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By allaboutfa3909812, Oct 16 2019 08:38PM

What counselors can do to help clients stop smoking

By Bethany Bray November 29, 2016

Nearly half of the cigarettes consumed in the United States are smoked by people dealing with a mental illness, according to the Substance Abuse and Mental Health Services Administration. The federal agency says that rates of smoking are disproportionately higher — a little more than double — among those diagnosed with mental illness than among the general population.

It is widely accepted that the nicotine in cigarettes is highly addictive, but people struggling with mental health issues often turn to cigarettes for reasons that go beyond their addictive qualities. For instance, many people smoke as a coping mechanism to deal with difficult feelings. In addition, despite their negative health effects, cigarettes are still largely viewed by society as an “acceptable” addiction in comparison with other substances.

The reality? “[Smoking] is a devastating addiction and a difficult one to quit,” says Gary Tedeschi, clinical director of the California Smokers’ Helpline and a member of the American Counseling Association. “This clientele [those with mental illness], in particular, need the encouragement and support to go forward [with quitting], and many of them want to, despite what people might think. … To let people continue to smoke because ‘it’s not as bad’ [as other addictions] is missing a really important chance to help someone get healthier.”

To drive home his point, Tedeschi points to a statistic from the 2014 release of The Health Consequences of Smoking - 50 Years of Progress: A Report of the Surgeon General, which says that more than 480,000 people die annually in the United States from causes related to cigarette smoking. Close to half of the Americans who die from tobacco-related causes are people with mental illness or substance abuse disorders, Tedeschi says.

In Tedeschi’s view, the statistics connecting smoking to mental illness are “so obvious that it’s almost an ethical and moral responsibility to help this population quit.”

Part of a package

Ford Brooks, a licensed professional counselor (LPC) and professor at Shippensburg University of Pennsylvania, says he has never had a client walk in to therapy with a primary presentation of wanting to stop smoking.

Tobacco use “is always part of a package” that clients will bring to counseling, Brooks says. In his experience as an addictions counselor, smoking is often piled on top of a laundry list of other challenges that may include alcohol or drug addiction, depression, a marriage that is on the rocks, the loss of a job or financial trouble.

“They’re on the train to destruction, and their nicotine use, in their minds, is on the back end [in terms of importance]. … Is the smoking related to what their presenting issue is? Chances are it probably connects somehow. Don’t be afraid to bring it up,” advises Brooks, co-author of the book A Contemporary Approach to Substance Use Disorders and Addiction Counseling, which is published by ACA.

Tedeschi, a national certified counselor and licensed psychologist, notes that many people who call the California Smokers’ Helpline are struggling with comorbid conditions or mental illness in addition to tobacco use. The phone line is one in a system of “quitlines” operating in each of the 50 U.S. states, the District of Columbia, Puerto Rico and Guam.

For clients struggling with mental health issues, smoking may serve as a coping mechanism to deal with uncomfortable feelings or anxiety, Brooks says. Years ago, when smoking was still allowed in many indoor spaces, Brooks led group counseling in detox, outpatient and inpatient addictions facilities. “When powerful emotions would come up in group, [clients] would fire up cigarette after cigarette to deal with those feelings and quell anxiety,” he recalls.

With this in mind, counselors should help prepare clients for the irritability, anxiety and other uncomfortable feelings they are likely to experience when they attempt to stop smoking cigarettes. “Talk about what it will feel like to be really anxious and not smoke” and how they plan to handle those feelings, Brooks says. “… If a person has anxiety or depression and stops smoking, what initially happens is they could get more depressed or more anxious without nicotine to quell the emotion.”

The counselors interviewed for this article urge practitioners to ask every single client about their tobacco use during the intake process, no matter what the person’s presenting problem is. “If you’re helping them to get mentally and physically healthier, this [quitting smoking] is a very critical part of the overall wellness picture,” Tedeschi says.

Counselors shouldn’t be afraid to ask their clients whether they smoke, says Greg Harms, a licensed clinical professional counselor (LCPC), certified addictions specialist, and alcohol and drug counselor with a private practice in Chicago. “It can feel weird the first couple of times, especially if this is not your area of expertise,” says Harms, who does postdoctoral work at Diamond Headache Clinic in Chicago, an inpatient unit for people with chronic headaches. “A lot of times, clients have heard all the bad stuff about smoking. A lot of them, deep down, they know they’d be better off if they were to quit smoking. They may have failed so many times in the past that they’re discouraged. They might be hesitant to bring it up because this is a counselor and not the [medical] doctor. If you bring it up, more often than not, the client is going to engage with that. Even if they don’t, if it’s not the right time for them, you’ve planted that seed. … It might come to fruition down the road. I’d much rather plant that seed than not say anything at all.”

When Harms was a counseling graduate student, he completed an internship at the Anixter Center, a Chicago agency that serves clients with disabilities. While there, he worked as part of a grant-funded program for smoking cessation for people with disabilities that was spearheaded by the American Lung Association. He also presented a session titled “Integrating Smoking Cessation Treatment with Mental Health Services” at ACA’s 2013 Conference & Expo in Cincinnati.

If a client doesn’t feel ready to begin the quitting process right away, the counselor can put the topic on the back burner to address again once the client has made progress on other presenting problems or has forged a stronger relationship with the practitioner. However, that shouldn’t mean that the topic is off the table completely, Harms says. A counselor should talk regularly with the client about quitting smoking, even if it’s only for a few minutes each session.

“Give them a little nugget of information [about quitting], and then you can focus on what they’re there for,” Harms says. “Help them find ways to deal with their presenting problem, then they’ll trust you. Once they’re in a better place, revisit [the idea of quitting]. We don’t have to address it and get their buy-in during the first session. It would be fantastic if that was the case, but it’s OK if it’s not. In most cases, time is on our side to develop the relationship, plant the seed and revisit it. If the client is not ready, we can harp on [quitting] all we want, [but] it won’t do anything.”

“You really have to take the client’s lead and go at the pace they’re willing,” Harms continues. “Don’t push. Respect their decision. Even if they’re not ready for [quitting], let them know that [you’re] there for them and respect their autonomy to make that decision.”

Positioned to help

Counselors are particularly suited to help clients quit smoking because the profession has an array of tools focused on behavior modification, Tedeschi asserts. Motivational interviewing, cognitive behavior therapy, acceptance and commitment therapy, and other models can be useful in helping clients stop smoking. But techniques from any therapy model that counselors are comfortable using can be adapted to help clients navigate the challenge of quitting, Tedeschi says, especially when combined appropriately with pharmacologic aids approved by the Food and Drug Administration.

“We’re in the business of helping people change. The principles that a counselor uses to help someone understand an issue and begin to make steps toward change apply to smoking cessation as well,” Tedeschi says. “Counselors help people understand their motivation to change and help them come up with a plan to change.”

Harms agrees, noting that in most cases, a counselor will have significantly more time with a client than a medical professional will. Instead of “hitting [the client] over the head” with the dangers of smoking, Harms says, a counselor can afford to focus on the positive, use a strengths-based approach and build on what the client wants to work toward rather than what he or she wants to avoid.

“We [counselors] are so strengths-based. It’s our natural inclination to tell the client, ‘Yes, you’re strong enough to do this,’ rather than [taking] a scare approach,” Harms says. “We can find their strength and have that unconditional positive regard for them, regardless of how long it’s taking. We have the patience to sit with a client as they’re going through [quitting]. We can build that relationship and be a resource.”

Start small

Tedeschi recommends that counselors use the “five A’s” to discuss smoking with clients. In this approach, a practitioner should:

• Ask each client about his or her tobacco use

• Advise all tobacco users to quit

• Assess whether the client is ready to quit

• Assist the client with a quit plan

• Arrange follow-up contact to mitigate relapse

Each of these steps is important, but providing support and follow-up as the client begins to quit is particularly critical, Tedeschi says.

“The first week of quitting is the hardest. If [a counselor] waits for a week to talk to the client, you could lose about 60 percent of people back to relapse,” he says. “If someone is able to quit for two weeks, their risk of relapse drops dramatically.”

If clients resist the idea of quitting or do not feel ready to quit entirely, Tedeschi suggests that counselors work with them to stop smoking for one day or even just an afternoon. During this time, have clients monitor how they felt: How was their anxiety level? What were their cravings like? This technique can introduce the idea of stopping and prepare clients for the quitting process, he says.

Brooks recommends using motivational interviewing to help clients make the life change to quit smoking. “Nicotine is a drug, and it’s no different than if [clients] were to say they want to stop drinking. Work with their motivation to identify what they can possibly do for that,” he says.

Part of the quitting process involves clients going through an identity shift, Tedeschi notes. Clients can be behaving as nonsmokers — abstaining from cigarettes — long before they make the mental leap that they are no longer smokers, he says. It is important for clients to make that mental shift from “a smoker who is not smoking” to a “nonsmoker,” Tedeschi says. Counselors need to work with these clients to identify as and accept the nonsmoker label. “As long as someone calls [himself or herself] a smoker, they will be open to turning back to cigarettes,” he explains.

By allaboutfa3909812, Jan 1 2019 08:36PM

WHAT CAUSES HOLIDAY BLUES?

Many factors can cause the "holiday blues": stress, fatigue, unrealistic expectations, over-commercialization, financial constraints, and the inability to be with one’s family and friends. The

demands of shopping, parties, family reunions, and house guests also contribute to feelings of tension. People who do not become depressed may develop other stress responses, such as: headaches, excessive drinking, over-eating, and difficulty sleeping. Even more people experience post-holiday let down after January first. This can result from disappointments during the preceding months

compounded with the excess fatigue and stress.

COPING WITH STRESS AND DEPRESSION DURING AND AFTER THE HOLIDAYS:

• Keep expectations for the holiday season manageable. Try to set realistic goals for yourself.

Pace yourself. Organize your time. Make a list and prioritize the important activities. Be realistic about

what you can and cannot do. Do not put entire focus on just one day (i.e., Thanksgiving Day) remember

it is a season of holiday sentiment and activities can be spread out (time-wise) to lessen stress and increase enjoyment.

• Remember the holiday season does not banish reasons for feeling sad or lonely; there is room for these feelings to be present, even if the person chooses not to express them.

• Leave "yesteryear" in the past and look toward the future. Life brings changes. Each season is different and can be enjoyed in its own way. Don’t set yourself up in comparing today with the "good ol’ days."

• Do something for someone else. Try volunteering some time to help others.

• Enjoy activities that are free, such as driving around to look at holiday decorations; going window shopping without buying; making a snowperson with children.

• Be aware that excessive drinking will only increase your feelings of depression.

• Try something new. Celebrate the holidays in a new way.

• Spend time with supportive and caring people. Reach out and make new friends or contact someone you have not heard from for awhile.

• Save time for yourself! Recharge your batteries! Let others share responsibility of activities.

CAN ENVIRONMENT BE A FACTOR?

Recent studies show that some people suffer from seasonal affective disorder (SAD) which results from fewer hours of sunlight as the days grow shorter during the winter months. Phototherapy, a treatment involving a few hours of exposure to intense light, is effective in relieving depressive symptoms in

patients with SAD.

Other studies on the benefits of phototherapy found that exposure to early morning sunlight was effective in relieving seasonal depression. Recent findings, however, suggest that patients respond equally well

to phototherapy whether it is scheduled in the early afternoon. This has practical applications for antidepressant treatment since it allows the use of phototherapy in the workplace as well as the home.

Not all of us find ourselves tapping our toes along with “Jingle Bells” during the holidays. For some,

days meant to be jolly are about as much fun as sour eggnog.

The "holiday blues" is sadness, anxiety, and sometimes depression that manifests during the holiday season. For some people, it inevitably comes along with each winter's gloom.

For example, someone who lost a best friend on Christmas Eve 20 years ago may not feel like going caroling this year either.

“That's when we have these particular illnesses, deaths, or trauma,” said Sam Moreno, a psychologist

at the Robert Young Center for Community Mental Health in Moline, Ill. “The holidays trigger some kind

of past unpleasantness, and it permeates them.”

Others prefer not to be reminded of their family's dysfunction and loathe annual get-togethers.

Many people have had unpleasant situations throughout the holidays via a function of families and personalities. People look at the holidays, and they're not what we see on TV or the movies.

Plus, burning the candle at both ends takes a toll. Leading up to the holidays, we work extra hard to prepare for time off, while at the same time cooking, shopping, and planning parties. Afterward, some people are just down, You need to rest, sleep, and take care of yourself.

On the flip side, going back to everyday life after the holidays sometimes seems bland and depressing.

Lastly, if you feel despondent regularly during the dark winter months you may have seasonal affective disorder, or SAD. While little is known about SAD, researchers at Yale University hope to find some answers soon. Experts theorize that this type of seasonal depression may be triggered by a lack of UV light from the sun, and some recommend spending time beneath a UV lamp.

People with SAD often crave sugar, overeat, and generally become lethargic and withdrawn. Symptoms may begin as early as September and last until April. More than 11 million Americans suffer from SAD,

and research shows women may be four times as likely to have SAD symptoms as men.

By allaboutfa3909812, Sep 7 2017 07:43PM

The start of the new school year is exciting for most kids. But it also prompts a spike in anxiety: Even kids who are usually pretty easy-going get butterflies, and kids prone to anxiety get clingier and more nervous than usual. Parents feel the pain, too: Leaving a crying child at preschool isn’t anyone’s idea of fun. And having to talk a panicked first grader onto the bus or out of the car at school can be a real test of your diplomatic skills.

Kids who normally have a little trouble separating from mom and dad will see their anxiety peak during times of stress or transition. The start of school may be especially challenging for kids who are entering

a transition year such as going into kindergarten, into middle school, or to a new school. It can also be stressful if there’s a change in your child’s social support system — maybe a good friend has moved, or has a different teacher this year.

Being anxious is just one possible issue that your child may face. Getting bullied, moving to a new school, struggling academically or having trouble with self-confidence and body image. Regardless of

age and grade, these are some of the timeless problems your kids may be encountering when they’re heading back to school. Going back to school is a big transition for kids since the freedom of summer gets replaced with the structure of school.

Problem: Your child is getting bullied at school or isn’t making friends.

Getting picked on at school is incredibly embarrassing, so your child may not admit that they’re getting bullied by fellow students. Parents need to focus on how their child is behaving instead of what he or

she is saying. Your child could have unexplained injuries, missing or damaged property, they might not want to go to school, or they may have trouble eating and sleeping.

Parents need to communicate with their children exactly what they are seeing and offer help. He’ll be reassured to hear that he doesn’t have to deal with this on his own – although he may also be very

afraid of what might happen if the parent were to become involved.

You can help to alleviate that worry by letting him know that you’ll follow his lead as much as possible while also fulfilling your parenting responsibility to do your best to keep him safe. Let your kids know that bullying is extremely common and they shouldn’t blame themselves for what’s happening.

Problem: Your child isn’t getting good grades or is struggling academically.

If your child is struggling in school, she won’t say it outright either so be prepared to read between the lines.She could complain about the teacher, act out in class, or talk about how the material is boring.

She could skip, show up late or even complain about a tummy ache or feeling unwell to get a sick note.

They could be forgetting textbooks or pencils and doing things that drive parents crazy. We think it’s kids not paying attention but it happens more when you’re disengaged with a subject. Help your child brainstorm solutions once you’ve identified a problem. This will give her the chance to practice self-advocacy skills, such as asking the teacher for help, or getting a tutor to work on subjects that need improvement.

Problem: Your child is lacking self-confidence, or has body image issues.

Check in with your child to see how they’re feeling about their body image, confidence with public speaking or any other issues. If they’re nervous about an issue, such as reading out loud, practice breathing exercise and start an informal book club at home so they can share their thoughts in a comfortable setting.

Weight and body image concerns are legitimate. This is an area of high pressure for all ages in the

world. Try to discuss the issue so you can dispel any misunderstandings or explain what’s going on

with their growing bodies, such as puberty and growth spurts. Ask your kids outright what they think

could help them feel better about themselves. If it’s a weight issue, you could carve out a healthy eating plan and exercise as a family.

It is important your kids know that things won’t always be as tumultuous as they are right now, and that you’re there to support them. Hope is very important when they’re grappling with difficult issues. Kids need to know that they’re not alone and that they can count on you for practical assistance and moral support.

By allaboutfa3909812, Jun 12 2017 07:00PM

What are your memories of playing as a child? Some of us will remember hide and seek, house, tag,

and red rover red rover. Others may recall arguing about rules in kickball or stick ball or taking turns at jump rope, or creating imaginary worlds with our dolls, building forts, putting on plays, or dressing-up. From long summer days to a few precious after-school hours, kid-organized play may have filled much

of your free time. But what about your children? Are their opportunities for play the same as yours were? Most likely not. Play time is in short supply for children these days and the lifelong consequences for developing children can be more serious than many people realize.

________________________________________

THE DECLINE OF PLAY

An article in the most recent issue of the American Journal of Play details not only how much children's play time has declined, but how this lack of play affects emotional development, leading to the rise of anxiety, depression, and problems of attention and self control. "Since about 1955 ... children's free play has been continually declining, at least partly because adults have exerted ever-increasing control over children's activities," says the author Peter Gray, Ph.D., Professor of Psychology (emeritus) at Boston College. Gray defines "free play" as play a child undertakes him- or her-self and which is self-directed

and an end in itself, rather than part of some organized activity.

Gray describes this kind of unstructured, freely-chosen play as a testing ground for life. It provides

critical life experiences without which young children cannot develop into confident and competent adults. Gray's article is meant to serve as a wake-up call regarding the effects of lost play, and he believes that lack of childhood free play time is a huge loss that must be addressed for the sake of our children and society.

WHO AND WHAT IS INTERFERING WITH CHILDREN'S PLAY?

Parents who hover over and intrude on their children's play are a big part of the problem, according to

Gray. "It is hard to find groups of children outdoors at all, and, if you do find them, they are likely to be wearing uniforms and following the directions of coaches while their parents dutifully watch and cheer."

He cites a study which assessed the way 6- to 8-year-olds spent their time in 1981 and again in 1997.

The researchers found that compared to 1981, children in 1997 spent less time in play and had less

free time. They spent 18 percent more time at school, 145 percent more time doing school work, and

168 percent more time shopping with parents. The researchers found that, including computer play, children in 1997 spent only about eleven hours per week at play.

In another study, mothers were asked to compare their own memories of their playtime, to their children's current schedules. Eighty-five percent noted that their children played outdoors less frequently and for shorter periods of time than they had. The mothers noted that they restricted their own children's outdoor play because of safety concerns, a fact echoed in other surveys where parents mentioned child predators, road traffic, and bullies as reasons for restricting their children's outdoor play. Adding to the problem, Gray notes, is our increasing emphasis on schooling and on adult-directed activities. Preschools and kindergartens have become more academically-oriented and many schools have even eliminated recess. It is not that anyone set out to do away with free play time. But its value has not been recognized. As a result, kids' free play time has not been protected.

FIVE WAYS PLAY BENEFITS KIDS

When children are in charge of their own play, it provides a foundation for their future mental health as older children and adults. Gray mentions five main benefits:

1. Play gives children a chance to find and develop a connection to their own self-identified and self-guided interests.

As they choose the activities that make up free play, kids learn to direct themselves and pursue and elaborate on their interests in a way that can sustain them throughout life. Gray notes that: "...in school, children work for grades and praise and in adult-directed sports, they work for praise and trophies.... In free play, children do what they want to do, and the learning and psychological growth that results are byproducts, not conscious goals of the activity."

2. It is through play that children first learn how to make decisions, solve problems, exert self control,

and follow rules.

As children direct their own free play and solve the problems that come up, they must exert control over themselves and must, at times, accept restrictions on their own behavior and follow the rules if they want to be accepted and successful in the game.

As children negotiate both their physical and social environments through play, they can gain a sense of mastery over their world, Gray contends. It is this aspect of play that offers enormous psychological benefits, helping to protect children from anxiety and depression.

"Children who do not have the opportunity to control their own actions, to make and follow through on

their own decisions, to solve their own problems, and to learn how to follow rules in the course of play grow up feeling that they are not in control of their own lives and fate. They grow up feeling that they are dependent on luck and on the goodwill and whims of others...."

Anxiety and depression often occur when an individual feels a lack of control over his or her own life. "Those who believe that they master their own fate are much less likely to become anxious or depressed than those who believe that they are victims of circumstances beyond their control." Gray believes that the loss of playtime lessons about one's ability to exert control over some life circumstances set the scene for anxiety and depression.

3. Children learn to handle their emotions, including anger and fear, during play.

In free play, children put themselves into both physically and socially challenging situations and learn to control the emotions that arise from these stressors. They role play, swing, slide, and climb trees ... and "such activities are fun to the degree that they are moderately frightening ... nobody but the child himself

or herself knows the right dose." Gray suggests that the reduced ability to regulate emotions may be a

key factor in the development of some anxiety disorders. "Individuals suffering from anxiety disorders describe losing emotional control as one of their greatest fears. They are afraid of their own fear, and therefore small degrees of fear generated by mildly threatening situations lead to high degrees of fear generated by the person's fear of losing control." Adults who did not have the opportunity to experience

and cope with moderately challenging emotional situations during play are more at risk for feeling

anxious and overwhelmed by emotion-provoking situations in adult life.

4. Play helps children make friends and learn to get along with each other as equals.

Social play is a natural means of making friends and learning to treat one another fairly. Since play is voluntary and playmates may abandon the game at any time if they feel uncomfortable, children learn to

be aware of their playmates' needs and attempt to meet them in order to maintain the play.

Gray believes that "learning to get along and cooperate with others as equals may be the most crucial evolutionary function of human social play ... and that social play is nature's means of teaching young humans that they are not special. Even those who are more skilled at the game's actions ... must

consider the needs and wishes of the others as equal to their own, or else the others will exclude them." Gray cites increasing social isolation as a potential precursor to psychopathology and notes that the decline in play may be "both a consequence and a cause of the increased social isolation and

loneliness in the culture."

5. Most importantly, play is a source of happiness.

When children are asked about the activities that bring them happiness, they say they are happier when playing with friends than in any other situation. Perhaps you felt this way when remembering your own childhood play experiences at the beginning of this article. Gray sees the loss of play time as a double whammy: we have not only taken away the joys of free play, we have replaced them with emotionally stressful activities. "[A]s a society, we have come to the conclusion that to protect children from danger

and to educate them, we must deprive them of the very activity that makes them happiest and place them for ever more hours in settings where they are more or less continually directed and evaluated by adults, setting almost designed to produce anxiety and depression."

THE LOSS OF PLAY AND RISE OF ANXIETY AND DEPRESSION

There has been a significant increase in anxiety and depression from 1950 to present day in teens and young adults and Gray cites several studies documenting this rise. One showed that five to eight times

as many children and college students reported clinically significant depression or anxiety than 50 years ago and another documented a similar trend in the fourteen- to sixteen-year-old age group between1948 and 1989.

Suicide rates quadrupled from 1950 to 2005 for children less than fifteen years and for teens and young adults ages 15-25, they doubled. Gray believes that the loss of unstructured, free play for play's sake is

at the core of this alarming observation and that as a society, we should reassess the role of free play

and the factors that seem to have all but eliminated it from our children's lives. When parents realize the major role that free play can take in the development of emotionally healthy children and adults, they may wish to reassess the priorities ruling their children's lives. The competing needs for childcare,

academic and athletic success, and children's safety are compelling. But perhaps parents can begin to identify small changes -- such as openings in the schedule, backing off from quite so many supervised activities, and possibly slightly less hovering on the playground that would start the pendulum returning

to the direction of free, imaginative, kid-directed play.

________________________________________

This article originally appeared on TheDoctorWillSeeYouNow.com.

By allaboutfa3909812, Feb 22 2017 09:36PM

Anxiety attacks can feel awful, intense, and frightening. Because they can be powerful experiences, it can seem like anxiety attacks are out of our control.Those who experience anxiety attacks quickly learn that they can be highly unpleasant experiences. Even so, anxiety attacks and their symptoms can be successfully addressed with the right information, help, and support.

Symptoms of an anxiety attack can include:

• A feeling of overwhelming fear

• Feeling of going crazy or losing control

• Feeling you are in grave danger

• Feeling you might pass out

• A surge of doom and gloom

• An urgency to escape

• Dizziness

• Heart Palpitations

• Trembling

• Sweating

• Shortness of breath

• Chest pressure or pain

There is a long list of signs and symptoms of an anxiety attack. But because each body is somewhat chemically unique, anxiety attacks can affect each person differently. Consequently, anxiety attack symptoms can vary from person to person in type or kind, number, intensity, duration, and frequency.

If your symptoms don’t exactly match this list, that doesn’t mean you don’t have anxiety attacks. It simply means that your body is responding to them slightly differently. Anxiety attacks (panic attacks) and their signs and symptoms are episodes of high degree stress responses accompanied or precipitated by

a high degree fear and anxiety.

Anxiety is defined as: A state of apprehension, uncertainty, and fear resulting from the anticipation of a

real or imagined event, situation, or circumstance that we think might be threatening. In other words, if

we become concerned (afraid) that something could harm or endanger us in some way, this concern (fear) creates the state of being anxious.

When we’re anxious, the body produces a stress response. The stress response is designed to give us an extra ‘boost’ of awareness and energy when we think we could be in danger. The stress response causes a number of physiological, psychological, and emotional changes in the body that enhance the body’s ability to deal with a perceived threat – to either fight or flee, which is the reason the stress response is often referred to as the ‘fight or flight response.

The degree of accompanying stress response and its physiological, psychological, and emotional changes are directly proportional to the degree of anxiety. For example, if you are only slightly concerned, such as being slightly nervous about meeting someone new, the body produces a small degree stress response. The small degree stress response can be so slight that you don’t even notice it. If you are greatly afraid, however, such as being terrified that there is a burglar in your home that is about to harm you, the body produces a high degree stress response. We generally experience high degree stress responses as being anxiety attacks: where the changes are so profound they get our full attention. The greater the degree of anxiety and stress response, the more changes the body experiences. Low

degree anxiety will produce small fight or flight changes in the body. High degree anxiety will produce

high degree fight or flight changes. Again, high degree fight or flight response changes are called anxiety attacks.

The most common cause of anxiety attacks is thinking you are in grave danger. Believing you are in extreme danger causes the body to produce a high degree stress response. A high degree stress response can cause profound physiological, psychological, and emotional changes in the body, which can be unnerving to the unsuspecting person. And once these changes are initiated, many anxious personalities react to them with more fear, which causes more stress responses, which can cause

more physiological, psychological, and emotional changes, and so on. So, the most common cause of anxiety attacks is overly anxious behavior (the ways we think and act in overly apprehensive ways).

When the body’s stress is kept within a healthy range, the body functions normally. When we allow stress to build up with no relief, the body can cause an involuntary panic attack – an involuntary high degree stress response that wasn’t caused by behavior. When we experience an involuntary high degree stress response, the sensations can be so profound that we think we are having a medical emergency, which anxious personalities can react to with more fear. And when we become more afraid, the body is going to produce another stress response, which causes more changes, which we can react to with more fear, and so on.

Those who experience anxiety attack disorder are not alone. It’s estimated that 19 percent of the North American adult population (ages 18 to 54) experiences an anxiety disorder, and 3 percent of the North American adult population experiences anxiety attack disorder. We believe that number is much higher, since many conditions go undiagnosed and unreported.

While everyone experiences brief episodes of intense anxiety from time to time, and a great many people experience one or two anxiety attacks over the course of their lifetime, anxiety attack disorder occurs when these attacks become frequent or persistent, begin interfering with or restricting normal lifestyle, or when the individual becomes afraid of them. Once established, anxiety attack disorder can be very debilitating.

Anxiety attack disorder generally starts with one unexplained attack that can include a number of intense anxiety attack symptoms, which causes the individual to become concerned. As other attacks occur, fear

of having anxiety attacks, what they mean, what the associated symptoms mean, and where the attacks and symptoms may lead, increases. This escalation of fear is often the catalyst that brings on the attacks, causing the individual to be seemingly caught in a cycle of fear then panic, then more fear, then more panic.

An anxiety attack can be described as a sudden attack of fear, terror, or feelings of impending doom that strike without warning and for no apparent reason. This strong sensation or feeling can also be accompanied by a number of other symptoms, including pounding heart, rapid heart rate, sweating, lightheadedness, nausea, hot or cold flashes, chest pain, hands and feet may feel numb, tingly skin sensations, burning skin sensations, irrational thoughts, fear of losing control, and a number of other symptoms. (While other symptoms often do accompany anxiety attacks, they don’t necessarily have to.)

Anxiety attacks can last anywhere between a few moments to 30 or more minutes. It’s also common for subsequent anxiety attacks to follow, causing the overall anxiety attack experience to last much longer as one episode is followed by another. Even though anxiety attacks eventually end, it’s common for the symptoms and after effects of an anxiety attack to linger for hours or even days, depending upon the severity of the attack and the level of stress your body is under.

The highest incidence of the onset of anxiety attack disorder occurs in the 17 to 25 years of age range.

But people from all age groups can experience anxiety attacks. Many people remember having them as children (anxiety attacks that occur in childhood are often misunderstood as feeling “sick” or the onset of the flu).

Women are thought to experience a higher prevalence of anxiety attacks than men, however, the statistics may be misleading because men are more reluctant to seek professional help. Anxiety attacks are often misunderstood. Many sources claim that anxiety attacks are genetically or biologically caused, or both, because they commonly occur in families. But independent research and practical evidence has disproven these claims. For example, based on our personal and professional experiences with anxiety, anxiety disorders, including anxiety attacks, we know that the factors that cause anxiety disorders are learned, and therefore, are behavioral and NOT genetically inherited or biologically caused.

Yes, anxiety disorders DO have a biological component, but the biological component is a RESULT of

our behaviors and NOT the CAUSE of them.

And yes, it’s common for anxiety disorders to run in families. But this is due to learned and passed on behavior, NOT due to genetic factors (children who grow up with anxious parents most often see, learn, and adopt their anxious behavioral style).

Anyone who has experienced anxiety attacks can tell you that anxiety attacks can be frightening and debilitating. But anxiety attacks can be stopped and prevented. Anyone can do it with the right information, help, and support.

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