapist will teach you a number of techniques for coping with the stress and fear that accompany exposing yourself to traumatic thoughts.

Your therapist will have you use several tools to guide you through the steps of your exposure plan. Some of these include keeping a journal, guided reading, or making recordings. For example, you may confront fearful thoughts by saying them aloud repeatedly, writing, reading and rewriting a biography of the events or recording them on a tape and playing them over and over until they are no longer distressing.

Tips for successful Exposure Therapy experiences

Your commitment to your Exposure Therapy is key to its success!

The skill and experience of your therapist is very important to developing and evaluating an Exposure Therapy plan. However, your efforts are even more important for its success. You will be the one executing the steps in your plan, both in your therapy sessions, and more essentially, outside them.

You will be on your own 167 hours of the week outside your one-hour therapist’s appointment! It will be your responsibility to initiate and complete your exposure exercises, and in some cases, to determine when to move on to the next step.

Here are some tips for making your Exposure Therapy exercises successful and confidence-building:

• Keep your final goal firmly in mind at all times. Picture yourself being successful in overcoming the feared object or situation and living your life free of their power.
• Always have in mind your exposure plan’s steps toward success. Each should be small enough that success is easy, and close enough to the next that you can move on as you are able. Your plan may be explicit, in the form of increasingly challenging tasks, or implicit, in the form of a set of principles for escalating the exposure.
• One step at a time: Follow your plan and don’t suddenly jump into the deep end. It’s tempting in the glow of success to want to skip steps in your plan, but you are only inviting failure if you do.
• At every stage, your self-exposure should be completely voluntary, and should offer an easy way to terminate it. By choosing not to escape, and practicing a better response, you are weakening your learned avoidance behaviors and learning new ways to think about the situation.
• Stay in the situation and try not to leave or quit if you suddenly feel anxious. Use the techniques your therapist has taught you such as rational thinking, focusing, controlled breathing, and relaxation. If you have to end the exposure, try to do it again as soon as possible. However, it may be that the step was too big for you, and you need to repeat the previous step again to gain confidence.
• Repeat the successful exposure experience before moving on to the next step, since doing something only once can be interpreted as a fluke! The more often you do something challenging, the more you will feel comfortable in the situation.
• Regular practice is very important. Try to do your exposure exercises as much as you can, rather than letting long periods of time come between repetitions. Just like learning the guitar, regular practice is more effective than occasional practice.
• Ups and downs are a part of life. Some days will be good days when your exposure task will be easy, and there will be other days when it is almost impossible. Try not to beat yourself up on the bad days with negative self-talk. Rather, accept it for what it is — a not-so-good day! If you have a series of bad days, it might be wise to repeat the previous step until you gain more self-confidence.
• Be aware of avoidance: It’s what got you into your problem in the first place! By not doing something that you fear, you are only making it harder for yourself, and allowing your avoidance to grow and keep your fears alive and healthy. Remember, it is you who are in control of your anxiety, and it is you who can decrease and manage it, as well.

Don’t miss yesterday’s Part 1 of the series!

Yesterday’s Part 1 describes Exposure Therapy and what goes into a typical Exposure Therapy plan. If you missed it, be sure to read it now to better understand what Exposure Therapy can do for you! The topics of discussion in Part 1 are:

• Exposure Therapy is based on habituation
• Exposure Therapy counteracts Anxiety Disorders’ avoidance
• Exposure Therapy is a part of Cognitive Behavioral Therapy
• Characteristics of a typical Exposure Therapy plan

What do you think?

As with many of life’s experiences, you only get out of Exposure Therapy what you put into it. You have to have the desire to end the constriction and suffering that your avoidance causes. You must endure the discomfort of exposure to that which causes that suffering, and do it repeatedly and on an ever-more-challenging basis.

But you are not suddenly thrown to the lions: The exposure plan will present the feared situation to you in small steps that are designed for success. Your therapist will prepare you by helping you learn coping strategies that will defend you, not only in the series of exposures, but against other fear-triggering experiences you will have throughout life.

I have been through Exposure Therapy for my Agoraphobia, and I can say without hesitation that it works magnificently. Where I was once confined to the house, I now go where I want with a minimum of anxiety and fear — if any at all.

• Do you have situations that you avoid? Do you think Exposure Therapy might be able to help you?
• Do you think you could do Exposure Therapy on you own, without the help of a therapist?

©2009 Michael L Nichols. All rights reserved.

Resources used in this post:
Andrews, G.; Crino, R.; Hunt, C.; Lampe, L.; Page, A. (1994). The Treatment of Anxiety Disorders. Cambridge, England: Cambridge University Press. (Quoted) Retrieved October 1, 2008 from Shyness & Social Anxiety Treatment Australia Web site: http://www.socialanxietyassist.com.au/treatment/exposure.shtml
Anxiety Treatment Center. (2006). Exposure and Response Prevention Therapy. Retrieved October 1, 2008 from Anxiety Treatment Center Web site: http://www.anxietytreatmentexperts.com/cbt_exposure_therapy.asp
Atherton, J.S. (2005). Learning and Teaching: Cognitive Dissonance and Learning. Retrieved October 3, 2008 from Learning and Teaching Web site: http://www.learningandteaching.info/learning/dissonance.htm
ChangingMinds. (2002). Cognitive Dissonance. Retrieved October 3, 2008 from ChangingMinds Web site: http://changingminds.org/explanations/theories/cognitive_dissonance.htm
HealthyPlace. (2008). Exposure Therapy for Anxiety Disorders, Panic Attacks. Retrieved October 1, 2008 from HealthyPlace Web site: http://www.healthyplace.com/Communities/Anxiety/treatment/exposure_therapy.asp
Hoffman, Hunter. (2008). VR Therapy for Spider Phobia. Retrieved October 1, 2008 from HITLab Web site: http://www.hitl.washington.edu/projects/exposure/
Katz-Wise, Sabrina; Poore, Ralph. (2006, November 10). Exposure therapy. Retrieved October 1, 2008 from RevolutionHealth Web site: http://www.revolutionhealth.com/articles/exposure-therapy/aa131258
Madison, N. (2008). What is Exposure Therapy? Retrieved October 1, 2008 from WiseGeek Web site: http://www.wisegeek.com/what-is-exposure-therapy.htm
Mindsite. (2008, March 12). Exposure Therapy. Retrieved October 1, 2008 from MindSite Web site: http://www.mindsite.com/article/229/exposure_therapy
PTSD Facts for Health. (2008). Exposure Therapy. Retrieved October 1, 2008 from PTSD Facts for Health Web site: http://ptsd.factsforhealth.org/exposure.html
Rapee,R.M., (1998), Overcoming Shyness and Social Phobia. Cambridge, MA: Lifestyle Press.
Terri. (2007, February 24). Exposure Therapy for Treating PTSD. Retrieved October 1, 2008 from A Soldier’s Mind Web site: http://soldiersmind.com/2007/02/24/exposure-therapy-for-treating-ptsd/

Related Posts:

• Exposure Therapy: Eliminating Anxiety Disorder’s Fear, Part 1
• Radical Approach to Therapy for Anxiety Disorder
• Pills Are Not Enough: Effective Treatment of Anxiety Disorders With Psychotherapy
• Anxiety’s Bad Memories Can Be Minimized, Scientists Find
• 10 Reasons Why We Lie to Our Therapists

The neighbor’s dog barks night and day. If you have gotten used to it, you have used one of the root principles of Exposure Therapy.

Exposure therapy is a type of Behavioral Therapy used to help the patient confront a feared situation, object, thought, or memory and dispel its power over them. It involves reliving a traumatic experience in a controlled, therapeutic environment.

In a way, Exposure Therapy is related to the old maxim “face your fears,” but instead of jumping into a terror-inducing situation with both feet, therapy usually advocates a carefully planned, gradual approach to alleviating fears.

Exposure therapy has been shown to be effective with many of the Anxiety Disorders, including Social Phobia (SAD), Generalized Anxiety Disorder (GAD), panic attacks and Panic Disorder, Agoraphobia, Adult Separation Anxiety Disorder (ASAD), Post Traumatic Stress Disorder (PTSD), and specific phobias.

This two-part series of articles describes what Exposure Therapy is, and offers tips to make your Exposure Therapy successful. Today’s installment has these headings:

• Exposure Therapy is based on habituation
• Exposure Therapy counteracts Anxiety Disorders’ avoidance
• Exposure Therapy is a part of Cognitive Behavioral Therapy
• Characteristics of a typical Exposure Therapy plan

Tomorrow’s part of the article will continue the discussion under these headings:

• Exposure Therapy: Better in real life or in imagination?
• Tips for successful Exposure Therapy experiences

Exposure Therapy is based on habituation

Habituation: Just getting used to the annoying things in life

Exposure therapy is based on the principle that we get used to things that are just annoying and not truly dangerous if the experience is not overwhelming. This is called habituation, and it occurs naturally in over 95 percent of all people.

For example, you visit a friend in a large city who lives in an apartment right beside an elevated railroad. It is very annoying every time a train screeches by, shaking the building and rattling the windows to the point that conversation becomes difficult.

You might say to your friend, “How do you live in all this noise?” And the friend might answer, “What noise?”
If you only visited for a few days, you would leave with a belief that your friend lives in an impossible situation. If you were to stay for a week or two, you too would become habituated to the noise, and no longer be annoyed by passing trains.

In the same way, Exposure Therapy gradually habituates the patient to the feared thing — be it a situation, an item, a memory, or a thought. Through exposure, it gradually loses its power to produce fear and anxiety, with the goal being that it is no longer even noticed.

Exposure Therapy counteracts Anxiety Disorders’ avoidance

Avoidance is the key features of Anxiety Disorders

One of the key components of the Anxiety Disorders is the tendency to avoid the situations, thoughts, and objects that trigger anxiety. This avoidance builds upon itself: real things that cause anxiety are avoided, then more related real things are avoided, then imaginary things related to the real things, then imaginary things related to the imaginary things — until your life is a minefield of things to be avoided.

Avoidance does provide temporary relief from anxiety, but it never lasts. There’s always a new situation that requires some sort of negotiation with your anxious fears, causing you to once again use avoidance as your first line of defense.

Exposure Therapy works in opposition to the typical, self-prescribed avoidance approach. It recognizes the fears behind the learned avoidance behavior, and names the triggers that produce your Anxiety symptoms. Exposure Therapy uses a carefully devised plan of exposure to the feared situation to gradually defuse its anxiety-producing power, to the point that it has no ability to produce anxiety at all.

Exposure Therapy is a part of Cognitive Behavioral Therapy

Cognitive Behavioral Therapy is effective treatment

Cognitive Behavioral Therapy (CBT) has been shown to be one of the most effective kinds of psychotherapy for dealing with the Anxiety Disorders. It has two basic components:

• It helps to change thinking patterns (cognitions) that have prevented individuals from overcoming their fears.
• The behavioral component helps individuals to slowly come in contact with their fears. This is done through Exposure and Response Prevention Therapy (ERP) and is designed to systematically desensitize a person to their fears.

Exposure Therapy within CBT is based on our natural tendency to habituate ourselves to situations, along with a concept called cognitive dissonance. “Cognition” is simply any mental process that we have involving knowledge, attitude, emotion, belief, or behavior. “Dissonance” is a term borrowed from music, meaning the grating together of two conflicting, incompatible notes. The theory of cognitive dissonance states that contradicting cognitions serve as a driving force that causes the mind to acquire or invent new thoughts or beliefs, or to modify existing beliefs, so as to reduce the amount of dissonance between cognitions.

For example, you may enter Exposure Therapy with the fear of flying. You hold the thought in your mind that flying is unsafe, which produces fearful sensations in your mind and body. Your therapy will teach you that airplanes have an admirable safety record, and though uncomfortable, flying is nothing to fear. During the course of your Exposure Therapy, the two conflicting, or dissonant, thoughts — fear of flying and the safety of flying — gradually resolve themselves into a belief that flying is safe and nothing to fear: a consonance of thoughts.

Characteristics of a typical Exposure Therapy plan

What a good Exposure Therapy plan looks like

Your therapist will work with you to determine what your root fears are, and to develop a plan to confront them in a controlled manner. While some therapists may determine that the best solution is what is called “flooding,” wherein you are exposed to the full situation all at once, most will create a plan that will gradually expose you to the fear until it is dissipated.

Along with an exposure plan, you will be taught relaxation techniques, such as breathing exercises, and other coping skills to deal with emotional and physical distress and fear. Using these techniques helps you maintain a sense of control whenever you are confronted with the feared object, situation, or distressing thought or memory.

The basic principles of Exposure Therapy are:

• Gradual exposure
• Repeated and regular exposure
• Prolonged exposure

Gradual exposure
You and your therapist will create an exposure plan, with gradual steps that lead to full exposure to the feared situation. Each step should be difficult enough to provoke some anxiety, but easy enough for you to be fairly confident you can do it. Once you can successfully cope with a step, you can move on to a more difficult situation and gradually work up your most feared scenarios.

It is important not to confront a feared situation that is far too difficult for you. If you tackle something too stressful without sufficient preparation, you may become extremely anxious or even have a panic attack. Such a negative experience would only strengthen the association between fear and the setting that provokes it. Therefore, it is important to follow your plan exactly, without skipping steps.

Repeated and regular exposure
You need to confront your feared situations frequently and regularly if you are going to overcome your anxiety. If your exposures are too far apart your fear will rise again by the next time you confront it. Your therapist will likely give you exposure assignments to practice between sessions. It is important that you do these assignments several times in order to become confident enough to move to the next step.

Prolonged exposure
You should stay in the feared situation until your anxiety starts to decrease. Your past pattern was to attempt a feared situation, but then choose to escape or avoid it. When you avoid or leave feared situations two things happen:

• Your fear of the anxiety-triggering situation increases even more.
• The idea that avoidance is a helpful strategy is strengthened because your escape caused a decrease in anxiety.

However, if you stay in the feared situation your anxiety will eventually decrease, and the next time you confront the situation you will be less anxious. A good exposure plan will never put you in a situation that is too much for you — keep this in mind as you challenge yourself to cope with each exposure step.

Don’t miss tomorrows’ installment with tips for success!

Today’s installment discusses what Exposure Therapy is and what a good plan looks like. Tomorrow’s part of the article will continue the discussion, and also provides tips for making Exposure Therapy a successful experience:

• Exposure Therapy: Better in real life or in imagination?
• Tips for successful Exposure Therapy experiences

What do you think?

As mentioned, Exposure Therapy has a lot in common with the notions of conventional wisdom. We know that we must face our fears, but the only way we know how is to face them in all their fury, which is bound to be unsuccessful and produce even more anxiety. The advantage of formal Exposure Therapy is that the therapist is experienced in helping people discover their core fears, and developing a plan for gradually confronting them. The therapist can also help you learn techniques to cope with your fears during your exposure practice — techniques that will help you for the rest of your life.

I’m reminded of when I was a little boy. My uncles threw me into the deepest part of the swimming hole to “teach me to swim.” All that did was almost drown me and reinforce my fear of the water. It was only through swimming lessons — with its gradual steps toward learning the skill — that I learned to swim and not fear the water.

The old maxims tell us to throw ourselves into the middle of feared situations and just be brave. All that does is to create more fear and cause for avoidance. It is only through a well-planned and executed program of exposure that we will learn to conquer our fears and dispel the power they have over us.

• Have you had any experience with Exposure Therapy? How has it helped you?
• Exposure Therapy is closely related to normal habituation. Have you been able to overcome fears on your own using a gradual approach?

©2009 Michael L Nichols. All rights reserved.

Resources used in this post:
Andrews, G.; Crino, R.; Hunt, C.; Lampe, L.; Page, A. (1994). The Treatment of Anxiety Disorders. Cambridge, England: Cambridge University Press. (Quoted) Retrieved October 1, 2008 from Shyness & Social Anxiety Treatment Australia Web site: http://www.socialanxietyassist.com.au/treatment/exposure.shtml
Anxiety Treatment Center. (2006). Exposure and Response Prevention Therapy. Retrieved October 1, 2008 from Anxiety Treatment Center Web site: http://www.anxietytreatmentexperts.com/cbt_exposure_therapy.asp
Atherton, J.S. (2005). Learning and Teaching: Cognitive Dissonance and Learning. Retrieved October 3, 2008 from Learning and Teaching Web site: http://www.learningandteaching.info/learning/dissonance.htm
ChangingMinds. (2002). Cognitive Dissonance. Retrieved October 3, 2008 from ChangingMinds Web site: http://changingminds.org/explanations/theories/cognitive_dissonance.htm
HealthyPlace. (2008). Exposure Therapy for Anxiety Disorders, Panic Attacks. Retrieved October 1, 2008 from HealthyPlace Web site: http://www.healthyplace.com/Communities/Anxiety/treatment/exposure_therapy.asp
Hoffman, Hunter. (2008). VR Therapy for Spider Phobia. Retrieved October 1, 2008 from HITLab Web site: http://www.hitl.washington.edu/projects/exposure/
Katz-Wise, Sabrina; Poore, Ralph. (2006, November 10). Exposure therapy. Retrieved October 1, 2008 from RevolutionHealth Web site: http://www.revolutionhealth.com/articles/exposure-therapy/aa131258
Madison, N. (2008). What is Exposure Therapy? Retrieved October 1, 2008 from WiseGeek Web site: http://www.wisegeek.com/what-is-exposure-therapy.htm
Mindsite. (2008, March 12). Exposure Therapy. Retrieved October 1, 2008 from MindSite Web site: http://www.mindsite.com/article/229/exposure_therapy
PTSD Facts for Health. (2008). Exposure Therapy. Retrieved October 1, 2008 from PTSD Facts for Health Web site: http://ptsd.factsforhealth.org/exposure.html
Rapee,R.M., (1998), Overcoming Shyness and Social Phobia. Cambridge, MA: Lifestyle Press.
Terri. (2007, February 24). Exposure Therapy for Treating PTSD. Retrieved October 1, 2008 from A Soldier’s Mind Web site: http://soldiersmind.com/2007/02/24/exposure-therapy-for-treating-ptsd/

Related Posts:

• Exposure Therapy: Eliminating Anxiety Disorder’s Fear, Part 2
• Radical Approach to Therapy for Anxiety Disorder
• Spiders! Snakes! Blood! 13! – Specific Phobias: Where They Come From and What You Can Do About Them
• Aviophobia: Understanding the Fear of Flying
• Anxiety Sensitivity Linked To Future Psychological Disorders

Anxiety Disorders cause severe distress and disrupt the lives of individuals suffering from them.

The frequency and intensity of anxiety involved in these Disorders is often debilitating. Fortunately, with proper and effective treatment, people suffering from Anxiety Disorders can lead normal, productive, and happy lives.

Many people think of treatment for Anxiety Disorders as being solely medication. While drugs can be effective, their remedy is temporary; they work only as long as you take them. And some medications for Anxiety Disorders are habit-forming and cannot be taken for more than a few months at a time.

But there is an equally effective treatment for Anxiety Disorders that will teach you how to manage and control them for the rest of your life: psychotherapy. Although psychotherapy requires more time to work than a pill, it is the best use of your time you will ever experience.

This article discusses the role of psychotherapy in the treatment of Anxiety Disorders under the following headings:

• Avoidance is at the core of Anxiety Disorders
• Why is it important to seek treatment for Anxiety Disorders?
• Are there effective treatments available for Anxiety Disorders?
• How can a qualified therapist help someone suffering from an Anxiety Disorder?
• How long does psychological treatment take?

Avoidance is at the core of Anxiety Disorders

If left untreated, Anxiety Disorders can take over your life. You first will begin to avoid situations, experiences, and feelings that cause you to be anxious. Then you will start avoiding more and more anxiety-provoking things. Over time, this avoidance can grow until you are trapped in a prison of your own making. You may find your family and job severely affected, and the basic activities of daily life nearly impossible.

For example, most people who suffer from recurring panic attacks avoid putting themselves in situations that may trigger another attack. This avoidance frequently grows until they go on to develop Panic Disorder. And people with Panic Disorder commonly develop Agoraphobia (as I have). It’s a vicious cycle of one Disorder causing the next — all through avoidance.

Some Anxiety Disorders, such as Agoraphobia, develop rapidly due to avoidance. The world of Agoraphobics is shrunk down to their home: They can’t leave it without suffering a great deal of Anxiety and even panic attacks. A simple trip to the doctor is an ordeal, and going to the grocery store is impossible.

Even people with Generalized Anxiety Disorder or Social Phobia may become so restricted in what they can and can’t do that they are virtual prisoners. Unable to take a job that involves making presentations, a person with Social Phobia may be doomed to lower-paying work — that is, if they can even go to a job interview. A person with Generalized Anxiety Disorder can become so afraid of the world that they lead a miserable, abnormal life of continual fretting and worrying.

Why is it important to seek treatment for Anxiety Disorders?

The relief of the pain and suffering of Anxiety Disorders would seem to be reason enough to seek treatment. But there are other reasons just as compelling.

Many people who suffer from an untreated Anxiety Disorders:

• Grow increasingly prone to other psychological disorders, such as other Anxiety Disorders and depression.
• Have a greater tendency to abuse alcohol and other drugs.
• Experience increased physical health problems due to the effects of uncontrolled anxiety and stress.
• Have severe and growing problems with relationships with family members, friends and coworkers. They find coping with daily life to be increasingly difficult, and job performance plummets.

Are there effective treatments available for Anxiety Disorders?

Yes, very much so. Most cases of Anxiety Disorder can be treated successfully by appropriately trained mental health care professionals. And many people can be treated without using medication.

The National Institute of Mental Health reports that research has demonstrated both Behavioral Therapy and Cognitive Behavioral Therapy (CBT) to be highly effective in treating Anxiety Disorders.

Behavioral Therapy involves using techniques to reduce or stop the undesired behaviors associated with Anxiety Disorders. For example, panic attack sufferers experience severe agitation, physical discomfort, and hyperventilation before and during an attack. One approach to the treatment of panic attacks involves training patients in relaxation and deep breathing techniques to counteract these feelings.

Cognitive Behavioral Therapy (CBT) teaches people to understand how their thoughts contribute to the symptoms of Anxiety Disorders. They learn how to change those thought patterns to reduce the likelihood of occurrence and the intensity of reaction. Along with increasing the person’s cognitive awareness, treatment is often combined with behavioral techniques. CBT techniques help the individual gradually confront and tolerate fearful situations in a controlled, safe environment.

How can a qualified therapist help someone suffering from an Anxiety Disorder?

Licensed psychologists are highly qualified to diagnose and treat Anxiety Disorders. Experienced mental health professionals have years’ worth of experience helping people recover from Anxiety Disorders. They will know a number of effective techniques to treat people with varying personalities and needs.

Since Behavioral Therapy and Cognitive Behavioral Therapy have been proven to be very effective in treating the Anxiety Disorders, you should seek a mental health professional who is competent in these types of therapies.

In addition, family psychotherapy, involving the treatment of related individuals, and group psychotherapy, typically with unrelated people, are also valuable ways to treat some patients with Anxiety Disorders. These may employ Behavioral or Cognitive therapies, or may use other techniques. Many people combine both individual and family or group therapy for a more thorough treatment experience. There are also mental health clinics and other specialized treatment programs dealing with specific disorders such as panic or phobias available in some areas.

How long does psychological treatment take?

It is very important to understand that treatments for Anxiety Disorders do not work instantly. Time is required to reverse and learn to manage the avoidance behaviors and other symptoms of the Disorders.

You should be comfortable from the beginning with the general treatment plan being proposed by the therapist you are working with. Sometimes it takes “interviewing” a number of therapists before you find the right one.

Your cooperation and dedication to your treatment is crucial. You will have assignments to carry out between sessions, and your willingness to do these is essential to your treatment’s effectiveness. You must have a strong sense that you and the therapist are collaborating as a team to remedy your Anxiety Disorder.

No one plan works well for all people. Treatment needs to be tailored to your needs and to the type of Anxiety Disorder or disorders that you have. You and your therapist should work together to evaluate whether your treatment plan is being effective over time. Adjustments to the plan sometimes are necessary, since different people respond differently to various treatments.

Many people find that they begin to improve noticeably within eight to ten sessions when they have carefully followed the treatment plan outlined by their therapist. Other Anxiety Disorders take longer to treat, particularly if you have multiple Disorders or another psychological condition is involved.

However long your treatment takes, remember that you are learning to deal with your Anxiety Disorder for the rest of your life. A pill may be effective in the short run, but only therapy can help you learn to live a successful, fulfilling, and happy life without constant medication.

What do you think?

Personally, I have found therapy to be very effective in learning to manage and control my Anxiety Disorders. I am able to get out and do things that I haven’t been capable of for years, all without significant Anxiety symptoms. My therapy has taken longer than many people’s, because I have multiple Anxiety Disorders and bipolar disorder, as well.

But I firmly believe that the time I have spent in therapy is for my long-lasting good, and I look forward to the day when I no longer need it.

• Have you ever had therapy? What has been your experience?
• Many people go through several therapists before they find the right one. Has this happened to you?
• What do you think of this article? Do you believe that medication is just as good or better than therapy?

Resource used in this post:
Anxiety Disorders: The Role of Psychotherapy in Effective Treatment

©2009 Anxiety, Panic & Health. All rights reserved.

Related Posts:

• Exposure Therapy: Eliminating Anxiety Disorder’s Fear, Part 2
• Radical Approach to Therapy for Anxiety Disorder
• Group Therapy: Is It Right for You?
• Exposure Therapy: Eliminating Anxiety Disorder’s Fear, Part 1
• Drugs Are Not a Silver Bullet! There’s Another Way to Gain Relief!

You experience a pounding heart, sweaty palms, and dizziness. What do you think of? Are you frightened? Do you think you’re going crazy?

People who get scared when they have these symptoms — even if the cause is something as mundane as stress, exercise or caffeine — are more likely to develop a clinical case of an Anxiety Disorder, such as Post Traumatic Stress Disorder, or Panic Disorder, according to recent research. The chronic fear of these kinds of symptoms is a condition called Anxiety Sensitivity.

Those of us with Anxiety Disorders — and those of us without — can become hyper-aware of bodily sensations that lead to anxiety. When this awareness becomes morbid and takes over our lives, it can easily be labeled Anxiety Sensitivity.

Anxiety Sensitivity is a concept introduced in the 1980′s which has attracted a great deal of attention from researchers and clinicians. It is thought to be a preventable precursor to developing Anxiety Disorders, and a treatable condition for those who have already have a disorder.

This article explores Anxiety Sensitivity and its implications for you under the following headings:

• What is Anxiety Sensitivity?
• Is Anxiety Sensitivity inherited or is it learned?
• What is the relationship between Anxiety Sensitivity and Anxiety Disorders?
• Treating Anxiety Sensitivity

What Is Anxiety Sensitivity?

Anxiety Sensitivity refers to a person’s tendency to fear anxiety-related symptoms due to the belief that there will be some negative outcome as a result of having those symptoms.[1] They perceive their physical responses to certain triggers as a sign of imminent personal harm. They not only fear their reactions, they also fear that other people will detect their anxiety, which only serves to increase their anxiety.[2]

These symptoms may be as common as increased heart rate, sweating, muscle tension, headaches, or a sense of unreality in a given situation (derealization).

Anxiety Sensitivity fears lead to unrealistic conclusions:

• A person may fear having an increased heart rate because they believe that it will increase their risk for a heart attack or it will lead their having a heart attack.[3]
• An individual may fear being anxious because they think that others will view them in a negative light.
• Sweating or trembling are feared if the person believes these reactions will attract ridicule from others.[4]
• Someone might fear having the anxiety symptoms of having a headache or difficulties concentrating because they think this is a sign that they are “going crazy.”
• A sense of unreality (derealization) is feared if the person believes it is the harbinger of insanity.[5]

Is Anxiety Sensitivity inherited or is it learned?

Most researchers believe that Anxiety Sensitivity is a learned response, and is therefore environmentally influenced. However, there have been studies that show that it might be partially inherited from your parents.[6] [7]

It is generally thought that Anxiety Sensitivity develops from early experiences in a person’s life. For example, a child who sees his or her parents overreact with fear to sickness may begin to believe that certain normal bodily feelings, such as those connected with anxiety, are dangerous and threatening.[8]

What is the relationship between Anxiety Sensitivity and Anxiety Disorders?

There is a particular relationship between Anxiety Sensitivity and panic attacks, Panic Disorder, and Post Traumatic Stress Disorder (PTSD). It seems that there is a hyper-sensitivity to bodily sensations that lead to heightened anxiety over what would otherwise be normal physical reactions.

People with PTSD typically have high levels of Anxiety Sensitivity. Those who develop PTSD as a result of intimate partner violence also usually have higher levels of Anxiety Sensitivity than those who do not develop PTSD. Often, the extent of a person’s Anxiety Sensitivity predicts whether or not they develop more severe PTSD symptoms following the experience of a traumatic incident, such as a motor vehicle accident.[9]

Researchers have not discovered why Anxiety Sensitivity increases risk for PTSD. They speculate that fearing anxiety symptoms may cause people to have stronger emotional responses to situations that bring about anxiety, such as traumatic events, thereby increasing the severity of the hyperarousal symptoms of PTSD. As with all the Anxiety Disorders, the fear of Anxiety symptoms causes people to avoid those experiences or feelings that give rise to them. This may put people at risk for developing PTSD because they are not actively confronting and processing their emotions surrounding a traumatic event.[10]

Anxiety Sensitivity leads to the avoidance of experiences and feelings that cause anxiety, and this in turn can lead to panic attacks and the development of Panic Disorder. People soon develop a “fear of fear” and may begin to restrict their activities in an attempt to prevent more attacks. While a single panic attack does not indicate development of a psychological disorder — in fact, some estimates indicate that about 20 percent of people will experience a spontaneous panic attack at some point in their lives — repeated occurrences do.

N. Brad Schmidt, a researcher at Florida State University, says: [11]

When people start having repeated panic attacks, plus a lot of what we call panic-related worry — they worry when the next attack will occur and they start avoiding things due to worry — this is when someone has panic disorder.

Treating Anxiety Sensitivity

Anxiety Sensitivity is very treatable and can be reduced markedly through the proper treatment. In particular, Cognitive Behavioral Therapy (CBT) has been found to be very effective in reducing Anxiety Sensitivity. Although medications may reduce the immediate effects of Anxiety Sensitivity, the best long-term treatment has been found to be talk therapy, in which a person relearns reactions to common bodily sensations.[12]
In addition, exposure therapy for PTSD has been found to also reduce a person’s Anxiety Sensitivity. These treatments help people confront and experience their anxiety, allowing them to realize that anxiety is not dangerous and will not have negative consequences (such as having a heart attack or “going crazy”).[13]
Recent research has shown that Cognitive Behavioral Therapy can be useful in actually preventing PTSD, panic attacks, and Panic Disorder among those with Anxiety Sensitivity. N. Brad Schmidt states:[14]

The [research] findings offer an exciting possibility for prevention of anxiety and panic reactions among high-risk individuals… [T]he key is to teach people cognitive and behavioral skills to reduce their anxiety sensitivity so that it does not lead to a serious problem.

What do you think?

It is a hallmark of the Anxiety Disorders that we learn to fear what causes our fear, and increasingly avoid those situations, experiences, and feelings that engender those fears. This builds on itself, soon locking us into a prison of our own making. The predilection to these fears, Anxiety Sensitivity, is an important discovery that can lead to the prevention of the fears, and possibly, the development of Anxiety Disorders themselves.

• Have you ever experienced “fear of fear?” What did it feel like?
• Do you think the concept of Anxiety Sensitivity is valid in your experience?
• Do you think there should be screening for Anxiety Sensitivity for possible proactive treatment?

©2009 Anxiety, Panic & Health. All rights reserved.

FOOTNOTES
1. Tull, Matthew. (November 5, 2008). Anxiety Sensitivity and PTSD. Retrieved June 9, 2009 from http://ptsd.about.com/od/causesanddevelopment/a/AS_PTSD.htm ↑
2. Elish, Jill. (n.d.) FSU study links anxiety sensitivity to future psychological disorders. Retrieved June 9, 2009 from Florida State University web site: http://www.fsu.edu/news/2006/11/06/anxiety.sensitivity/ ↑
3. Taylor, Steven (ed). Anxiety Sensitivity: Theory, Research, and treatment of the Fear of Anxiety. Mahwah, New Jersey: Lawrence Erlbaum Associates, 1999. Page xi.↑
4. Taylor. (1999).↑
5. Taylor. (1999).↑
6. Broman-Fulks, Joshua, Green, Bradley, Berman, Mitchell, Olatunji, Bunmi, Arnau, Randolph, Deacon, Brett, Sawchuk, Craig. (2008, June 1). The Latent Structure of Anxiety Sensitivity — Revisited. Retrieved June 9, 2009 from http://asm.sagepub.com/cgi/content/abstract/15/2/188?rss=1 ↑
7. Stein, Murray, Jang, Kerry, Livesley, John. (February, 1999). Heritability of Anxiety Sensitivity: A Twin Study. Retrieved June 9, 2009 from http://ajp.psychiatryonline.org/cgi/content/abstract/156/2/246↑
8. Tull. (November 5, 2008).↑
9. Tull. (November 5, 2008).↑
10. Tull. (November 5, 2008).↑
11. Elish. (n.d.)↑
12. Tull. (November 5, 2008).↑
13. Tull. (November 5, 2008).↑
14. Elish. (n.d.)↑


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Artwork by Maria Yakunchikova

We all have fears and anxieties from time to time, but for most people they trouble you today and are gone tomorrow.

It’s when these fears and anxieties become persistent that they threaten to derail your life. Your every moment, your every thought is taken up by negative thoughts. You feel overwhelmed and it seems that everything is happening at once.

Stanley Popovich is the author of today’s guest post. He is a Penn State graduate who struggled with fear and anxiety for 15 years. He has written a book based on his personal experiences in overcoming his fear, as well as on interviews with a variety of professionals. 

The book, “A Layman’s Guide to Managing Fear Using Psychology, Christianity and Non Resistant Methods” is easy to read and comprehend. It presents a general overview of techniques that are effective in managing persistent fears and anxieties. It is available both as a paperback and as an ebook. For more information and a number of helpful free articles, visit his web site, “A Layman’s Guide to Managing Fear.”

Everybody deals with anxiety, fears and depression, however some people have a hard time in managing them. Here is a brief list of techniques that a person can use to help manage their most persistent fears and every day anxieties.

Overwhelmed? Break the task down into small steps

When facing a current or upcoming task that overwhelms you with a lot of anxiety, the first thing you can do is to divide the task into a series of smaller steps. Completing these smaller tasks one at a time will make the stress more manageable and increases your chances of success. 

Take a break when everything happens at once

Sometimes we get stressed out when everything happens all at once. When this happens, a person should take a deep breath and try to find something to do for a few minutes to get their mind off of the problem. A person could get some fresh air, listen to some music, or do an activity that will give them a fresh perspective on things. 

Visualize a red stop sign to conquer fearful thoughts

A person should visualize a red stop sign in their mind when they encounter a fear provoking thought. When the negative thought comes, a person should think of a red stop sign that serves as a reminder to stop focusing on that thought and to think of something else. A person can then try to think of something positive to replace the negative thought.

Carry a notebook of positive statements and affirmations

Another technique that is very helpful is to have a small notebook of positive statements that makes you feel good. Whenever you come across an affirmation that makes you feel good, write it down in a small notebook that you can carry around with you in your pocket. Whenever you feel depressed or frustrated, open up your small notebook and read those statements. This will help to manage your negative thinking.

Take one day at a time. Focus on the present

Learn to take it one day at a time. Instead of worrying about how you will get through the rest of the week, try to focus on today. Each day can provide us with different opportunities to learn new things and that includes learning how to deal with your problems. You never know when the answers you are looking for will come to your doorstep. We may be ninety-nine percent correct in predicting the future, but all it takes is for that one percent to make a world of difference.

Take advantage of the help available

Take advantage of the help that is available around you. If possible, talk to a professional who can help you manage your depression and anxieties. They will be able to provide you with additional advice and insights on how to deal with your current problem. By talking to a professional, a person will be helping themselves in the long run because they will become better able to deal with their problems in the future. Remember that it never hurts to ask for help.

Patience, persistence, education, commitment are key

Dealing with our persistent fears is not easy. Remember that all you can do is to do your best each day, hope for the best, and take things in stride. Patience, persistence, education, and being committed in trying to solve your problem will go a long way in fixing your problems.

What do you think?

Stanley Popovich has some good tips to help overcome persistent fears and anxieties. What I like about them is that they are simple, easy to remember, and easy to do. It goes to show you that it doesn’t take a clinical psychologist to make effective suggestions to help others in their lives.

Guest posts are a great way to expand the variety of voices and outlooks here on Anxiety, Panic & Health. Each one of us has experiences that would be helpful to others. If you think that you would like to write a guest post, I have a new page entitled “Guidelines for Guest Posts” that covers how to go about it. Click on the link, or look under “Reference & Info” in the rightmost sidebar.

• Can you share any techniques that you use to set aside fears and anxieties?
• Have you used any of Popovich’s techniques? Do they work?
• This was a short post. Would you like to see more of this type post in the future?

Artwork by Maria Yakunchikova (1870-1902), entitled “Fear,” 1893-95.

©2009 Anxiety, Panic & Health. All rights reserved.

As always, your comments are welcome!

If you have enjoyed this post, please consider subscribing to updates, either via RSS or email at the top of your screen. It’s free! You can also follow me on Twitter from the same place. I would also appreciate your sharing this post using your favorite social media, such as StumbleUpon or Digg. Just click the little green “ShareThis” button at the bottom of this post.

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The recession has most of America in its clutches, but it’s not time to roll over and play dead. It’s time to be proactive!

The magnitude of the this calamity causes people to have a great deal of stress and anxiety over their financial situations. They react to this stress and anxiety in a variety of different ways — unfortunately among them is denial, paralysis, and sticking their heads in the sand. 

It doesn’t have to be so. I hope that the main thing you come away with from this series is that you can be proactive; you can maintain control over your life even in the worst of times.

This is the fourth and final part of a four-part series on “Surviving the Recession.” Today’s installment has 16 tips to help you regain control of your finances, your emotional life, and your relationships. Yesterday’s post, “Surviving the Recession, Part 3: 15 Things You Can Do to Regain Control” has 15 more tips, for a total of 31. 

The tips are presented in no particular order. They come from over 20 different sources, each with a particular point of view. There may be some overlap, there even may be some contradictions, but there is a wealth of good advice among them. 

Be sure to read the first and second parts of this series. The first, “Surviving the Recession, Part 1: What It’s Doing to Us,” discusses the effects of financial crisis on Americans under these subject headings:

• How are people handling the recession?
• Women in particular are stressed by the economy
• What the recession and economic worry are doing to us

“Surviving the Recession, Part 2: Anxiety, Harmful Behavior, and Paralysis” is the second part of the series, and deals with how the recession is affecting our mental health. It covers the topics:

• Economic stress and mental disorders
• Excessive worry may lead to Generalized Anxiety Disorder
• If you’re stressed out, anxious or depressed, avoid turning to harmful behavior
• Paralyzing yourself: Denial and catastrophizing

Tip #16: Recognize how you deal with stress related to money

It is important that you take stock of yourself and your behavior during these tough economic times. Stress and anxiety caused by money can lead you into activities that generate even more stress and anxiety. For example, it is all too easy to try to relieve stress by turning to unhealthy activities like smoking, drinking, gambling or emotional eating. 

In addition, money stress can change the way we relate to other people. We might become secretive, or defensive, or even completely incommunicative. The strain can also lead to more conflict and arguments between spouses, partners, and family members.[1] 

Be alert to these behaviors — if they are causing you trouble, consider seeking help from a mental health professional or community mental health clinic before the problem gets worse.[2]

Tip #17: Pause but don’t panic

There are many negative stories in newspapers and on television about the state of the economy. Pay attention to what’s happening around you, but refrain from getting caught up in doom-and-gloom hype, which can lead to high levels of anxiety. It is all too easy to overreact, panic, and make bad decisions. At the other end of the spectrum, avoid the tendency to deny your problems or to become passive.[3]

Above all, avoid becoming fearful, which can make you do things without thinking about them properly. Brian Jones, a financial planner and vice president of CJM Wealth Advisers in Fairfax, Virginia, says:[4]

Fear is a very powerful motivator, but you should never make a financial decision in the heat of the moment or during an emotionally charged period of time.

Remain calm and stay focused. If you are too stressed out and anxious to make decisions, it’s ok to step back from the situation and take a breather. While it’s important to make plans and take action, there are times when pausing to catch your breath is the best thing you can do.

Tip #18: Turn these challenging times into opportunities for real growth and change

Times like these, while difficult, can offer opportunities to take stock of your current situation and make needed changes. Think of ways that these economic challenges can motivate you to find healthier ways to deal with stress.[5]

Try taking a walk—it’s an inexpensive way to get good exercise. Having dinner at home with your family may not only save you money, but help bring you closer together. Consider learning a new skill. Take a course through your employer or look into low-cost resources in your community that can lead to a better job. The key is to use this time to think outside the box and try new ways of managing your life.[6]

Tip #19: Take the opportunity to better understand your investments

If you have investments, use the current economic situation to better understand them and make decisions for the future. But do not make any rash decisions right now, such as selling your stocks, which will only lock in losses.

Questions you might ask yourself and actions you might take are:[7]

• Better understand what kind of investor you are and need to be. Are you: conservative? risk-taking? What part of life are you in and how does your investing strategy match what you need to be doing?
• Build a better portfolio. Is your portfolio balanced properly? Do you have 90% of your portfolio in stocks? Or are you overloaded with bonds? What kind of balance do you want and need not only now, but in the future?
• Research the funds you own and use this knowledge to fully understand what you own rather than always counting on an “expert” — you’ll build confidence and feel better.
• If your 401(k) is your only savings consider a balanced approach: part stocks, part bonds. Look at the different ways to invest your 401(k). Learn about the stocks and bonds that you have invested in. If you do the research, you’ll feel much better about your future.

Review what you have with your spouse or partner, make decisions for your own time horizon, and you’ll sleep better at night.

Tip #20: Create a pool of certainty in your life

Nobody likes uncertainty. It makes us uncomfortable in the best of times. And in the current economic crisis it is easy to have your faith in the things you hold most certain shaken. Finding and building on the certainties in your life will go a long way toward relieving your day-to-day stresses and anxieties.

Examine your life to find out what the bedrock values and activities are that serve to create certainty for you. Look at your values to ensure that the life you lead is the life you want.

Determine what the anchors of certainty are for your life, for example:

• Is it your family? Then maximize the time and the quality of interaction with them.
• Have you kept up with your friends the way you want to?
• How about personal development? Have you set it aside for more “urgent” things?
• Is there an organization, such as a church or charity, that you want to devote more time to?
• Do you have a neglected hobby or favorite pastime?

The list could go on and on; you probably have more in mind right now. The one thing that they all seem to have in common is that they cost little or no money to cultivate. That’s the irony of the current financial mess: as they say, the best things in life are free!

Tip #21: Short-term plans may be better than long-term at this time

As you are reassessing your values and goals, take a close look at your long-term plans. They have the benefit of making you stay focused, but they have the drawback of limiting your vision and causing you to rule out lots of possibilities as they come along.[8]

Slavish adherence to long-term plans gets us attached to specific outcomes, when it’s possible that other outcomes we haven’t explored would be even better. Consider whether your long-term plan is actually keeping you from actuating your values by being too rigid. In a world that is constantly changing financially, technologically, and in every other way, you could miss out if you are chained to a long-term plan.

It is said that we over-estimate what we can achieve in 1 year and we under-estimate what we can achieve in 5 years. If that is the case, we are limiting ourselves by creating a 5-year plan, much less a 10-year plan.[9]

Think about making your long-term plans much shorter to take advantage of new possibilities and opportunities that are constantly presenting themselves. Would a better “long-term” plan be 2 years? 1 year? 9 months? And in the current recession, which is already easing up, it might be folly to commit yourself to a 5- or 10-year plan when things are changing so rapidly.

Only you can determine whether a shorter plan meets your needs and your level of comfort — but it’s something to think seriously about.

Tip #22: It’s ok to fail — it just means you are taking action

When our financial decisions are so crucial to the well-being of our families, it is easy to fall into the error that we cannot afford to make a mistake. Ironically, this attitude leads to indecision, denial, and paralysis: if you can’t afford to make a mistake, maybe it’s better if you do nothing at all.

There are a thousand quotations that urge taking action, even a wrong action. One of my favorites is by the American essayist and poet Ralph Waldo Emerson:

Don’t be too timid and squeamish about your actions. All life is an experiment. The more experiments you make the better.

In the current financial situation, no one can really know what the future will hold. All we can know is what is at our feet in this journey called life. Every step we take, no matter how well thought out, no matter how well-planned, is in its essence an experiment. And experiments fail just as often as they succeed.

All we can do when we fail is to pick ourselves up and use the failure as an opportunity for growth — and for taking yet another experimental step.

You cannot get away from the fact that every step you take is experimental. All you can do is to accept the fact, or try to deny it by insisting that every action you take must be error-free.

Tip #23: Average is better than nothing: Avoiding perfectionism

Some people are prone to being perfectionists, particularly people with one of the Anxiety Disorders. They want every little “i” to be dotted precisely and every “t” crossed exquisitely. They want their plans and actions to take in every bit of information possible.

Unfortunately, perfectionists don’t live in the real world. It is impossible to have digested every piece of information or considered every option before acting — to think that you can is just setting yourself up for failure and disappointment. And more stress and anxiety.

Perfectionists know this in their heart-of-hearts, and often are the biggest procrastinators and do-nothings on the block. To take no action is mistaken as taking no incorrect action, when taking no action is a choice itself. It goes almost without saying that such an attitude leads to yet more anxiety and stress.

Cass Grange, a senior adviser associate at Lucien, Sterling & Gray Advisory Group in Austin, Texas says that, “One of the problems is the sheer volume of information out there.” Some people have trouble taking action because they’re convinced that out of all the available options, they are going to find the “perfect” one. She continues:[10]

I would argue that [an average outcome] is better than nothing, You don’t have to get too complicated; just do something.

Tip #24: Don’t be embarrassed to ask for a financial advisor’s help

One of the big problems people face in this recession is embarrassment, particularly if they have lost their jobs or have experienced a big financial reversal. What used to be chump change is the sum total of their unemployment checks. They are struggling to feed their families and keep a roof over their heads, perhaps for the first time in their lives. They don’t know where to look for help.

But embarrassment is not reserved only for those fallen upon hard times. Many of us find we are over our heads when we try to get a handle on our finances. Perhaps we are not good with numbers, or don’t understand our options. Maybe our finances are in such a mess that we don’t know where to start. Or maybe we’re embarrassed that we are not doing as well as the guy next door, or our sister, or our parents. 

Asking for help with finances when you are embarrassed is very hard to do. We think that the financial advisor will look down on our slim wallets, our financial mess, or consider us losers for the shape we are in. Cass Grange says:[11]

One hang-up people have is they’re ashamed that they’re not more organized with their money and feel too embarrassed to contact a professional adviser. But a good adviser won’t be criticizing you, even if you bring in all your statements stuffed in a brown paper bag.

Tip #25: Ask for professional help

It would be nice if we had all the resources within ourselves to cope with the stress, anxiety, fear, and uncertainties of this financial crisis. But we don’t. Not one of us.

Americans are taught from the cradle to rely on ourselves, to be independent, to grit our teeth and power through every storm. We just aren’t very good at asking for help.

But we all need help from time to time. In the financial realm, it is a simple fact that not everybody is good at researching, planning, and executing a good money plan. Credit counseling services, tax advisors and financial planners are available to help you take control over your money situation. They do not work for free, but you will find that what you gain in self-assurance and peace of mind will more than offset their fees.[12]

If you continue to be overwhelmed by stress and anxiety, or you are involved in unhealthy behaviors in an effort to cope, you may want to talk with a mental health professional. They can help you address the emotions behind your financial worries, better manage stress and change unhealthy behaviors. Mental health professionals are experts trained to understand the connection between the mind and body as well as the factors that promote behavior change.[13]

Tip #26: Take care of the emotional needs of your family

It’s easy to neglect your family when you’ve just lost your job, or you have had to take a big cut in pay. The stress and anxiety you feel is felt by them, too. Tensions mount, you and your spouse argue, and the kids break into tears.

Be sure to continue to demonstrate your love and appreciation to loved ones. Hold a family meeting to discuss the situation and to agree on things each one can do. Sort out resentments, angers, and fears. It is much easier to bear a burden when it is shared with your family.

There are many activities that you can do with your family without spending any money. You could:

• Write simple, thoughtful notes
• Have a candlelight dinner with a toast to them
• Make a CD of your partner’s favorite songs
• Go on a picnic in a local park
• Have a “movie” night with popcorn in front of the TV

Avoid adding to the general aggravation with your own issues that are not really that important. Stay focused on what matters to keep the home free of stress.[14]

Tip #27: Take care of the emotional needs of your children

Often we think that the stress and anxiety of big financial changes are the province of you and your spouse or partner. You wait until the kids are in bed to discuss finances. No matter how successful you think you are in keeping the bad news away from them, children will know that something is not right, and that mom and dad are very upset.

The children will not understand, and will think that they have done something wrong. They will transfer your fear, stress, and anxiety into their world where it will become acting out, bad grades, bedwetting, and a host of other ways that children have of expressing emotional upset.

The very first thing — not the last thing — you should do is to involve your kids. Include them in family meetings, and get everyone’s opinion on how to save money. Look upon this as an opportunity to prepare your children for the real world and to set an example of how to take charge of your money.[15]

Work on your own stress and anxiety, but don’t try to hide it from the kids — they will know something is wrong. Reinvigorate your efforts to show your love and attention to your children. Do not, among all your cares and woes, ignore them or take your frustration out on them.

Tip #28: Take charge of your job

Many people in this recession have lost their jobs, and many more fear they will lose them or have their pay cut.

Now is not the time to hide away, hoping that the axe will not find you, but to showcase yourself. Demonstrate your value to the company’s bottom line. If you’re not in a position that creates or saves money, offer to take on a job (even if it’s extra duties) of a position that does. 

Most importantly, position yourself for the next big thing. If you’re a banker, move into workouts. If you’re in manufacturing, become the “savings chief.” If you are in sales, learn about new products outside your range of expertise.

Take advantage of job retraining in your local college or trade school. One ex-executive is going through training with gang kids in L.A. to learn about solar panels. He intends to start a business hiring his former “classmates.”[16]

Tip #29: Ignore your amygdala

The amygdala, the almond-shaped group of neurons in the limbic system of the brain, is considered by most neurobiologists to be the seat of our fear system. It is a very primitive part of the brain, and acts like an ape or a human would have acted, say, back when we still had lots of hair all over.[17]

The adrenaline that you are feeling when you see the stock exchange plummet is the amygdala going into fits, spreading fear to every part of your body. It gets you ready for what is called the “fight or flight” reaction. The problem is that stress and anxiety keep the amygdala in a constant state of alert, draining you of energy — both physical and emotional.

Knowing and being aware of your “fight or flight” status will help you learn to calm down and control it better. There are many ways to control the overreactions of your amygdala, such as:

• Take slow, deep breaths
• Reassure yourself that what you are feeling is just your amygdala overreacting
• Relax your muscles by shaking your arms or legs. If you can’t do this, flex and relax the muscles in your arms and legs.
• If you are hyperventilating or over-breathing, try to hold your breath as long as you can to prevent the dissipation of carbon dioxide.

You can’t really ignore your amygdala, but you can take steps to reduce its impact on your life.

Tip #30: Distract yourself

The stress, fear, and anxiety of the financial crisis can take over your life. You need to get away from it, to occupy your mind and body in some way to give them a break from worry.

There are many ways to distract yourself — you know the best ways. For some people it is a hobby, for others bad TV movies, and for yet others, yard work.

My mother knitted. After her two open heart surgeries and the death of my father, she knitted continuously. For many years on every occasion that called for a gift, she would present an afghan, a sweater, or a scarf. People got tired of them (we have a closet-full that we just can’t give away), but we all understood that she was knitting as a way to distract herself from the physical and emotional pain she was experiencing. I can say without hesitation that knitting added many years to her life.

Tip #31: Trust yourself

In the final analysis, you will have to trust yourself to come out of this financial crisis relatively unscathed. That doesn’t mean that you won’t face economic hardship, but that you will come out on the other side stronger and without emotional scarring.

Trust and confidence in yourself can be built. Looking the situation square in the face, realistically planning and executing your plans will give you trust in yourself. Even when you fail — and you will from time to time — self-trust will help you pick yourself up, dust yourself off, and keep trying.

Focus on building trust in yourself rather than giving in to the effects of stress and anxiety. Look at the economic crisis as a way of making yourself stronger and more fit to take the opportunities that come your way. Build trust in yourself that you can face any obstacle and get past it unharmed.

You know that the recession will run its course, and the country will be back on its feet again. The trust you build now will make you a better and more emotionally fit person when it does.

Be sure to read the other parts of the series!

This is the fourth and last part of a four-part series on “Surviving the Recession.” Yesterday’s post, “Surviving the Recession, Part 3: 15 Things You Can Do to Regain Control” has 15 more tips, for a total of 31. 

Be sure to read the first and second parts of this series. The first, “Surviving the Recession, Part 1: What It’s Doing to Us,” discusses the effects of financial crisis on Americans under these subject headings:

• How are people handling the recession?
• Women in particular are stressed by the economy
• What the recession and economic worry are doing to us

“Surviving the Recession, Part 2: Anxiety, Harmful Behavior, and Paralysis” is the second part of the series, and deals with how the recession is affecting our mental health. It covers the topics:

• Economic stress and mental disorders
• Excessive worry may lead to Generalized Anxiety Disorder
• If you’re stressed out, anxious or depressed, avoid turning to harmful behavior
• Paralyzing yourself: Denial and catastrophizing

What do you think?

Whew! This series is finally finished! It’s the biggest undertaking to date here at Anxiety, Panic & Health. In total, it contains 14,298 words and 84 footnotes — enough for a small book. It has taken almost 40 hours to research and write the series. The things that immediately come to mind are the questions:

• Did the series have to be so long? Could I have left out material and still have the same authority and impact?
• Should I have split the sections — especially the tips — even further to aid readability? The tips might have been better as 3 parts.
• Are the tips too wordy? I wanted each to be able to stand on its own, so often found myself saying some of the same words in some.

If you have any thoughts on these questions and others I should have asked myself, I would really appreciate if you were to leave a comment or use the contact form at the top of the page to email me privately.

Now, for the usual questions:

• Which is your favorite tip today?
• Do you disagree with any of the tips presented?
• Could you add any tips of your own?

Artwork by Andy Warhol. “Dollar Signs,” 1981. Silkscreen on canvas.

©2009 Anxiety, Panic & Health. All rights reserved.

As always, your comments are welcome!

If you have enjoyed this post, please consider subscribing to this blog, either via RSS or email at the top of your screen. It’s free! You can also follow me on Twitter from the same place. I would also appreciate your sharing this post using your favorite social media, such as StumbleUpon or Digg. Just click the little green “ShareThis” button at the bottom of this post.

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FOOTNOTES
1. Molitor, Nancy; Staff of American Psychological Association. (2008, December). Managing Your Stress in Tough Economic Times. Retrieved April 10, 2009 from http://www.apahelpcenter.org/articles/article.php?id=171 ↑
2. Molitor, Nancy; Staff of American Psychological Association. (2009, April) Economic Worries Tax Out Americans as April 15 nears. Retrieved April 10. 2009 from http://www.apahelpcenter.org/articles/article.php?id=174 ↑
3. Molitor, Nancy; Staff of American Psychological Association. (2008, December)↑
4. Staff of the Anxiety Disorders Association of America. (2009). How to Survive Tough Economic Times and Manage Your Anxiety. Retrieved March 25, 2009 from http://www.adaa.org/gettinghelp/MFarchives/EconomicTimes.asp ↑
5. Molitor, Nancy; Staff of American Psychological Association. (2008, December)↑
6. Molitor, Nancy; Staff of American Psychological Association. (2008, December)↑
7. Staff of Just a Guy Thing. (2009). 5 Keys to Recession Proof Your Anxiety. Retrieved April 17, 2009 from http://www.justaguything.com/5-keys-to-recession-proof-your-anxiety/ ↑
8. Duncan, Cath. (2009, April 23). Tips for Agile Living. Retrieved April 23, 2009 from http://www.adaringadventure.com/blog/wordpress/business-coaching/tips-for-agile-living/ ↑
9. Duncan, Cath. (2009, April 23)↑
10. Lindner, Sarah. (2009, March 31). Feeling financial anxiety? Take some steps in the right direction. Retrieved April 16, 2009 from http://www.statesman.com/life/content/life/stories/other/08/31/0831guide.html ↑
11. Lindner, Sarah. (2009, March 31)↑
12. Molitor, Nancy; Staff of American Psychological Association. (2009, April)↑
13. Molitor, Nancy; Staff of American Psychological Association. (2008, December)↑
14. Staff of Just a Guy Thing. (2009)↑
15. Staff of Just a Guy Thing. (2009)↑
16. Staff of Just a Guy Thing. (2009)↑
17. Borchard, Therese J. (2009, February 1). Recession Anxiety: 8 Tips to Manage Financial Stress. Retrieved April 17, 2009 from http://psychcentral.com/blog/archives/2009/02/01/recession-anxiety-8-tips-to-manage-financial-stress/ ↑


Related Posts:

• Surviving the Recession: Announcement
• Surviving the Recession, Part 3: 15 Things You Can Do to Regain Control
• Surviving the Recession, Part 1: What It’s Doing to Us
• Surviving the Recession, Part 2: Anxiety, Harmful Behavior, and Paralysis
• 5 Interesting Articles for You: Your Occasional Reader

Artwork by Andy Warhol

The current economic crisis has been a disaster for many individuals and families, to say the least. 

As has been pointed out in Parts 1 and 2 of this series, the recession is causing almost unbearable stress and anxiety to untold millions of Americans. For some, it is pushing them into harmful behaviors and mental illness. Yet, however bad your situation is, there are things you can do to help alleviate some of the stress and anxiety it is causing you.

This is the third part of a four-part series on “Surviving the Recession.” Today’s installment has 15 tips to help you regain control of your finances, your emotional life, and your relationships. Tomorrow’s post, “Surviving the Recession, Part 4: 16 More Things You Can Do to Regain Control“ has 16 more tips, for a total of 31. 

The tips are presented in no particular order. They come from over 20 different sources, each with a particular point of view. There may be some overlap, there even may be some contradictions, but there is a wealth of good advice among them. I hope that the main thing you come away with is that you can be proactive; you can maintain control over your life even in the worst of times.

Be sure to read the first and second parts of this series. The first, “Surviving the Recession, Part 1: What It’s Doing to Us,” discusses the effects of financial crisis on Americans under these subject headings:

• How are people handling the recession?
• Women in particular are stressed by the economy
• What the recession and economic worry are doing to us

“Surviving the Recession, Part 2: Anxiety, Harmful Behavior, and Paralysis” is the second part of the series, and deals with how the recession is affecting our mental health. It covers the topics:

• Economic stress and mental disorders
• Excessive worry may lead to Generalized Anxiety Disorder
• If you’re stressed out, anxious or depressed, avoid turning to harmful behavior
• Paralyzing yourself: Denial and catastrophizing

Tip #1: Turn off the TV and radio. Put down the newspaper and the news magazine. 

Take a break from the bad news, especially if it adds to your fear and anxiety. Remember that the news media thrives on sensationalism, and that this is a boom time for headline writers. Psychologist Katherine Nordal, PhD, the American Psychological Association’s executive director for professional practice says. “Pay attention to what’s happening around you, but refrain from getting caught up in doom-and-gloom hype.”[1]

One of the worst things you can do for the fear system in the brain is to keep the TV and radio tuned into the latest news on the recession and to keep checking CNN.com to find out what the newest grisly Wall Street number is. This kind of compulsive behavior is toxic for people who are prone to stress and anxiety — even without a reporter telling them to run for cover.[2] 

And Cass Grange, a senior adviser associate at Lucien, Sterling & Gray Advisory Group in Austin, Texas, states:[3]

We’re daunted by news reports. The news media make it appear so grim out there. I’m not saying people should not listen to the news, but you need to have a longer-term perspective.

Tip #2: Determine if immediate action is required

When you act now to plan for this national emergency, you can avoid the pitfalls of procrastination, denial, and panic. Hold a family meeting to work on a plan to ride the recession through. Look at your finances realistically and clearly without panic. There probably are several things you can do to tune up your finances. For some, drastic action is called for. For others, only watchful caution is required. 

Whatever you decide to do, it will cut stress and anxiety greatly, even if your situation is dire. 

Sally Winston, PsyD, co-director of the Anxiety and Stress Disorders Institute of Maryland advises:[4]

Make a plan, whether it’s to call a financial adviser, delay vacation plans, or even to do nothing for right now. Then let your worries take a back seat to the plan and the rest of your day.

Tip #3: Control what you can control, and don’t worry about things you can’t control

The most uncomfortable part of a Wall Street crash or economic recession is the lack of control most of us feel. It’s contrary to our human psychology. 

We want to drive the car, or at least be the passenger in the front seat giving directions. But in an economic downturn, we’re not even in the car.[5] Nicholas Yrizarry, an adviser with Nicholas Yrizarry & Associates in Reston, Virginia flatly tells us that, “You can’t control what’s going on today” in the larger economy.[6]

This lack of control tempts us to just give up, to sigh, “Why bother?” To combat those feelings, Cass Grange recommends that we:[7]

Concentrate on the things you can control — like saving more money or paying off debt. The antidote to fear is action. If you even take small steps, you’re going to feel more in control of your money.”

Tip #4: Put things into a broader perspective

It’s easy to panic when faced with the current economic crisis, especially if you have no plans to confront it. But acting out of panic almost guarantees unwise choices. Instead, you should base your decisions on calm, rational thinking. To be a solid, workable plan, each element will need to be thought through and prioritized, so the whole is more than the sum of its parts.

The most important thing to do is to start working on your financial plan right away, if you haven’t already. As you encounter each situation, ask, “What’s the worst that can happen?” and “What is the best that can happen?” Will you merely be uncomfortable? Will bills go unpaid? Will you lose your house? Keep asking questions until you are satisfied you have the right answer.

Without asking these hard questions, you can have no realistic sense of the reliability of your answers, as well as the priority each situation must take within your financial plan.[8] 

Tip #5: Think in the long term 

Always remember that even the Great Depression was eventually over. This recession is already showing signs of easing, and even the most pessimistic pundit predicts it will be largely over within a year or so.

When it comes to your finances, unless you’ve recently lost your job or you are close to retirement, think in the long term. [9] The measures that you are taking today to keep afloat in this economic storm will not always be necessary. When planning, don’t just stop at the measures necessary to make it through the next few months. Work on your long-term goals, realizing that the recession is just a glitch in your 5- or 10-year plan.

Tip #6: Take the opportunity to simplify your life

Over the years, it’s easy to accumulate both physical and mental junk in our lives. It piles up everywhere, in every corner, in every closet. Rather than think about how much a disruption the recession is causing, look on it as an opportunity to clear away this junk from all corners of your life.

The easy steps are those involving physical junk. The great thing about physical de-junking is that it can be turned into money through:

• A yard sale
• eBay or CraigsList
• A consignment shop
• Barter with a friend or neighbor for something you need
• A donation that you can get a tax deduction for

For each physical item you examine, ask the following questions:[10]

• Have I used this item recently?
• Does this item help me in my life’s goals?
• Do I need to own this item? Or is there a way that I can rent, borrow or improvise the function of this item when I need it?

Other tips for physical de-junking are:[11]

• Work on a small area at a time. Trying to de-junk large areas can be discouraging.
• Consider disposing of extra versions of items that you only use or wear one at a time.
• Dispose of items that you accumulate, but can get more of, such as cardboard boxes and plastic bags.
• Pay particular attention to getting rid of items that are useful, but not in the quantity you may have accumulated.
• Rethink your choice of owning structures that hold items, such as shelves, dressers, wardrobes, and storage buildings.

De-junking your mind is another matter entirely. Typically, it’s full of outmoded attitudes, bad decisions clung to, unexamined goals and values, and other things that are getting in the way of your inner peace and balance. Take the time to really think about yourself and your life. Examine everything, no matter how small. Work on your values and your goals for yourself. There are many ways to do this — far beyond the scope of this article — but there are many, many sources of help online, or that you already know about and have put off until a “better day.” Today’s that day!

With all your de-junking, don’t forget your quality of life. Many times, in fits of desperation or misplaced virtue, we back a dumpster up to the door (physical or mental) and just start tossing without considering what kind of life we will live without all that junk. Remember that real peace of mind comes both from keeping those things that are valuable, and discarding those things that are not.

Rather than repeat myself, you might be interested in a guest post I wrote for the Time Goes By blog entitled “Getting Rid of the Junk.” It goes into detail how we have been de-junking our lives, but holding the quality of our lives as the number one thing we consider as we do so. 

Tip #7: Think conservatively about your investments

There are times in our lives when it pays to think conservatively about our investments, such as when we are nearing or are in retirement. In these times, you may also be concerned about your investments if you are worried about your job or financial security.

It’s not the time to sell everything and stuff the money in your mattress! But it might be time to talk to your financial advisor about diversifying your portfolio to include more low-risk investments that will minimize the impact of a struggling market economy.[12]

Tip #8: Stay healthy in body and mind

It almost goes without saying that anxiety and stress are made worse when you’re not taking care of your body and your mind. We overeat, or eat the wrong things. We don’t get enough exercise. Our sleep patterns are disrupted with either too much or too little sleep. We cram our lives so full of “things” that we don’t have any opportunities for personal time.

But getting enough sleep, eating healthy, exercising, and allowing for personal time will help clear your mind of negative thoughts. If you are exhausted — physically or emotionally — it will be more difficult for you to handle stress and anxiety.[13]

In this recession, many people are turning to comfort food to, well, comfort themselves in the middle of all this anxiety and stress. Don’t let this time of tension expand your waistline — more weight gain means even more stress. It’s a well-known fact that candy and snack companies are almost recession-proof. People will buy snacks before they buy more healthy food![14]

Healthy exercise need not be expensive. A simple walk regularly will do wonders for your stress. There are shelves full of exercise books at your library that will teach you how to exercise at home using common items like chairs, canned foods for weights, and isometric exercises that require no props at all. Commit to regular exercise for at least 30 minutes a day. If you’re likely to ignore it at the end of the day, do it at the beginning and feel great knowing you started the day off right. Take a walk regularly with a friend or your spouse; it will be good for both of you. [15]

Too often we let the tensions of the day get in the way of taking personal time for ourselves. But your mind’s equilibrium is more important than ever to maintaining a positive, productive attitude. Carve out some time for yourself each day, even if it is only 15 minutes. You’ll feel much better for it. 

Tip #9: Talk to someone 

In these stressful times, we often try to go it alone, either from a misplaced feeling of independence, or shame over being in a financial bind. Cass Grange, a senior adviser associate at Lucien, Sterling & Gray Advisory Group in Austin, Texas says that we can feel a lot of shame and guilt around our money issues, and that can make us secretive. She continues:[16]

Aloneness is one of the greatest contributors to financial fear. People feel they have no one to talk to about this.The first step to getting a handle on your finances can be opening up about them to someone you trust, whether that’s a financial pro or your spouse if the two of you aren’t already communicating about money.

Being secretive or going it alone can be very harmful to your mental health, building stress and anxiety with no way to relieve the pressure. Psychologist Katherine Nordal, PhD, the American Psychological Association’s executive director for professional practice advises:[17]

Reach out to family, friends and trusted advisors. Research shows that receiving support from others is effective in managing stress. If you continue to feel overwhelmed by stress, then consider seeking professional help.

And don’t try to make major financial decisions alone. You may think that you can’t afford professional help, but it can be the best money you ever spent. “If you do have questions, or if you feel paralyzed by fear, go talk to someone who does this for a living,” says Brian Jones, a financial planner and vice president of CJM Wealth Advisers in Fairfax, Virginia. He advises asking friends and family which financial planner they use and recommend if you don’t already have one.[18]

If you’re feeling overwhelmed, stressed out and anxious, it may be time to talk to a mental health professional. They are trained to help you deal with these issues and put your life back into perspective.

Tip #10: Start small, but start somewhere

One of the first reactions many people have had to the recession is paralysis: They don’t know what to do, so they do nothing. Of course, this can be disastrous, not only to your financial situation, but to your stress and anxiety levels. Others panic and try to do everything at once, another recipe for disaster.

The best approach when you are confused and paralyzed is just to start somewhere. Start small, but start somewhere. Dr. Stephanie Smith, a Colorado psychologist, says that:[19]

Many of us bury our heads in the sand because our finances are so overwhelming. This can just make the problem — and ultimately our anxiety about the problem — worse. Start small and start somewhere. Think of this recession as an opportunity to evaluate your financial situation and money habits and figure out ways to change.”

Tip #11: Come up with a short-term plan with small, manageable steps

One of the mistakes that people make during this finite economical crisis is to try to make a huge 5- or 10-year plan for their finances and their lives. Rather, you should focus on a short-term plan to tide you over for the next year or so, and revisit it regularly to revise and adapt it to circumstances as they happen.

Terry Diebold, president of the Virginia Association for Marriage and Family Therapy in Fredericksburg, says that:[20]

[People] need to sit down and look at their finances and be realistic. Remember that this is not going to last forever. So what you need to do is come up with a short-term plan. Think, “How are we going to get through the next year?” instead of `This is going to go on forever.”

And while focusing on the next year, divide your action plans into achievable steps instead of radical, giant steps. Dan Abrahamson, assistant executive director for state advocacy at the American Psychological Association, advises you to:[21]  

Break [your financial plan] down to small, manageable steps. You have to make some moderate steps that might begin to change the economic landscape for you.

Tip #12: Be here in the present, not in the future or the past

Garth Mintun of SelfGrowth.com advises us to:[22]

Be here in the present now! Look at the situation right now. Are you breathing? Do you have food on the table and a roof over your head today? If the answer to those questions is “Yes,” reality is kinder than your imagination.

Do not moan and reminisce over the “good old days.” They are gone forever, for good or ill, and can only serve to harm you in the present. The stress and anxiety of today are sufficient to keep you occupied!

The stress of imagined future fears or anxieties may cause you to overindulge in food, alcohol, chemical substances, shopping, gambling or a host of other compulsive activities to numb you from feeling the pain of the current moment. If allowed to continue, it can make you physically weaker from the stress — and then you will have new problems to worry about! All this is unnecessary if we stay with the reality of the present.

Focus on what can be done, and not on what has been or what could be. Become proactive and plan for the future without scaring yourself about the future. Look realistically at your financial situation, and manage problems with your health and your prized relationships in the here and now. 

Be interested and curious about your process of “catastrophizing” and exaggerating the future. Try to catch yourself in those dire thoughts and fantasies, and notice that in the present those events and circumstances simply are not in your life. Remind yourself the future is still unknown. Name your projections into the future so you can begin to distinguish the present from future fears. Remember your own history of overcoming adversity and take stock of the wisdom of your life experience.[23]

Tip #13: Identify your financial stressors and make a plan

Knowing yourself is more than just a path to inner peace. It’s a way to know your tolerance for financial risk and uncertainty. It’s also a way to know what causes you the most stress about your financial situation.[24]

Take stock of your particular financial situation and what causes you stress and anxiety. Write down specific ways you and your family can reduce expenses or manage your finances more efficiently. Then commit to a specific plan and review it regularly.[25]

Although writing your financial plan can be daunting and anxiety-provoking in the short term, putting things down on paper and committing to a plan can reduce stress. If you are having trouble paying bills or staying on top of debt, reach out for help by calling your bank, utilities or credit card company.[26]

Tip #14: Examine your financial priorities

If you have developed a plan for your finances, it is time to examine it for what it shows about your priorities — not only financial priorities, but your life priorities, as well. Does the plan take you where you want to go in life? Are the actions required by the plan in accord with your values and life goals? If not, you need to take a serious look at that plan to make sure you are not taking drastic steps in the present that you will regret in the future.

Are your financial priorities and money goals matching up with your spending habits? Are they in accord with your short-term financial plan? Dissonance between your plan and the way you are executing it can be a source of anxiety and conflict, especially between spouses or partners.[27]

Tip #15: Realize that your situation is unique, and not the same as your parents

Many of us have parents or grandparents who lived through the Great Depression. If you don’t, then it’s easy enough to find first-hand accounts on the front page of almost any newspaper.

I distinctly remember the tales of want and privation that my parents told of their lives during the Depression. And my in-laws, in their late 80′s, never miss an opportunity to impress on me the financial lessons they learned during that time.

Frankly, I feel a great deal of shame that I haven’t heeded their advice. I speculate whether not listening to them has gotten my family into a financial pinch. And those stories generate a fear that those terrible days will become real here in the present.

I have to keep reminding myself that the current situation is entirely different from the days of the Depression. More importantly, my family, our finances, and our goals and values are very — maybe even radically — different than theirs.

Trying to graft our parents’ advice and cautions onto our family’s lives only leads to a great deal of stress and anxiety. As much as it makes us feel that we are in some way rejecting them, we have had to decide to go our own way, the way that feels best to us. This in itself creates stress, but it is small in relation to trying to live your life with someone else’s values.

Be sure to read the other parts of the series!

This is the third part of a four-part series on “Surviving the Recession.” Tomorrow’s post, “Surviving the Recession, Part 4: More Things You Can Do to Regain Control” has 16 more tips, for a total of 31. 

Be sure to read the first and second parts of this series. The first, “Surviving the Recession, Part 1: What It’s Doing to Us,” discusses the effects of financial crisis on Americans under these subject headings:

• How are people handling the recession?
• Women in particular are stressed by the economy
• What the recession and economic worry are doing to us

“Surviving the Recession, Part 2: Anxiety, Harmful Behavior, and Paralysis” is the second part of the series, and deals with how the recession is affecting our mental health. It covers the topics:

• Economic stress and mental disorders
• Excessive worry may lead to Generalized Anxiety Disorder
• If you’re stressed out, anxious or depressed, avoid turning to harmful behavior
• Paralyzing yourself: Denial and catastrophizing

What do you think?

A total of 31 tips for you! I really got carried away, but there is so much good material that I hated to hold any of it back. I hope they are of use to you, and you enjoy reading them as much as I have enjoyed researching and writing them.

• Which is your favorite tip today?
• Do you disagree with any of the tips presented?
• Could you add any tips of your own?

Artwork by Andy Warhol. Dollar signs, 1981. Silkscreen on canvas.

©2009 Anxiety, Panic & Health. All rights reserved.

As always, your comments are welcome!

If you have enjoyed this post, please consider subscribing to this blog, either via RSS or email at the top of your screen. It’s free! You can also follow me on Twitter from the same place. I would also appreciate your sharing this post using your favorite social media, such as StumbleUpon or Digg. Just click the little green “ShareThis” button at the bottom of this post.

Related posts:

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FOOTNOTES
1. Bethune, Sophie; Brownawell, Angel. (2008, October 7). APA Poll Finds Women Bear Brunt of Nation’s Stress, Financial Downturn. Retrieved April 13, 2009 from http://www.apa.org/releases/women-stress1008.html ↑
2. Borchard, Therese J. (2009, February 1). Recession Anxiety: 8 Tips to Manage Financial Stress. Retrieved April 17, 2009 from http://psychcentral.com/blog/archives/2009/02/01/recession-anxiety-8-tips-to-manage-financial-stress/ ↑
3. Lindner, Sarah. (2009, March 31). Feeling financial anxiety? Take some steps in the right direction. Retrieved April 16, 2009 from http://www.statesman.com/life/content/life/stories/other/08/31/0831guide.html ↑
4. Staff of the Anxiety Disorders Association of America. (2009). How to Survive Tough Economic Times and Manage Your Anxiety. Retrieved March 25, 2009 from http://www.adaa.org/gettinghelp/MFarchives/EconomicTimes.asp ↑
5. Borchard, Therese J. (2009, February 1)↑
6. Trejos, Nancy. (2009, March 1). Fear, Stress, Anxiety: A Global Recession’s Personal Economics. Retrieved April 13, 2009 from http://www.washingtonpost.com/wp-dyn/content/article/2009/02/28/AR2009022800150.html ↑
7. Lindner, Sarah. (2009, March 31)↑
8. Staff of the Anxiety Disorders Association of America. (2009)↑
9. Staff of the Anxiety Disorders Association of America. (2009)↑
10. December, John. (2009). Live simple: Dejunk your home. Retrieved April 23, 2009 from http://www.december.com/simple/live/dejunkhome.html ↑
11. December, John. (2009)↑
12. Staff of the Anxiety Disorders Association of America. (2009)↑
13. Staff of the Anxiety Disorders Association of America. (2009)↑
14. Bachmann, Helena. (2009, April 11). Chocolate Sales: A Sweet Spot in the Recession. Retrieved April 23, 2009 from http://www.time.com/time/business/article/0,8599,1890565,00.html ↑
15. Staff of Just a Guy Thing. (2009). 5 Keys to Recession Proof Your Anxiety. Retrieved April 17, 2009 from http://www.justaguything.com/5-keys-to-recession-proof-your-anxiety/ ↑
16. Lindner, Sarah. (2009, March 31)↑
17. Bethune, Sophie; Brownawell, Angel. (2008, October 7)↑
18. Staff of the Anxiety Disorders Association of America. (2009)↑
19. Molitor, Nancy; Staff of American Psychological Association. Economic Worries Tax Out Americans as April 15 nears. (2009, April). Retrieved April 10. 2009 from http://www.apahelpcenter.org/articles/article.php?id=174 ↑
20. Trejos, Nancy. (2009, March 1)↑
21. Trejos, Nancy. (2009, March 1)↑
22. Mintun, Garth. (2009). Controlling Anxiety About the Economy. Retrieved April 10, 2009 from http://www.selfgrowth.com/articles/Controlling_Anxiety_about_the_Economy.html ↑
23. Mintun, Garth. (2009)↑
24. Borchard, Therese J. (2009, February 1)↑
25. Molitor, Nancy; Staff of American Psychological Association. (2008, December). Managing Your Stress in Tough Economic Times. Retrieved April 10, 2009 from http://www.apahelpcenter.org/articles/article.php?id=171 ↑
26. Molitor, Nancy; Staff of American Psychological Association. Economic Worries Tax Out Americans as April 15 nears. (2009, April)↑
27. Molitor, Nancy; Staff of American Psychological Association. Economic Worries Tax Out Americans as April 15 nears. (2009, April)↑


Related Posts:

• Surviving the Recession, Part 4: 16 More Things You Can Do to Regain Control
• Surviving the Recession, Part 1: What It’s Doing to Us
• Surviving the Recession, Part 2: Anxiety, Harmful Behavior, and Paralysis
• Surviving the Recession: Announcement
• Seven Myths About Stress That You Really Need to Know About

    

 

 

 

 

Artwork by Andy Warhol

The sustained economic tensions of the recession are taking a dire toll on Americans.

Stress and anxiety are now everyday demons threatening to overcome your life, rendering you helpless and hopeless.

In this climate, many Americans are finding that their stress and anxiety are growing to the point where they are more than annoyances, but real problems in and of themselves. We see more and more people self-medicating with alcohol and drugs. Others curl up in a ball of denial, hoping it will all just go away.

This series of 4 articles about surviving the recession offers an understanding of the situation that so many of us find ourselves in, as well as positive suggestions to help you regain control of your life and finances. 

Today’s installment details how stress and anxiety can tip you over into Anxiety Disorder or other mental illnesses, as well as leading to harmful behaviors. It covers these topics:

• Economic stress and mental disorders
• Excessive worry may lead to Generalized Anxiety Disorder
• If you’re stressed out, anxious or depressed, avoid turning to harmful behaviors
• Paralyzing yourself: Denial and catastrophizing

The final two installments, “Surviving the Recession, Part 3: 15 Things You Can Do to Regain Control,” and “Surviving the Recession, Part 4: 16 More Things You Can Do to Regain Control” is a list of proactive steps that you can take to regain control, not only of your financial situation, but your and your family’s lives. It will be published tomorrow.

Be sure to read yesterday’s installment, “Surviving the Recession, Part 1: What It’s Doing to Us.” It discusses what the recession is doing to us, and has the following sections:

• How are people handling the recession?
• Women in particular are stressed by the economy
• What the recession and economic worry are doing to us

Economic stress and mental disorders

Stress and anxiety causing serious mental illnesses

The level of stress caused by the economy is taking a dreadful toll on many Americans. It is causing them to experience more serious mental illnesses such as Anxiety Disorders and depression. And it is causing some with mental disorders that had been under control to rise up again. Alan A. Axelson, a Pittsburgh psychiatrist, says that many former patients are returning to him having relapsed, needing more therapy and medications to cope with their stress and anxiety. He also finds that first-time patients need more care to overcome their problems.[1]

Sarah Bullard Steck, a Washington therapist who also directs the employee assistance program at the Commerce Department says:[2]

The economy and fear of what’s going to happen is having a huge effect. People are coming in more with severe anxiety or more marital strife, some domestic violence, some substance abuse.

Psychologist Katherine Nordal, PhD, the American Psychological Association’s executive director for professional practice, states that:[3]

With the deteriorating economy dominating the headlines, it’s easy to worry more about your finances than your health, but, stress over money and the economy is taking an emotional and physical toll on America, especially among women.

Many say they are handling their stress well. Yet, people report more physical and emotional symptoms. If Americans continue to experience these high levels of stress for prolonged periods of time, they are at risk for developing serious illnesses.

In a March, 2009 Washington Post-ABC News poll, 57 percent of those surveyed said the nation’s economic condition is a cause of stress in their lives. More than a quarter said they had “serious” anxiety. The percentage of stressed-out people was higher among those who said their finances had suffered “a great deal” from the recession. Among this group, 83 percent said they were stressed, with 55 percent reporting serious anxiety.[4]

Unfortunately, many do not seek the help of a mental health professional. Rather, they ask primary physicians for medication, not therapy referrals, because they fear that employers will consider them unstable or resent counseling during work hours, says Allen J. Dietrich, a family doctor in Lebanon, N.H. He says he has to broach the subject of emotional stress gently because many come in with physical complaints like stomach upset or headaches, which are symptoms of stress.[5]

Nancy Molitor, a psychologist in Wilmette, Illinois says that:[6]

I’ve never seen this level of anxiety and depression in 22 years of practice, The mental health fallout has been far worse than after 9/11.

Excessive worry may lead to Generalized Anxiety Disorder

Warning signs of Generalized Anxiety Disorder

We all have mild anxieties and stresses, and actually need them to function and survive. But if you find yourself worrying about the economy and your finances for hours each day, to the point where you have difficulty sleeping or concentrating on other tasks, you may have Generalized Anxiety Disorder (GAD). GAD affects 6.8 million adults, or 3.1% of the U.S. population, in any given year. Women are twice as likely to be affected.[7] 

People with GAD experience persistent, excessive, and unrealistic worry about issues like money, health, family, or work for six months or longer. They know that their fears are irrational, but they don’t know how to stop the worry cycle, feeling it is beyond their control. 

Physical symptoms of GAD include fatigue, restlessness, difficulty sleeping, irritability, edginess, muscle tension, and gastrointestinal discomfort or diarrhea.

According to Sally Winston, PsyD, co-director of the Anxiety and Stress Disorders Institute of Maryland, some of her patients are also experiencing the following signs of excessive worry:[8]

• Checking online finances every hour
• Worrying about things that are not at risk, such as bank deposits that are insured by the Federal Deposit Insurance Corporation (FDIC)
• Worrying about standing in food kitchen or unemployment lines
• Watching TV for hours each day and hearing the same information over and over

In addition to GAD, chronic, untreated anxieties and stress can trigger or exacerbate other psychological or physical problems such as depression, substance abuse, gastrointestinal problems and coronary artery disease. So it is very important to address it seriously and as soon as you can.[9]

The good news is that even anxiety that feels out of control can be successfully treated with either short-term therapy, called Cognitive-Behavioral Therapy (CBT), medication or a combination of both.[10]

If you’re stressed out, anxious or depressed, avoid turning to harmful behavior

Harmful behaviors lead to future physical and emotional problems

The American Psychological Association (APA) cautions that, while the current economic climate may seem excessively difficult, relying on harmful behaviors to alleviate stress may contribute to physical and emotional health problems in the future. Dr. Nancy Molitor states that: [11]

It’s tempting to turn to bad habits, but stress and health are so strongly linked that it’s important for people to take care of themselves. Engaging in unhealthy behaviors usually makes things worse and then distracts you from making the necessary changes in your financial situation that could ultimately make life better.

And the harmful behaviors that people engage in are brought to the fore in the APA’s report, “Stress in America.” It found that:[12]

• Almost half of Americans (48 percent) reported overeating or eating unhealthy foods to manage stress
• One in four (39 percent) skipped a meal in the last month because of stress
• Almost one-fifth of Americans (18 percent) report drinking alcohol to manage their stress 
• One in six (16 percent) report smoking

The APA report found that women were more likely than men to report unhealthy behaviors to manage stress:[13]

• Eating poorly (56 women versus 40 percent men)
• Shopping (25 women versus 11 percent men)
• Excessive napping (43 women versus 32 percent men)

Of course, “The worst response to feeling anxious is increased substance abuse, especially alcohol,” as Sally Winston says.[14] Self-medication with drugs and alcohol may alleviate cares and woes for the moment, but lead to even greater problems in the near future.

Paralyzing yourself: Denial and catastrophizing

Denial and catastrophizing prevent action

Events and circumstances in the current economic climate may seem to be completely out of your control. There is a real danger of panicking or freezing like a deer in the headlights. 

And there are two very real additional dangers that we can fall prey to when we are under the pressure of anxiety and stress: denial and catastrophizing. The problems of the day have many people caught between the opposite poles of these two perils. 

At the one pole is denial: doing nothing in the face of knowing that something must be done. Denial is a kind of paralysis that is easily ripped apart by a dose of reality. It’s a self-stunning strategy that doesn’t solve anything; rather it just puts off the day that the toll will be reckoned.[15]

At the other pole is catastrophizing: irrational thoughts that something is far worse than it actually is. Catastrophizing can take two forms. The first of these is making a catastrophe out of every situation. The truth is that not every situation is of the same magnitude as others. Things may be bad, but not everything is as bad as everything else. This kind of catastrophizing takes current situations and gives them a truly negative “spin.”[16]

The second kind of catastrophizing is closely linked to the first, but it is more mental and more future oriented. This kind of catastrophizing occurs when we look to the future and anticipate all the things that are going to go wrong. We then create a kind of reality around those thoughts (e.g. “It’s bound to all go wrong for me…”). Because we believe something will go wrong, we make it go wrong.[17]

Falling prey to catastrophizing is like striking out in your mind before you even get to the plate. Both of these types of catastrophizing limit your ability to respond to the challenges and opportunities of your current economic situation. They can affect your entire outlook in life, and create a self-fulfilling prophecy of failure, disappointment and underachievement.

Both types of catastrophizing can lead you to self-pity, to an irrational, negative belief about the situation, and to a feeling of hopelessness about your future prospects. And both of these types will define whether you see the presence or absence of alternative possibilities, possibly paralyzing you from going further with efforts toward a clear-headed assessment of your economic status, as well as your goals in life.[18]

Don’t miss the other parts of the series!

Be sure to read parts 1, 3 and 4!

This is part 2 of the 4-part series, “Surviving the Recession.” The first part, “Surviving the Recession, Part 1: What It’s Doing to Us” lays out how the recession and its economic uncertainties is affecting us. It has these headings:

• How are people handling the recession?
• Women in particular are stressed by the economy
• What the recession and economic worry are doing to us

The third and fourth installments, “Surviving the Recession, Part 3: 15 Things You Can Do to Regain Control,” and “Surviving the Recession, Part 4: 16 More Things You Can Do to Regain Control‘ are lists of proactive steps that you can take to regain control, not only of your financial situation, but your and your family’s lives.

What do you think?

Humans deny, panic, freeze and catastrophize

In the face of danger, it is our tendency as humans to panic, freeze, deny its existence, or let fear make it out to be much larger than it is. We run to alcohol and drugs to give us some relief from our fears. Yet we know all the while that each of these things will not help us in the long run, and that they just make things worse.

The first two installments in this series have been pretty grim — I thought twice about including them, but I couldn’t in good conscience withhold the results of my research from you. Fortunately, tomorrow’s article is very positive and full of helpful advice from a wide range of sources. Writing it has helped me gain a good perspective and attitude toward my own family’s finances, and helped to quell my wife’s and my stress about the economic situation.

• Do you think your stress and anxiety are pushing you toward a mental disorder?
• What do you think about the section on catastrophizing? Does it ring true?
• Have you taken up any harmful behaviors due to the stress and anxiety of the recession?

Artwork by Andy Warhol, 1982. Screenprint on Lenox Museum Board. Edition 60.

©2009 Anxiety, Panic & Health. All rights reserved.

As always, your comments are welcome!

If you have enjoyed this post, please consider subscribing to this blog, either via RSS or email at the top of your screen. It’s free! You can also follow me on Twitter from the same place. I would also appreciate your sharing this post using your favorite social media, such as StumbleUpon or Digg. Just click the little green “ShareThis” button at the bottom of this post.

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FOOTNOTES
1. Belluck, Pam. (2009, April 8). Recession Anxiety Seeps Into Everyday Lives. Retrieved April 8, 2009 from http://www.nytimes.com/2009/04/09/health/09stress.html?_r=1&ref=us ↑
2. Belluck, Pam. (2009, April 8)↑
3. Bethune, Sophie; Brownawell, Angel. (2008, October 7). APA Poll Finds Women Bear Brunt of Nation’s Stress, Financial Downturn. Retrieved April 13, 2009 from http://www.apa.org/releases/women-stress1008.html ↑
4. Trejos, Nancy. (2009, March 1). Fear, Stress, Anxiety: A Global Recession’s Personal Economics. Retrieved April 13, 2009 from http://www.washingtonpost.com/wp-dyn/content/article/2009/02/28/AR2009022800150.html ↑
5. Belluck, Pam. (2009, April 8)↑
6. Molitor, Nancy. (2009, February 3). Recession Anxiety. Retrieved April 10, 2009 from http://blog.syracuse.com/opinion/2009/02/recession_anxiety.html ↑
7. Staff of the Anxiety Disorders Association of America. (2009). How to Survive Tough Economic Times and Manage Your Anxiety. Retrieved March 25, 2009 from http://www.adaa.org/gettinghelp/MFarchives/EconomicTimes.asp ↑
8. Staff of the Anxiety Disorders Association of America. (2009)↑
9. Ross, Jerilyn. (2008, October 28). Managing Anxiety During Tough Economic Times. Retrieved April 5, 2009 from http://www.healthcentral.com/anxiety/c/33722/46569/managing-economic ↑
10. Ross, Jerilyn. (2008, October 28)↑
11. Molitor, Nancy; Staff of American Psychological Association. Economic Worries Tax Out Americans as April 15 nears. (2009, April) Retrieved April 10. 2009 from http://www.apahelpcenter.org/articles/article.php?id=174 ↑
12. Staff of the American Psychological Association. (2008, October 7). Stress in America. Retrieved April 18, 2009 from (pdf) http://apahelpcenter.mediaroom.com/index.php?s=pageC&item=46 ↑
13. Staff of the American Psychological Association. (2008, October 7)↑
14. Staff of the Anxiety Disorders Association of America. (2009)↑
15. Elliott, Charles H. (2009, March 13). Anxious About the Economy? Retrieved April 11, 2009 from http://blogs.psychcentral.com/anxiety/2009/03/anxious-about-the-economy/ ↑
16. Grohol, John M. (2007, November 19). What is Catastrophizing? Retrieved April 20, 2009 from http://psychcentral.com/lib/2007/what-is-catastrophizing/ ↑
17. Grohol, John M. (2007, November 19)↑
18. Grohol, John M. (2007, November 19)↑


Related Posts:

• Surviving the Recession, Part 1: What It’s Doing to Us
• Surviving the Recession: Announcement
• Surviving the Recession, Part 3: 15 Things You Can Do to Regain Control
• Surviving the Recession, Part 4: 16 More Things You Can Do to Regain Control
• What Are the Stressors in Your Life?

Artwork by Andy Warhol

With the nation’s housing market in a ditch, the stock market in freefall, food prices rising, and government bailouts making the news almost every day, it’s no surprise that so many people are feeling anxious and stressed about the economy and their financial futures.

Anxiety and mild stress are a normal reactions to these events. It’s your body’s way of telling you to stay alert and work harder to protect your finances and your family’s future.

But with the nation in a recession, more Americans are feeling panicky about their future, leading to a remarkable increase in stress about their finances and job.

More than that, local and national mental health experts say that the loss of jobs, homes and retirement savings has triggered an increase in the number of people with symptoms related to toxic stress, Anxiety, or depression, such as changes in sleeping and eating patterns, headaches, and nervousness.

This series of 4 articles about surviving the recession offers an understanding about the situation so many of us find ourselves in, as well as positive suggestions to help you regain control of your life and finances. Today’s installment covers what the recession is doing to us, and has the following sections:

• How are people handling the recession?
• Women in particular are stressed by the economy
• What the recession and economic worry are doing to us

Part 2, “Surviving the Recession, Part 2: Anxiety, Harmful Behavior, and Paralysis” details how stress can tip you over into Anxiety or other mental disorders, and can lead to harmful behaviors. It will have these sections:

• Economic stress and mental disorders
• Excessive worry may lead to Generalized Anxiety Disorder
• If you’re stressed out, anxious or depressed, avoid turning to harmful behaviors
• Paralyzing yourself: Denial and catastrophizing

The final 2 installments, “Surviving the Recession, Part 3: 15 Things You Can Do to Regain Control,” and  ”Surviving the Recession, Part 4: 16 More Things You Can Do to Regain Control“ are lists of proactive steps that you can take to take back control, not only of your financial situation, but your and your family’s life.

How are people handling the recession?

Money and the economy are top sources of stress

Not very well. The American Psychological Association (APA) completed a poll in late 2008 called “Stress in America.” It reported that for 81 percent of Americans, money is the top source of stress. The economy is only slightly behind money as a stressor at 80 percent, up from 66 percent in April, 2008.[1] [2] [3]

Other stressors reported by the APA affected by the declining economy are considered significant sources of stress for two-thirds of Americans:[4]

• Work (67 percent)
• Health problems affecting the family (67 percent) 
• Housing costs (62 percent). 
• Job stability (56 percent)
• Providing for the family’s basic needs (49 percent)

A recent poll by the Associated Press (AP) shows that perceptions of Americans about the quality of their lives is dropping dramatically. In September, 2008, 70 percent said they were personally happy. This new poll showed only 59 percent called themselves happy. More recent polls have shown this percentage to have fallen even more.[5]

The AP poll also shows how financial worries have permeated all corners of society, with some hit harder than others:[6]

• While about one-third overall worry about financing a child’s college education, 6 in 10 people under age 45 are anxious about it.
• 53 percent worry they will have to work longer because their retirement savings have dwindled, and 66 percent of people in their 40′s feel that way.
• One-third worry about losing their job, but nearly half in their 30s and 40s do.
• 46 percent of whites and 62 percent of blacks worry about making mortgage and credit card payments.
• 66 percent overall are concerned about facing major medical bills, including 78 percent of unmarried women.
• Nearly 8 in 10 college graduates worry that the value of their stocks and retirement investments is falling.

While a recent New York Times/CBS News poll found fewer people saying the economy had worsened since late 2008, most did not think it was improving. People overwhelmingly thought the recession would last another year or more, and 70 percent were concerned that a household member would be jobless.[7]

Women in particular are stressed by the economy

Women are bearing the brunt of financial stress

Women are bearing the brunt of financial stress, according to data from the American Psychological Association’s newly released 2008 “Stress in America” survey.[8] According to the APA, women are most likely to report stress related to the economic climate. Compared with men, more women say they are stressed about: [9]

• Money (83 percent women vs. 78 percent men)
• The economy (84 percent women vs. 75 percent men)
• Job stability (57 percent women vs. 55 percent men)
• Housing costs (66 percent women vs. 58 percent men)
• Health problems affecting their families (70 percent women vs. 63 percent men)

Women of the Boomer generation (aged 44 to 62) and elders (aged 63+) are most likely to report the economy as a significant stressor, while women in general rank financial worries above personal health.[10]

The National Women’s Law Center (NWLC) conducted a poll in mid-2008 that reported that women are significantly more pessimistic than are men in their attitudes about the current state of affairs in America — both on a societal level and in terms of trends in their own lives:[11] 

• 92 percent of women feel that the nation overall is experiencing challenging or difficult times
• 60 percent of women characterize their current personal situation as challenging or difficult

The NWLC poll reports that women are more likely than are men to feel they are falling behind economically, and women are much more likely than are men to be worried and concerned about their economic prospects for the future.  Other results from the NWLC poll show that:[12]

• 59 percent of women, as compared with 46 percent of men, look ahead to the next five years and say they are more worried and concerned about being able to achieve their economic and financial goals than they are hopeful and confident.  
• Only 6 percent of women say that their income is growing faster than the cost of living.  
• 60 percent of women say that their income is actually falling behind the cost of living.
• Only 33 percent of women say their income is keeping pace with the cost of living.
• Lower-income women (75 percent falling behind), women with a high school degree or less education (68 percent), and African-American women (70 percent) feel particularly vulnerable. 

Other surveys, such as one by the Rockefeller Foundation with an analysis by the Institute for Women’s Policy Research, reiterate the same message. As Barbara Gault, vice president and director of research at the Institute for Women’s Policy Research, says:[13]

As our economy gets worse, women are going to feel the pain the most. We found striking gender differences in economic anxiety and insecurity, with women much more likely than men to feel economically insecure. And, not surprisingly, perhaps this insecurity is even more pronounced among women of color.

What the recession and economic worry are doing to us

Economic stress causes physical and emotional symptoms

This is a time of increasing stress for everybody. The APA survey of late 2008 reported that many more people reported physical and emotional symptoms due to stress than they did in their 2007 survey. More people report fatigue (53 percent compared to 51 percent in 2007), feelings of irritability or anger (60 percent compared to 50 percent in 2007) and lying awake at night (52 percent compared to 48 percent in 2007) as a result of stress.[14] 

Except for the oldest Americans, none of us has lived through anything like the current recession. Many of us are not spending money, but spending more is tied tightly to helping the economy recover. Charles McMillion, chief economist at MBG Information Services, says:[15]

It is a vicious cycle, and people are under remarkable stress. There are a lot of people that are severely affected by this and have never had to deal with it before and don’t know where to turn because the country hasn’t dealt with it.

Just look at what is happening:

• The National Sleep Foundation said 27 percent of people surveyed in late 2008 had sleeplessness because of economic anxiety. Many seeking help are fearful, but not actually incurring economic difficulty, said Joseph Ojile, founder of Clayton Sleep Institute in St. Louis, where patients increased 25 percent since October, 2008.[16]
• National Suicide Prevention Lifeline calls jumped to 50,158 in January 2009, from 39,465 a month in January 2008, and economic stress more frequently “played a central role,” said Richard McKeon, the group’s federal project officer.{{Belluck}} The total number of calls increased from 412,000 in 2007 to 568,000 in 2008.[17]
• In a November-December, 2008 study by the National Domestic Violence Hotline, 54 percent of participating hotline callers said their household’s financial situation had changed in the past year.[18]
• At ComPsych, the nation’s largest employee assistance mental health program, the demand for therapists surged 40 percent in the last half of 2008.[19]
• Daniel A. Cohen, a Manhattan psychiatrist, said he saw “more families in crisis,” with children experiencing “increased signs of anxiety and depression” and more nightmares and acting out.[20]
• The Treasury, Labor and other departments started a Web site for people experiencing stress. [21]
• The Substance Abuse and Mental Health Services Administration is training counselors who usually assist people devastated by tornadoes and floods to now help people with what they “are going through with the economy,” said Dr. McKeon, an agency adviser.[22]

Don’t miss the other parts of the series!

Important information in parts 2, 3 & 4!

Tomorrow’s installment, Part 2, “Surviving the Recession, Part 2: Anxiety, Harmful Behavior, and Paralysis” details how stress can tip you over into Anxiety or other mental disorders, and can lead to harmful behaviors. It has these sections:

• Economic stress and mental disorders
• Excessive worry may lead to Generalized Anxiety Disorder
• If you’re stressed out, anxious or depressed, avoid turning to harmful behaviors
• Paralyzing yourself: Denial and catastrophizing

The final 2 installments, “Surviving the Recession, Part 3: 15 Things You Can Do to Regain Control,” and “Surviving the Recession, Part 4: 16 More Things You Can Do to Regain Control” are lists of proactive steps that you can take to take back control, not only of your financial situation, but your and your family’s life.

What do you think?

My family is deeply affected by the recession

The recession has hit my family pretty hard. First, my wife’s overtime was cut out, which amounted to one-third of her pay. Now she is waiting to find out if her job will be eliminated completely in May. Our modest retirement savings are down about 50 percent.

We’ve tried to simplify our lives without affecting our quality of life, but it’s been hard. I wrote a guest post on the Time Goes By blog entitled “Getting Rid of the Junk” about our struggle to simplify, if you’re interested.

This first installment of the three-part series is not very cheerful. If that were all there was to it, it would be time for all of us to cover our heads with ashes, wear burlap, and moan with deep despair. Unfortunately, tomorrow’s offering won’t lift the spirits much, either. It’s about stress and what it can do to us. However, part 3 is entirely positive, with many proactive tips to help you weather the current economic storm.

But the questions today are gloomy in keeping with today’s post:

• What is your take on the economy and the stress that it causes?
• Have you, loved ones, or friends been among the victims of the recession?
• How are you handling economic stress?

Artwork by Andy Warhol 1982, Unique screenprint on Lenox Museum Board, Edition 60

As always, your comments are welcome!

If you have enjoyed this post, please consider subscribing to this blog, either via RSS or email at the top of your screen. It’s free! You can also follow me on Twitter from the same place. I would also appreciate your sharing this post using your favorite social media, such as StumbleUpon or Digg. Just click the little green “ShareThis” button at the bottom of this post.

©2009 Anxiety, Panic & Health. All rights reserved.

Related posts:

%RELATEDPOSTS%

FOOTNOTES
1. Staff of the American Psychological Association. (2008, October 7). Stress in America. Retrieved April 18, 2009 from (pdf) http://apahelpcenter.mediaroom.com/index.php?s=pageC&item=46 ↑
2. Molitor, Nancy; Staff of American Psychological Association. Economic Worries Tax Out Americans as April 15 nears. (2009, April) Retrieved April 10. 2009 from http://www.apahelpcenter.org/articles/article.php?id=174 ↑
3. Molitor, Nancy; Staff of American Psychological Association. (2008, December). Managing Your Stress in Tough Economic Times. Retrieved April 10, 2009 from http://www.apahelpcenter.org/articles/article.php?id=171 ↑
4. Staff of the American Psychological Association. (2008, October 7). Stress in America. Retrieved April 18, 2009 from (pdf) http://apahelpcenter.mediaroom.com/index.php?s=pageC&item=46, figure 1↑
5. Staff of the Associated Press. (2008, October 20). Poll: Public anxiety on economy intensifies. Retrieved April 10, 2009 from http://www.msnbc.msn.com/id/27282845/ ↑
6. Staff of the Associated Press. (2008, October 20).↑
7. Belluck, Pam. (2009, April 8). Recession Anxiety Seeps Into Everyday Lives. Retrieved April 8, 2009 from http://www.nytimes.com/2009/04/09/health/09stress.html?_r=1&ref=us ↑
8. Bethune, Sophie; Brownawell, Angel. (2008, October 7). APA Poll Finds Women Bear Brunt of Nation’s Stress, Financial Downturn. Retrieved April 13, 2009 from http://www.apa.org/releases/women-stress1008.html ↑
9. Staff of the American Psychological Association. (2008, October 7)↑
10. Staff of the American Psychological Association. (2008, October 7)↑
11. Staff of Peter D. Hart Research Associates, Inc. for the National Women’s Law Center. (2008, August 5). Poll Findings: Understanding What Women Want in 2008. Retrieved April 5, 2009 from (pdf) http://www.nwlc.org/pdf/2008poll_whatwomenwantmemo.pdf ↑
12. Staff of Peter D. Hart Research Associates, Inc. for the National Women’s Law Center. (2008, August 5)↑
13. Staff of Reuters. (2008, May 8). U.S. economic anxiety hits women harder: study. Retrieved April 10, 2009 from http://www.reuters.com/article/domesticNews/idUSN0842366820080508 ↑
14. Bethune, Sophie; Brownawell, Angel. (2008, October 7)↑
15. Trejos, Nancy. (2009, March 1). Fear, Stress, Anxiety: A Global Recession’s Personal Economics. Retrieved April 13, 2009 from http://www.washingtonpost.com/wp-dyn/content/article/2009/02/28/AR2009022800150.html ↑
16. Belluck, Pam. (2009, April 8)↑
17. Trejos, Nancy. (2009, March 1)↑
18. Trejos, Nancy. (2009, March 1)↑
19. Molitor, Nancy. (2009, February 3). Recession Anxiety. Retrieved April 10, 2009 from http://blog.syracuse.com/opinion/2009/02/recession_anxiety.html ↑
20. Belluck, Pam. (2009, April 8)↑
21. Belluck, Pam. (2009, April 8)↑
22. Belluck, Pam. (2009, April 8)↑


Related Posts:

• Surviving the Recession, Part 2: Anxiety, Harmful Behavior, and Paralysis
• Surviving the Recession, Part 3: 15 Things You Can Do to Regain Control
• Surviving the Recession, Part 4: 16 More Things You Can Do to Regain Control
• Surviving the Recession: Announcement
• Adult Separation Anxiety Disorder: Not Just Kids, Part 2

Adult Separation Anxiety Disorder affects almost 7 percent of the American people. Yet it was unheard of only 15 years ago.

Adult Separation Anxiety Disorder sufferers experience extreme anxiety and fear when separated from major attachment figures; avoidance of being alone; and fears that harm will befall those close to them.

Because the diagnosis is so new, there is no standard way to treat Adult Separation Anxiety Disorder. Sadly, it is hardly mentioned in the standard diagnostic manuals that mental health care professionals use.

This two-part post accompanies the posting of the reference article on Adult Separation Anxiety Disorder. The current post is the second of two. The two posts are a short version of the reference article, which has full information about the disorder. The information in today’s post falls under the following headings:

• How does Adult Separation Anxiety Disorder affect your life?
• Adult Separation Anxiety Disorder and other mental disorders
• What is the treatment for Adult Separation Anxiety Disorder?

Yesterday’s post, part 1, had these headings:

• Just what is Adult Separation Anxiety Disorder?
• How many people have Adult Separation Anxiety Disorder?
• What are the diagnostic criteria for Adult Separation Anxiety Disorder?

Who is most affected by Adult Separation Anxiety Disorder?

Relationships, education, employment are all affected

There are more women than men with ASAD. However, men are more likely than women to have the first onset of ASAD in adulthood.[1] Separation Anxiety Disorder, both the adult and the childhood versions, seems to run in families.[2]

The odds of being not married or being separated are elevated both among those who had childhood Separation Anxiety Disorder and those with ASAD. This suggests that childhood Separation Anxiety Disorder might be a risk factor for subjects remaining unmarried and, once married, for marital instability.[3]

Education seems to play a large role in an adult’s susceptibility to ASAD. Those with fewer years of education are more likely to suffer from ASAD than those who have more years. [4]

ASAD plays havoc with employment, with a large portion of ASAD sufferers being unemployed or employed in a non-traditional manner. It is not known whether ASAD caused the unemployment, or if the ASAD was triggered by the unemployment.[5]

How does Adult Separation Anxiety Disorder affect your life?

ASAD causes serious impairment to your life

ASAD takes a dreadful toll on a person’s life and on the lives of those around them. For the person with ASAD the recurring distress, worrying, fear and sleep disturbances make every day a confusing and torturous experience.[6] For those who are the “subject of attachment” — the spouse, friend, parent, etc — the continual clinginess, neediness, and drama of life with a person with ASAD can be almost more than one can take.

ASAD is extremely hard on relationships. Many people cannot handle such neediness in a partner. As noted above, people with ASAD are much more likely not to have been married or to be divorced or separated.

ASAD is often linked to personal and social impairment. As noted above, ASAD is associated with roughly doubling of the odds that a sufferer will have low (0–12 years) education, be unemployed, and be unmarried or experiencing marital disruption. This is consistent with the findings of several studies that ASAD can be seriously damaging to one’s life.[7][8]

The following table shows the personal and social impairment experienced by people with ASAD:[9]

Housework

• Any personal and social impairment: 56.1 percent
• Severe personal and social impairment: 21.1 percent

Work

• Any personal and social impairment: 51.6 percent
• Severe personal and social impairment: 21.7 percent

Personal relationships

• Any personal and social impairment: 66.6 percent
• Severe personal and social impairment: 28.0 percent

Social relationships

• Any personal and social impairment: 66.4 percent
• Severe personal and social impairment: 31.5 percent

Maximum impaired performance in any role area

• Any personal and social impairment: 73.4 percent
• Severe personal and social impairment: 45.0 percent

Adult Separation Anxiety Disorder and other mental disorders

Over 88% of people wit ASAD have another mental disorder

ASAD often occurs along with other psychiatric conditions, especially other Anxiety Disorders or mood disorders.[10] Research findings indicate that up to 91.1 percent of people with ASAD could be classified as meeting the criteria for at least one other mental disorder found in the DSM-IV.[11][12]

People with ASAD are nearly three times as likely to become addicted to illegal drugs, compared to those without the disorder. They are nearly five times more likely to have an additional Anxiety Disorder and four times more likely to have a mood disorder.[13] Katherine Shear, lead author of one of the most important ASAD studies to date, says:[14]

I think that separation anxiety disorder is a vulnerability factor for all kinds of mental health problems.

A significant proportion of people with Anxiety Disorders tend to relapse, or remain significantly symptomatic, despite improvements in medications and psychiatric therapy. Theorists have proposed that untreated attachment anxieties and Separation Anxiety Disorder occurring along with other mental disorders contribute to the ineffectiveness of treatment.[15] In other words, if co-occurring ASAD is untreated, it tends to cause the treatment to be ineffective or fail entirely.

The following table lists the most common co-occurring mental disorders that appear with ASAD:[16]

Anxiety Disorders

• Panic Disorder: 14.8 percent
• Agoraphobia without Panic Disorder: 5.8 percent
• Generalized Anxiety Disorder (GAD): 16.1 percent
• Specific phobias: 35.8 percent
• Social Anxiety Disorder (SAD or Social Phobia): 34.5 percent
• Post Traumatic Stress Disorder (PTSD): 23.7 percent
• Obsessive-Compulsive Disorder (OCD): 9.9 percent
• Any other Anxiety Disorder: 65.6 percent

Mood Disorders

• Major depressive disorders: 40.8 percent
• Dysthymia: 8.9 percent
• Bipolar disorder: 19.4 percent
• Any mood disorder: 61.7 percent

Substance Abuse

• Alcohol abuse: 33.1 percent
• Alcohol dependence: 20.1 percent
• Drug abuse: 22.5 percent
• Drug dependence: 12.6 percent
• Any substance abuse disorder: 35.9 percent

Any mental disorder: 88.5 percent

What is the treatment for Adult Separation Anxiety Disorder?

There is no standard treatment for ASAD yet

Due to the recentness of the separate diagnosis for ASAD, there is no standard treatment for the disorder. Most therapies treat it similarly to other Anxiety Disorders with a combination of medication and therapy, especially a form of cognitive behavioral therapy called exposure therapy. Exposure therapy is often used to treat phobias. It involves slowly increasing the person’s ability to tolerate a stressful situation.

The person called Stacy, whose story was told in the “Just what is Adult Separation Anxiety Disorder?” section, was treated successfully by Katherine Shear. She used an antidepressant similar to Prozac that also helps reduce obsessive thinking. In addition, Shear used cognitive behavioral therapy, along with exposure therapy, to slowly increase Stacy’s tolerance of separation from her husband. Working with the couple together, Shear gradually helped Stacy learn how to cope with longer and longer periods without her husband by helping her see that each increment didn’t result in catastrophe. When one situation or time period was no longer stressful, another would be tackled.[17]

Sadly, the majority of people with ASAD remain untreated, even though many obtain treatment for co-occurring mental conditions such as Anxiety Disorders or depression. The vast majority of patients are treated for co-occurring conditions rather than for ASAD. Less than one-third of patients with ASAD (31.9 percent) report that ASAD was ever a focus of their treatment. This suggests that treatment providers often fail to recognize ASAD in the context of other co-occurring mental conditions.[18]

What do you think?

We all have symptoms of ASAD sometimes

Everybody has some symptoms of ASAD from time to time, especially in dire circumstances such as a prolonged separation or a death. There are also some cultures where what might be called “symptoms” are the norm. Research is ongoing to determine what is “normal” and what is not. The full reference articles takes this subject up in detail.

The effects of ASAD in a person’s life have barely been studied. As might be expected due to the newness of the diagnosis, none of the studies of the effects of mental disorders include ASAD. But the warping of a person’s life and those about them by ASAD is very real and very painful. 

I have known several people who have had symptoms of ASAD. They were needy, clingy, or labeled “insecure” by others. Though I knew they really wanted my attention, I did my best to avoid them. Inevitably, this caused them to try all the harder to draw me into a relationship with them. I’m sure my rebuffs were painful for them, and I’m sorry now that I didn’t understand their motivations better. However, for whatever reason, this type of person seems drawn to me, and I have had to fend them off all my life!

• What do you think might be a “normal symptom” of separation that is not full-blown ASAD?
• How do you handle needy, clingy, or insecure people?

Glass figurines entitled “Separation Anxiety” created by Robert Mickelsen. Visit myglassart.org for more information.

As always, your comments are welcome!

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FOOTNOTES
1. Shear, Katherine; Jin, Robert; Meron Ruscio, Ayelet; Walters, Ellen; Kessler, Ronald. (2006, June). Prevalence and Correlates of Estimated DSM-IV Child and Adult Separation Anxiety Disorder in the National Comorbidity Survey Replication. Retrieved April 1, 2009 from http://ajp.psychiatryonline.org/cgi/content/full/163/6/1074 Table 1 ↑
2. Manicavasagar, Vijaya; Silove, Derrick; Rapee, Ronald; Waters, Felicity; Momartin, Shakeh. (2001, May 2). Parent-child concordance for separation anxiety: a clinical study. Retrieved April 1, 2009 from http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T2X-42YDM3K-D&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=0b88db10b139bd52283a4a2d3efc2007 ↑
3. Shear, Katherine.(2006, June). ↑
4. Shear, Katherine.(2006, June). Table 2 ↑
5. Shear, Katherine.(2006, June). Table 2 ↑
6. Staff of Depression Perception. (2006). Separation Anxiety Disorder. Retrieved April 1, 2009 from http://www.depressionperception.com/anxiety/anxiety_conditions/separation_anxiety_disorder.asp#_jmp0_ ↑
7. Shear, Katherine.(2006, June). ↑
8. Staff of Insight Journal. (2007). Adult separation anxiety often overlooked. Retrieved April 1, 2009 from http://www.anxiety-and-depression-solutions.com/articles/news/071706_sep_anxiety.php ↑
9. Shear, Katherine.(2006, June). Table 4 ↑
10. Staff of Insight Journal. (2007).↑
11. Shear, Katherine.(2006, June). ↑
12. Wijeratne, Chanaka; Manicavasagar, Vijaya. (2002, September 11). Separation anxiety in the elderly. Retrieved April 1, 2009 from http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6VDK-46RCS0B-6&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=2d783326f3f9f29f343c838507b168cd ↑
13. Szalzvitz, Maia. (2006). Pathological Clinginess: Study: Adult Separation Anxiety Disorder is prevalent yet poorly understood. Retrieved April 1, 2009 from http://health.msn.com/health-topics/articlepage.aspx?cp-documentid=100235522 ↑
14. Szalzvitz, Maia. (2006).↑
15. Kirsten, Laura; Grenyer, Brin; Wagner, Renate; Manicavasagar, Vijaya. (2008, March). Retrieved April 1, 2009 from http://www.informaworld.com/smpp/35862073-66953207/content~db=all~content=a790668570~tab=content ↑
16. Shear, Katherine.(2006, June). Table 3 ↑
17. Szalzvitz, Maia. (2006).↑
18. Shear, Katherine.(2006, June). ↑


Related Posts:

• Adult Separation Anxiety Disorder: Not Just Kids, Part 1
• Beyond Zits: Acne and Anxiety Disorders Part 1
• Bullying Causes Anxiety Disorders – and It’s Not Just Kids!
• Beyond Zits: Acne and Anxiety Disorders Part 2
• Sleeping Geriatric Giant: Anxiety Disorders in Older Adults, Part 1