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Covers cognitive behavioral therapy, relaxation techniques, and natural treatments for treating anxiety and panic attacks.

Who hasn't felt it? Anxiety, that unremitting voice in your head warning that something is wrong—or will be wrong very soon. A voice that sets your nervous system aflutter.

The thoughts evoking such unease can be specific, from concerns over avian flu to rodents or finances, but the feeling commonly gets disconnected from the trigger and spirals away into a universe of its own making. When this happens you whirl into worry after worry after worry. For some, such anxiety comes and goes. But for others, this pernicious condition can cast a shadow over day-to-day activities, well being and, yes, even health. That's when anxiety becomes a "disorder."

There is no one-size-fits-all definition of anxiety disorder. However, all types of anxiety do appear to have a strong genetic component, exacerbated by life events, trauma and stress. Those with anxiety most likely suffer from several different manifestations and are also at increased risk of depression.

The different manifestations run the gamut from a generalized anxiety disorder (GAD, characterized by relentless, often unspecified worry) to social anxiety disorder (excessive self-consciousness and fear of social situations), phobias (an intense fear of something that, in fact, poses no danger), post-traumatic stress disorder (PTSD, debilitating fear that arises after a terrifying event), obsessive-compulsive disorder (OCD, recurring, persistent thoughts, images and impulses that manifest in repetitive behaviors) and panic disorder (sudden overwhelming feelings of terror, accompanied by intense physical symptoms).

If you suffer from any of these or know someone who does, take heart. A variety of techniques, some simple and others more involved, can bring a greater sense of peace to your life.

It also may help to know you're not alone. Statistics from the National Institute of Mental Health (NIMH) show some 19 million Americans suffer from anxiety disorders right along with you, making it the most prevalent psychiatric complaint, according to psychotherapist Jerilyn Ross, president of the Anxiety Disorders Association of America and director of The Ross Center for Anxiety and Related Disorders in Washington. Yet only a third of those who suffer seek treatment, she says. She adds that of the millions who wrestle with anxiety disorders, women outnumber men two-to-one, and 10 percent of sufferers are children.


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When is worry worrisome?

Covers cognitive behavioral therapy, relaxation techniques, and natural treatments for treating anxiety and panic attacks.How do you know you have an anxiety disorder? Give yourself six months. If, after this amount of time, you still regularly wrestle with such symptoms as excessive worry, undue panic, negative thinking or endless obsessing over the "what ifs" of life, or their possible dire outcomes, chances are you have an anxiety disorder. It doesn't much matter what you worry about. It could be a specific problem, or it could just be an amorphous feeling—what you might call the free-floating variety. All this stress wreaks havoc by catapulting you into the fight-or-flight response—the kind of automatic body reaction that occurs when you step off a curb and narrowly miss being hit by a bus. Your autonomic nervous system goes on high alert, and adrenaline and other stress hormones kick in. Immediately your heart rate soars, your breathing becomes shallow, you begin to sweat and your muscles tighten. Over time, these high-stress responses will wear out your body, not to mention your mind.

This state of preparedness is perfectly appropriate when you're reacting to the oncoming bus because it increases your chances of survival. But when the trigger is an everyday event like seeing a spider in the bathtub, riding an elevator or simply leaving the house, then you have a problem. In this day and age, those prone to anxiety are more likely misinterpreting environmental and internal cues by misperceiving them as life threatening when, in actuality, they are not.

One reason anxiety disorder is so well understood is because new brain imaging technology and neurochemical tracing techniques now exist. Researchers can pinpoint particular areas in the brain and certain neurotransmitters involved in different anxiety manifestations. Daniel G. Amen, MD, author of Healing Anxiety and Depression (New York, 2003), has studied the brain patterns for different types of anxiety using SPECT (single photon emission computed tomography) scans. While symptoms only suggest a certain type of anxiety, the scans map, by color, where the brain is inappropriately responding to environmental and internal cues.

"This technology is like looking under the hood of the car," says Amen. Using it in his own medical practice, he has discovered that five parts of the brain are involved with anxiety and depressive disorders.

"We've found that anxiety is not one thing but a bunch of things. Therefore, there is no one fix for each person," Amen adds.

In his research, Amen has traced some people's anxieties to an unfocused brain that is under-functioning in some areas so it can't efficiently process information; some to an overactive brain that can't stop thinking; others to an overly focused brain that fixates on unpleasant thoughts; and still others to injury to the frontal lobe.

Treating Anxiety and Panic

The upside is that such research has led to more specific treatments tailored to different types of anxiety. And experts say anxiety is highly responsive to specific remedies and coping techniques. "Anxiety is actually the most treatable of all mental health complaints," says David Carbonell, a psychologist specializing in anxiety and director of The Anxiety Treatment Centers in the Chicago area and Suffolk County, N.Y.

Amen suggests a multifaceted treatment adjusted to the particular flavor of anxiety disorder a person has. His recommendations include a mix of cognitive behavioral therapy, biofeedback (which provides concrete feedback of physiological reactions—heart rate, muscle tension and brainwave patterns) and physical exercise to increase blood flow to the brain. Other effective therapies, according to Amen, include deep breathing and relaxation techniques, dietary shifts (such as avoiding caffeine, refined carbohydrates and toxins like nicotine and recreational drugs) and taking supplements known to mediate mood disorders (omega-3 fatty acids, for example). He also uses medication when necessary, either short term to get symptoms under control or long term if associated with depression.