Therapy treatment for anxiety
Anxiety disorders - Diagnosis and treatment
Diagnosis
You may start by seeing your primary care provider to find out if your anxiety could be related to your physical health. He or she can check for signs of an underlying medical condition that may need treatment.
However, you may need to see a mental health specialist if you have severe anxiety. A psychiatrist is a medical doctor who specializes in diagnosing and treating mental health conditions. A psychologist and certain other mental health professionals can diagnose anxiety and provide counseling (psychotherapy).
To help diagnose an anxiety disorder, your mental health provider may:
- Give you a psychological evaluation. This involves discussing your thoughts, feelings and behavior to help pinpoint a diagnosis and check for related complications. Anxiety disorders often occur along with other mental health problems — such as depression or substance misuse — which can make diagnosis more challenging.
- Compare your symptoms to the criteria in the DSM-5. Many doctors use the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, to diagnose an anxiety disorder.
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Treatment
The two main treatments for anxiety disorders are psychotherapy and medications. You may benefit most from a combination of the two. It may take some trial and error to discover which treatments work best for you.
Psychotherapy
Also known as talk therapy or psychological counseling, psychotherapy involves working with a therapist to reduce your anxiety symptoms. It can be an effective treatment for anxiety.
Cognitive behavioral therapy (CBT) is the most effective form of psychotherapy for anxiety disorders.
Generally a short-term treatment, CBT focuses on teaching you specific skills to improve your symptoms and gradually return to the activities you've avoided because of anxiety.
CBT includes exposure therapy, in which you gradually encounter the object or situation that triggers your anxiety so you build confidence that you can manage the situation and anxiety symptoms.
Medications
Several types of medications are used to help relieve symptoms, depending on the type of anxiety disorder you have and whether you also have other mental or physical health issues. For example:
- Certain antidepressants are also used to treat anxiety disorders.
- An anti-anxiety medication called buspirone may be prescribed.
- In limited circumstances, your doctor may prescribe other types of medications, such as sedatives, also called benzodiazepines, or beta blockers. These medications are for short-term relief of anxiety symptoms and are not intended to be used long term.
Talk with your doctor about benefits, risks and possible side effects of medications.
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Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.
Lifestyle and home remedies
While most people with anxiety disorders need psychotherapy or medications to get anxiety under control, lifestyle changes also can make a difference. Here's what you can do:
- Keep physically active. Develop a routine so that you're physically active most days of the week. Exercise is a powerful stress reducer. It may improve your mood and help you stay healthy. Start out slowly and gradually increase the amount and intensity of your activities.
- Avoid alcohol and recreational drugs. These substances can cause or worsen anxiety. If you can't quit on your own, see your doctor or find a support group to help you.
- Quit smoking and cut back or quit drinking caffeinated beverages. Both nicotine and caffeine can worsen anxiety.
- Use stress management and relaxation techniques. Visualization techniques, meditation and yoga are examples of relaxation techniques that can ease anxiety.
- Make sleep a priority. Do what you can to make sure you're getting enough sleep to feel rested. If you aren't sleeping well, see your doctor.
- Eat healthy. Healthy eating — such as focusing on vegetables, fruits, whole grains and fish — may be linked to reduced anxiety, but more research is needed.
Alternative medicine
Several herbal remedies have been studied as a treatment for anxiety, but more research is needed to understand the risks and benefits. Herbal and dietary supplements aren't monitored by the Food and Drug Administration (FDA) the same way medications are. You can't always be certain of what you're getting and whether it's safe.
Some of these supplements can interfere with prescription medications or cause dangerous interactions.
Before taking herbal remedies or dietary supplements, talk to your doctor to make sure they're safe for you and won't interact with any medications you take.
Coping and support
To cope with an anxiety disorder, here's what you can do:
- Learn about your disorder. Talk to your doctor or mental health provider. Find out what might be causing your specific condition and what treatments might be best for you. Involve your family and friends and ask for their support.
- Stick to your treatment plan. Take medications as directed. Keep therapy appointments and complete any assignments your therapist may give you. Consistency can make a big difference, especially when it comes to taking your medication.
- Take action. Learn what triggers your anxiety or causes you stress. Practice the strategies you developed with your mental health provider so you're ready to deal with anxious feelings in these situations.
- Keep a journal. Keeping track of your personal life can help you and your mental health provider identify what's causing you stress and what seems to help you feel better.
- Join an anxiety support group. Remember that you aren't alone. Support groups offer compassion, understanding and shared experiences. The National Alliance on Mental Illness and the Anxiety and Depression Association of America provide information on finding support.
- Learn time management techniques. You can reduce anxiety by learning how to carefully manage your time and energy.
- Socialize. Don't let worries isolate you from loved ones or activities.
- Break the cycle. When you feel anxious, take a brisk walk or delve into a hobby to refocus your mind away from your worries.
Preparing for your appointment
You may start by seeing your primary care provider.
He or she may refer you to a mental health professional.
What you can do
Before your appointment, make a list of:
- Your anxiety symptoms. Note when they occur, whether anything seems to make them better or worse, and how much they affect your day-to-day activities and interactions.
- What causes you stress. Include any major life changes or stressful events you've dealt with recently. Also note any traumatic experiences you've had in the past or as a child.
- Any family history of mental health problems. Note if your parents, grandparents, siblings or children have struggled with any mental health problems.
- Any other health problems you have. Include both physical conditions and mental health issues.
- All medications you're taking. Include any medications, vitamins, herbs or other supplements, and the doses.
- Questions to ask your doctor to make the most of your appointment.
Some basic questions to ask your doctor include:
- What's the most likely cause of my anxiety?
- Are there other possible situations, psychological issues or physical health problems that could be causing or worsening my anxiety?
- Do I need any tests?
- Should I see a psychiatrist, psychologist or other mental health provider?
- What type of therapy might help me?
- Would medication help? If so, is there a generic alternative to the medicine you're prescribing?
- In addition to treatment, are there any steps I can take at home that might help?
- Do you have any educational materials that I can have? What websites do you recommend?
Don't hesitate to ask other questions during your appointment.
What to expect from your doctor
Your doctor will likely ask you several questions, such as:
- What are your symptoms, and how severe are they? How do they impact your ability to function?
- Have you ever had a panic attack?
- Do you avoid certain things or situations because they make you anxious?
- Have your feelings of anxiety been occasional or continuous?
- When did you first begin noticing your feelings of anxiety?
- Does anything in particular seem to trigger your anxiety or make it worse?
- What, if anything, seems to improve your feelings of anxiety?
- What traumatic experiences have you had recently or in the past?
- What, if any, physical or mental health conditions do you have?
- Do you take any prescription drugs?
- Do you regularly drink alcohol or use recreational drugs?
- Do you have any blood relatives who have anxiety or other mental health conditions, such as depression?
Preparing and anticipating questions will help you make the most of your time.
By Mayo Clinic Staff
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Therapy for Anxiety Disorders - HelpGuide.org
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Treatment of anxiety and anxiety in St. Petersburg
- Main
- Psychotherapy
- Stress
- Anxiety and restlessness
Anxiety and anxiety can be a normal condition caused by objective reasons. Such a natural emotional state for a person has a biological meaning: it allows you to adapt in stressful situations, mobilize the body's resources and maintain self-control in extreme situations. Moreover, it is an explicable and transient state.
Anxiety and restlessness, which interferes with the enjoyment and enjoyment of normal life, is a pathological condition. It can be steady, repetitive or severe, incessant for a long time. As a rule, over a long distance, anxiety and anxiety become the causes of some mental disorders and somatic diseases.
Left untreated, pathological anxiety and restlessness can lead to the development of neuroendocrine disorders, diseases of the gastrointestinal tract, nervous, cardiovascular, urogenital and respiratory systems.
In our clinic, depending on the case, the treatment of anxiety is carried out by psychotherapists or psychiatrists.
As a rule, outpatient psychotherapy sessions are sufficient to treat feelings of anxiety and restlessness. In the presence of pronounced symptoms of a pathological condition, drugs can be prescribed that restore healthy sleep and normalize mood.
Quiz: Spielberger Anxiety Scale
Read each of the following sentences carefully and choose an answer based on how you usually feel.
Anxiety and Worry Treatment Consultation:
+7 (812) 407-18-00
Thank you for your trust!
- Psychotherapy and therapeutic hypnosis
- Safe Medication Support
- Assistance in resocialization
| Service | Price | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Psychotherapist appointment | 5 000 ₽ | |||||||||||||||||||
| Family Therapy | 10 000 ₽ | |||||||||||||||||||
| Hypnotherapy | 8 000 ₽ | |||||||||||||||||||
| Psychiatric consultation | 5 000 ₽ | Psychological treatment of anxiety and anxiety Therefore, in addition to examination and examination (neuro- and psychological testing), the doctor can refer you to a cardiologist, gastroenterologist, neurologist or psychoneurologist for examination.
Relying on our point of view or not is up to you. 
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. 
I was examined, but the reasons were not found. Neurologists prescribed glycine, physiotherapy and pain relief according to the situation. 
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. 
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. 
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. 
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. 
" 
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. 
The psychotherapist asked me questions, led me to reasoning, as a result, he diagnosed me with generalized anxiety disorder, and prescribed treatment. 
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. 
Most likely, it was one of the variations of cognitive behavioral therapy. 
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. 
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. 
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. 
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. | 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 |
Treatment by a psychiatrist at the district dispensary according to compulsory medical insurance
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.
/list/psihiatr/
12 important questions to psychiatrist Kirill Sychev
I asked a question on the forum about the abolition of 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. 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 yourself
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.
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.
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.
/shizofreniya/
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:
- You need to come to the PND, apply to 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.
- 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.
At the appointment, the psychiatrist asked 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.
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 didn't 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.
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.
/spravka/
How to get a certificate from the PND
Treatment in a hospital according to compulsory health 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.
Clinical psychologist gives tests for attentiveness 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 an appointment 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.
| Neat and pleasant day hospital department | 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 |
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.
The pills prescribed by the doctor were dispensed 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.
They provide food in the hospital, 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.
/bye-depression/
“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.
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.
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.
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.
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.
/psychotherapy-pros-cons/
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 P |
Psychotherapist appointment
Cost
From 3500 R per visit
Total for the year
14 000 R
Antidepressants - in a pack of 100 tablets, I have enough for 40 days
Cost
1200 R per year
10 950 9
Neuroleptic In a pack of 60 tablets, I have enough for 120 days
Cost
1100 R per pack
Total for the year
3300 R
What helps me to work with anxiety
I will tell you about books, applications and other things that are, which are, which helped me before and help me now, but do not replace therapy and taking pills:
- 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.
- 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.
- Spiritual Balance Forum. 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.
- TED Talks about psychological first aid and emotional hygiene.
- 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.
- Muscle relaxation according to Jacobson. I like a particular video, but there are many options on the Internet.
- Application for meditation Insight Timer and meditation by Valery Veryaskin. 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.
Remember
- If you feel that anxiety interferes with your life, you should go to a psychiatrist. For self-examination, you can take the Beck test.
- It's better to seek help - from a doctor, relatives, friends, people on the forum. Anxious thoughts are much easier to deal with if you speak them out.
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