Hi,

Thanks for your question.

It is a good one and the matter comes up frequently in the mental health field. How to attack generalized high anxiety? There are many valid approaches.

The first thing to understand about anxiety is that it occurs frequently in the general population at large. You are not alone in suffering from it. In fact, statistically speaking, anxiety disorders are the commonest psychiatric disorders in people worldwide.

The next thing to understand about anxiety is very important: it's a biologically-based, hereditary disorder. In other words, the disorder is caused by chemical imbalances in the brain and tends to run in families. Anxiety symptoms can be attacked in many different ways.

The most obvious way to reduce anxiety is to go for psychiatric evaluation and have a psychiatrist prescribe you some medication to prevent and/or abort the anxiety. Medications do work and many people the world over take them to quell anxiety. Though medications may be effective (and they are in about 70% of cases), they can come with side effects that can be annoying and debilitating.

Another approach to anxiety is to go for some form of talk therapy. The best-studied and best-respected talk therapy modality for anxiety is known as CBT (cognitive behavioral therapy).

Spearheaded about fifty years ago by Dr. XXXXXXX T. Beck MD of Philadelphia PA, he developed a talk therapy system that postulates that negative automatic thoughts can trigger and perpetuate anxiety symptoms and training oneself in therapy to recognize and reframe those thoughts can cure one of one's anxiety. This modality certainly works, particularly when it's paired with medication management.

The downside to CBT is that is requires the patient to engage in treatment very proactively by completing homework exercises outside the context of office-based therapy sessions.

Traditional supportive talk therapy can be useful, but it often doesn't help that much with diminishing anxiety symptoms. Other modalities for anxiety treatment include behavioral techniques (which you seem to be using).

These include methods like exposure and response prevention, which simply means going to places or doing things that cause your anxiety and toughing it out by self-talk to get oneself through it. This can be painful while you do it, but the payoff can be big at the end with good remission of anxiety symptoms.

A classic book to read on CBT techniques is THE FEELING GOOD HANDBOOK by XXXXXXX Burns MD. This is the go-to self-help guide that millions have used to get through anxiety without engaging in medication and psychotherapy. I could go on and on, but I will stop here and let you follow up with me if you have any further questions or need clarification. Thanks for your excellent question!

Dr. J. Clive Spiegel MD

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