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A Cure For Anxiety?

Question:

I have GAD. I am well read on the subject, and spent some months with a psychotherapist and subsequently some months with a hynotherapist. Both had their place; hypnotherapy being more effective for me. I have spent the last two years changing belief systems; controlling negative thought patterns; doing deep relaxation daily (and regularly during the day); and have included yoga and exercise daily. I have excellent eating and nutritional habits. Eight months ago I had to sell my business because after all my changes (including relooking and changing all significant personal relationships) I still wasn’t coping well. I have been on a spiritual and reading sabbatical for six months without ANY responsibilities or concerns, but my anxiety is still not manageable. I have avoided medications because I understand that they are not cures, just temporary symptom helpers. I’m not interested in temporary help from chemicals with side effects. I’m interested in a cure and starting to question whether that is actually possible–especially when I read of people having the disorders for 20 years or more. Can someone become 100% cured of anxiety disorders? (Please give me the straight stuff.) What are factors that prohibit cure, if patient is cooperative and follows all the programs for recovery? Can recovery be done without medications? Are there herbal alternatives? I’ve been reading about 5-HTP. What is your suggestion for the next line of action? Is there such a thing as an anxiety treatment center in the U.S.A.?

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Answer:

Anxiety is fundamental to the human condition. Some anxiety is a good thing. Anxiety is part of what helps us to pay attention to things that are dangerous for us – things we need to respond to. Without any anxiety in us at all we would be like plants or sleeping people – unresponsive. The goal should not be to be “cured” of all anxiety (in my humble opinion) but rather to come to terms with it and to learn how to manage it when it gets out of control. I have a personal problem with the whole concept of “cure” as applied to psychological difficulties. Being “cured” of something means that it was there at one point and then it is wholly gone. The idea behind a “cure” is a binary one – either ON or OFF – either BLACK or WHITE. While this works well for computers, light switches and some physical diseases – it is a very bad metaphor for stuff like anxiety, which is not binary – but rather continuous (shades of gray or intensity). I don’t think anyone can be or should aspire to be “cured” of anxiety 100% – this is an inhuman goal. Rather – one should aspire to manage their anxiety – and not be managed by it. Consider rethinking the place of medication in your treatment program. Medication treatment has its place along side of psychotherapy, hypnotherapy and all the rest. Medication is not just a crutch for ‘temporary symptom relief’ – but can be (properly used) a valuable means of managing otherwise disabling conditions. With regard to anxiety it is important to be careful as some medications (benzodiazipines in particular) are highly addicting – but there are alternative meds that are helpful and less concerning. Your MD can help you with this. Psychological research tells us that some people are just born (genetically predisposed) to be more anxious than others. Such persons are just more sensitive to things and seem to naturally fall into patterns of anxious worry. This doesn’t mean that there is no hope for these people, but rather that they are as a group more vulnerable to develop disorders of anxiety than some other people. Research in this area is searchable under the keywords: Temperament. See also the “five-factor” model of personality and associated theories of vulnerability to ‘distress’ psychopathology (e.g., the Tripartite Model due to David Watson and Lee-Anna Clark). There are some excellent therapies for treating anxiety disorders such as GAD. The very best one that I know of that you can ask for by name is called the “Mastery of Anxiety and Panic” program – which is a behaviorally oriented therapy protocol (and associated workbook for patients) that an up-to-date behavioral therapist can offer you. Don’t get hung up on this particular book – it is the principles described in this book that are most important – not the physical possession of this book. The success rate for this type of therapy (Cognitive Behavioral Therapy for Anxiety) is high – but note that success means that pathological anxiety symptoms are reduced – not that they go away entirely. There are a number of excellent Anxiety Treatment Centers in the United States of America. I can recommend several university affiliated ones – (there is one in Philadelphia at Temple University attached to the Psychology Department – and there is one in Boston at Boston University – also attached to the Psychology Department I believe). I think there is also one at UCLA. And there are many others as well. Since my background is Clinical Psychology (Ph.D.) and not medicine I am not qualified to advise you on medications or herbal alternatives to medications for anxiety. Only a MD (Psychiatrist preferably) is qualified to discuss medicines with you. A ND (naturopathic doctor) might be a choice to discuss herbal remedies with – but you will have to make that distinction. I haven’t answered all your questions – but you’ve got a lot to work with here I think! Dr. Dombeck

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