“Between a shaky world economy, increasing unemployment, and related issues, many today are being forced to come to the edge of uncertainty. Just like the baby sparrows, they find themselves leaning into the mystery that change brings, because they have no choice: It’s fly or die.”

For persons struggling with depression and anxiety — and for those of us who are highly sensitive — uncertainty is especially difficult. Forget about learning to fly. The uncertainty itself feels like death and can cripple our efforts to do anything during a time of transition.

I have been living in uncertainty, like many people, ever since December of 2008 when the economy plummeted and the creative fields — like architecture and publishing — took a hard blow, making it extremely difficult to feed a family. In that time, I think I have worked a total of 10 jobs — becoming everything from a defense contractor to a depression “expert.” I even thought about teaching high school morality. Now that’s desperate.

I don’t think I’ll ever be comfortable with uncertainty, but having lived in that terrain for almost five years now, I’m qualified to offer a few tips of how not to lose it when things are constantly changing.

1. Pay attention to your intention

I’m not a new-age guru. I don’t believe that you can visualize a check for $20,000 and find one in your mailbox the next day. Nor can you get on Oprah by believing you’ll be her next guest. (I tried both of those.) But I do recognize the wisdom in tuning into your intention because therein exists powerful energy that you can tap.

Awhile back I did Deepak Choprah’s exercise of recording my intentions and seeing how many of them actualized. I was surprised at the synchronicity between intention and events. Psychologist Elisha Goldstein writes in his book, The Now Effect: “Our intention is at the root of why we do anything and plays a fundamental role in helping us cultivate a life of happiness or unhappiness. If we set an intention for well-being and place it at the center of our life, we are more likely to be guided toward it.”

2. Tune into the body.

Psychologist Tamar Chansky, Ph.D. reminds us to listen to the body when we get anxious. If you understand why certain symptoms occur in the body – racing heart, dizziness, sweating, stomachaches – and repeat to yourself, “This is a false alarm,” you are less afraid, less panicked by the situation. Knowing that these symptoms are part of the sympathetic nervous system (SNS) trying to protect you from danger – part of the primitive regions of the brain mobilizing the “flight-or-fight” response –the reaction becomes less about the situation and more about talking to your body about why it’s freaking out so that you can use the parasympathetic nervous system (PNS) to restore the body to normalcy, which, in my case, is still pretty panicky.

3. Imagine the worst.

I’m not sure you will find a psychologist to agree with me on this exercise, but it has always worked for me every time I do it. I simply envision what it would look like if my worst nightmare happened. What if my husband and I could not get any architecture gigs or writing assignments? What if we can’t pay for health care insurance and my heart malfunctions (I have a heart disorder)? What if we both come to a bone fide professional dead end? Then I move to my actions. I think about selling our house, moving into a small apartment, and working as a waitress somewhere or maybe as a barista at Starbucks. (If you work more than 20 hours, you get health care insurance.) I research health care insurance options for persons who make minimum wage. Under ObamaCare, my kids, at least, would be covered. I invariably come to the conclusion that we will be okay. All is okay. A huge adjustment. Yes. But we are getting to be pros at that. This exercise makes me fret less about the things that I think I must have and get back to the essentials—literally a warm meal on the table, even if it’s one a day.

I am comforted by the words of Charles Caleb Colton: “Times of general calamity and confusion have ever been productive of the greatest minds. The purest ore is produced from the hottest fire.”

4. Describe, don’t judge.

In his book Get Out of Your Mind and Into Your Life, Steven Hayes, Ph.D. dedicates a few chapters to learning the language of your thoughts and feelings. Especially helpful to me is learning how to distinguish descriptions from evaluations.

Descriptions are “verbalizations linked to the directly observable aspects or features of objects or events.” Example: “I am feeling anxiety, and my heart is beating fast.” Descriptions are the primary attributes of an object or event. They don’t depend on a unique history. In other words, as Hayes, explain, they remain aspects of the event or object regardless of our interaction with them. Evaluations, on the other hand are secondary attributes that revolve around our interactions with objects, events, thoughts, feelings, and bodily sensations. They are our reactions to events or their aspects. Example: “This anxiety is unbearable.”

If we are feeling anxious about the uncertainty of our job, for example, we can tease apart the language of our thoughts and try to transform an evaluation, “I will be destroyed if I am fired,” to a description, “I am feeling anxious and my job is unstable.” By naming the emotion and the situation, we don’t necessarily have to assign an opinion. Without the opinion, we can process the object, event, etc. without hyperventilation.

5. Learn from fear.

Eleanor Roosevelt wrote, “You gain strength, courage, and confidence by every experience in which you really stop to look fear in the face … You must do the thing you think you cannot do.” My body usually protests against that statement, but theoretically I concur with Eleanor. I sincerely believe the good stuff happens when we are afraid. If we go a lifetime without being scared, as Julia Sorel said, it means we aren’t taking enough chances.

Fear is rather benign in itself. It’s the emotions we attach to it that disable us. If we can confront our fear, or rather approach it as an important messenger, then we can benefit from its presence in our life. What is the fear saying to us? Why is it here? Did it bring roses or chocolate? According to Jones, this is an exercise of getting comfortable with being out of control, of learning to let go of the illusion of control — because we never really had it in the first place — and developing an inner knowing that everything will be okay.

Proper treatment doesn’t suppress emotions or dull a person’s ability to feel things deeply. It builds a protective layer — an emotional resilience — to safeguard a depressive from becoming overwhelmed and disabled by the difficulties of daily life.

However, the tools found in happiness research are those I practice in my recovery from depression and anxiety, even though, theoretically, I can be happy and depressed at the same time. I came up with my own recovery program that coincides with the steps toward happiness published in positive psychology studies.

1. Sleep

Sleep is crucial to sanity because sleep disturbances can contribute to, aggravate, and even cause mood disorders and a host of other illnesses. The link between sleep deprivation and psychosis was documented in a 2007 study at Harvard Medical School and the University of California at Berkeley. Using MRI scans, they found that sleep deprivation causes a person to become irrational because the brain can’t put an emotional event in proper prospective and is incapable of making an appropriate response. Chronic sleep deprivation, especially, is bad news. It often affects memory and concentration. And, according to one recent study, it can cause a decline in cognitive performance similar to the intoxicated brain.

2. Diet

My mouth and brain are in constant negotiation with each other because while one loves white bread, pasta, and chocolate, the other throws a hissy fit whenever they enter my blood stream. My diet has always been an important part of my recovery from depression, but two years ago — after working with the naturopath and reading Kathleen DesMaison’s “Potatoes Not Prozac” — I could more competently trace the path from my stomach to my limbic system. Moreover, I recognized with new clarity how directly everything that I put in my mouth affects my mood.

Here are the bad boys: nicotine, caffeine, alcohol, sugar, white flour, and processed food — you know, what you live on. Here are the good guys: protein; complex starches (whole grains, beans, potatoes); vegetables; vitamins (vitamin B-complex, vitamins C, D, and E, and a multivitamin); minerals (magnesium, calcium, and zinc); and omega-3 fatty acids. I’m religious about stocking up on omega-3 capsules because leading physicians at Harvard Medical School confirmed the positive effects of this natural, anti-inflammatory molecule on emotional health.

3. Exercise

Dr. James A. Blumenthal, a professor of medical psychology at Duke University, led a recent study in which he and his team discovered that, among the 202 depressed people randomly assigned to various treatments, three sessions of vigorous aerobic exercise were approximately as effective at treating depression as daily doses of Zoloft, when the treatment effects were measured after four months. A separate study showed that the depressives who improved with exercise were less likely to relapse after 10 months than those treated successfully with antidepressants, and the participants who continued to exercise beyond four months were half as likely to relapse months later compared to those who did not exercise.

Even as little as 20 minutes a week of physical activity can boost mental health. In a new Scottish study, reported in the British Journal of Sports Medicine, 20,000 people were asked about their state of mind and how much physical activity they do in a week. The results showed that the more physical activity a person engaged in — including housework, gardening, walking, and sports — the lower their risk of distress and anxiety.

Exercise relieves depression in several ways. First, cardiovascular workouts stimulate brain chemicals that foster growth of nerve cells. Second, exercise increases the activity of serotonin and/or norepinephrine. Third, a raised heart rate releases endorphins and a hormone known as ANP, which reduces pain, induces euphoria, and helps control the brain’s response to stress and anxiety. Other added benefits include improved sleep patterns, exposure to natural daylight (if you’re exercising outside), weight loss or maintenance, and psychological aids.

4. Relationships and Community

We are social creatures and are happiest when we are in relationship. One of the clearest findings in happiness research is that we need each other in order to thrive and be happy, that loving relationships are crucial to our well-being. Relationships create a space of safety where we can learn and explore. Belonging to a group or a community gives people a sense of identity. Studies indicate that social involvement can promote health, contribute toward faster recovery from trauma and illness, and lower the risk of stress-related health problems and mental illness.

Plenty of evidence indicates that support groups aid the recovery of persons struggling with depression and decrease rates of relapse. The New England Journal of Medicine published a study in December 2001 in which 158 women with metastatic breast cancer were assigned to a supportive-expressive therapy. These women showed greater improvement in psychological symptoms and reported less pain than the women with breast cancer who were assigned to the control group with no supportive therapy.

Another study in 2002, published in the American Journal of Psychiatry, followed a group of more than 100 persons with severe depression who joined online depression support groups. More than 95 percent of them said that their participation in the online support groups helped their symptoms. The online groups here on Psych Central are a great resource where you can find support from people going through similar struggles.

5. Purpose

The father of positive psychology, Martin Seligman, explains in his book, “Authentic Happiness,” that a critical element to happiness exists in using your signature strengths in the service of something you believe is larger than you. After collecting exhaustive questionnaires he found that the most satisfied people were those that had found a way to use their unique combination of strengths and talents to make a difference. Dan Baker, Ph.D., director of the Life Enhancement Program at Canyon Ranch, believes that a sense of purpose — committing oneself to a noble mission — and acts of altruism are strong antidotes to depression. And then there’s Gandhi, who wrote: “the best way to find yourself is to lose yourself in the service of others.”

6. Gratitude

Gratitude doesn’t come easily to me. When my girlfriend sees a half-full glass of fresh milk, I see a half-empty glass of cholesterol-rising, cardiac-arresting agents. And when the kids’ school is called off because some road somewhere in our county apparently accumulated a half of an inch of snow, she thanks God for an opportunity to build snowmen with she kids. I have a conversation with God, too, but it’s much different.

However, I train myself to say thank you more often than is natural for me because I know that gratitude is like broccoli — good for your health in more than one way. According to psychologists like Sonja Lyubomirsky at the University of California Riverside, keeping a gratitude journal — where you record once a week all the things you have to be grateful for — and other gratitude exercises can increase your energy, and relieve pain and fatigue.

Shameless plug! Join me at one of three private screenings of “Happy,” a film that explores what makes us happy, followed by a discussion on depression and happiness and a book signing. Click the following links for more information:

When we function in a healthy manner, we don’t just experience joy and happiness, prancing around without a care in the world. We actually still experience a range of emotions, some of which can be very difficult to live with.

It’s absolutely healthy to feel anxiety, depression, anger, jealousy, envy, guilt, hurt or shame. But what makes experiencing these emotions healthy is that we don’t linger in them for longer than is good for us. We don’t demand that they ‘go away.’ We accept the appropriateness of how we feel, and do something about our situation.

Let me give you an example of how a person’s thinking can perpetuate depression.

Imagine that your favorite dog was very sick and you took her to the vet, who tells you she’s in a lot of pain and it’s best to euthanize her. How do you think you might feel? Very sad (most likely), guilty (perhaps), happy (to some degree if you know you can stop her suffering). So, do those emotions seem healthy and appropriate to you? Of course they do, and to experience them is human.

Given the choice, you may not have wanted to face that situation in the first place, but we can’t always pick and choose what happens to us in life. We can only choose how we deal with those situations when they arise.

So how could a person drive themselves into depression after such an event? It’s easy. When a person feels sad about a loss or death, if they start taking far too much responsibility for what happened and judging themselves negatively, then depression will be only a short taxi ride away. The kind of thinking that perpetuates depression will be thoughts such as “I’m such a bad person for killing her,” “I should have done more to make her life happy,” “I should have taken her to the vet sooner and I would have saved her.”

None of those statements is wholly true, yet when you repeat them, you start to believe it and you feel depressed. You’ll even start acting depressed. Instead of going out for a walk, which you used to enjoy, you might stay at home watching TV, because ‘there’s no point in going out without your dog.’ You might even stop socializing with other dog walkers and so you’ll become more isolated, which perpetuates the problem.

So from a healthy sadness about the loss of a loved pet, with unhealthy thinking and behavior, your mood sinks into depression. And once there, it is a lot harder to get out of than when you’re healthily sad.

Anxiety, on the other hand, is depression’s opposite. Rather than dwelling on the past, people with anxiety tend to focus on the possible threat in the future, and employ defensive mechanisms against that perceived threat or problem. Let me give you another example.

Frank gives a presentation at work that doesn’t go down well with his boss. Frank gets shouted at and bawled out for not doing a good enough job. His boss also tells him that he must improve before the next presentation or else! How do you think you might feel? Disappointed (sure). Frustrated (maybe). Concerned (oh yeah).

So how does Frank perpetuate his anxiety? The first thing he does is to fly into the future and use ‘what if’ and ‘if…then’ type thinking. “If I deliver another bad presentation, then my boss will fire me.” “What if I can’t do it the way he wants?” “What if I’m terrible?”

These ‘what if’ thoughts are the precursors to the unhealthy demands that lead to anxiety: “I must know that the presentation will go well.” “I must not screw up the presentation or my boss will fire me.” “I must be perfect.”

The trouble with these irrational demands is that they lead to anxious behaviors: spending hours on the presentation; not sleeping; seeking others’ opinions; asking for reassurance; feeling nauseous beforehand; sweating; feeling ill at ease.

Clearly, Frank is not in a good state to be giving a presentation. He’ll most likely deliver a sub-par presentation. What do you think will happen next time he needs to give a presentation? He’ll feel worse.

To end these destructive cycles, we need to understand that emotions — even the difficult ones — are healthy. Emotions should be used as a guide to let us know that something is off-balance and might need changing. When we demand unreasonable things from ourselves, we’re destined to feel strong, unhealthy emotions.

It’s a thin line between healthy and unhealthy emotions, but by understanding how our thinking perpetuates our emotional disturbance, we can become a healthier version of ourselves.

In my 20 years living in the Boston area, I cheered on the runners on many occasions and now, even from far way, these events feel close to home.

Experiencing trauma can have a dramatic effect on our bodies and our minds.  And although it’s a different experience to witness a trauma on television, it still can affect us.

When you perceive a threat, the body activates the stress response. The stress response occurs in both your body and brain.

The body’s response to acute stress is a preparation for emergency.  Adrenaline and other hormones are released.  The body shuts down processes associated with long-term care.  When under immediate threat, digestion, reproduction, cell repair and other body tasks related to long-term functioning are unimportant.

Of immediate importance is survival.  Increased blood sugar can provide extra energy for muscles. Increases in cortisol counter pain and inflammation. Blood pressure increases. Blood is diverted from our extremities to our major muscles to provide us with extra strength. Increased endorphins can help us ignore physical pain.

You can see the effects of these changes to the body in many of the symptoms of stress, such as racing heart, dizziness, nausea, shortness of breath, shaking, feeling hot and flushed, and sweating.

But it is the impact of trauma on the mind that is often the most disturbing.  Traumatic events can leave us feeling unsafe.  They can disrupt our beliefs and assumptions about the world. Your sense of your ability to control your life may be shattered. You may question how much influence you have over your life and your life choices.

A trauma, such as the one the occurred at the Boston Marathon, can leave us distrustful of other people.  You may question your basic trust of other people in the world.  Trauma can affect your ability to be intimate with others and may impact your feelings of self-worth.  Those who survive the trauma often feel guilt and wonder why they lived when others were less fortunate.

As we grow, change and have varied experiences throughout life, our beliefs and assumptions typically evolve over time.  With trauma, those beliefs and assumptions that we use to make sense of the world around us change nearly instantaneously.

It’s common to experience a wide range of psychological symptoms, including intrusive thoughts, worry, difficulty sleeping, trouble focusing, bouts of crying, blame or self-judgment and lack of satisfaction.

The effects of trauma also can cause intense emotion, including extreme emotional fluctuations, unhappiness, anxiety, loneliness, anger, and irritability.

Multiple traumas or repeatedly being exposed to life-threatening events can have a further impact on your body and mind. Parts of the brain can become sensitized, causing you to be on high alert and to perceive threats all around, leaving you jumpy and anxious.

Other parts of the brain associated with memory can actually shrink, making it difficult to consolidate and form new memories.  Prolonged stress can effect the development of a number of health issues, including diabetes, obesity and hypertension. And repetitive stress affects our moods, brings on anxiety disorders, and affects our experience of chronic pain and our ability to control food intake.

But when horrible events occur, such as those that occurred at the 2013 Boston Marathon, we also see the generosity and caring that is a large part of human nature.

Countless individuals ran to help without a second thought.  First responders, medics, EMTs and even bystanders jumped into action to do what they could to save lives.  Runners crossed the finish line and kept on running straight to give blood.

As we deal with the impact of violence, we can also keep in our minds the heroes and the strength of the human spirit that brings us together when we are faced with senseless tragedy.

Image: Wikimedia Commons: Aaron “tango” Tang

At one time in my life, this used to bug me. I would look at the clock and think, “oh no, I must get back to sleep or I’ll be so tired in the morning.” And then I’d spend the next hour or two willing myself to go back to sleep: tossing and turning, demanding that I slip back into unconsciousness; huffing and puffing that I wasn’t sleeping. I’d even check the clock every 10 minutes to see if I’d slept.

But the reality was, and still is, the more that I demand something of myself, the less likely I am to achieve that goal — and that really is the principle of living an unhappy life.

Sure I want to go back to sleep. I would even really, really, really, prefer to be sleeping right now, but I’m not. So, instead of lying there, beating myself up for waking when I “absolutely shouldn’t have,” I get up. I grab a drink, get something to eat and power up my laptop.

I realized a while back that, for me, it’s easier to get up and do something I enjoy. Use the extra time I have to write something, read, watch some TV, or just get lost in the weird and wonderful things people upload on YouTube.

This extra quiet time can be a bonus, before the world machine cranks up, and I slip into my lane on the daily highway of life.

Sure, I might be a little tired later, but the reality is that a few hours less sleep every now and then is not going to affect my performance. It will only affect that if I’m constantly telling myself, “I won’t be able to cope with work/life/kids because I woke so early and I’ll get tired.”

If you’re the type of person who uses that snippet of destructive thinking, then you’ll start sabotaging yourself. Sometimes after not sleeping well, people even play the ‘poor me card.’ They tell work colleagues how little sleep they’ve had, and how they won’t be able to do so-and-so job, or how they might need to go home early because of exhaustion.

Thinking and behaving like this can be quite common, and its roots can usually be found in childhood messages such as “You’ve got school tomorrow. You need to get your sleep or you won’t be able to do well.”

Really? How many times did you hear this, yet still stayed up late reading about dinosaurs, and made it through school the next day?

Even scientists don’t know how much sleep people need.

Each person’s sleep patterns and needs are different. You might be somebody like me, who likes around eight hours a night, or you might need fewer, such as four. Trouble is, if you’re the type of person who needs four, but you think you should have eight, that is where your problems will start.

Sleep problems can start if, instead of embracing your pattern and learning to live with it, you start to create your own anxiety around not getting enough sleep. Soon enough, sleeping will start to be a problem because you’ll be worrying about it before you go to bed, and that worry will interfere with your sleep pattern.

Soon you’ll be going to sleep, only to wake yourself so you can check that clock to see if you’ve been sleeping. And as you can tell, that irrational behavior will confirm that you haven’t slept as much as you demand because you woke yourself up!

The next step from there is usually some type of insomnia, because you’ve worked yourself up into such anxiety about sleeping. After a while you will be tired and your cognitive functioning will be impaired. You’ll be worrying during the day whether you’ll even sleep at night; and nearer to sleep time you get, the more anxious you’ll become and the more your body won’t be able to relax, so the more impossible it is to sleep. Catch-22, created by you.

If you do wake early, then make the best of that time. If your sleep pattern is such that you sleep a few hours a night, but need a nap during the day, then do it. Stop telling yourself you “must sleep now or else.”

I’ve found my way with managing my occasional lack of sleep. What about you? Is there a pattern you could change? Are you demanding something of yourself that leads to sleep problems? If so, these need to be addressed. So go do it — go change.

Then, I walk into the lab next door for a blood test and the line I hear is: “Oh, your blood pressure was high, let me see if I can draw your blood now.”

Wait, what? Do they actually think that these comments will make me feel more relaxed?

I’ve also experienced more direct unpleasantries from doctors who project an icy, or even a rude demeanor. A poor bedside manner does affect a patient’s emotional disposition; it does heighten any anxiety, and it certainly ensures difficulty in forming a positive bond with a professional who’s in a field that’s supposed to alleviate illness.

“A bedside manner refers most often to the way a medical professional interacts and communicates with patients,” a 2012 post on Wisegeek stated. The post stresses that a doctor with a good bedside manner demonstrates empathy,¹ and emits an aura of ease for the patients, while also involving them in health decisions. On the flip side, poor bedside manners reflect rudeness, cold attitudes, inadequate listening skills, and a complete disregard for the patient’s fears.

Why are such mannerisms prominent in the medical field?

Lorianna De Giorgio’s 2012 article in the Toronto Star discusses why positive relationships between patients and doctors may be lacking in the profession.

Adam Waytz, assistant professor of management and organizations at Northwestern University, explained that a process of “dehumanization” lies behind an unfortunate patient-doctor rapport. Dehumanization may occur due to psychological demands placed on practitioners, and from ongoing advances in technology as well. Waytz determined that a bulk of medical decision-making gives way to a very mechanical method of thinking; problems are often solved and issues are fixed without recognizing the patient’s feelings.

While many individuals enter the medical field for humane reasons, “they get into the system, and the system is so stressful that sometimes the humanity is just beaten out of them,” notes Marjorie Stanzler, senior director of programs at the Schwartz Center for Compassionate Healthcare.

Waytz and Stanzler advocate that a proper bedside manner would result in improved psychological and physical outcomes for the patients in treatment.

A 2008 blog post entitled What Bad Bedside Manners Really Mean reviews the negative impact and consequences of these adverse behaviors:

“Doctors are supposed to be in the line of work of helping people. With this profession comes a lot of responsibility. The medical field is not supposed to be simply diagnosing a problem, handing out a few pills, and moving onto the next patient. It means much more. It means being a physician, and a physician means being a healer.”

I could not agree more. Patients may feel naturally anxious, waiting on an impending prognosis (especially if the condition has the potential to be serious). Do they really need aloofness on top of that?

“If the doctor seems disinterested in what you are telling him, there are greater chances of him missing something that you said,” the post stated. “If he seems put-out or preoccupied, the patient might be more likely to leave out pertinent information.” Furthermore, if the doctor is disrespectful, it may discourage patients from seeking medical assistance altogether.

Due to a distressing environment and technological developments, I can understand why medical practitioners may harbor some poor bedside manners, but that doesn’t make their etiquette right or beneficial.

I think it’s important for them to remember why they’ve entered the field in the first place; if it’s because they sincerely want to help people, it’s crucial to know how to relate to patients on an emotional level.

1. l personally think medical schools should have official courses on being more empathetic

So what is alternative treatment? You may already have some experience with the most popular, according to the Monitor on Psychology. Meditation, biofeedback, hypnosis and progressive muscle relaxation are all popular complementary or alternative psychological treatments. 

Although you may be familiar with the most popular, there are dozens of alternative and complementary treatments, which typically fall into four categories:  mind-body medicine, biologically-based practices, manipulative and body-based practices and energy medicine.

The Monitor article reports that, although these, and many other, alternative and complementary treatments have been around for thousands of years, the National Institute of Health (NIH) has been studying their usefulness, safety and role in improving health and health care for only a little more than a decade.

But many people embrace these treatments and are visiting alternative medicine practitioners more frequently than they visit their primary care doctors.  And these treatments are big business. A 2007 study found that $34 billion is spent each year on products and services for alternative and complementary medicines.

Continued research on the effectiveness of these treatments is ongoing and crucial.  However, current research suggests that many are effective for treating a wide range of problems, ailments and disorders.

There are too many to document in one post, but the following are the top 4 according to frequency of use, as reported in the Monitor.

1. Dietary Supplements.

Dietary supplements are used to promote general health, as well as to improve depression and anxiety and to decrease pain.  Common supplements reported in the Monitor include ginkgo biloba, St. John’s wort and vitamin supplements.  Although regulated by the FDA, they are held to very different quality standards than more conventional medicines.

• Caution: The FDA does not review the safety and effectiveness of any supplement before it is sold to consumers.  Supplements can vary widely from brand to brand and may interact with other medications. They should not be used without the knowledge of a physician.

2. Meditation.

Meditation is a process in which people learn to focus their attention in a particular way and on purpose.  It is used to treat a variety of symptoms, including high blood pressure, chronic pain, anxiety, depression, stress and insomnia.  It is also used to promote general health and well-being.

Meditation is integrated into many psychological treatments and practices with positive results; however, there are no formal qualifications necessary to practice it.  It is important that those who use this method receive appropriate training.

3. Chiropractic.

Chiropractic physicians use noninvasive treatments, such as spinal manipulations or chiropractic adjustments, with the aim of improving nerve and organ functioning by aligning spinal vertebrae.  These treatments are used to treat an array of ailments, from pain and headaches to stress and ADHD, among others.

Becoming a chiropractic physician requires several years of graduate work.  Most psychologists are unlikely to hold a chiropractic degree and, if they did, it would not be appropriate to serve as both a psychologist and chiropractor for the same client.

4. Aromatherapy.

Aromatherapy uses smells and aromas naturally extracted from plants to balance, harmonize and promote health of mind, body and spirit.  It is used clinically to relieve symptoms typically addressed in psychotherapy; holistically, to improve overall well-being; and aesthetically, in various oils and skin care products.

The Monitor cites recent research that indicates that aromatherapy can help treat pain, anxiety and agitation specific to dementia.  However, while certification is not required, it is recommended.  There are also risks related to toxicity, skin irritation and dosing regulations that require a competent professional to oversee, the article states.

Reference

Barnett, J.E., Shale, A.J.,(2013). Alternative Techniques.  Monitor on Psychology, 44(4).

Unfortunately that advice wouldn’t have been able to stop me from praying rosary after rosary when I was in fourth grade to avert going to hell, nor does it quiet the annoying noise and chatter inside my brain today in any given hour. But the fact that a great leader battled the worry war does provide me some consolation.

It doesn’t matter whether you are a chronic worrier without an official diagnosis or battling severe obsessive-compulsive disorder (OCD), a neurobehavioral disorder that involves repetitive unwanted thoughts and rituals. The steps to overcome faulty beliefs and develop healthy patterns of thinking are the same.

Worrying about facing the inferno as a 10-year-old and fretting about whether or not I’ll provide enough income to keep my kids in private school stems from the same brain abnormality that Jeffrey M. Schwartz, M.D. describes in his book, Brain Lock.

When we worry, the use of energy is consistently higher than normal in the orbital cortex, the underside of the front of the brain. It’s working overtime, heating up, which is exactly what is the PET scans show. Too many “what if’s” and your orbital cortex as shown in a PET scan will light up in beautiful neon colors, like the walls of my daughter’s bedroom. However, with repeated cognitive-behavioral exercises, you can cool it down and return your PET scan to the boring black and white.

In their book, The OCD Workbook, Bruce M. Hyman, Ph.D., and Cherry Pedrick, RN, explain the ABCDs of faulty beliefs. It’s a four-step cycle of insanity:

A = Activity Event and Intrusive Thought, Image or Urge. (What if I didn’t lock the door? What if I upset her? I know I upset her.)

B = Faulty Belief About the Intrusive Thought. (If I don’t say the rosary, I’m going to hell. If I made a mistake in my presentation, I will get fired.)

C = Emotional Consequences: Anxiety, Doubt, and Worry. (I am a horrible person for upsetting her. I keep making mistakes … I will never be able to keep a job. I hate myself.)

D = Neutralizing Ritual or Avoidance. (I need to say the rosary to insure I’m not going to hell. I should avoid my friend who I upset and my boss so that he can’t tell me I’m fired.)

Those might seem extreme for the casual worrier, but the small seed of anxiety doesn’t stay small for long in a person with an overactive orbital cortex.

Hyman and Pedrick also catalog some typical cognitive errors of worriers and persons with OCD:

• Overestimating risk, harm, and danger
• Overcontrol and perfectionism
• Catastrophizing
• Black-and-white or all-or-nothing thinking
• Persistent doubting
• Magical thinking
• Superstitious thinking
• Intolerance of uncertainty
• Over-responsibility
• Pessimistic bias
• What-if thinking
• Intolerance of anxiety
• Extraordinary cause and effect

One of the best approaches to manage a case of the worries and/or OCD is the four-step self-treatment method by Schwartz, explained in Brain Lock,

Step 1: Relabel.

In this step you squeeze a bit of distance between the thought and you. By relabeling the bugger as “MOT” (my obsessive thought) or something like that, you take back control and prevent yourself from being tricked by the message. Because I’ve always suffered from OCD, I remind myself that the illogical thought about which I’m fretting is my illness talking, that I’m not actually going insane.

Step 2: Reattribute.

Here is where you remember the PET scan that would look like your brain. By considering that colorful picture, you take the problem from your emotional center to your physiological being. This helps me immensely because I feel less attached to it and less a failure for being able to tame and keep it under control. Just like arthritis that is flaring up, I consider my poor, overworked orbital cortex, and I put some ice on it and remember to be gentle with myself.

Step 3: Refocus.

If it’s at all possible, turn your attention to some other activity that can distract you from the anxiety. Schwartz says: “By refusing to take the obsessions and compulsions at face value—by keeping in mind that they are not what they say they are, that they are false messages—you can learn to ignore or to work around them by refocusing your attention on another behavior and doing something useful and positive.”

Step 4: Revalue.

This involves calling out the unwanted thoughts and giving yourself a pep talk on why you want to do everything you can to free yourself from the prison of obsessive thinking. You are basically devaluing the worrying as soon as it tries to intrude.

“Partners may find themselves in roles they do not want, such as the compromiser, the protector, or the comforter,” says Kate Thieda, MS, LPCA, NCC, a therapist and author of the excellent book Loving Someone with Anxiety.

They might have to bear the brunt of extra responsibilities and avoid certain places or activities that trigger their partner’s anxiety, she said. This can be very stressful for partners and their relationship.

“Partners of loved ones with anxiety may find themselves angry, frustrated, sad, or disappointed that their dreams for what the relationship was going to be have been limited by anxiety.”

Thieda’s book helps partners better understand anxiety and implement strategies that truly support their spouses, without feeding into or enabling their fears.

Below, she shared five ways to do just that, along with what to do when your partner refuses treatment.

1. Educate yourself about anxiety.

It’s important to learn as much as you can about anxiety, such as the different types of anxiety disorders and their treatment. This will help you better understand what your partner is going through.

Keep in mind that your partner might not fit any of these categories. As Thieda writes in Loving Someone with Anxiety, “The truth is, it doesn’t matter whether your partner’s anxiety is ‘diagnosable.’ If it’s impairing your relationship or diminishing your partner’s quality of life or your own quality of life, it will be worthwhile to make changes.”

2. Avoid accommodating your partner’s anxiety.

“Partners often end up making accommodations for their partner’s anxiety, whether it is intentional [such as] playing the part of the superhero, or because it just makes life easier, as in, doing all the errands because their partner is anxious about driving,” said Thieda, who also created the popular blog “Partners in Wellness” on Psych Central.

However, making accommodations actually exacerbates your partner’s anxiety. For one, she said, it gives your partner zero incentive to overcome their anxiety. And, secondly, it sends the message that there really is something to fear, which only fuels their anxiety.

3. Set boundaries.

Your partner might continue asking for accommodations, such as having you drive everywhere or regularly stay home with them, Thieda said. “You have the right to have a life, too, and this may mean telling your partner on occasion, and in a loving way, that you are going to do what you want and need to do.”

In her book Thieda devotes an entire chapter to effectively communicating this to your partner. Essentially, she suggests being empathetic, using “I” statements and giving specific requests.

For instance, she gives the following examples: Instead of saying, “You worry too much about what other people think of you,” you might say, “I’m concerned that your fears about what others think of you are holding you back at work.”

Instead of saying, “Don’t call me at work so much,” you might say, “It would be helpful if you would try some of the techniques you’ve learned for calming yourself down before calling me at the office.”

Also, “always consider whether a compromise is possible, but also recognize that you have the right to do things independently,” she said.

4. Relax together.

There are many techniques you can try together to alleviate anxiety. According to Thieda, “The body scan is a great couples mindfulness technique because one person can guide the other through the process.”

This promotes mindfulness for both partners. The partner giving instructions needs to pay attention to timing and the specific directions, she said. And the partner receiving the instructions needs to pay attention to each body part and releasing its tension, she said. (Here’s a sample body scan.)

5. Focus on your own care.

According to Thieda in her book, “When you live with an anxious partner, there can be a lot of tension in your relationship and in your home. Having self-care routines and plans in place can help you neutralize the static.”

Consider what you’re already “doing to promote physical, spiritual, mental, emotional, professional, and relationship health,” Thieda said. Assessing where you are helps you better understand where you need to go. For instance, you might want to set goals about improving your health or seek support from others, she said. You might want to work with a therapist or attend support groups.

What to Do When Your Partner Refuses Treatment

Anxiety is highly treatable. But your partner might not want to seek professional help. Thieda suggested considering the reasons behind their refusal.

For instance, they might’ve tried treatment before but it didn’t work. One reason treatment “fails” is because it’s not the right treatment for the person’s anxiety. According to Thieda, “It is best to work with a professional who uses cognitive-behavioral therapy techniques and is specifically trained in working with people who struggle with anxiety.”

They might’ve tried medication or psychotherapy alone, but they’d do better with a combination of treatments, she said. It’s also possible that your partner tried to take on too much, and ended up feeling even more anxious. “Maybe they need to approach their treatment in a different way, breaking down the challenges into smaller, more manageable pieces.”

Ultimately, the decision to seek treatment rests with your partner, Thieda said. “No amount of begging, pleading, or threatening is going to be effective, and will likely make things worse.”

The best thing you can do is to be supportive, encouraging and loving when they do decide to seek help, she said.

Having a spouse who’s struggling with anxiety can naturally become stressful for partners. But while this can be challenging, by educating yourself, setting healthy boundaries and practicing self-care, you can truly help your spouse and your relationship.

Specifically, about 1 in 5 Americans will receive a diagnosis of major depression in their lifetime. But Shorter believes that the term major depression doesn’t capture the symptoms most of these individuals have. “Nervous illness,” however, does.

“The nervous patients of yesteryear are the depressives of today,” he writes.

And these individuals aren’t particularly sad. Rather, their symptoms fall into these five domains, according to Shorter: nervous exhaustion; mild depression; mild anxiety; somatic symptoms, such as chronic pain or insomnia; and obsessive thinking.

As he writes in this recent blog post:

… The problem is that many people who get the diagnosis of major depression aren’t necessarily sad. They don’t cry all the time. They drag themselves from bed and go to work and plow through family life, but they aren’t sad. They may well have one of the “D-words”  — dysphoria, disenchantment, demoralization – but they aren’t necessarily depressed.

Instead, what do they have in addition? They’re anxious. They’re exhausted and often report crushing fatigue. They have all kinds of somatic pains that come and go. And they tend to obsess about the whole package.

What they have is a whole-body disorder, not a disorder of mood. And that is the problem with the term depression: it shines the spotlight on mood, a spotlight that belongs elsewhere.

Severe depression, which has been lumped in with depression, is a completely different disorder. It’s a serious illness akin to melancholia, a term used around the mid 18th century to the early 20th century. Melancholia speaks more accurately to the gravity of this severe depression and its serious symptoms, which include despair, hopelessness, lack of pleasure in one’s life and suicide.

Shorter also describes melancholia as a “dejection that appears to observers as sadness but that patients themselves often interpret as pain.” It’s recurrent. “Melancholia digs deep into the brain and body, putting patients in touch with their most primeval – and often sinister – impulses. Fantasies of murder and suicide are common themes.”

So how did everyone become depressed?

Shorter names three main culprits: psychoanalysis, which shifted the emphasis away from the body and solely to the mind; the pharmaceutical industry, “the marketing to the public of drugs for depression on the grounds that they rested on an unshakable foundation of neuroscience”; and the Diagnostic and Statistical Manual (DSM).

Before 1980 (and the DSM-III), psychiatry had two depressions: melancholia, which was also called “endogenous depression;” and nonmelancholia, which was called a variety of names, such as “reactive depression” and “neurotic depression.”

After 1980, with the publication of the DSM-III, we were introduced to one term. The manual did include melancholia as a subtype of “major depressive episode.” But, according to Shorter, this was “a pale shadow of the historic melancholia, with its crushing burden of intolerable pain.” It was there “in letter, not in spirit.”

In the book Shorter harshly criticizes this diagnostic decision. He writes:

Whereas melancholia designated a small population of people with life-threatening illness, the diagnosis called simply “depression” was applied to millions. Before DSM-III in 1980, psychiatry had always had two depressions, and now it had only one, and that depression, which began life in 1980 as “major depression,” was a scientific travesty, a poor limp thing of a diagnosis that did not necessarily mean that the patient was sad at all – which is what a depressive mood diagnosis is supposed to convey – but was unhappy, aggrieved, tried, anxious, uncomfortable, or had nothing at all really wrong; the doctor had put her on antidepressants because he or she could think of nothing else to do.

Throughout the book Shorter features stories, case histories, diary excerpts and experts’ quotes along with research and survey data that bolster the need for separate diagnoses.

For instance, he cites one study where “depressed” patients most frequently picked words such as dispirited, sluggish, empty and listless — not sad — to describe how they felt. In the National Comorbidity Survey of 1990-1992, lack of energy appeared to be a prominent symptom for people with depression and anxiety.

Shorter also cites Bernard Carroll’s work. In 1968 Carroll, a psychiatrist and endocrinologist, discovered a biochemical marker for depression, a “promising lead” that’s largely been forgotten. According to Shorter:

…Carroll discovered that administering a synthetic steroid drug called dexamethasone to melancholic patients uncovered an unsuspected dysfunction of their endocrine system: It keeps their cortisol levels high.  Cortisol is a stress hormone. Unlike normal subjects, if you gave them dexamethasone at midnight, their systems did not experience the normal late-night-early-morning reduction of cortisol; this nonreduction correlated with the severity of the illness, and it disappeared after patients were successfully treated for their depression. Later studies found that the endocrine systems of patients with most other psychiatric diagnoses showed normal suppression in response to dexamethasone. Thus, melancholic patients had a distinctive dysfunction of the hypothalamus-pituitary-adrenal axis called ‘DST nonsuppression.’

Other illnesses share this suppression. But they’re not mistaken for melancholia, Shorter says. In fact, he compares the accuracy of the DST to the diagnostic test for epilepsy.

The marker of cortisol nonsuppression is not biologically unique to melancholia: it occurs in severe physical illness and in some psychiatric disorders that are unlikely to be confused with melancholia, such as anorexia nervosa and dementia. Yet the dexamethasone suppression test, or “DST,” has about the same ability to diagnose melancholia properly, without too many “false negatives” and “false positives,” that the interictal (between seizures) electroencephalogram has in epilepsy: useful but not perfect. The DST provides evidence that most melancholic patients, whether unipolar or bipolar, have an underlying biochemical homogeneity that is entirely lacking in other psychiatric disorders.

Ultimately, Shorter calls for a de-emphasis of sad mood in depression. “People with the nerve syndrome are not necessarily sad, weepy, or down in the dumps any more than the population as a whole. They feel ill at ease in their bodies, preoccupied with their state of mind, and are unable to get their thoughts off their internal psychic condition.”

He also calls for a division of depression. He believes that lumping melancholia with depression is dangerous. “…[P]oorly diagnosed patients are denied the benefit of proper treatment while being exposed to all the side effects of classes of medication, such as Prozac-style drugs, that are ineffective for serious illness.”

In sum, having one term to describe melancholia and “nervous illness” simply makes no sense. As Shorter writes, these two illnesses are as different as “tuberculosis and mumps.”

One strategy particularly struck me. He suggested that if you’re feeling a negative emotion, you can work to reduce it simply by labeling it in one or two words.

Note, however, that thinking or talking at length about the emotional state tends to intensify it, while simply observing and labeling it helps to quell it.

I do this myself, instinctively. I find myself thinking, “I’m overwhelmed” or “I’m frazzled” or “I’m feeling defensive” — and it’s odd how calming it is. Just putting a label on a feeling helps me to master it.

For those who enjoy reading about what’s happening in their right ventrolateral prefrontal cortex and elsewhere, Rock explains how brain function accounts for this phenomenon.

How about you?
Have you ever tried a strategy like this — and did it work?

Lots of great material on Positive Prescription — I especially enjoy the category Visual Prozac — “because looking at beautiful things increases happiness.” Indeed.

I got a big kick from seeing The Happiness Project make an appearance in Dan Zevin’s hilarious piece in the New York Times Sunday Review, on The Dow Jones Emotional Average.  “The Dow feels better about itself today after it stayed up all night reading ‘The Happiness Project.’”

Millions of people know the challenge of living with an easily concealed mood disorder and the difficulty on some days of simply getting dressed, putting on a smile, and acting as if all is right with the world when the feelings on the inside do not match at all.

It would be nice if there were one special magic-bullet treatment or approach that would help everyone faced with a chronic mood or anxiety disorder.

However, I’ve discovered over time that there is not one skill, outlook, philosophy or approach to coping with a chronic illness or mood or anxiety disorder. Everyone has his or her own way of living and coping with ongoing symptoms and challenges. Some people meditate; others use medication.

The trick is to expose yourself to a variety of possibilities and numerous methods and hone in on those treatment[s] or coping techniques that work best for you in your particular situation.

The more determined you become to manage your symptoms and not allow them to manage you, the better your quality of life will be. Playing an active role in your treatment and taking care of yourself and your needs helps enormously, whether it’s doing regular meditation, exercise or educating yourself on various treatment options. When you become an expert in your disease, you manage it better. Meshing acceptance of your mood or anxiety disorder with determination to do the best you can, when you can, is a winning combination.

Many who suffer from mood or anxiety disorders tend to feel guilty when they are unable to participate in social activities or work, or they berate themselves if they are too fatigued to accomplish what they originally set out to do.

But guilt is a wasted emotion. Learning to honor your limitations instead of playing the blame game and generating self-destructive thoughts that chronicle your shortcomings can be an extremely difficult skill to master.

For instance, you have to learn to say ‘no’ to some things that pushed you too far too fast. But, by doing so, it can assist you in regaining a sense of control rather than being at the mercy of your symptoms and setbacks.

One of the most beneficial coping tools is to take goals and break them into a series of small steps. This is quite difficult for those of us with Type A personalities! However, it truly helps to pace yourself and not bite off more than you can chew.

Learning to be compassionate toward oneself is another important tool, especially for women. We are taught to be caregivers, always watching out for those around us. We are not accustomed to taking care of ourselves or making ourselves the priority.

Most observers cannot fathom how a mood or anxiety disorder can have such a devastating internal impact and not reveal itself on the outside. This sometimes causes others to perceive the disorder as something less than legitimate. This makes having a chronic mood or anxiety disorder even more isolating. Therefore, seeking social support is crucial. Joining or starting a support group helps keep you connected with others who truly understand your challenges.

You can even learn to laugh at your symptoms and challenges, and laughter may be the greatest coping skill of all.

I often have thought of getting a fresh start somehow. I got that opportunity, but in an unfortunate way.

A failed suicide attempt left me completely disabled, unable to work and with a severe hypoxic brain injury that affected many aspects of my life. I had to start from rock bottom and completely rebuild my entire life.

Before the suicide attempt, I had a great job, made great money, bought a new car and had lots of friends that I hung out with often. In retrospect, I had everything and I was proud of myself for working so hard and doing so well.

Behind the scenes, I had a bad drinking problem and was constantly self-medicating my anxiety and depression.

Now I have no job, car, or friends. But I no longer have a drinking problem and do not self-harm or attempt suicide. It is so frustrating having to wait on things that are out of my control and coping with daily life along with a mental illness and a physical disability.

When I asked for a fresh start, I never imagined this would be it. It’s a thousand times harder than it was before, when I had a great life.

I didn’t consider what happened if I survived drinking antifreeze and taking hundreds of anti-anxiety pills. I don’t have a clue where I got the idea or the impulse to do that. I have no recollection of doing it and had no plans to kill myself in the past.

The previous week I was in a great mood, got along great with my family and didn’t feel overly depressed or down. I had just stopped taking a powerful anti-depressant anti-anxiety medication that I had been on for awhile because I switched jobs and lost my health insurance and the medication was outrageously expensive.

Because of that choice I made, I got what I wished for — and a whole lot more that I wouldn’t wish on my worst enemy. I went from being extremely independent to being completely dependent on everybody for everything. I went from working 40 to 60 hours a week to sitting in bed all day, bored and broke.

Eventually, I will work again and function like my old self, but the wait is nearly agonizing on a mind that is so used to being busy. Patience has never been a strong asset of mine, but the last year and a half of having no choice but to wait has taught me that patience truly is a valuable virtue.

Some days it’s impossible for me to see past the clouds of depression to the other side of the storm where it is sunny and calm and holds peace of mind. But I know I can make it through this day, too, and nothing lasts forever — especially emotions. Feelings aren’t facts and too often I trick myself into forgetting that and jump to impulsive, extreme conclusions.

I have to remember that this is a journey and it isn’t always pleasant. I can’t lose sight of my dreams or give up on hope, because then I have nothing to work toward or look forward to.

Now imagine that out of nowhere, a repulsive creature has stepped into your path. He’s got a grotesque body, horns on his head and a menacing smile. You freeze in terror as this hideous face stares into yours!

Though you desperately wish to flee, you find yourself helplessly frozen. Your heart is racing. Your chest is pounding. You can’t catch your breath. You feel lightheaded. You feel faint. You think you might die right there on the spot.

Now imagine feeling this very same terror when there’s no creature in your path. What would your experience be? Would you feel mystified? Bewildered? Embarrassed? Wonder if you’re going crazy?

This is the experience of those who endure panic attacks. Many keep their experiences secret, for they are embarrassed and at a loss for words to describe what happens to them. Nobody else has ever had such a reaction, or so they believe. Panic attacks, however, are more common than you may think.

The word “panic” emanates from the ancient Greeks, who were said to experience overwhelming terror when they encountered Pan, their god of nature. Half man, half beast, Pan had a scream so intense that terrified travelers who happened upon him in the forest died from fear.

In our modern world, we don’t believe in Pan. But we do have plenty of fears that paralyze us. Those who have had panic attacks are fearful of having another one. So they avoid being in places or situations in which they feel vulnerable or where there’s no quick and easy escape. For some, this means they can’t be alone. For others, it means they can’t be with new people or in crowds of people. In their attempt to create a safe life, they inadvertently create a small life.

Some panic attacks are not so omnipresent, occurring only when zero hour draws near. Students panic before an exam. Hosts panic before their guests arrive. Actors panic before the curtain rises. Working folks panic before their annual evaluations. Patients panic before their medical test.

When family and friends witness the panic, they typically offer well-meaning advice. “Just relax.” “Chill out.” “Take it easy.” “Roll with the punches.” Easy to say. Hard to do.

If the panic doesn’t subside, many people confide in their physicians. They are then prescribed anti-anxiety medication. At first, these meds may take the edge off. Over time, however, nothing changes. So, the medication is increased or another drug, usually an anti-depressant, is added to the mix. Fogginess, sleepiness and lethargy now become additional issues that the panicky person needs to deal with.

There’s a better way to treat panic attacks. It involves a combination of:

• Cognitive therapy (changing your thought patterns and internal dialogue)
• Behavioral therapy (gradually exposing yourself to scarier situations)
• Body therapy (controlling your breathing and muscle relaxation)
• Adjunct medication, if needed, to calm your body down.

If you or a loved one are sweating bullets over an upcoming event, feeling frenzied about the future, restricting your life to cope with your fears or shuddering at the thought of another panic attack, don’t shrug your shoulders and assume that nothing can be done. Actively seek appropriate treatment that can help you master your fears and get on with your life.

For more information about strategies and skills that can help you move forward, read my book, “Master Your Fears: How to Triumph over Your Worries and Get on with Your Life,” available at Amazon or at www.PsychWisdom.com

Panicked woman photo available from Shutterstock

An anxious person will report an unreasonable exaggeration of threats, repetitive negative thinking, hyper-arousal, and a strong identification with fear. The fight-or-flight response kicks into overdrive.

Anxiety is also known for producing noticeable physical symptoms, such as rapid heartbeat, high blood pressure, and digestive problems. In General Anxiety Disorder (GAD) and Social Anxiety Disorder (SAD) the symptoms become so severe that normal daily functioning becomes impossible.

Cognitive-behavioral therapy (CBT) is a common treatment for anxiety disorders. Cognitive-behavioral therapy theorizes that in anxiety disorders, the patient overestimates the danger of disruptive events in his life, and underestimates his ability to cope. CBT attempts to replace maladaptive thinking by examining the patient’s distorted thinking and resetting the fight-or-flight response with more reasonable, accurate ones. The anxious person and the therapist work to actively change thought patterns.

In contrast, instead of changing thoughts, mindfulness-based therapies (MBTs) seek to change the relationship between the anxious person and his or her thoughts.

In mindfulness-based therapy, the person focuses on the bodily sensations that arise when he or she is anxious. Instead of avoiding or withdrawing from these feelings, he or she remains present and fully experiences the symptoms of anxiety. Instead of avoiding distressing thoughts, he or she opens up to them in an effort to realize and acknowledge that they are not literally true.

Although it may seem counter-intuitive, fully realizing the experience of anxiety enables anxious people to release their over identification with negative thoughts. The person practices responding to disruptive thoughts, and letting these thoughts go.

By remaining present in the body, they learn that the anxiety they experience is merely a reaction to perceived threats. By positively responding to threatening events instead of being reactive they can overcome an erroneous fight-or-flight response.

At the University of Bergen in Norway, Vollestad, Nielsen, and Nielsen surveyed 19 studies of the effectiveness of MBTs on anxiety. They found that MBTs are associated with robust and substantial reductions of anxiety symptoms. MBTs proved as effective as CBT, and are generally less expensive.

The researchers also found that MBTs are successful in reducing symptoms of depression. This is especially important since major depressive disorder affects 20 to 40 percent of people with GAD and SAD.

The study finds the success of MBTs notable “given that these approaches put less emphasis on the removal of symptoms as such, and more emphasis on cultivating a different relationship to distressing thoughts, feelings, and behavioral impulses. It seems that this strategy paradoxically could lead to less distress.”

In other words, a way to reduce the symptoms of anxiety is to be fully, mindfully, anxious. As anxiety reveals itself to be a misperception, symptoms will dissipate.

Reference

Vollestad, Nielsen, and Nielsen (2011). Mindfulness and acceptance-based interventions for anxiety disorders: A systematic review and meta-analysis.