Can anxiety cause add

What is Anxious ADD? Anxious ADD Symptoms & Treatment

Anxious ADD is one of the theorized “7 types of ADD” (Classic ADD, Ring of Fire ADD, Temporal Lobe ADD, Limbic ADD, Inattentive ADD, Overfocused ADD) and is characterized by a severe feeling of anxiousness and nervousness as well as inattention..

These symptoms are caused by a dysregulated brain. After undergoing a qEEG brain map, we can often see that regions of the brain, including the prefrontal cortex and limbic system, are demonstrating atypical neuronal activity or simply brain dysregulation. These regions of the brain are responsible for attention and memory, anxiety, mood regulation, and executive functions (e.g., decision making).

There’s a lot to learn about Anxious ADD, and in this article, we will discuss specific features of this theorized type of ADD, including how our medical and psychological professionals at the Drake Institute have helped families all around the world find relief from their ADD and ADHD symptoms.

Please note that while ADD/ADHD has been recognized as a formal disorder since 1980, the theoretical 7 types of ADD, including Anxious ADD, are not official diagnoses recognized by the American Psychiatric Association. However, because the general population has become aware of these labels, we feel that they are still worth addressing in order to provide some clarifying information about the term.

Anxious ADD Symptoms

Anxious ADD encompasses a wide range of symptoms, some of which are listed below:

  • Inability to sustain focus
  • Feelings of anxiousness
  • Fear of disapproval or Criticism
  • Social anxiety
  • Stress related digestive symptoms,  headaches,  and/or sleeping difficulties
  • Pessimism

The primary distinction between Anxious ADD and Anxiety is that with Anxious ADD, the anxiety occurs in addition to the individual’s attentional deficits. Anxious ADD can have a devastating effect on both children and adults, especially during events that are already intrinsically stressful, like presentations, exams, and social interactions with peers.

This is why so many individuals suffering from this disorder will have such difficulties during times of stress or take steps to avoid difficult or stressful situations.

Unfortunately, this avoidance tactic can only last for so long. The individual is eventually forced to confront the negative situation, resulting in increased anxiety as they are being forced to attempt a task that causes such high levels of distress.

This chronic cycle of anxiety, fear of criticism or confrontation, and eventual emotional distress can cause a person to experience physical symptoms as well, like headaches, digestive problems, muscle spasms, confusion, and depression.

Is it ADD or Anxiety?

In terms of answering the question “Is it ADD or Anxiety”, this can be very difficult to differentiate because of overlap with the 2 disorders. However, what is most important is the linkage or correlation between the symptoms and the dysregulated regions of the brain that can be helped with the Drake Institute’s individualized treatment protocols.

Anxious ADD Treatment Options

Typical treatment protocols for Anxious ADD range from varying Anxious ADD diets to Anxious ADD medications, and at times counseling.

However, these treatment protocols are often sub-optimal solutions that may only provide temporary relief from symptoms.

In some cases, ADHD anxiety medications can provide temporary relief from symptoms; however, once the medication stops, the symptoms can return.

And while diet, exercise, and even medication can have a positive effect on a person’s mood, it still doesn’t address the primary issue, which is dysregulation of the brain’s attentional networks and possibly limbic system.

At the Drake Institute, we approach ADD treatment in an entirely different way: by relying on qEEG brain mapping technology to identify the location and severity of the dysregulation within the brain, we can develop a treatment plan that is not only highly effective but also individually tailored to the patient’s specific needs (linking symptoms to the dysregulated brain activity).

Our treatment plans utilize both neurofeedback/biofeedback therapy and neuromodulation to strengthen the brain’s natural ability to regulate itself properly. Neurofeedback, Biofeedback and Neuromodulation are non-invasive treatment methods, but what’s more, they’re also capable of providing patients with the capacity for self-regulation, which can lead to long-lasting symptom relief.

By helping our patients develop the mental skills and improved brain functioning required for self-regulation, we can help reduce our patient’s dependency on medications, though, in some cases medication and changes to diet may still be necessary.

With these important tools in place, our patients can now rely on the resources of their own brain to improve their symptoms. In fact, many of our patients may be able to be titrated off of or at least reduce their reliance on expensive and sometimes potentially harmful medications as a result of the treatment they received at the Drake Institute.

Contact the Drake Institute

Anxious ADD is a serious disorder involving a very specific set of complex structures within the brain, and manifesting symptoms similar to an Anxiety Disorder.  

Without proper treatment, those experiencing the effects of Anxious ADD are at risk of growing more dysfunctional, compromised, and unhappy as symptoms persist or progress.

At the Drake Institute, we help patients rediscover their full potential and get their lives back on track, often without relying on drugs.

Get the help your family deserves at the Drake Institute today! Contact us at 1-800-700-4233 to schedule a no-cost screening consultation.

“David F. Velkoff, M.D., our Medical Director and co-founder, supervises all evaluation procedures and treatment programs. He is recognized as a physician pioneer in using biofeedback, qEEG brain mapping, neurofeedback, and neuromodulation in the treatment of ADHD, Autism Spectrum Disorders, and stress related illnesses including anxiety, depression, insomnia, and high blood pressure. Dr. David Velkoff earned his Master’s degree in Psychology from the California State University at Los Angeles in 1975, and his Doctor of Medicine degree from Emory University School of Medicine in Atlanta in 1976. This was followed by Dr. Velkoff completing his internship in Obstetrics and Gynecology with an elective in Neurology at the University of California Medical Center in Irvine. He then shifted his specialty to Neurophysical Medicine and received his initial training in biofeedback/neurofeedback in Neurophysical Medicine from the leading doctors in the world in biofeedback at the renown Menninger Clinic in Topeka, Kansas. In 1980, he co-founded the Drake Institute of Neurophysical Medicine. Seeking to better understand the link between illness and the mind, Dr. Velkoff served as the clinical director of an international research study on psychoneuroimmunology with the UCLA School of Medicine, Department of Microbiology and Immunology, and the Pasteur Institute in Paris. This was a follow-up study to an earlier clinical collaborative effort with UCLA School of Medicine demonstrating how the Drake Institute's stress treatment resulted in improved immune functioning of natural killer cell activity. Dr. Velkoff served as one of the founding associate editors of the scientific publication, Journal of Neurotherapy. He has been an invited guest lecturer at Los Angeles Children's Hospital, UCLA, Cedars Sinai Medical Center-Thalians Mental Health Center, St. John's Hospital in Santa Monica, California, and CHADD. He has been a medical consultant in Neurophysical Medicine to CNN, National Geographic Channel, Discovery Channel, Univision, and PBS.”

More About What Makes Drake Institute Unique

Understanding the Link and How To Treat

Written by Rachel Reiff Ellis

Attention deficit hyperactivity disorder (ADHD) and anxiety are separate conditions, but for a lot of folks they come as a package deal. About half of adults with ADHD also have anxiety disorder. If you're one of them, the right treatment can improve your ADHD symptoms and ease your anxious feelings, too.

What to Expect From ADHD and Anxiety

When you have anxiety along with ADHD, it may make some of your ADHD symptoms worse, such as feeling restless or having trouble concentrating. But anxiety disorder also comes with its own set of symptoms, like:

  • Constant worry about many different things
  • Feeling on edge
  • Stress
  • Fatigue
  • Trouble sleeping

Anxiety disorder is more than just having anxious feelings from time to time. It's a mental illness that can affect your relationships, work, and quality of life.

How to Tell Your ADHD and Anxiety Apart

Sometimes, anxiety comes as a result of ADHD. When that's the case, your worries are often about how much -- or how little -- you're able to get done. You're anxious about or overwhelmed by your ADHD.

When you have anxiety disorder on top of your ADHD, your worries are usually about a wide variety of things and not only tied to your ADHD struggles.

Talk to your doctor so the two of you can figure out where your anxiety is coming from. Some questions they may ask you are:

  • Do you worry about things that don't make sense?
  • Do you have a hard time controlling these worries?
  • Are you getting good sleep?
  • Are your fears and worries keeping you from doing your regular activities?
  • Do you feel anxious at least three to five times a week for an hour or more a day?
  • Have you had a big life event happen recently?
  • Do any of your family members have a history of anxiety?

How to Treat ADHD and Anxiety

To zero in on the best way to treat ADHD and anxiety, your doctor will likely look at which condition affects you the most. It's possible that your treatment for ADHD may ease your anxiety, so you may only need to take ADHD medication.

When you get treatment for ADHD, it can:

  • Cut your stress
  • Improve your attention so you manage tasks better
  • Give you mental energy to handle anxiety symptoms more easily

If your anxiety is a separate condition and not a symptom of ADHD, you may need to treat both disorders at the same time.

Some treatments can work for both ADHD and anxiety, such as:

  • Cognitive behavioral therapy
  • Relaxation techniques and meditation
  • Prescription medications

Effects of ADHD Medication on Your Anxiety

The most common drugs that doctors suggest for ADHD are stimulants like methylphenidate and amphetamines. Even if you have anxiety, these meds may work well for your ADHD.

Anxiety is a common side effect of stimulants. Your doctor won't know how a medication will affect you until you take it, but it's possible stimulants may make your anxiety symptoms worse.

If that's the case for you, your doctor may suggest other medicines, such as the nonstimulant medications atomoxetine (Strattera) or viloxazine (Qelbree).

Your doctor may also recommend antidepressants like:

  • Bupropion (Wellbutrin)
  • Desipramine (Norpramin)
  • Imipramine (Tofranil)
  • Nortriptyline (Pamelor)
  • Venlafaxine (Effexor)

High blood pressure drugs like clonidine (Kapvay) and guanfacine (Intuniv, Tenex) may also help.

How to Understand Why You Can't "Just Calm Down"

You can listen to this article. If it's convenient for you, turn on the podcast.

What causes anxiety

Anxiety is a natural response to stress. The body feels danger, triggers the “fight or flight” reaction, releases adrenaline and noradrenaline into the blood, the heart begins to beat faster.

But in some cases anxiety attacks arise and end quickly. And in others they become long and destructive. The scenario depends on why the alarm occurred. nine0006

Events that happen to you

Perhaps this is the most common cause of unrest. We are worried about the future. We care about the health and well-being of loved ones. We are wondering if there is enough money to pay.

This daily anxiety is not dangerous. It goes away when the stressful situation ends. And it decreases when you switch to some kind of routine calming activity, get support from friends, or just tell yourself: “Pull yourself together, rag!”

Hormonal changes

A striking example is premenstrual syndrome in women. Hormonal surges affect the functioning of the brain, which is why even a girl who is always balanced and generally satisfied with life can feel unhappy, offended, deeply worried about innocent reasons.

There are more serious hormonal disorders. For example, hyperthyroidism (increased production of thyroid hormones) increases nervousness. This means that a person with such a disease reacts more sharply and brighter to the slightest stress. nine0006

Chronic stress

It develops if you find yourself in a stressful situation day after day. The fight-or-flight response becomes constant, and the endless hormonal blast eventually depletes the body's reserves.

Fear and excitement remain, because the stressful situation has not gone away. But in addition to them, new symptoms also appear: weakness, fatigue, a feeling of a lump in the throat, an acute desire to wrap yourself in a blanket and hide from the world.

As a result, things can come to the development of psychosomatic diseases and mental disorders. nine0006


The word “depression” is often used as a synonym for “low mood” or “low energy”. But this is incorrect. Depression is a complete mental disorder caused by an imbalance of chemicals in the brain. This is a serious disease, one of the symptoms of which is anxiety.

If left untreated, depression can lead to other problems, such as those of the heart and blood vessels, and other mental disorders.

Anxiety disorder

An anxiety disorder is defined as when anxiety—permanent or in the form of acute attacks—lasting more than six months presents itself with physical symptoms: rapid heartbeat, sweating, weakness, inability to concentrate on anything other than fear.

But it is possible to assume this mental disorder even earlier - according to a number of characteristic symptoms inherent in different types of anxiety disorders. The most common are listed below. nine0006

1. Generalized Anxiety Disorder

Behind this definition lies a constant and excessive worrying about the smallest things, which is almost uncontrollable and affects physical well-being. For example, you sincerely, to the point of trembling in the knees and pain in the region of the heart, are worried if one of the family members is delayed for five minutes. Or break out in a cold sweat every time you take on a new project because you're always afraid of making a mistake. It happens that even the ringing of the phone leads to panic. nine0006

Generalized anxiety disorder is often accompanied by other types of anxiety disorders or depression.

2. Social phobia

It is also social anxiety disorder. A person is very sensitive to the attitude of others. He is terribly afraid of being ridiculed, rejected, unnoticed.

This fear is so great and uncontrollable that if it is necessary to “get out in front of people”, the legs of the social phobe literally give way. Therefore, he avoids social contacts with all his might. nine0006

Find out 😱

  • How to know if you are a real social phobe
3. Health-related anxiety disorder

It usually occurs in those who suffer from a serious physical illness. For example, diabetes.

Diabetics may worry about the need to constantly monitor weight, diet, blood sugar levels. They worry because of the high risk of complications: from hypoglycemia to heart or kidney disease, stroke. nine0006

Fear also haunts those diagnosed with cardiovascular disease, asthma and other respiratory disorders, cancer, skin diseases, and so on.

4. Phobias and irrational fears

They are caused by specific objects or situations. For example, it may be a fear of spiders - so hypertrophied that a person cannot enter a room if he notices a piece of cobwebs. Or claustrophobia, which prevents a person from using elevators or the subway. Or fear of flying. nine0006

5. Panic disorder

It is manifested by repeated attacks of severe panic. They do not last long, most often a matter of minutes, but they have extremely unpleasant symptoms: shortness of breath, heart palpitations, chest pain, fear of impending death.

During a panic attack, a person does not control his behavior: he may fall or scream. Because of the fear that the attack could recur at any time, new disorders appear - the same social phobia or anxiety associated with a state of health. nine0006

Memorize 😤

  • What are panic attacks and how to cope with them

Other mental disorders

Excessive and constant anxiety is a characteristic symptom of other mental disorders. For example, schizophrenia, obsessive-compulsive disorder (compulsive disorder), manic-depressive psychosis, alcohol and drug use disorders. nine0006

How to know what you have

Basically, the question should be: “Do I have anxiety that I can manage, or is the situation out of control?”

In fact, the boundary between these states is rather arbitrary. To find it, experts suggest answering seven questions:

  1. Do you regularly catch yourself being worried, irritated, tense, and this becomes your habitual state?
  2. Does anxiety prevent you from working, studying, communicating with people, building relationships? nine0061
  3. Do you have an irrational fear (for example, you are afraid to go down the subway), but you can't overcome it?
  4. Do you believe that if some things are not done right (like not putting shoes on shelves or doing a little ritual before the start of the day), something catastrophic can happen?
  5. Are there situations or activities that you regularly avoid because you are afraid?
  6. Do you have sudden, severe panic attacks during which you cannot control yourself? nine0061
  7. Do you feel that the world is an unsafe place, where just a little mistake is enough to become a victim of scammers, get sick, lose money or lose close friends?

In principle, a single “yes” is enough to suspect an anxiety or other mental disorder. If there are more than one of these answers, you need help.

How to get rid of anxiety if it is not associated with a mental disorder

In this case, the usual methods to control stress will help. There are dozens of them. Here are the most popular and effective ones. nine0006

Take a few deep breaths and long exhales

Stanford University scientists have discovered an area in the brain that links the frequency and depth of breathing and emotional state. As it turned out, the more actively and superficially we breathe, the more nervous and excited we experience.

Play soothing music or listen to nature sounds

In 2017, researchers found that when people listen to nature sounds, their stress level is noticeably reduced. The same applies to calm muffled music. nine0006

By the way, here is the most soothing track recorded by scientists at the British Academy of Sound Therapy:

Switch off the topic that makes you anxious

For example, if you are nervous about the news, turn off the TV and log out of social networks. Instead, watch a comedy or romance, read a book, play with your cat, call a friend. Your task is to occupy your head with something else, to distract yourself from a stressful situation.

Hold hands

There are many options. Start knitting. Plant flowers under windows. Read a book to your child or do a couple of physical experiments with him. Wash the dishes or clean the apartment. These activities will help you switch.

Learn to say “stop” to yourself

Watch your thoughts and stop when you are. If you find yourself thinking about something disturbing, be aware of this fact. Imagine that you take a thought that causes anxiety into a fist and put it aside. And then consciously begin to think about something else - about the situation that you can control. nine0006

Try also 😨

  • 22 unexpected ways to deal with anxiety

How to get rid of anxiety if it is caused by a mental disorder

In this case, breathing deeply, unfortunately, is almost useless. If your anxiety has reached the level of a mental disorder, you will need help. nine0006

Talk to your doctor

You can start by visiting your doctor, telling him about your symptoms and asking for recommendations.

The sooner you seek help, the easier it will be to regain your cheerfulness and positive attitude towards the world.

Another option is to immediately contact a psychotherapist. The specialist will be able to determine exactly what is happening to you and what kind of violation is preventing you from living.

Change your lifestyle

Most likely, the doctor will advise you to change your habits first. nine0006

  • Avoid alcohol, coffee, high sugar drinks and energy drinks. They excite the nervous system and can increase anxiety.
  • Exercise regularly. Physical activity increases the level of endorphins, hormones associated with good mood.
  • Eat well. This will increase your body's reserves and reduce the negative effects of the fight-or-flight response.
  • Get at least 8 hours of sleep.
  • Try relaxation techniques. It can be regular meditation or yoga classes. nine0061

Get psychotherapy

This is the most effective way to deal with anxiety and other disorders. There are various types of psychotherapy, but the most popular are cognitive-behavioral and exposure therapy.

1. Cognitive Behavioral Therapy

Its idea is that your well-being does not depend on a stressful situation, but on how you feel about it. Therefore, the therapist will teach you to

  • Identify negative thoughts - what specifically you think about when you start to worry. Example: "They will laugh at me." nine0061
  • Evaluate and challenge the negative. It means asking questions: “Is the bad thing that scares me really going to happen? And if so, will it really be disastrous? Maybe it's not so scary?
  • Replace negative thoughts with realistic ones.
2. Exposure Therapy

It is based on the assumption that avoiding stressful situations only makes fear worse. To learn how to control it, you need to meet him face to face. Of course, this won't happen right away. nine0006

First, you and your doctor will write down the steps that will help you get rid of anxiety for you. For example, if your goal is to overcome your fear of flying, the list might include the following steps:

  • look at photos of aircraft, cabin, and passengers;
  • reread good flight reviews;
  • describe what reward awaits you after landing;
  • buy a plane ticket;
  • check in for a flight;
  • have tea by the porthole. nine0061

Then, under the guidance of your therapist, you will start working on the list. The goal is to dwell on each frightening item until the fear subsides. Most of the time will be spent on working out the first steps.

As you complete each item, you will put a bold tick. This will help you stay confident that you are in control of the situation and make it easier to keep moving towards your goal.

Take medication if necessary

In some cases, psychotherapy alone is not enough. Your doctor may prescribe medication to relieve your anxiety. For example, sedatives or antidepressants.

This article was first published in November 2015. In April 2020, we updated the material.

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  • What is bipolar affective disorder and how to live with it
  • Personal experience: how I got off antidepressants
  • 9 symptoms of obsessive-compulsive disorder that should not be ignored
  • 10 early symptoms of schizophrenia not to be missed
  • 12 signs of anxiety disorder

causes, symptoms, diagnosis, treatment, therapy and drugs

Anastasia Somova

worries a lot

Author profile

Since childhood, I suffered from increased anxiety, and at 22, a psychiatrist diagnosed me with generalized anxiety disorder.

I am now 24 years old and have had severe anxiety since I was 15 years old. I was treated for vascular dystonia, headaches, sleep problems, low blood pressure.

In the eleventh grade, at the peak of preparation for the Unified State Examination, I fainted at school and ended up in the hospital - in the children's neurological department. There, too, no one suspected a psychiatric diagnosis and problems with mental health. But they prescribed a whole list of non-working drugs - nootropics and the like. At that moment, I myself did not know anything about mental disorders. nine0006

Explain how I got the correct diagnosis and how I live with Generalized Anxiety Disorder.

Go see a doctor

Our articles are written with love for evidence-based medicine. We refer to authoritative sources and go to doctors with a good reputation for comments. But remember: the responsibility for your health lies with you and your doctor. We don't write prescriptions, we make recommendations. Relying on our point of view or not is up to you.

What is Generalized Anxiety Disorder

The International Classification of Diseases has an entire section on anxiety and fear-related disorders.

Generalized Anxiety Disorder in Adults - Uptodate

Generalized Anxiety Disorder in Adults: Management - Uptodate

Generalized Anxiety Disorder is the most common among them. In addition, this disease is generally one of the most common mental disorders. nine0006

Why Generalized Anxiety Disorder develops is not yet known. Perhaps this is due to a disruption in the production of a number of neurotransmitters, that is, connections due to which brain neurons communicate with each other, or to a change in metabolism in some parts of the brain. There is also a link between increased anxiety and a large number of traumatic situations, especially in childhood.

Generalized Anxiety Disorder - NHS

Generalized anxiety disorder can begin at any age. For no reason, a strong anxiety appears that prevents a person from living and working normally. Anxiety attacks can be accompanied by bodily manifestations: a feeling of lack of air, a strong heartbeat, numbness of the limbs, and others.

The disease does not pass without a trace, not only for the psyche. According to some data, increased anxiety increases the risk of coronary heart disease and hypertension, and also increases the risk of death from cardiovascular diseases in general. nine0277

I believe that my disorder began to manifest itself in childhood. I grew up with a constant feeling of anxiety, which became stronger with age. My father is a very specific person. He could at one point just stop talking to me and mom. I collected my things and "moved" to another room - the apartment was big enough. I don’t know why I, a small child, fell under this “torture by silence”. Colliding in the corridor or at the front door, we did not say hello. nine0006

I also had constant headaches from the age of six. I was examined, but the reasons were not found. Neurologists prescribed glycine, physiotherapy and pain relief according to the situation.


How to treat migraines in children and teens

Now, after going through therapy and many hours of self-digging, I understand that almost every interaction with my father went through anxiety.

For example, with a good family income, you had to beg for clothes, choosing the time when he was in a good mood. Trips - no matter to the country or abroad - have always been nervous and stressful. nine0006

I wasn't taught to recognize emotions, so I didn't know it was anxiety. I felt it as a restless state in which everyone lives in one way or another - that's how it seemed to me then.

Headaches, by the way, disappeared with the start of taking antidepressants. The psychiatrist said that most likely they were one of the symptoms of the disorder.

Symptoms of generalized anxiety disorder

Kirill Sychev

psychiatrist, psychotherapist

The main difference between generalized anxiety disorder and other disorders is that anxiety in it is not limited to specific situations. That is, anxiety lasts for a long time - a month or more, for at least two weeks, and does not depend on what the person does. nine0006

The main signs of pathological anxiety are intense, constant, almost uncontrollable, and appear without clear causes. A person with an anxiety disorder usually feels fear, distress, and impending danger most of the time.

Anxiety becomes a constant companion: a person wakes up in anxiety, worries all day for a million different reasons and without, falls asleep for a long time and sleeps badly because of anxiety. At the same time, he cannot cope with this feeling on his own. nine0006

Life before diagnosis

Anxiety did not recede in adolescence, and then it only got worse. After school, I entered St. Petersburg State University, where I really wanted to go. However, as a result, I was expelled at the end of the third year - I did not even pass the session to get an incomplete higher education.

Six months before that, there was a period of constant causeless anxiety, absolute powerlessness, inability to sleep and unwillingness to get out of bed. Most of the time I didn't go to university. The people around attributed everything to laziness, but in fact, sometimes I physically could not force myself to get out of bed and go to study. In fact, I did everything to be expelled: I didn’t have the strength to reach the administration and refuse to study myself. And the alarm would not even allow me to enter the faculty building. nine0006

It was not customary in my environment to talk about problems with mental health. Perhaps if I had come across a person, video or text with recommendations to go to a psychiatrist with my symptoms, I would not have been expelled and life would have turned out differently.

After leaving the university for two years, I lived in a state of anxiety. I had a constant headache, ten painkillers were enough for a week. I went to a neurologist - he prescribed muscle relaxants and nootropics, and advised melatonin for sleep problems. nine0006


Nootropics: do they really improve brain function

My body has never been relaxed. Every little muscle was tense every second. Massage trips always took place with the requests of the master to relax. I didn’t sleep well, I could wake up at night and lie awake for several hours.

Anxiety arose even because of everyday trifles and was incommensurable with the problem. For example, dirty dishes in the sink in the morning, which the boyfriend had to wash, became the cause of terrible anxiety for the whole day. Even fixing the problem - washing dishes - did not change the state. nine0006

I think it comes from childhood - my father constantly scolded me for what I thought was a mess. It seemed to me that the dirty dishes in the sink meant that I was useless, you couldn’t love me, you had to leave me as soon as possible. In those moments, I did not recognize such thoughts as strange and illogical.

There was a similar situation with spending money: I bought something expensive, spent the money, so you can’t love me, you have to leave me alone. At the same time, my boyfriend and I have been together for a long time and have never quarreled over expenses that fit into the budget. nine0006

Community 08/24/21

How to get rid of the idea that there is not enough money?

In general, I had a clear set of anxiety triggers. These are dirty dishes and the floor, spending money on something relatively expensive, buying coffee to go, talking with your father. And if before the trigger, anxiety was background, then after it began to grow to the size of an entire planet.

At this time, popular science books came into my life. In the summer I bought a book by Daria Varlamova and Anton Zainiev “Go crazy! A Guide to Mental Disorders for a Big City Resident. One of the chapters is devoted to anxiety disorders - and it was about me, and so precisely that it became scary. At the same time, I learned about the Beck test for determining the level of anxiety, passed it and got almost the maximum score. nine0006

Beck's Anxiety Scale in Russian

However, I still didn't think about the urgent need for a psychiatrist. To go to the doctor, I had to make an effort and admit that I have a problem. I didn’t want to do this - I was afraid to be unnecessary and unloved again. After all, you cannot love a person with mental problems. My logic, of course, was wonderful.

Anxiety, like depression, has no face. I remember how bad I felt at that moment. And you can't tell from the photo

First visit to a psychotherapist and diagnosis

One day I went to the market where I bought Uzbek tomatoes for 800 R per kilo. They were insanely delicious, fit into the budget, that is, the purchase should not have caused me discomfort. However, anxiety didn't think so. She covered me as soon as I left the market building.

The anxiety was so strong that I did not remember either the way to the house or how I spent the evening. I was shaking, at home I locked myself in the toilet and sobbed sobbing. I was suffocating, I was terribly out of breath. The night did not sleep, every second I thought about the price of tomatoes. One obsessive phrase was spinning in my head: "Tomatoes cost 800 R per kilogram." nine0006


How to choose a psychotherapist

In the morning I began to google a psychotherapist. At that moment, I did not know about psychiatry according to compulsory medical insurance, as well as about the division of doctors into psychiatrists, psychotherapists and psychologists.

Can a psychologist work with anxiety disorders

Anna Shilova


For a psychologist, the first meeting with a client is a diagnostic one. On it, we find out whether it is necessary to connect a psychiatrist. I ask questions about the quality of sleep, the level of libido, eating habits and appetite, chronic and current diseases, fatigue, somatic manifestations of anxiety, if any. nine0006

When I complain about anxiety, regardless of the data that I collected during the first meeting, after it I send a diagnostic questionnaire - it allows you to determine the likelihood of a diagnosis.

As a psychologist, I have no right to make diagnoses - this is beyond my competence. This part of the work is done by a psychiatrist. If, according to the results of the questionnaire and the collection of information, there are symptoms of a disorder, I send the person for a psychiatric consultation. I do this even with the slightest suspicion, because only a doctor can comment on whether it is necessary to connect medication to psychotherapy. nine0006

I chose my first psychotherapist based on reviews and the ability to see me on the same day. The appointment then cost 3500 R. At the clinic, I was met by a pleasant doctor, led to the office, where he asked me to tell me what was bothering me. I told him about the tomatoes, the inability to sleep well, and my relationship with my father.

3500 Р

one appointment with a private psychotherapist cost

Before the appointment, I made a checklist for myself, where I wrote down the main causes of anxiety. It helped me a lot - due to the large flow of emotions at the reception, it was difficult to focus on my thoughts. The psychotherapist asked me questions, led me to reasoning, as a result, he diagnosed me with generalized anxiety disorder, and prescribed treatment. nine0006

Diagnosis of generalized anxiety disorder

Kirill Sychev

psychiatrist, psychotherapist

For a doctor to make a diagnosis, a person must have the following manifestations:

  • difficulty in relaxing, constant tension, restlessness. Sometimes even headaches due to this tension;
  • vegetative manifestations: sweating, tachycardia, dizziness, tremor, gastrointestinal disorders, cold extremities, and others. nine0061

    The DSM-5 American Diagnostic Manual also emphasizes that a person must have at least three of these symptoms: feeling "on edge", easy fatigue, difficulty concentrating, irritability, muscle tension, or sleep disturbance.

    Treatment of generalized anxiety disorder

    Anxiety disorder is treated with psychotherapy, particularly cognitive behavioral therapy, and medications, most commonly antidepressants. Psychotherapy can sometimes be used as the main method of treatment - it depends on the severity of anxiety and the patient's capabilities, since not everyone can regularly visit a psychotherapist. nine0006

    Pharmacotherapy for Generalized Anxiety Disorder in Adults - Uptodate

    Generalized Anxiety Disorder in Adults: Cognitive Behavioral Therapy and Other Therapies - Uptodate

    My doctor recommended antidepressants at my first consultation. He told about their work and how to properly start a reception.

    I really liked the metaphor about crutches and broken legs. Crutches are antidepressants. They will not help the leg grow together, but they will make life easier and make it possible to walk while the leg in the cast grows together. Gypsum, on the other hand, is therapy and its own work. You can walk on crutches for a long time without a cast, but nothing good will come of it. nine0006

    With a psychotherapist, we also went through therapy. Then I didn’t know about different methods and schools of psychotherapy, so I can’t say exactly what technique he used. Most likely, it was one of the variations of cognitive behavioral therapy.

    I was prescribed an antidepressant from the group of selective serotonin reuptake inhibitors, or SSRIs. Simply put, these drugs increase the concentration of serotonin in the brain, which improves mood and relieves anxiety. However, in the first weeks of taking such medications, they can cause the opposite side effect - increased anxiety. Therefore, in addition, I was prescribed a tranquilizer. He also helped to sleep well. nine0006


    8 myths about antidepressants

    When I first handed the prescription to the pharmacist, I felt like I was buying something forbidden and scary. In the countries of the former CIS, antidepressants, it seems to me, do not have a good reputation, but in fact there is nothing wrong with such pills, let alone prohibited.

    Tranquilizer relieves symptoms almost immediately. For a long time I lived with the feeling that someone stepped on my chest and I couldn’t breathe normally. The feeling of relaxation and calmness that I got after the first use of the medicines is hard to forget. It's like taking off uncomfortable shoes after a hard day's work or unzipping your jeans after a heavy meal - only ten times better. nine0006

    Taking an antidepressant was easy enough for me. A month later, I again went to a psychotherapist and received a prescription for six months. In addition, I was also prescribed one of the neuroleptics for sleep. It took about 900 R per month for pills. We also discussed the issues that worried me again, they mainly concerned behavior patterns.

    900 R

    on average I spent monthly on pills

    Summer and early autumn after the first dose were among the best for me in several years. I lived the life of an ordinary person, I had enough strength to work, go to the gym, take long walks. If earlier I started shaking at the sight of a dirty plate in the sink in the morning, now it worried me much less. nine0006 My prescriptions for drugs

    How generalized anxiety disorder is treated

    Kirill Sychev

    psychiatrist, psychotherapist

    Treatment of generalized anxiety disorder usually begins with cognitive behavioral therapy, if the person agrees to it and is ready to do it. If it does not help or this option is not suitable for a person, we use pharmacological treatment.

    Antidepressants, selective serotonin reuptake inhibitors and selective serotonin and norepinephrine reuptake inhibitors, i.e. SSRIs and SSRIs, are usually prescribed first. nine0006

    Antidepressants are well-researched and effective drugs. This is the same adequate treatment for mental disorders as insulin for a person with diabetes or a painkiller for a fracture. They restore the correct functioning of the brain and thinking, give the patient the necessary resource to fight the disease.

    Antidepressants are not addictive. From a medical point of view, addiction is a craving for use, accompanied by a constant increase in the dose of the substance taken. When taking antidepressants, there is no such craving. The patient does not need to constantly increase the dose. However, at the stage of selecting the drug, the doctor can increase it. nine0006

    There are concepts of the minimum and maximum therapeutic dose - the first is not always enough, but they never rise above the maximum. And then the patient drinks the medicine in the required amount until the end of the course.

    In the treatment of depression and anxiety disorders, antidepressants should be taken for at least a year from the moment the condition noticeably improves. So the risk of relapse is lower.

    The first unsuccessful attempt to get to a doctor under compulsory health insurance

    In the autumn, a few months after the start of treatment, I decided to go to a psychotherapist again. The anxiety went away, but the dream began to go astray, there were questions that I would like to solve in therapy: I still transferred the patterns from the relationship with my father to the relationship with my boyfriend. At that moment, the price of seeing a paid psychotherapist increased to 5,000 R. I could not afford it and for the first time decided on CHI therapy. nine0006

    At that time, a list with numbers of free psychological help roamed the Internet. There was also a number of a free psychotherapist in St. Petersburg, where I lived. Everything turned out to be not so simple: at first, I called the reception desk of one of the PNDs for about an hour, and they told me to call another phone number. By the second number they gave me another number. As a result, after a couple of hours, I got through and made an appointment. They asked me for my name and age, gave me the address and name of the doctor.


    How psychotherapy works

    The office was in one of the clinics in my neighborhood. I arrived for the session at nine in the morning. At the registry, which was separate for a psychotherapist, they took my address of residence, passport number, compulsory medical insurance and SNILS, then I went to the doctor.

    The first question the therapist asked me was if I was working. At that moment, I had problems with this, I honestly answered that I didn’t, and my boyfriend helps me with money. Here he began to scold me. He said that I had no right to apply for help under compulsory medical insurance, that I had to go to a paid doctor, that I was a parasitic and all that. And also that I can’t come to him, because this is an office not in my place of residence. After that, I didn’t want to open up to the person, I shrunk in my chair and almost cried. But I needed to extend the prescription - this is the only thing that kept me from escaping. nine0006

    After somehow telling what I take and what my diagnosis is, I asked for a prescription. He shook his head and began to tell me that I needed to leave Russia and there was nothing for me to do here. Then he recommended taking Phenibut, a drug that is available by prescription, but does not have proven effectiveness.


    9 problems of free healthcare in Russia

    I left the office in shock. Fortunately, this did not affect my psyche - from the very beginning I managed to build an armor between me and this pseudo-psychotherapist. By the way, in the end he wrote out the prescriptions I needed. However, the experience was unsuccessful, so until the next year I was afraid to even think about psychotherapy. nine0006

    Minor work helped me get rid of obsessive thoughts during the treatment process. For the first time in my life, I picked up a hook and began to knit a string bag. Then it had to be dissolved, but these are trifles But I still knitted a blanket made of special yarn - still one of my favorite things
    Minor work helped me get rid of obsessive thoughts during the treatment process. For the first time in my life, I picked up a hook and began to knit a string bag. Then I had to unravel it, but these are already trifles. But I nevertheless knitted a blanket made of special yarn - still one of my favorite things

    Treatment by a psychiatrist at the district dispensary according to CHI

    In winter, I went into remission, which means that I felt like a healthy person for a long time on the therapeutic dosage of the medicine. Then I decided to reduce the dosage. A paid psychotherapist told me about the correct exit from treatment in one of the first sessions, so it seemed to me that I understood how to do it.

    Back then, I was actively sitting on a mental health forum where people share their stories of illness and treatment. You can also consult a psychiatrist there. Such a consultation will not replace treatment and face-to-face sessions, but it can help in situations where you need an answer to a small question, but you don’t want to pay 5000 R for a session. nine0006


    12 important questions for psychiatrist Kirill Sychev

    I asked a question on the forum about stopping pills and received general recommendations. The dosage of the antidepressant was reduced very slowly, reaching 1/8 tablet. It was hard, because out of ignorance I did not take anything to alleviate the symptoms.

    Of course, stopping antidepressants on my own was a big mistake. When taking any medication, you do not need self-activity and advice from the Internet. nine0277 I decided to stop taking the pills too early - it was necessary to take antidepressants for at least a year from the improvement of the condition, best under the supervision of a doctor.

    Why you can’t stop drugs or change the dosage on your own

    Kirill Sychev

    psychiatrist, psychotherapist

    You can’t stop psychiatric drugs on your own, because there is a high probability that side effects or a withdrawal syndrome will occur.

    It is best to be in touch with your doctor during dose changes or withdrawals. So you can choose the right withdrawal tactics, add other drugs for this period that will remove side effects, change the rate of withdrawal, taking into account the reaction of the body. nine0006

    In the spring of 2020, the COVID-19 pandemic struck, and I again developed severe anxiety. The social and medical problems associated with the coronavirus bypassed me, there were no objective reasons to worry. And I was worried.

    And it happened all of a sudden. I could do yoga and in the middle of the practice lie on the floor with a rapid heartbeat due to sudden unreasonable anxiety or suddenly cry. It feels like a sudden wave: it covers your head, you can’t run away from it anywhere. nine0006

    About two months had passed since the end of taking the pills. I tried to cope with anxiety non-drug - meditation, dynamic relaxation according to Jacobson, freewriting about experiences. It did not help. The prices for therapy at that moment rose again, and I needed, if not psychotherapy, then definitely crutches in the form of pills.


    How much does it cost to support a relative with a mental disorder? To do this, I found the address of the district PND in the issuance of a search engine, called the registry office and found out what was needed for admission. Everything turned out to be simple:

    1. You need to come to the PND, contact the reception. There, give your passport, policy and SNILS, give the actual address of residence. At the reception, they will issue a card and call the office number.
    2. People go to the office in a queue. Each section has its own psychiatrist. You cannot sign up for a specific time, as it happens in a regular clinic. It is better to come early, then you will get there faster. Arriving 15-20 minutes before the doctor started the appointment, on average I was third or fourth in line. nine0061

    At the appointment, the psychiatrist asked me what was bothering me. I told my story, he offered me several antidepressants to choose from, talking about the pros and cons of each. He also prescribed a tranquilizer to remove the primary side effects.

    The antidepressant was from the same group as the first time, but different. The packaging cost me 800 R, in total I bought two of them. I was told to come back in three or four weeks. This is necessary to understand whether the medicine suits me or not, whether the dosage needs to be adjusted. The diagnosis remained the same - generalized anxiety disorder. nine0006

    A month later, I came back to PND. At that moment, another doctor saw me, because my district police officer fell ill. During my visit to the dispensary, I talked with four different psychiatrists - and I had no problems with any of them. No one humiliated me, everyone spoke politely and professionally, they really tried to help.

    The pills did not help me this time, so the psychiatrist suggested trying to be treated in a hospital. With a residence permit in St. Petersburg, I could be hospitalized in a neurosis clinic. However, there was no registration, so they could only offer me a day hospital at the hospital named after. Kashchenko. nine0006

    You can get to the hospital only in the direction from the PND. The doctor appoints a day, issues a referral with which you need to come to the hospital. They make a card there, and then send it to the primary appointment with the doctor.


    How to get a certificate from the PND

    Treatment in a hospital according to compulsory medical insurance

    In total, I was treated in a day hospital twice. I don't have a single negative memory associated with it, I liked this place, I liked the people there.

    Treatment is quite simple. After an initial conversation with a psychiatrist, medications are selected. You also need to consult with a clinical psychologist, make a cardiogram, if necessary, visit other doctors - for example, a cardiologist or endocrinologist. This can be done either in the hospital itself, or in the clinic in the direction. nine0006

    Clinical psychologist gives tests for attention and memory. Together with him, we also filled out several questionnaires - for the level of anxiety and the presence of depression.

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    What is depression?

    There is a psychotherapist in the hospital, and a psychiatrist also makes appointments with him. Usually these are one-hour sessions once or twice a week. You can also go to a theater or art studio, to bibliotherapy, dance therapy, adaptive yoga. All this is free.

    Studio teachers really want to help patients. People in the hospital are different, with different diseases, different states of mind, but it was very comfortable to work with everyone. nine0006

    Neat and pleasant day care unit In the head nurse's office, before admission, you need to fill out documents with basic information: height, weight, pressure, place of work. For the duration of treatment, they give sick leave, if necessary
    The day hospital has a small ward with beds. There are patients who are put on drips. And I was lying down there after taking blood - I always do not tolerate the procedure There were many flowers in the hospital. I then became interested in plants, so this mini-garden was very pleasing
    Neat and pleasant department of the day hospital In the head nurse's office, before admission, you need to fill out documents with basic information: height, weight, pressure, place of work. A sick leave is given for the duration of treatment, if necessary. There is a small ward with beds in the day hospital. There are patients who are put on drips. And I was in bed there after taking blood - I always do not tolerate the procedure well. There were a lot of flowers in the hospital. I then became interested in plants, so this mini-garden made me very happy. The hospital is located in the city center, not far from Sennaya Square. During the pandemic, I went there by taxi and returned on foot. I called it a “healing walk” because it helped me get distracted

    I went to psychotherapy twice a week, every other day I went to the psychiatrist. I wanted to go to yoga several times, but it was early in the morning, I woke up every time.

    The way psychotherapy sessions go depends on the methodology that the therapist uses. I wanted to do cognitive behavioral therapy, one of the techniques supported by evidence-based medicine. This was not the case at the hospital, but my doctor offered to help me find a good private therapist working in this direction if I wanted to. nine0006

    Tablets prescribed by a doctor were distributed by nurses in a special room. You need to go to the hospital often - at first every day, then every other day, at the end at least twice a week. The drugs are given in the amount they are needed for the time while the patient is not in the hospital. The nurses are sympathetic and sweet, they call everyone by diminutive names, they remember them in just a couple of days.

    In the hospital they provide food, you can have breakfast and lunch. The food is ordinary hospital food, but I liked it: I love simple food, especially all sorts of stews. nine0006


    “Reminds me of a strict regime sanatorium”: how much I spent on treating depression

    During the pandemic, consultations with psychotherapists were moved to Skype, and visits to a psychiatrist were once or twice a week, sometimes more, depending on the state.

    Due to frequent visits, any changes in the condition are easily monitored and the dosage of drugs is quickly adjusted. For example, once I was unsuccessfully prescribed a drug. The next day, I told about it at the meeting - and it was canceled for me. nine0006 There are many drawings on the walls of patients who go to the art studio here. My favorites are a pig and a space cat.

    Treatment in the hospital continues until a stable condition is reached. For example, in my case it was the disappearance of constant anxiety for at least a few weeks.

    Both times I left the hospital myself because I got tired of visiting it so often. But before that, the doctors selected a treatment for me, and it worked. I had to try several schemes. As a result, we came to my very first medicine, only at a dosage 2.5 times higher. I still take it. nine0006

    My experience only describes a particular hospital. The system of psychiatry in Russia is imperfect, it is difficult, but possible, to find a competent doctor for CHI. The biggest problem in this situation is not to run into a specialist who will only make things worse. However, incompetent specialists are also found in the commercial system.

    Even then, I began to actively buy books about anxiety and mental disorders. It helped keep me going

    How I currently live with Generalized Anxiety Disorder

    I am still undergoing compulsory medical insurance. It will soon be a year since I follow the latest version of the therapeutic regimen. Once every three or four months I go to a paid psychologist, a consultation costs 3500 R, but now I don’t need regular therapy.

    Increased anxiety is still in my life, but it does not immobilize me, does not deprive me of freedom. I still have problems sleeping, and the crowd is filled with terrible anxiety and lack of air. Mostly somatic manifestations remained: muscle tension in trigger situations, a feeling of lack of air and headaches if I am very nervous. nine0006

    On the other hand, I learned a lot during the treatment period: talk about problems, look for solutions, work with anxiety, and even relax. Both psychotherapy and antidepressants helped me with this.


    Pros and cons: is it worth spending money on a psychotherapist

    I spend 28,250 R per year on the treatment of anxiety disorder

    Spending Cost Total for the year
    Psychotherapist appointment From 3500 R per visit 14 000 R
    Antidepressants - pack of 100 tablets, enough for me for 40 days 1200 R per pack 10 950 Р
    Antipsychotic - pack of 60 tablets, enough for me for 120 days 1100 R per pack 3300 R

    Psychotherapist appointment


    From 3500 R per visit

    Condition for the year

    14 000 R

    Antidepressants - in a pack of 100 tablets, I have enough for 40 days


    1200 R per pack

    9000 950 2 9000 9000 Neuroleptic - In a pack of 60 tablets, I have enough for 120 days


    1100 R per pack

    Total for the year

    3300 R

    What helps me to work with anxiety

    I will talk about books, applications and other things that are helped me before and help me now, but do not replace therapy and taking pills:

    1. Mental health diary application. It is built on the principles of cognitive behavioral therapy. Helps to recognize automatic thoughts and rationalize them, makes it possible to become more conscious. The application has a diary of automatic thoughts, where you can write daily what worries you. My favorite feature is the destruction of negativity, try it.
    2. Robert Leahy, "Freedom from Anxiety". A must have book for all anxious people. The author is a doctor of psychology, adheres to the methods of cognitive therapy. You can read in order, or you can only read the chapters of interest. It will not replace therapy, but it will help to understand where the anxiety manifestations come from, teach you how to work with the disorder. nine0061
    3. Forum "Emotional Balance". As in any other forum, the audience there is different, so the information needs to be filtered. However, it was there that they supported me when I was very ill. Here you can also consult with psychiatrists, read useful articles and case histories of other people.
    4. TED Talks about psychological first aid and emotional hygiene.
    5. Lindsey K. Gibson, Adult Children of Emotionally Immature Parents. One of my favorite books that helped me understand and let go of my relationship with my father. The book has interactive tasks to help work through the questions. nine0061
    6. Muscle relaxation according to Jacobson. I like a particular video, but there are many options on the Internet.
    7. Application for Insight Timer meditation and Valery Veryaskin's meditation. I tried a thousand and one meditations, but only Valery's audio helps me relax and fall asleep in the evening. My favorite is The Practice of Relaxation.


    1. If you feel that anxiety interferes with your life, you should go to a psychiatrist. For self-examination, you can take the Beck test. nine0061
    2. It is better to ask for help - to the doctor, relatives, friends, people on the forum. Anxious thoughts are much easier to deal with if you speak them out.
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