Mind & Body

Peace of mind

If you always feel anxious and stressed, you may have Generalized Anxiety Disorder. Here's how to reclaim a sense of calm.

Peace of mind
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Thinking Things Through
"For the past 20 years, the standard treatment for all anxiety disorders has been cognitive-behavioral therapy," says Bourne. The term refers to any therapies that teach you how to think more realistically-so fearful thoughts don't build into anxiety. While some psychologists view long-term talk therapy as a more effective solution for deep-seated issues, cognitive-behavioral therapy is most commonly recommended for GAD.

"What we think about an event affects our feelings more than the event itself," Bourne says. Constant worry can increase your physical symptoms, which in turn can bring about even more worry.

In cognitive-behavioral therapy, you examine the thoughts that underlie those feelings and determine whether or not they really make sense. If not, you can replace them with more realistic thoughts. For instance, you might think, "I am in danger" while walking on a crowded street; the therapist would help you see the situation more clearly, so you instead think something like, "Realistically, the thing I'm most afraid of isn't likely to happen." Therapy sessions are combined with "homework" such as keeping track of your moods and challenging your negative thoughts during the week. The treatment can last from six weeks to several months, with "booster sessions" recommended afterward.

Changing Your Life
Conquering your anxiety symptoms can be a huge relief. But to be sure they don't come back, Bourne says, it may be helpful to go deeper. "After treating the symptoms, you should look at the underlying causes. And if you have interpersonal problems with your significant others, that might also contribute to anxiety." In addition to cognitive therapy, traditional psychotherapy or family counseling can help with this.

You can improve your life further by living in a way that is less stressful. "Allow yourself time for rest, being with loved ones." If you do that, Bourne adds, you'll have less to worry about and more to enjoy.

The Anxiety Drugstore
If your symptoms feel overwhelming or are impairing your ability to function, you may need to complement natural treatments with prescription medications. The following drugs are currently available.

Selective Serotonin Reuptake Inhibitors (SSRIs) are antidepressants that increase brain levels of the calming neurotransmitter serotonin . They include Prozac (fluoxetine), Lexapro (escitalopram), and Zoloft (sertraline). "Depression and anxiety often go together, and SSRIs can be effective for both," says Mark Goulston, M.D., a psychiatrist in Los Angeles and author of Post-Traumatic Stress Disorder for Dummies (For Dummies, 2007). Side effects, which are often temporary, can include stomach upset, sleep problems, weight gain, and sexual dysfunction.

Tricyclic Antidepressants (TCAs) such as Tofranil (imipramine) and Elavil (amitriptyline) are also prescribed for anxiety. They affect a wider range of neurotransmitters than the newer SSRIs but may cause more side effects and are usually prescribed for people who don't tolerate SSRIs well.

Beta-Blockers prevent adrenaline and noradrenaline from stimulating the sympathetic nervous system, resulting in a slower pulse and lower blood pressure. Originally used to treat heart problems, they're now prescribed for occasional anxiety and post-traumatic stress disorder, as well as for stage fright and performance anxiety. Side effects can include dizziness or a tendency toward depression.

Benzodiazepines such as Xanax (alprazolam) and Ativan (lorazepam) are minor tranquilizers that slow the nervous system by modulating gamma-aminobutryic acid (GABA) receptors, and they're frequently prescribed for serious anxiety. While benzodiazepines are very effective, they can be addictive.

Buspirone (sold as BuSpar and other brands) affects serotonin, dopamine, and possibly other neurotransmitters in the brain. It works more slowly against anxiety than benzodiazepines, but it's less likely to cause side effects or addiction. Side effects can include dizziness or nausea.

Herbal Remedies can provide short-term help for mild anxiety but haven't proven effective against GAD. However, if you're uncomfortable taking pharmaceuticals and your doctor doesn't think prescription drugs are necessary, herbs may be helpful in conjunction with other therapies. (Be sure to discuss with your doctor any herbs or supplements you choose to take-they can cause unwanted effects or interact with drugs.) To deal with symptoms of anxiety, Edmund J. Bourne, Ph.D., recommends valerian, passionflower, chamomile, and theanine, the relaxing component in green tea. While there have been questions about the safety of kava, modern supplements made from only the root are safe for occasional use, according to Bourne.

Develop New Habits
You can reduce anxiety with these simple changes, as recommended by anxiety researchers:

  • Get Regular Exercise
    Any kind of aerobic workout (or aerobics combined with weightlifting) practiced for 30 minutes four times a week will reduce adrenaline and muscle tension, give you more of a sense of control over your life, and naturally take your mind off things that are bothering you.
  • Eat A Balanced Diet
    A sufficient intake of nutrients such as calcium, magnesium, B vitamins, and omega-3 fatty acids (from fish or flaxseed oil) is associated with lower levels of anxiety.
  • Get Eight Hours of Sleep Every Night
    Adequate sleep allows your nervous system to recover and helps your body to produce hormones that mitigate anxiety.
  • Avoid Caffeine, Tobacco, and Excess Alcohol
    All of these can overstimulate the nervous system and affect your sleep.
  • Watch Your Drug Intake
    Various over-the-counter, recreational, and even prescription drugs can cause or worsen anxiety-including certain cold and allergy medications, diet aids, energy supplements, hormones, caffeine-laced painkillers, steroids, asthma drugs, and ADHD medicines. Discuss with your doctor everything you're taking.