What is Anxiety?

What is Anxiety?

焦虑是心灵和身体对压力,危险或不熟悉的情况的反应。在重要的事件之前,这是不安,痛苦,悲伤或害怕的感觉。一定程度的焦虑有助于我们保持警惕和意识,但对于那些患有焦虑症的人来说,感觉远远往往 - 它可以完全衰弱。

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焦虑症的类型188体育平台app

Abigail Powers Lott, PhD那andAnaïsStenson,博士

这re are many anxiety-related disorders, and they are divided into three main categories:

1。188体育平台app: Anxiety disorders are characterized by a general feature of excessive fear (i.e. emotional response to perceived or real threat) and/or anxiety (i.e. worrying about a future threat) and can have negative behavioral and emotional consequences.

2.Obsessive-compulsive and related disorders: Obsessive-compulsive and related disorders are characterized by obsessive, intrusive thoughts (e.g., constantly worrying about staying clean, or about one's body size) that trigger related, compulsive behaviors (e.g. repeated hand-washing, or excessive exercise). These behaviors are performed to alleviate the anxiety associated with the obsessive thoughts.

3.创伤和压力源相关疾病: Trauma- and stressor- related anxiety disorders are related to the experience of a创伤(e.g., unexpected death of a loved one, a car accident, or a violent incident like war or sexual assault) or stressor (e.g., divorce, beginning college, moving).

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  • Your anxiety disorder may be a特定恐惧症if you have a persistent and excessive fear of a specific object or situation, such as flying, heights, animals, toilets, or seeing blood. Fear is cued by the presence or anticipation of the object/situation and exposure to the phobic stimulus results in an immediate fear response or panic attack. The fear is disproportionate to the actual danger posed by the object or situation. Commonly, adults with specific phobias will recognize that their fear is excessive or unreasonable.在这里了解有关恐怖症的更多信息。
  • An excessive fear of becoming embarrassed or humiliated in social situations, which often leads to significant avoidance behaviors may be an indicator of118bet金博宝app 。Find out more about118bet金博宝app - 特别是如果您对社交场合的恐惧持续超过六个月。
  • Post-Traumatic Stress Disorder (PTSD)是最着名的创伤和压力源相关障碍。这些是与创伤的经验有关的疾病(例如,爱人,汽车事故,战斗或暴力事件的意外死亡)或压力源(例如,离婚,开始大学,移动)。该类别还包括急性应激障碍和调整障碍。完整的讨论重点的症状和治疗可以在这里找到。
  • 118bet金博宝 特点是过度,无法控制的担忧对活动和活动以及潜在的负面结果。这anxiety and worrymust cause significant distress or interfere with the individual's daily life, occupational, academic, or social functioning to meet diagnosis. The symptoms cannot be better accounted for by another mental disorder or be caused by substances, medications, or medical illness. Find more information here about118bet金博宝
  • 金宝博188滚球推荐反映了经验sudden panic symptoms(一般从蓝色,没有特定的触发)结合持续存在,挥之不去担心恐慌症状会恢复和害怕那些恐慌症状。症状包括经常性预期或意外的恐慌发作,可以持续几分钟到一小时。188平台首页
  • Obsessive-Compulsive Disorder (OCD)is one of a number of related disorders that share certain characteristics.重复和持续的想法(“痴迷”)通常导致苦恼并且,个人试图通过反复执行特定行动(“强制”)来缓解。共同痴迷的例子包括:恐惧失败以特定方式做事将导致harm为了自我或他人,对肮脏或受细菌污染的极度焦虑,关注忘记可能导致错误的结果或围绕精确性或对称性的痴迷。共同强迫的示例包括:检查(例如,门被锁定或误差),计数或排序(例如,金钱或家庭项目),并进行心理行动(例如,祈祷)。其他疾病包括概念(皮肤拣选),囤积,身体疑似疾病和三胞嘧啶(毛发牵引)。
  • Other categories of anxiety disorders include:分离焦虑症金宝博亚洲投注那and Agoraphobia as well as disorders that are substance-induced or are a result of other medical conditions.

原因和风险因素

Jessica Maples-Keller, PhD那andVasiliki Michopoulos,PHD

  • Comorbidities
  • Genetics
  • 环境因素
  • 医疗条件
  • Behavioral Choices
  • 人口统计学

It's important to note that everyone feels anxiety to some degree regularly throughout their life. Fear and anxiety are helpful emotions that can function to help us notice danger or threats that keep us safe and help us adapt to our environment. Anxiety disorders occur when significant distress impairs your ability to function in important facets of life, such as work, school, or relationships. There are many potential risk factors for anxiety disorders, and most people likely experience multiple different combinations of risk factors, such asneurobiological factors,遗传标志,环境因素和生活经验。但是,我们还没有完全理解导致一些人有焦虑症的原因。188体育平台app

Comorbidity is more common than not with anxiety disorders, meaning that most individuals who experience significant anxiety experience multiple different types of anxiety. Given this comorbidity, it is not surprising that many risk factors are shared across anxiety disorders, or have the same underlying causes. There is a lot of research identifying risk factors for anxiety disorders, and this research suggests that both nature and nurture are very relevant. It is important to note that no single risk factor is definitive. Many people may have a risk factor for a disorder and not ever develop that disorder. However, it is helpful for research to identify risk factors and for people to be aware of them. Being aware of who might be at risk can potentially help people get support or assistance to prevent the development of a disorder.

为所有焦虑症造成了遗传危险因素。188体育平台app临床遗传学研究表明,焦虑症的遗传性估算范围为30-67%。188体育平台app许多研究,过去和现在都集中在识别提高一个人对焦虑症风险的特定遗传因素。迄今为止,已经发现了一系列单核苷酸多态性(SNP)或遗传密码的小变化,已经发现了赋予焦虑症的风险。在大多数情况下,与焦虑风险相关的变体位于基因内,这对于神经递质系统或应激激素的表达和调节至关重要。

It is important to note that genetic factors can also bestow resilience to anxiety disorders, and the field continues to pursue large-scale genomics studies to identify novel genetic factors that are associated with anxiety disorders in hopes of better understanding biological pathways that 1) contribute to the development and maintenance of anxiety; and 2) may lead to better treatment for these disorders. Most people are not aware of what specific genetic markers they may have that confer risk for anxiety disorders, so a straightforward way to approximate genetic risk is if an individual has a history of anxiety disorders in their family. While both nature and nurture can be at play with family history, if several people have anxiety disorders, genetic vulnerability to anxiety likely exists in that family.

关于家庭内的环境因素,育儿行为也会影响患焦虑症。188体育平台app父s who demonstrate high levels of control (versus granting child autonomy) while interacting with their children has been associated with the development of anxiety disorders. Parental modeling ofanxious behaviorsand parental rejection of the child has also been shown to relate to greater risk for anxiety potentially. Experiencing stressful life events or chronic stress is also related to the development of anxiety disorders. Stressful life events in childhood, including experiencing adversity, sexual, physical, or emotional abuse, or parental loss or separation may increase the risk of experiencing an anxiety disorder later in life. Having experienced a traumatic event or very stressful event can be a risk factor for the development of anxiety across different age groups. Consistent with the notion of chronic life stress resulting in increased anxiety risk, having lower access to socioeconomic resources or being amember of a minority grouphas also been suggested to relate to greater risk.

体验慢性病或严重或频繁的疾病,也可以增加焦虑症的风险,以及处理家庭成员或亲人的重要疾病。188体育平台app鉴于若干医疗条件与显着焦虑有关,在某些情况下,医生可以进行医疗测试以排除潜在的医疗状况。例如,甲状腺疾病通常通过体验焦虑的重大症状来表征。更年期,心脏病,和糖尿病也与焦虑症状有关。此外,许多物质的药物滥用或戒断的特征在于急性焦虑,慢性药物滥用可以增加发展焦虑症的风险。焦虑也可以是某些药物的副作用。经历显着的睡眠障碍,例如难以入睡或入睡,也可能是发展焦虑症的危险因素。

行为选择也可以显着影响风险,因为过度烟草或过度烟草caffeineuse can increase anxiety, whereas regular exercise can decrease anxiety. Specific temperament and personality traits also may confer risk of having an anxiety disorder. With regards to temperament, shyness, and behavioral inhibition in childhood can increase the risk of developing an anxiety disorder later in life. About personality traits, the Five-Factor Model of Personality consists of five broad trait domains, including Neuroticism, Extraversion, Openness to Experience, Agreeableness, and Conscientiousness. An individual higher on trait Neuroticism or low on Conscientiousness is at a higher risk for all anxiety disorders, and an individual low on trait Extraversion is at a higher risk of developing social phobia and agoraphobia. Some more narrow personality traits have also been found to relate to risk for anxiety, including anxiety sensitivity, a negative or hostile attributional style, and self-criticism. Personality disorders have also been shown to relate to increased risk for anxiety disorders.

Demographic factors also impact the risk of anxiety disorders. While there is not a strong consensus, research suggests that risk for anxiety disorders decreases over the lifespan with the lower risk being demonstrated later in life.女性更有可能体验焦虑症。188体育平台app焦虑症的另一个稳健的生物学和社会危险因素是性别,因为女性的可能性是男性患有焦虑的两倍。188体育平台app整体症状严重程度也已被证明与男性相比,女性更严重,患有焦虑症的女性通常会报告比男性更低的生活质量。188体育平台app这种性别差异患有焦虑症的患病率和严重程度,让女性对男性的劣势并不具体对焦虑症,而且还发现抑郁症和其他与压力相188体育平台app关的不良健康结果(即肥胖症和心脏素质疾病)。基础科学与临床研究表明,卵巢激素,例如雌激素和孕酮,它们的波动可能在焦虑症患病症和严重程度的这种性别差异中发挥重要作用。While changes in estrogen and progesterone, over the month as well as over the lifetime, are linked to change in anxiety symptom severity and have been shown to impact systems implicated in the etiology of anxiety disorders (i.e., the stress axis), it still remains unclear how these hormones and their fluctuations increase women's vulnerability to anxiety.


Anxiety Physical Symptoms

Vasiliki Michopoulos,PHD

188体育平台app焦虑症增加了患有其他身体医学疾病的机会,例如心血管障碍,包括肥胖,心脏病和糖尿病。更具体地说,体重增加,腹部脂肪,高血压和更大水平的胆固醇,甘油三酯和葡萄糖都与焦虑联系起来。虽然尚不清楚导致焦虑和身体健康状况不佳的高融资,但研究表明,焦虑特征的潜在生物学的变化也可能促进这些其他身体健康结果随着时间的推移。例如,压力激素,自主反应以及高度的全身炎症的变化均与焦虑症和负健康结果相关。188体育平台app这些共同的生理国家建议他们共同分享生物学,焦虑可能是全身状况。

Anxiety disorders are associated with chronic life stress. Unpredictable, unrelenting, unresolvable stressors chronically stimulate the stress hormone system and cardiovascular system and lead to states of constant increased activity. Biologically, the body has evolved to deal with imminent and concrete danger in the environment, rather than continuous stressors. Under normal conditions where chronic stress is low, exposure to a sudden threat activates the autonomic nervous system, i.e., increased levels of adrenaline and faster breathing, and racing heart rate. These reactions, in turn, trigger activation of stress hormones, such as cortisol. One of the effects of these stress hormones is to increase glucose levels in the bloodstream to respond to the imminent threat so that muscles can be activated for the flight or fight response. Another effect of stress hormones is to suppress the immune system since processes such as healing and repair can wait until after the threat subsides. However, in someone with an anxiety disorder, where there is constant activation of these responses to everyday stressors, the stress hormone system loses its ability to control immune function, thus contributing to heightened systemic inflammation that increases the risk for cardiovascular and even autoimmune disorders. Neuroscience and clinical research continue to investigate how anxiety disorders increase the individual risk for developing physical health co-morbidities in hopes of identifying new treatments that may alleviate suffering from and prevent the development of these whole-body disorders.


Treatment Options

Yvonne Ogbonmwan, PhD

这re are many highly effective treatment options available for anxiety and anxiety-related disorders. These treatments can be broadly categorized as: 1) Psychotherapy; 2) Medications; and 3) Complementary and Alternative Therapies. Patients diagnosed with anxiety can benefit from one or a combination of these various therapies. Discussions of emerging therapies and types of care providers are also included.

循证疗法

咨询

咨询is a form of talk therapy in which a mental healthcare provider helps patients develop strategies and coping skills to address specific issues like stress management or interpersonal problems. Counseling is generally designed to be a short-term therapy.

心理治疗

这re are many types of psychotherapies used to treat anxiety. Unlike counseling,心理治疗更长期,目标是更广泛的问题,如行为模式。患者的特殊焦虑诊断和个人偏好指导最适合对待他们的疗法。任何类型的心理治疗的最终目标是帮助患者调节他们的情绪,管理压力,了解影响其人际关系的行为的模式。基于认知行为疗法(CBT),延长的暴露治疗(PE)和辩证行为治疗(DBT)等所示的疗法是一些最有效的治疗焦虑。

Cognitive Behavioral Therapy (CBT)

CBT.is a short-term treatment designed to帮助患者在导致焦虑的情况下确定不准确和消极的思考恐慌attacksCBT.can be used in one-on-one therapy or in a group therapy session with people facing similar problems. CBT primarily focuses on the ongoing problems in a patient's life and helps them develop new ways of processing their feelings, thoughts and behaviors to develop more effective ways ofcoping with their life。In patients who suffer from PTSD, CBT can take on a trauma-focused approach, where the goal is to process and reframe the traumatic experience that lead to the symptoms. On average, the length of treatment is around 10-15 weekly one-hour sessions depending on the type and severity of symptoms.

Prolonged Exposure Therapy (PE)

Prolonged exposure therapy is a specific type of CBT used to treat PTSD and phobias. The goal of this therapy is to help patients overcome the overwhelming distress they experience when reminded of past traumas or in confronting their fears. With the guidance of a licensed therapist, the patient is carefully reintroduced to the trauma memories or reminders. During the exposure, the therapist guides the patient to use coping techniques such asmindfulness或放松治疗/图像。这种治疗的目标是帮助患者认识到创伤相关的记忆(或恐惧症)不再危险,不需要避免。这种类型的治疗通常会持续8-16周次会议。

Eye Movement Desensitization Reprocessing Therapy (EMDR)

EMDR is a psychotherapy that alleviates the distress and emotional disturbances that are elicited from the memories of traumatic events. It is primarily administered to treat PTSD and is very similar to exposure therapy. This therapy helps patients to process the trauma so that they can heal. During the therapy, patients pay attention to a back and forth movement or sound while recounting their traumatic memories. Patients continue these sessions until the memory becomes less distressing. EMDR sessions typically last 50-90 minutes and are administered weekly for 1-3 months, although many patients report experiencing a reduction of symptoms after a few sessions of EMDR.

Dialectical Behavioral Therapy (DBT)

DBTuses a skills-based approach to help patients regulate their emotions. It is a preferred treatment for Borderline Personality Disorder, but call also be effective for anxiety disorders such as PTSD. This treatment teaches patients how to develop skills for how to regulate their emotions, stress-management, mindfulness, and interpersonal effectiveness. It was developed to be employed in either one-on-one therapy sessions or group sessions. This type of therapy is typically long-term, and patients are usually in treatment for a year or more.

Acceptance and Commitment Therapy (ACT)

ACTis a type of CBT that encourages patients to gain in positive behaviors even in the presence of negative thoughts and behaviors. The goal is to improve daily functioning despite having the disorder. It is particularly useful for treatment-resistant Generalized Anxiety Disorder and Depression. The length of treatment varies depending on the severity of symptoms.

Family Therapy

家庭疗法是一种组织疗法,包括患者的家庭,以帮助他们改善沟通,并开发更好的解决冲突技能。如果家庭对患者的焦虑有助于这种疗法,这种疗法很有用。在此短期治疗期间,患者的家庭学会了如何不使焦虑症状更糟糕并更好地理解患者。治疗长度根据症状的严重程度而变化。

Medications

Medications are sometimes used in conjunction with psychotherapy. The most commonly prescribed medications are generally safe, although some do have side effects to consider. The specific type of medication administered to patients will be determined by their providers based on the patient's specific symptoms and other factors like general health.

Antidepressants

抗抑郁药是用于治疗抑郁症状的药物,但也可用于治疗焦虑症状。特别是,选择性血清素再摄取抑制剂(SSRI)选择性去甲肾上腺素再摄取抑制剂(Snri.)are the primary class of antidepressant used to treat anxiety. SSRIs commonly used to treat anxiety are escitalopram (Lexapro) and paroxetine (Paxil, Pexeva). SNRI medications used to treat anxiety include duloxetine (Cymbalta), venlafaxine (Effexor XR).

Buspirone

Buspirone is a drug indicated for the treatment of anxiety. This drug has high efficacy for Generalized Anxiety Disorder and is particularly effective at reducing the cognitive and interpersonal problems associated with anxiety. Unlike benzodiazepines, buspirone does not have a sedative effect or interact with alcohol. Most importantly, there is a low risk of developing a dependence on buspirone. Its side effects are minimal but can include dizziness, nervousness, and headaches. BuSpar and Vanspar are brand names associated with buspirone.

苯二氮卓卓

苯二氮藻是诱人,表明焦虑,癫痫,酒精戒断和肌肉痉挛。苯并二氮虫病在治疗广泛性焦虑症的情况下表现出短期有效性,可以帮助睡眠障碍。188比分直播吧篮球医生可以在有限的时间内规定这些药物以缓解焦虑的急性症状。然而,长期使用这些药物由于它们具有强烈的镇静效果并且可以是习惯形成的。此外,服用苯并二氮虫病,同时也从事PE等心理治疗可以降低暴露治疗的有效性。一些知名的品牌名称是Liblium,Xanax,Valium和Ativan。

Beta Blockers

β受体阻滞剂,也称为β-肾上腺素能阻断剂,通过阻断神经递质肾上腺素(肾上腺素)。阻断肾上腺素减慢并降低心肌收缩力,导致血压降低。β-阻滞剂还增加了血管的直径,导致血流增加。从历史上看,β受体阻滞剂已被规定治疗焦虑的躯体症状(心率和震颤),但它们在治疗广泛性焦虑,恐慌症或恐惧症方面并不是很有效。188比分直播吧篮球188平台首页Lopressor和Inderal是您可能熟悉的品牌名称。

互补和替代疗法

互补和替代疗法可以与常规疗法结合使用以减少焦虑的症状。由于它们是非侵入性的,因此对这些类型的替代疗法产生了日益增长的兴趣,并且对患者来说可能有用。它们通常不旨在取代常规疗法,而是可以是可以提高患者的整体生活质量的辅助疗法。

压力管理

A collection of activities focused in which an individual consciously produces the relaxation response in their body. This response consists of slower breathing, resulting in lower blood pressure and overall feeling of well-being. These activities include: progressive relaxation, guided imagery, biofeedback, and self-hypnosis and deep-breathing exercises.

冥想

一个心灵和身体实践,指示个人以非评判方式注意到思想,感受和感觉。已经证明可用于降低焦虑患者心理压力的症状。

Yoga

A mindfulness practice that combines meditation, physical postures, breathing exercises and a distinct philosophy. It has been shown to be useful inreducing some symptoms of anxietyand depression.

新兴的疗法

这re are also a number of experimental treatments that have shown promise in treating the symptoms of anxiety. Here we include a brief description of a few of those, including brain stimulation (neurostimulation), acupuncture, and psychoactive drugs (marijuana and ecstasy).

Neurostimulation

焦虑与大脑中的活动异常相关。治疗焦虑的一种方法是直接针对异常神经细胞活性。神经调节或脑刺激治疗是一种刺激人脑的非侵入性和无痛的治疗。在最近的一些临床试验中,没有反应更传统的治疗形式(即药物)的患者表现出抑郁和焦虑症状的降低。有两种主要类型的神经调节:

  • 重复的经颅磁刺激(RTMS)

A large brief current is passed through a wire coil that is placed on the front of the head, which is near the areas that regulate mood. The transient current creates a magnetic field that produces an electric current in the brain and stimulates nerve cells in the targeted region. The current typically only affects brain regions that are 5 centimeters deep into the brain, which allows doctors to target which brain regions to treat selectively. Typical sessions last 30-60 minutes and do not require anesthesia. Sessions are administered 4-5 times a week for about six weeks. Although the procedure is painless, patients may experience a gentle tapping in the area of the head where the current is being administered. Neuromodulation has very few side effects, but they may include headaches, slight tingling, or discomfort in the area in which the coil is placed. rTMS may be administered alone or in combination with medication and/or psychotherapy.

  • 深度经颅磁刺激(DTM)

靶向更深的脑区的专业线圈比RTMS更深。患者佩戴缓冲头盔(类似于在FMRI期间佩戴的盔甲类型)。DTM中使用的线圈于2013年通过FDA批准用于治疗抑郁症,但目前正在研究治疗焦虑症,如OCD。188体育平台app该程序施用20分钟4-6周。每次治疗后,患者可以立即恢复日常生活。

Acupuncture

针灸是一种源自中医的治疗。它包括将薄针插入目标区域中的体内。迄今为止,虽然目前正在进行的PTSD研究试验,但针灸可以显着治疗广泛性焦虑。188比分直播吧篮球一项研究确实发现针灸可以减少术前焦虑。

Psychoactive drugs

最近有兴趣使用精神活性物质与心理治疗;已经收到了更多关注的两者大麻(大麻)和甲基二氧基甲丙胺(MDMA,称为狂喜或莫尔)。鉴于它们也有精神活性,即“感觉很高”的效果,这些药物有些有争议的争议。然而,随着大麻的合法化,重要的是解决这些物质是否可用于减轻焦虑的临床症状。虽然这些药物只有少数随机临床试验,但某些形式的大麻都对焦虑表现出积极影响。具体而言,大麻,大麻的组分对于社交焦虑症是有效的,而Tetrahydrocannabol(THC)有助于应激障碍患者。然而,大麻的植物形式没有显示出很大的疗效,并且有可能恶化症状,因此应该谨慎使用,并且仅在提供者的监督下使用。MDMA对PTSD显示了一些积极影响,但只能用作心理治疗的辅助,再次在临床护理下。


护理提供者的类型

有许多不同类型的许可精神卫生提供者可以治疗焦虑和其他相关疾病的范围。

Primary Care Physician

许多患者首先向其初级保健医生报告症状。初级保健医生(PCP)将彻底管理,以排除荷尔蒙失衡,药物的副作用和某些疾病。如果症状不是由于其他条件,医生可以患有焦虑的患者,因此将患者推荐给心理学家或精神科医生。医生练习医院,诊所和私人实践。

Clinical Psychologist

在临床心理学中授予授权的心理健康专家,治疗情绪,心理和行为问题。临床心理学家受过培训,提供咨询和心理治疗,进行心理测试,并为精神障碍提供治疗。他们一般不规定药物;但是,伊利诺伊州,路易斯安那州和新墨西哥州是唯一允许心理学家规定的国家。临床心理学家共同与精神科医生和/或PCP一起使用,他们为患者提供医疗治疗,而心理学家提供心理治疗。临床心理学家可以在医院,学校,咨询中心和集团或私人医疗实践中找到。

Psychiatrist

专门诊断和治疗心理健康障碍的医生(MD)。精神科医生可以为患者提供心理治疗并使药物分配药物。他们通常在医院工作,咨询中心和团体或私人医疗保健实践。

精神科护士

一名拥有精神健康障碍硕士或博士学位的护士。精神科护士可以诊断和治疗心理健康障碍。他们主要提供心理疗法,但在某些国家也可以开出药物。精神病护士还担任患者倡导者并提供案例管理服务。他们经常在私人做法,医院和学校工作。

Licensed Mental Health Counselor (LMHC) - Licensed Clinical Professional Counselor (LCPC) - Licensed Clinical Social Worker (LCSW) - Licensed Marriage and Family Therapist (LMFT)

A licensed mental health professional that has earned a master’s degree from a variety of educational backgrounds (e.g., general counseling background, social work, marriage, and family counseling). Once their formal education is completed, these clinicians usually undergo at least two years of supervised clinical experience in the field and pass an exam to become fully licensed in the state in which they practice. These mental health professionals are licensed to diagnose emotional, mental health, and behavioral health problems. They can provide mental health treatment in the form of counseling and psychotherapy, or work in other capacities as patient advocates or care managers. Licensed Master’s level clinicians work in many settings, including hospitals, community mental health clinics, private practice, school settings, nursing homes, and other social service agencies. Titles and licensing requirements may vary from state to state.

Clinical Social Worker

CSWs usually have a master's degree in social work and additional training to provide mental health services. They are qualified to provide case management and hospital discharge planning. They often work as patient advocates. Clinical social workers typically work in hospital settings, schools, clinics, social services or private practices


Where to Find Treatment

焦虑相关障碍的大多数治疗提供者可以在医院,诊所,私人或团体实践中找到。有些人还在学校运营(持牌心理健康辅导员,临床社会工作者或精神科护士。这re is also the growing field of telehealth in which mental health workers provide their services through an internet video service, streaming media, video conferencing, or wireless communication. Telehealth is particularly useful for patients that live in remote rural locations that are far from institutions that provide mental health services. Mental health providers that work in telehealth can only provide services to patients currently located in the state in which the provider is licensed.


Prevention and Coping With Anxiety

Sierra Carter, PhD

All human beings experience anxiety. In many cases, anxiety can have some beneficial and adaptive qualities such as pushing one to study for an upcoming difficult exam or propelling a person to flee from danger. Although experiencing some anxiety with life stressors and worries is normal, sometimes it can be difficult to manage and can feel overwhelming. Below we provide a list of tips and strategies to help individuals prevent anxiety from reaching a diagnosable level. Even though not everyone will struggle with a diagnosable anxiety disorder,学习策略帮助救援焦虑并管理日常生活中经历的“正常”焦虑可以帮助您过上您想要的生活。

学习放松策略

  • 放松策略,如深层膈肌呼吸,已被证明降低血压,慢心率,并减少与压力共同相关的张力。从事放松策略可以用允许您的身体从其焦急状态切换到更加轻松和平静的状态,以减少焦虑,以应对压力源。
  • 引导图像是另一种放松策略,可以帮助减少或防止压倒性的焦虑。引导图像涉及指示的心理可视化,以唤起放松。这可能涉及想象你最喜欢的海滩或一个可以分散你焦虑状态的宁静的花园,让你的思想和身体专注于图像运动的积极思想和感觉。
  • 学习利用放松策略作为焦虑的应对策略可以提高您能够在令人痛苦的情况下应对焦虑的信心。放松策略是焦虑预防工具,因为它们是免费的,简单,并且可以提供即时结果。

谨慎,冥想和瑜伽

  • A simple definition ofmindfulnessincludes the practice of being aware, without judgment, in the present moment. When feeling anxious, often, you might feel that you don't have control over your mind or your body's reaction to stress. You also might feel that anxiety causes you to focus and dwell on past mistakes or future fears.
  • 正念,冥想和瑜伽可以提高一个人对你周围世界的认识,并增加你对你如何体验的情况以及你如何回应的控制。当一个人感到不堪重负和压力时,对控制感的丧失往往是焦虑的症状。练习这些策略可以帮助您在目前的生活中生活,享受生活中的现状,为您带来快乐。

Exercise, Healthy Diet, and Rest

  • Another important prevention strategy for anxiety is to incorporate exercise into your daily activities. Exercise has been shown to decrease stress hormones that influence anxiety and also improve overall mood. Exercise can also help you disengage from worry and stress and focus on the current task of exercising. Exercises such as light jogging or brisk walking that can be incorporated into your daily activities can help reduce the impact of anxiety when it occurs.
  • A healthy diet is also important to reduce and prevent anxiety. It seems counterintuitive that you can "eat your way to calm" but sustaining a healthy diet can really help you to feel more at ease on a regular basis, despite stressors. Some foods that are particularly helpful for reducing anxiety include foods with omega 3 fatty acids (i.e., salmon, walnuts, and flaxseed) and probiotics. Avoid greasy, sugary, high-fat, and processed foods. Additionally, avoiding caffeine when feeling anxious as well as unhealthy substances (i.e., alcohol) could be beneficial. Drinking alcohol might seem like a good way to calm down, but it can lead to sustained anxious symptoms. Incorporating a healthy diet into your lifestyle is fundamental to preventing and reducing anxiety.
  • Not getting enough安宁睡眠可以引发焦虑。压力和焦虑也会干扰睡眠,让你在晚上保持清醒。当白天的压力和未来担忧导致你晚上熬夜时,它可能是一个令人沮丧的循环。花一些时间在床前卷起来,例如利用上述一些放松和冥想策略。此外,不是让您的思绪在晚上不断进行比赛,尝试将您的想法,担忧和计划在睡前的纸上进行纸张 - 这将缓解您忘记未来所需的事情,并让您放松和休息。

意识和识别触发器

  • A key component to the prevention of anxiety isawareness学习识别出现焦虑的思维模式,当他们出现时可以帮助您快速管理和减少它们。焦虑意识开始始于试图确定焦虑的原因和/或触发,并获得对其情绪和行为的理解。是你的老板最近给了你在工作中的负面反馈,你每天都很担心你对他们的标准做得不好吗?是你等到最后一分钟来学习考试,并且感到焦虑,你不会表现良好吗?意识到你的焦虑来源是找出缓解它的最佳方式的第一步。
  • 有时,你的生活中有一些东西,你已经知道引发焦虑。这可能是一个大测试,必须在观众面前发表演讲,以及与育儿相关的压力和焦虑。一旦你识别你的触发器,你就可以开始练习应对策略,以便在发生之前可以帮助平息焦虑。
    • 例如,如果您知道您常常在学习测试并获得重大测试焦虑时拖延,请尝试研究策略,提示您开始研究之前并设置现实的学习时间表。
    • If you can identify that after a long day of parenting you often feel exhausted and overcome with anxiety by all of the things you need to do, you can work to schedule in "me time" where you can make sure that you have time to relax, exercise or engage in an enjoyable activity that you know helps to reduce your anxiety. Taking care of yourself is important to be able to take care of others.
    • 有日记可以帮助你使用to track your stressors, mood, thoughts, and behaviors that are impacted by anxiety. This will further help you identify the cause of your anxiety and notice when you may be engaging in unhelpful thoughts that only increase your anxiety.

支持性友谊和家庭/联系治疗师

  • Some research shows that people who have close and supportive friendships have a greater ability to fight mental and physical diseases than isolated people. The mind can be our worst enemy when feeling anxious and having a supportive network that you can discuss and decompress your deepest worries to could help prevent anxiety from consuming your life. Find trusted friends during times of anxiety that you can open up to and know that they will provide a listening ear and supportive feedback about your experiences.
  • It should be noted that finding the right strategy that works for you to control your anxiety is important. Maybe you feel that you do not have the time to schedule "me time" with your busy schedule or kids, and you need to find another way to reduce your anxiety. A friend or therapist could be a great resource to turn to if you believe you need help with finding the right strategies to reduce your anxiety.
  • 这rapy services such as Cognitive Behavioral Therapy (CBT) have also been shown to help with the prevention of anxiety symptoms from reaching a diagnosable disorder. Even if you do not have a diagnosed anxiety disorder, attending therapy could be a wonderful resource to aid in gaining strategies to reduce your stress and anxiety.

Recognizing the Disorder in Others

詹妮弗史蒂文斯,博士

How do I recognize if someone close to me is having trouble with anxiety?

188体育平台app焦虑症是most美国常见的心理健康障碍,影响超过18%的人口。他们在儿童中更常见,影响了13岁和18岁之间的25%的儿童。最常见的焦虑症是特异性恐惧症,影响人口的8.7%,社会焦虑,影响6.8%的人口。188体育平台app

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你可能知道有焦虑症的人。

虽然有几种不同类型的焦虑障碍,每个都具有独特的特征,但有一些常见的症状可能是某人患有焦虑症的188体育平台app线索:

  • 这person indicates excessive anxiety or worry about future events. Some examples could be social situations, work demands, or separation from "safe" people or places such as a parent or the home.
  • 这person has feelings of恐慌and accompanying physiological reactions (sweaty palms, heart racing, heavy breathing) in certain situations.
  • 这person experiences sleep disturbances related to the anxiety or worry.
  • 这person has difficulty concentrating as a result of the anxiety or worry.
  • 您还可以注意到困境的一般迹象,如忽视个人卫生,体重增加或损失,工作或学校的表现下降,情绪的重大变化,或退出活动或关系。
  • 除了症状之外,还有两个重要指导方针。这些都是durationof symptoms and level ofimpairment。Anxiety is a normal reaction to stressful situations, and even high levels of anxiety can be healthy and beneficial at times. Disorders are only present when anxiety symptoms last for several weeks to months and significantly interfere with everyday function or cause long-lasting distress.

请注意,尝试诊断或标记朋友或家庭成员并不是一个好主意。只有心理健康专业人员可以诊断焦虑症,因为许多疾病都有重叠的特征,并且可以与其他类型的心理健康困难一起。但是,如果你注意到焦虑的迹象,或者只是觉得有些人对你关心的人来说并不是正确的,那么伸出援手是一个好主意,以问他们是如何感受的。你可以从中立和支持的东西开始,“似乎你最近一直没有自己。你想谈论什么事情吗?”

What can I do to help a family member or a close friend with anxiety?

您可以做的最重要的事情之一是倾听您的家人或朋友谈论他/她的生活中的事情,这些是压力来源。第一个本能可能是提供“快速修复”的建议或想法。然而,只接受你朋友的压力水平可以帮助他们处理他们的焦虑,因为即使他们的症状可能难以观察,他们也可以依靠你作为支持来源。研究表明,家庭和朋友的社会支持可以成为令人抑制焦虑水平的最强大的保护因素之一。

It may also be helpful to:

  • Avoid shaming your friend for their anxiety. Comments like "just get over it" or "chill out" can be hurtful.
  • Ask your friend how you can help.
  • Be patient. If a friend is experiencing an episode of anxiety, it may not be helpful to intervene or try to fix it. It can be most helpful to be available and let your friend know that you support and love them.
  • 支持的想法得到治疗。有be a lot of stigma around seeking help for mental health difficulties. Showing your support for this may allow them to get over initial fears around taking that first step in getting professional help.

我该怎么办才能帮助我的配偶或伴侣?

焦虑症状可以对关系进行重大负担。除了看到你的伴侣遇到高度的恐惧或压力,您还可能有超过日常责任的普通份额。以下是您可以尝试的四件事:

  1. 设定目标:您和您的伴侣可以同意关键目标,您可以识别成就。例如,如果您和您的伴侣同意您的孤立,您可以计划每月参加一个社交场合。
  2. Support treatment: Research treatment options with your partner and encourage treatment. There are several useful types of treatment for anxiety, and a number of them actively involve the partner and family members. Find a therapist in your area.
  3. Ask how you can help: Don't feel like you should be able to read your partner's needs without asking. Ask what you can do to help, and listen carefully to what they say.
  4. 把自己放在他们的鞋子上:承认你不明白你的伴侣在经历了恐慌袭击之类的重要焦虑时感觉到你的伴侣。

It's also important to take care of yourself. This is not selfish. You can't help your partner or support your family when you are completely overburdened. You could start by:

  • 追求自己的利益和爱好。这些活动将使您能够充满活力,并提醒您,您是一个真实而有趣的人,在您作为合作伙伴或父母的角色之外。
  • Keep up important relationships. Your friends and family are an important source of support for you too! Your social network can provide emotional support and discuss problems that your spouse may not be able to deal with.
  • Seek professional help if needed. Caregivers often experience symptoms of anxiety and depression themselves and may benefit from mental health treatment. You can take a look at how you are doing withthis caregiver self-assessment tool

What can I do to help my child with anxiety?

Anxiety disorders often118bet网址多少 。This is a good time to intervene or seek treatment, because children's brains are still developing, and can more easily adapt to new "modes" of thinking, relative to adult brains. Helping your child cope with an anxiety disorder can be a complex task, potentially involving family members, friends, teachers and counselors, and mental health professionals. These five basic tips may also help:

  1. 积极地加强健康的行为,而不是惩罚或批评问题行为(如避免,投诉,睡眠障碍)
  2. 认识或赞美孩子的进步或改进,思考她已经到了多远,而不是比较一系列标准。
  3. 重点发展benef健康习惯it everyone in your family, such as a good sleep routine, healthy meals and snack, and regular exercise.
  4. 促进强大的同行网络的发展。听到同伴关系成为青春期期间的主要支持来源可能并不奇怪。鼓励您的孩子从事兴趣(如艺术,音乐和体育),这将有助于他们发展和维护友谊。如果您的孩子已经有忙碌和结构化的时间表,请尝试扫除一些时间以获得更加轻松的社交。但请注意,有时同行可能是焦虑的来源,无论是通过同伴压力还是欺凌。与您的孩子在社交圈(学校或课程)中与您的孩子与您的关系的性质。
  5. If your child is experiencing separation anxiety, be supportive and caring when they are in distress but try to avoid changing behavior to overly accommodating the anxiety. If you notice the separation anxiety lasting for longer than four weeks, seek professional help from a psychologist or counselor to learn effective behavioral techniques to treat the anxiety.

Just as in the case of taking care of a spouse or partner with anxiety, taking care of a child with anxiety can make you lose sight of your own mental and physical health. See our self-help tips above.

我能做些什么来帮助一个同事吗?

Signs of mental health difficulty can be different in the workplace than in other settings. The哈佛心理健康信概述您可以在您的同事中注意到的迹象,这可能表明了重要问题。对于焦虑188体育平台app症,这些可能包括躁动,疲劳,集中困难,令人愉快的担忧,以及工作质量的一般损害。

如果您认为工作中的朋友或同事正在经历焦虑症或其他心理健康困难,您应该仔细考虑您的反应。您在工作场所的行为可能具有与工作相关的和法律后果。然而,在紧急情况下出现之前早期干预,可以帮助防止对您的同事的职业生涯,健康和安全产生更大的后果。

这American Psychiatric Association supportsa workplace training program这可以帮助您确定工作场所的心理健康问题,并有用的行动采取。

For a practical and sensitive review of mental health issues in the workplace, check out这种有用的方法


Anxiety Disorders: An Overview

Sanne van Rooij, PhD那andAnaïsStenson,博士

在焦虑相关的疾病中,你的恐惧或担心不会消失,随着时间的推移可能会变得更糟。它可以影响您的生活,以便它可以干扰日常活动,如学校,工作和/或关系。恐惧,压力和焦虑是“正常的感受和经验”,但它们与患有七种诊断疾病的任何患者的患者完全不同,而物质诱导的焦虑,强迫性疾病和创伤或压力相关疾病。

Anxiety disorders keep people from sleeping, concentrating, talking to others, or even leaving their home. Anxiety that may need treatment is often irrational, overwhelming, and disproportionate to the situation. It makes sufferers feel as though they have no control over their feelings, and it can involve severe physical symptoms like headaches, nausea, or trembling. It becomes classified as a disorder when normal anxiety becomes irrational and begins to recur and interfere with daily life.

蝴蝶在胃里一个重要的电动汽车ent? Worried about how you will meet a deadline? Nervous about a medical or dental procedure? If so, you are like most people, for whom some worry about major events (like having a child, taking an exam, or buying a house), and/or practical issues (like money or health conditions), is a normal part of life. Similarly, it is not uncommon to have fears about certain things (like spiders, injections, or heights) that cause you to feel some fear, worry, and/or apprehension. For example, many people get startled and feel nervous when they see a snake or a large insect. People can differ in what causes them to feel anxious, but almost everyone experiences some anxiety in the course of their life.

But, as an example, what if someone will not leave their home for extended periods of time because they are afraid of being in a crowd or being reminded of a past traumatic event. That is not a "normal feeling or experience."

这re are several different anxiety-related disorders. Some symptoms overlap across many of these disorders, and others are more specific to a single disorder. In general, however, all anxiety-related disorders feature worry, nervousness, or fear that is ongoing, excessive, and has negative effects on a person's ability to function. It can be tricky to decide when anxiety is typical or linked to a disorder, which is why diagnoses should be made by licensed professionals, such as psychologists or psychiatrists.

A helpful approach to distinguishing normal anxiety from an anxiety disorder is to identify the cause of the anxiety, and then assess whether the anxiety symptoms are a proportional response to it. Worries, fears, and intrusive thoughts that are extreme, unrealistic, or exaggerated and interfere with normal life and functioning could constitute an anxiety disorder. For instance, being concerned about getting sick and taking steps to avoid germs, like using hand sanitizer and avoiding touching door handles, does not necessarily constitute an anxiety disorder; however, if the concern about sickness makes it difficult to leave the house, then it is possible that the person suffers from an anxiety or anxiety-related disorder.

188体育平台app焦虑症的特点是过度恐惧的一般特征(即对感知或真正威胁的情绪反应)和/或焦虑(即担心未来的威胁)并且可以产生负面行为和情绪后果。强迫症和相关疾病的特点是强迫性侵扰性的思想(例如,不断担心停留干净,或大约一个人的身体大小),触发相关的强迫行为(例如,反复洗手或过度锻炼)。进行这些行为以缓解与强迫思想相关的焦虑。创伤和压力源相关的焦虑症与A的经验有关188体育平台app创伤(e.g., unexpected death of a loved one, a car accident, or a violent incident) or stressor (e.g., divorce, beginning college, moving).

精神障碍(DSM)的诊断和统计手册是用于诊断心理健康障碍的手册,并被世界各地的医疗保健专业人士广泛使用。对于每种疾病,DSM具有症状和其他标准的描述以诊断疾病。DSM很重要,因为它允许不同的临床医生和/或研究人员在讨论心理健康障碍时使用相同的语言。第一个帝斯曼于1952年发布,在新的研究和知识可用后已经多次更新。2013年,释放了DSM,DSM-5的最新版本。与其前任DSM-IV有一些关于焦虑症的重要差异。188体育平台app首先,强迫症(OCD)不再是焦虑症的一部分,但现在有自己的类别:强迫型,陈规定型和相关疾病。188体育平台app其次,创伤后应激障碍(PTSD)现在也有自己的类别:创伤和与压力源相关的疾病。

If you think you might be struggling with an anxiety disorder, you're not alone:

  • 188体育平台app焦虑症是美国最常见的精神疾病
  • Over 40 million American adults are afflicted by anxiety disorders
  • 女性are twice as likely as men to develop PTSD
  • 40%的美国成年人在他们生命中的某些时候经历了焦虑症
  • Only 1/3 of adults suffering from anxiety disorders receive treatment
  • Only 1/5 of teenagers suffering anxiety disorders receive treatment
  • Anxiety disorders are estimated to cost society over $42 billion per year

尽管如此,如果你陷入焦虑症的症状,那么孤独和误解并不罕见。因为担心患有焦虑症的人没有得到别人,他们可能不明白为什么,例如,在一群人中,没有能够在遇到新人之后洗手,或者驾驶街道在汽车事故中,您的车祸可以真正焦虑,为焦虑症的人引起挑衅。人们可能会发表评论“没有理由担心它”或者你应该只是让它走“。

不是每个人都明白是有人的nxiety disorder cannot "just let things go". This makes the struggle with an anxiety disorder even harder, and may prevent one from looking for help. However, it is very important to talk about these anxieties with someone and preferably find a health care professional as soon as you experience these symptoms. Anxiety should be considered as severe as a physical disease; however, most people in society do not appreciate the severity of this disorder. Some people may consider anxiety a fault or a weakness; however, it may help if people realize that many research studies have demonstrated biological explanations for (some of) the symptoms observed in anxiety disorders. Brain scans have demonstrated brain abnormalities in certain anxiety disorders, and also altered brain functioning has been demonstrated for individuals with anxiety disorders. Furthermore, there is some evidence that anxiety disorders might be linked to chemical imbalances in the brain.

所以,如果焦虑有很多负面影响,为什么我s it relatively common? Many scientists who study anxiety disorders believe that many of the symptoms of anxiety (e.g., being easily startled, worrying about having enough resources) helped humans survive under harsh and dangerous conditions. For instance, being afraid of a snake and having a "fight or flight" response is most likely a good idea! It can keep you from being injured or even killed. When humans lived in hunter-gatherer societies and couldn't pick up their next meal at a grocery store or drive-through, it was useful to worry about where the next meal, or food for the winter, would come from. Similarly avoiding an area because you know there might be a bear would keep you alive —worry can serve to motivate behaviors that help you survive. But in modern society, these anxiety-related responses often occur in response to events or concerns that are not linked to survival. For example, seeing a bear in the zoo does not put you at any physical risk, and how well-liked you are at work does not impact your health or safety. In short, most experts believe that anxiety works by taking responses that are appropriate when there are real risks to your physical wellbeing (e.g., a predator or a gun), and then activating those responses when there is no imminent physical risk (e.g., when you are safe at home or work).

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