ANXIETY TREATMENT IN SCOTTSDALE AZ

Anxiety treatment is one of my specialties at my practice in Scottsdale AZ. Treatment for most anxiety disorders usually has a very high success rate. There can be many triggers that bring on anxiety in someone’s life, especially in a busy society. Anxiety can manifest in numerous ways and treatment will be different in each case, especially when there is a comorbid illness accompanying the anxiety (which is often the case).

Continual stress in one’s life seems to increase the vulnerability to having an anxiety disorder or anxiety attack. Anxiety is a normal human emotion that everybody experiences from time to time when exposed to stressful situations. Generalized anxiety disorder is characterized by excessively high levels of anxiety for prolonged periods of time resulting in chronic mental and physical symptoms that interfere with school, work, relationships, and day-to-day activities. Anxiety often arises for no apparent reason, this is a symptom of an anxiety disorder.

Anxiety Disorders Requiring Treatment

Panic disorder
Recurring panic attacks. Feelings of terror that strike suddenly and repeatedly with no warning. Other symptoms of a panic attack include sweating, chest pain, heart palpitations, and a feeling of choking, losing control.

Generalized anxiety disorder (GAD)
Excessive, unrealistic worry and tension especially in the absence of external reasons for feeling anxious. Manifests itself in psychological and physical symptoms.

Post-traumatic stress disorder (PTSD)
Develops following a traumatic or terrifying event such as a sexual or physical assault, the unexpected death of a loved one, or a natural disaster. People with PTSD often have lasting and frightening thoughts and memories of the event, and tend to be emotionally numb. These situations affect their body chemistry. PTSD shares the symptoms of anxiety but is technically not an anxiety disorder; because it is more of a situational disorder versus a clinical disorder.

Social anxiety disorder
Overwhelming worry and self-consciousness about everyday social situations. Fear of being judged by others, or behaving in a way that might cause embarrassment. Bashful and shy to the extent that it interferes with everyday life.

Specific phobias
Intense fear of a specific object or situation such as snakes, heights, or flying. The level of fear usually is inappropriate to the situation and may cause the person to avoid common everyday situations.

Symptoms of Anxiety Disorders

These symptoms will vary depending on the specific anxiety disorder.

  • Feeling guilty for no reason
  • Hyper-sensitive to crowds or noise
  • Accelerated heart rate
  • Dizziness
  • Sweating or trembling
  • Dry mouth
  • Feeling of choking or shortness of breath
  • Feeling of dizziness or a feeling of faintness
  • Chest pain or pressure
  • Nausea or diarrhea
  • Fear of losing control or a fear of dying
  • Numbness or tingling in one’s extremities
  • Chills or hot flashes
  • Acid-Reflux

If these symptoms manifest, and are intense, lasting for about 10 minutes maximum, it is a panic attack. If these symptoms are milder but longer lasting for several hours of the day, or for about 6 months, we call it either panic disorder, or Generalized Anxiety Disorder. Especially when accompanied by excessive or unrealistic worries. Other symptoms of anxiety tend to be associated with phobias triggered by different objects or situations (animals, natural environment, situational or in social performance situations). People can become anxious from obsessive-thoughts which cause certain behaviors. The fear of germs and illnesses, causing a person to wash his or her hands excessively; and other compulsions. Those who witness or are involved in traumatic incidents can later have thoughts of the traumatic event, causing them to relive the events, and experience severe anxiety symptoms.

it can be very unnerving to the point one needs to get to the emergency room for fear that they are having a heart attack. If this is the result of anxiety, a benzodiazepine medication such as Xanax or Ativan is given. This usually is given intramuscular so that it takes effect more quickly. The side effects of anxiety can also cause physical harm to the body, especially with acid-reflux and Barrett’s Esophagus.

Causes of Anxiety Disorders

There is a lot of research being done in an attempt to find the causes of anxiety. Anxiety disorders are ultimately physiological disorders caused by environmental stress, inflammation, genetics, etc. These disorders involve an imbalance in the neurotransmitters, as well as how the brain processes stressful situations. Some data suggests prenatal stressors can actually change the genes of the fetus; and create a genetic predisposition for anxiety. Another study shows a connection between anxiety and an opioid peptide, dynorphin, found in the brain. Still other studies show that pregnant mother who is deficient in the D and possibly B vitamins would increase fetal stress; or that her body could not produce sufficient GABA which gives the child a predisposition for an anxiety disorder. Anxiety disorders often present with other disorders such as depression and should be evaluated by a healthcare professional. There are triggering events that an individual prone to anxiety should be aware of, and learn to avoid.

Stressful Experiences Trigger Anxiety

Severe or long-lasting stress can affect the neurotransmitters in the brain chemistry and provoke and anxiety attack. It has been demonstrated that people with anxiety have changes in certain brain structures that control the memory or mood. Anxiety runs in families which means that they can be inherited from one or both parents. Some statistics claim that 60% of children with anxious parents will have some form of anxiety. 80% of parents whose parents were anxious, will have children with anxiety disorders as well. Anxiety disorders affect about 19 million adults in the US. Most anxiety disorders begin in childhood, adolescence, and early adulthood. They occur slightly more often in women than in men. Diagnosing these disorders requires individuating the symptoms to arrive at a proper treatment plan. Sometimes our lifestyles can create symptoms of anxiety such as recreational drug and alcohol abuse.

Substance Abuse Can Cause Anxiety

Drug abuse, alcohol abuse, can alter a healthy developed brain and nervous system. Once the substances are out of the system, the anxiety symptoms dissipate, assuming they have not damaged the areas of the brain that are responsible for pleasure or dealing with stress. Other medical conditions can provoke anxiety. Once the underlying medical illness is diagnosed and treated, the anxiety symptoms generally resolve.

Treatment for Anxiety

The first-line treatment for anxiety disorders is to treat them with an antidepressant medication such as an NDRI or SNRI and psychotherapy. We know that the cause of these illnesses is similar to those of depression, in that some mechanism is not functioning properly in the nervous system. The chemical imbalance creates a deficiency in the neurotransmitters: serotonin, norepinephrine, and dopamine. This deficiency is corrected while taking the antidepressant medication. It can take up to four to six weeks for the antidepressant medication to reach full efficacy. Within the first few weeks many people see improvement in their amount of worry, decreasing along with their physical anxiety symptoms.

Sometimes, it is necessary to give an anti-anxiety medication such as Klonopin, Ativan, or Xanax during the ramp up period if the anxiety symptoms are very intense. These medications dampen the GABA responses and work very fast in diminishing the symptoms. These benzodiazepines are prescribed for a short amount of time because these medications, unlike antidepressant medications are addictive. We give them along with the antidepressant for the first four weeks to give the antidepressant time to reach the therapeutic levels. Treatment for anxiety should continue for 12 months to avoid any relapses, this is a very serious issue since the relapse us worse than the initial episode. Introducing a healthy diet and exercise to reduce the inflammation in the body is also helpful.

Medication Side Effects

Side effects that may occur with the antidepressants could include: upset stomach, headache, diarrhea or constipation, decreased libido, weight gain or weight loss. Many side effects go away after the first week of treatment and often are preferable to the symptoms of anxiety. Some of the side effects of the benzodiazepines (Klonopin, Ativan, Xanax), are psycho-motor slowing and sedation. Long-term use of the benzodiazepines is not recommended due to their addictive nature and possible brain damage after years of use. Overall the success rate and prognosis is very good when treating anxiety with medications.

Anxiety Treatment Augmentation

Another treatment of anxiety disorder is psychotherapy. Research has proven that the combination of medication and psychotherapy is the most effective way to treat anxiety. For this reason, I usually work in close association with therapists, EMDR and brainspotting specialists. Make certain lifestyle changes, some as simple as changing the route you drive to work or other routine places. Make sure you are taking care of yourself and getting plenty of rest. Eat well and get exercise to maintain a healthy physical status; diet and exercise provide significant psychological benefits and can help reduce stress and anxiety. Relaxation and meditation, control your breathing and ease your muscle tension when you are feeling stressed or anxious.

Avoid self-medicating with alcohol as this may worsen anxiety symptoms. Sleep to the brain is like insulin to the pancreas. Alcohol is not good for your sleep architecture and instead of medicating the symptoms, they only worsen. If you live in Scottsdale and are looking for an experienced psychiatrist, please contact me; I would find it a joy to bring your life back to one of wellness and fulfillment. Read more about anxiety treatment.

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