- STRIDES Anxiety Canada`s Newsletter - Spring 2016 Mindshift Up-date - Gala News - Membership - Surveys - Prescription Pad
STRIDES Anxiety Canada`s Newsletter - Spring 2016 Mindshift Up-date - Gala News - Membership - Surveys - Prescription Pad
Anxiety Canada has been working hard to bring
May 06, 2016
Managing Anxiety – Who can help?
So you think that you or a loved one is suffering because of anxiety. Anxiety Canada’s website (anxietycanada.com) has a wealth of evidence-based self-help resources. But where do you turn if this is not enough? Who can help?
General Practitioners (GPs): Your GP or family physician can help determine whether your symptoms are due to anxiety, another health problem, or both. Your physician may monitor your symptoms, prescribe medication to help you, or refer you to a mental health professional or program that will be covered by the Medical Services Plan of BC. Unfortunately, wait times to see a mental health professional or to enter a public program tend to be long. Your physician may know of good private clinics or mental health professionals that have helped other patients.
If you do not have a GP, this is the time to find one. Ask family or friends for a recommendation. Inquire at clinics near your home and/or office to see who is accepting new patients.
Mental Health Professionals: Psychiatrists, Psychologists, and Counsellors are the most common types of professionals who provide help to people with anxiety. Of these professionals, only psychiatrists can prescribe medications. Ask your physician to direct you to the type of professional that will be best suited to helping you. Health professionals have different training, credentials, licenses, and experience. Some people who claim to treat anxiety are not well-trained professionals in the mental health field. Check whether practitioners have a license to practice, training in evidence-based treatment (treatments scientific research shows are helpful), and experience treating anxiety.
More severe anxiety problems often require the services of a psychiatrist and/or a psychologist whereas a counsellor can often help with less severe problems. Psychiatrists require a referral from a physician and are covered by MSP. You can self-refer to most psychologists and counsellors; however, you will generally have to pay out of pocket for their services. For more information on the difference between psychologists, psychiatrists and counsellors, visit:
If you have extended health insurance or an Employee Assistance Program (EAP), contact them to find out what types of or specific mental health providers they will cover as coverage varies. Most EAP providers will give you a list of names and you will have to choose one of them. Your insurance provider may only reimburse you for therapy by certain types of registered mental health providers and only up to a maximum dollar amount. It is best to check with them directly.
If you find you are having difficulty managing your anxiety on your own – you are not alone. Many people require and benefit from professional care.
By Dr. Melanie Badali, R.Psych. Dr. Melanie Badali is a Registered Psychologist who is CACBT-ACTCC-Certified in Cognitive Behaviour Therapy. For additional information, please visit: http://www.anxietycanada.com/melanie-badali.
Depending on which survey you look at, Social Anxiety Disorder is among the top five most common of all psychological diagnoses. Nearly 15% of the populations will, at some point I their lives, experience enough anxiety and distress over social
interactions that they could be diagnosed with Social Anxiety Disorder.
Although mental health specialists have long since recognized that some people have social fears that are severe enough to cause a significant distress and interference in a person's life, it wasn't until the 1970's and 1980's that researchers began studying it closely. When they did, they quickly found that people with these social fears were so similar that the condition warranted its own diagnosis: Social Phobia.
The core of this disorder seemed to be an intense fear of negative evaluation. In other words, people with Social Phobia feared being embarrassed, humiliated, rejected, or judged by others as stupid or incompetent. This is very different from being a loner or preferring not to interact with others. Social Phobia is about wanting to be accepted by people, but
being intensely afraid that other people will think poorly of them and reject them. As one organization put it, it is
like being allergic to people.
The change in name from Social Phobia to Social Anxiety Disorder came about in the early 1990s when a group of preeminent clinicians and researchers recognized that phobia seemed to imply a fear of a very circumscribed thing, much like someone with a spider phobia specifically fears spiders. The fears of people with Social Anxiety Disorder tend to be much
broader. Like John, people with Social Anxiety Disorder usually fear a number of social situations. Most commonly, people with Social Anxiety Disorder fear public performances (e.g., public speaking, being observed doing something, etc.), interactions (e.g., initiating or maintaining conversations, mall talk, etc.), tests, dating, or even just being out in public places.
It may be hard for loved ones or others to truly understand Social Anxiety Disorder because, in most cases, people don't laugh at you when you misspeak. People usually do not stand up, call you a "moron," and walk out when you are giving a
presentation. But the mind of a person with Social Anxiety Disorder seems to evaluate his/her social performances
differently. A series of interesting research studies have clearly shown that people with Social Anxiety Disorder are much
more likely than others to find evidence that they messed up. They will notice the one person who is yawning in an audience of hundreds, and will interpret that as clear evidence that they were boring. They internally judge their own performance poorly, even though others thought that they did just as well as someone without Social Anxiety disorder. They tend to remember what didn't go well and forget about, or discount, social interactions that did go well.
Because of this intense fear, Social Anxiety Disorder often has a very severe impact on a person's life. Social Anxiety Disorder can, and often does, impact a person's work, school, social, and romantic life. In my own work, I have seen students drop or fail college courses because they cannot give a class presentation. I have seen a gentleman with an MBA working as a night janitor because he couldn't tolerate the day-to-day terror he felt when being around his former coworkers at an accounting firm. As we see in John's story, as a younger he hid himself in his room and didn't make friends. His school suffered. He lost his job, and couldn't begin applying for a new one. Social Anxiety Disorder can have a debilitating impact on a sufferer's life.
Social Anxiety Disorder can also lead to a number of other problems. They may isolate themselves and mentally "beat themselves up" so badly that they develop Major Depressive Disorder. Many people will also try to cope with their anxiety by using alcohol or drugs, which may lead to drug or alcohol abuse. John's story highlights this clearly. He started to use alcohol to calm himself, but even that wasn't enough to allow John to lead the life he wanted.
Despite this foreboding picture, many extremely helpful treatments exist for Social Anxiety Disorder. John is a testament to the fact that people can beat Social Anxiety Disorder. John's treatment involved two approaches: a psychological treatment that is clearly most effective (and the one used by John) is called Cognitive Behavioral Therapy-or CBT for short. CBT usually involves learning to recognize their anxious thoughts, and challenging how realistic the thoughts actually are. Clients then practice engaging in social interactions, starting with easier situations first, to test whether or not their thoughts were correct and to slowly get themselves used to feeling comfortable in social situations.
From a medication standpoint, many drugs are also extremely helpful. In particular, medications that affect levels of a brain chemical known as serotonin are typically very effective. Although scientists aren't exactly sure how raising serotonin levels helps, these same medications also seem to be helpful in treating other anxiety disorders, depression, and a variety of other emotional disorders.
The decision to get CBT, medications, or both should be made by the individual with the advice of his or her psychologist, physician, or therapist as there are advantages and disadvantages of both. Medications tend to work faster and are a lot
easier, but they may sometimes have unpleasant side-effects and many people relapse when they stop taking their medicine. On the other hand, CBT takes a bit longer and requires a lot more hard work, as John has testified, but the effects tend to be much more permanent and have no real side effect.
The jury is still out on whether combining CBT and medicine works any better than either alone, although a few recent studies seem to show that both work slightly better than either alone. Again, this is a question that should be discussed with your mental health provider. Still, with these effective treatments, most people with Social Anxiety Disorder overcome their fears and go on to lead happy and social lives.
Dear Concerned Mother,
Your question is very timely: The article by Dr. Watt and Ms DiFrancescant in this issue of Strides discusses a number of factors that can increase a child's vulnerability to developing an anxiety disorder.
There is good news for people such as yourself. There are several groups of researchers around the world who are attempting to determine which children are at greatest risk for developing Panic Disorder and other disorders. They are also attempting to devise effective tools for preventing the disorders from occurring. Two main groups, one in Australia and one in Canada, have found that parents' and teachers' reports of children's responses to stressful events are very helpful in identifying children who are at risk. Children who get easily upset, resist engaging in social or school activities, and who report a lot of bodily concerns (e.g., upset stomachs) during or prior to activities they perceive as stressful are possible indicators they might develop an anxiety disorder. There is also evidence that children of anxious parents are also more likely to develop anxiety related problems. These groups of researchers have also shown that early intervention can reduce or prevent the development of anxiety disorders. The procedures they use are very similar to those of Cognitive Behaviour Therapy. Children are taught, often with the help of parents or other aides, to make more realistic evaluations of the way they think about activities they see as threatening (e.g., going to a new school or joining a new play group), engaging in feared behaviours in progressive manner, such as going to the play group with the parent for the first few times. The amount of time in this activity might also increase. While the child is doing this, he/she might be asked to tell the parent/aide what they are thinking and feeling. If they are experiencing undue fear or anxiety, the parent/aide can help the child have more realistic thoughts/feelings. This is done in a positive manner. Once the child shows positive changes, these are verbally reinforced and bragged about to others, such as grandparents. There is very good evidence these techniques work for many at risk children.
Without spending some time with your friend I can't say for sure what his problem is, but from your description I would bet he has Social Anxiety Disorder. Social anxiety is characterized by extreme shyness. It is also not uncommon for people with Social Anxiety to use alcohol to bolster their courage when they are in situations of meeting new people.
There are two forms of Social Anxiety: fear of specific situations or activities such as giving a talk to a group of people, and generalized Social Anxiety. People with the generalized form have difficulty with almost all social activities, except for when they are with people they know well and whom they trust.
Most people with Social Anxiety have a dread fear they will say or do something “stupid.” As a result they often avoid social activities. It should come as no surprise that many people with Social Anxiety drop out of school if they think they will have to interact with others. They are also often unemployed or underemployed, preferring jobs that keep them away from others.
You may wish to discuss this with him (in a gentle and caring way) and suggest that he visist anxietycanada.com for more information and resources on anxiety.
you for your letter.