1) Is total recovery possible?
First, let’s define “total recovery.” To me that means that one’s life is not restricted by, or focused around, avoiding, hiding, or fearing high anxiety states. It’s not that one will never be anxious again, but rather, recovery means that one’s anxiety will be in proportion to the event. It’s helpful to remember that our “fight or flight” response is meant to keep us safe, either physically or emotionally.
Total recovery is possible for many people. However, for some people, particularly those who have had trauma in their lives, the tendency to react to life’s stresses or painful feelings may trigger anxiety or panic attacks.
People don’t recover for these reasons: They have not yet had the appropriate treatment, they have not done the work necessary for recovery, or they have other co-occurring conditions that complicate treatment (e.g. medical conditions).
2) What are the elements of effective treatment?
An effective treatment program is holistic, meaning it focuses on the whole person, not just the symptoms, and helps him/her understand why they have this problem, how they got it, and what they need to do to overcome the anxiety condition now and in the future. This means looking at the following areas:
- Biology: – diet, exercise, medical conditions, medication, herbs, vitamins
- Family background factors
- Personality factors
- Stress management strategies
- Anxiety reduction and panic control strategies
- Overcoming phobic avoidance behaviors
- Modifying attitudes and beliefs that create or contribute to anxiety
- Understanding one’s personal vulnerability to anxiety in order to prevent or prepare for relapses.
3) How long does treatment take?
While it may vary widely from person to person, you will decide how long treatment lasts. By the end of treatment, one should have made progress towards their goals, as well as have a clear understanding of what they need to do to continue their recovery process.
4) How does medication fit into a treatment plan?
On the positive side, medication is very helpful for some people whose anxiety is very chronically severe, and often helpful if depression is part of the clinical picture. Sometimes people must try different medications before they find what works best for them, with the least side effects. There are quite a few choices now, so the odds are good that one can find the medication that works for them.
On the negative side, medication may interfere with the sense of success and increased self-esteem one experiences from making progress by their efforts in therapy. It can interfere with learning; is the progress due to the medication or due to what one has learned about onesself and their anxiety? When medication subdues anxiety, the person may be less likely to try to understand themselves, making one more vulnerable to relapse when they are no longer on the drugs. In addition, it has been found that some people have difficulty getting off the medication because of a rebound effect where uncomfortable symptoms re-emerge.
5) How is working with anxious children and teens different?
When I work with an anxious child the family needs to be part of the treatment team. At times, sessions with the parents or family will be necessary. For adolescents that may or may not be the case.