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- When it affects your work/school
- When you self- medicate with drugs or alcohol
- When you miss out on things with your friends
- When it gets in the way of relationships

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40 million adults in the United States (U.S.) are affected by anxiety disorders (1). I will focus on the most prevalent anxiety disorder in the U.S.: Generalized Anxiety Disorder. I will outline some of the most effective methods I've personally used when dealing with anxiety.

Generalized Anxiety Disorder is a common anxiety disorder that is characterized by significant worrying, tension, and nervousness (2). We will refer to this disorder as "anxiety" for the remainder of this article.
*If your condition is persistent, severe, or ongoing, I highly encourage you to seek professional medical help. This article is not meant to serve as a substitute to proper medical treatment.
CURRENT MEDICAL TREATMENTS

I'm going to briefly touch on the most common medical treatments used for Generalized Anxiety Disorder. However, the majority of this article is meant to act as a guide for powerful lifestyle changes to combat anxiety.

COMMON MEDICATIONS USED IN THE TREATMENT OF ANXIETY:

Benzodiazepines: Diazepam (Valium), Alprazolam (Xanax), Clonazepam (Klonopin), Lorazepam (Ativan)

Selective Serotonin Re-uptake Inhibitors (SSRIs): Citalopram (Celexa), Escitalopram (Lexapro), Fluoxetine (Prozac), Paroxetine (Paxil, Pexeva), Sertraline (Zoloft)

There are some significant downsides to using these medications in the treatment of Anxiety. Benzodiazepines are habit forming. I've seen the effects of addictions to these medications in the long-term. It's not pretty. The addiction is difficult to break. I'd encourage you to seek other options if possible. (Note, I am not a doctor and this should be discussed further with your healthcare provider.) However, there are cases of extreme trauma or life circumstances that warrant these medications. You'll have to talk to your healthcare provider about this.

The evidence for the effectiveness of SSRIs in the management of anxiety is mixed. These drugs also come with a host of side effects and rarely address the underlying cause of your anxiety.

Cognitive Behavioral Therapy (CBT) is a type of thought restructuring supervised by a mental health professional. CBT is a highly effective method to treat anxiety (10). The results are often maintained in the long run as well.

DEALING WITH ANXIETY: LIFESTYLE MANAGEMENT OF ANXIETY

The good news is there are a lot of things you can do to manage anxiety in your daily life. In my case, I've assembled a list of lifestyle changes that have worked well for me. Here are my methods how I manage my own anxiety:

Vigorous exercise - if you are physically able, moderately intense exercise has been shown to significantly decrease anxiety (3) This includes activities that elevate your heart rate to approximately 80% of your target heart rate maximum. You can calculate the suggested target heart rate for your age here. 30 minutes of sustained target heart rate or 15-20 minutes of high intensity interval training will often suffice.

Yoga - While peer-reviewed evidence is limited (4), the use of yoga in your daily routine may help abate the symptoms of anxiety. The combination of conscious breathing with purposeful movement has a calming effect on the central nervous system.

Mindfulness Meditation - A recent meta-analytic review (5) concluded that Mindfulness-based therapies may be an effective means to reduce anxiety. This practice has been one of the most helpful tools in my anti-anxiety toolbox. Mindfulness meditation is not about "clearing the mind." It is a practice where we observe our thoughts through the mind's eye. We watch. We listen. We acknowledge without judgment. By doing this, the tension of unsolved problems become less burdensome on our psyche.

Progressive Muscle Relaxation (PMR) -The process involves a series of purposely tightening and relaxing muscles throughout your body. You typically start at your toes and systematically work your way up to your head. Most research of PMR has been performed on patients with cancer. In the research, PMR has produced favorable results for those dealing with anxiety (6). A free MP3 guided recording of PMR can be found here.

Regular Sleep Patterns - If you are coping with anxiety, regular sleep patterns are a must. Sleep is a time to repair and rejuvenate the brain and body for the coming day. Without sleep, you will have difficulty focusing, feel wired, and / or anxious. Make a strong commitment to the times you go to bed and rise for the day. Sleep in a dark, cool room (68-70 degrees F), with as little noise as possible. These are optimal sleeping conditions.

Address Gut Pathology - There is a significant amount of research (7) in the works examining the relationship between mood disorders and gut health. When I began working on my microbiome (gut environment) on a regular basis, there was a noticeable improvement in my mood. This likely is related to the gut-brain axis. Simply put, the gut-brain axis is a strong biologically-wired relationship between our mind and gut environment (8). If you have difficulty with your gut, it may be worth exploring further. An in-depth guide on how to restore gut-health can be found here.

Acupuncture - Evidence is mounting that supports Acupuncture in the treatment of anxiety (9). While I don't fully understand the mechanism behind this, I can personally attest how much acupuncture has helped me in the past while dealing with anxiety. While some may be averse to the idea of the needles, most clients report that acupuncture is almost entirely painless. This is my experience as well.

Essentialism - Do you feel busy but not productive? Is your time often hijacked by other people's agendas? Do you feel simultaneously overworked yet underutilized? If this is making it difficult to manage life while dealing with anxiety, I highly encourage you to check out the book, Essentialism: The Disciplined Pursuit of Less. Greg McKeown outlines an "essentialist" lifestyle that helps you cut out all the extra garbage in your life. Instead you can focus on what really matters to you. This book opened my eyes to how many non-essential tasks I was undertaking, thereby increasing my anxiety.

Toxic Relationships - If you are around individuals that suck the marrow out of your life, it might be worth reconsidering the value of such a relationship. This is certainly difficult. It may seem the relationship is worth more than it really is. This is because of how much time you may have invested already. Always continue to assess and re-assess the direction of such relationships.

These are but a few possible options that may help you cope with Anxiety. I've found these changes in my life to make the biggest impact dealing with anxiety in my own life. If you found this helpful, subscribe to our mailing list (above) to receive notifications on our upcoming online course to thrive despite anxiety.
Question for the comments section: How do you deal with anxiety?
REFERENCES:

(1) Anxiety and Depression Association Of America: Facts and statistics

(2) Generalized Anxiety Disorder (GAD)

(3) Regular exercise, anxiety, depression and personality: A population-based study

(4) Yoga for anxiety: a systematic review of the research evidence

(5) The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review.

(6) A randomized clinical trial of alprazolam versus progressive muscle relaxation in cancer patients with anxiety and depressive symptoms.

(7) The microbiota-gut-brain axis: neurobehavioral correlates, health and sociality

(8) Harvard: The Gut-Brain Connection

(9) Acupuncture for anxiety and anxiety disorders - a systematic literature review

(10) Cognitive-behavioral therapy for anxiety disordered youth: A randomized clinical trial evaluating child and family modalities

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Dealing With Anxiety: Long-Term Solutions

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40 million adults in the United States (U.S.) are affected by anxiety disorders (1). I will focus on the most prevalent anxiety disorder in the U.S.: Generalized Anxiety Disorder. I will outline some of the most effective methods I've personally used when dealing with anxiety.

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- Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States age 18 and older, or 18.1% of the population every year.

- Anxiety disorders are highly treatable, yet only 36.9% of those suffering receive treatment.

- Teenagers with anxiety receive treatment even less frequently – only 1 in 5 teen sufferers do.

Source:
https://adaa.org/about-adaa/press-room/facts-statistics

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A feeling of worry, nervousness, or unease, typically about an imminent event or something with an uncertain outcome.

Source: https://www.webmd.com/anxiety-panic/guide/anxiety-panic-guide-symptoms-types

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What are the different types of anxiety?

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What are the different types of anxiety?

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- General Anxiety Disorder (GAD)
symptoms include constant worry, restlessness, and trouble with concentration.
- Performance Anxiety
caused by speaking or being up in front of people.
- Social Anxiety Disorder
can cause excess fear of situations in which one may be judged, worry about embarrassment or humiliation, or concern about offending someone.

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- Stress at work
- Stress at school
-  Side effects of medication
- Financial stress
-  Stress from emotional trauma

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Anxiety Disorders Resource Center
Last updated July 2016
All children experience anxiety. Anxiety in children is expected and normal at specific times in development. For example, from approximately age 8 months through the preschool years, healthy youngsters may show intense distress (anxiety) at times of separation from their parents or other caregivers with whom they are close. Young children may have short-lived fears, (such as fear of the dark, storms, animals, or strangers). Anxious children are often overly tense or uptight. Some may seek a lot of reassurance, and their worries may interfere with activities. Parents should not discount a child's fears. Because anxious children may also be quiet, compliant and eager to please, their difficulties may be missed. Parents should be alert to the signs of severe anxiety so they can intervene early to prevent complications.

For additional information see:
AACAP Book Your Adolescent Anxiety and Avoidant Disorders
Glossary of Symptoms and Mental Illnesses Choose a topic:

1. How much anxiety is "normal" for a child?

2. What are the signs and symptoms of anxiety?

3. What causes anxiety disorders?

4. How are anxiety disorders treated?

AACAP's Facts for Families provide concise up-to-date information on issues that affect children, teenagers, and their families.

AACAP Practice Parameters
Considered resources for experts, mental health professional and physicians, AACAP's practice parameters were developed to guide clinical decision making. They show the best treatments and the range of treatment options available to families living with childhood and adolescent mental illness.Considered resources for experts, mental health professional and physicians, AACAP's Practice Parameters were developed to guide clinical decision making. They show the best treatments and the range of treatment options available to families living with childhood and adolescent mental illness.

Additional Clinical Resources

Cognitive-Behavioral Psychotherapy for Anxiety and Depressive Disorders in Children and Adolescents: An Evidence-Based Medicine Review
Journal of the American Academy of Child & Adolescent Psychiatry:
June 2015 - Volume 54 - Issue 6 - pp 454-463

Assessment and Management of Treatment-Refractory Obsessive-Compulsive Disorder in Children
Journal of the American Academy of Child & Adolescent Psychiatry:
April 2015 - Volume 54 - Issue 4 - pp 251-262

A Randomized, Placebo-Controlled Study of Duloxetine for the Treatment of Children and Adolescents With Generalized Anxiety Disorder
Journal of the American Academy of Child & Adolescent Psychiatry:
April 2015 - Volume 54 - Issue 4 - pp 283-293

Anxiety Disorders in Children and Adolescents: A Review of the Past 10 Years
Journal of Amer Academy of Child & Adolescent Psychiatry: Special Articles: PD onlh.

A review of Cognitive-Behavioral Therapy in anxiety and depression:
Cognitive-Behavioral Psychotherapy for Anxiety and Depressive Disorders in Children and Adolescents: An Evidence-Based Medicine Review
Journal of the American Academy of Child & Adolescent Psychiatry:
August 2004 - Volume 43 - Issue 8 - pp 930-959

A recent important study comparing medication and CBT in treating anxiety:
Cognitive Behavioral Therapy, Sertraline, or a Combination in Childhood Anxiety
New England Journal of Medicine, Volume 359:2753-2766 December 25, 2008 Number 26

Obsessive-Compulsive Disorder in Children
John Piacentini, R. Lindsey Bergman
Psychiatric Clinics of North America - 1 September 2000 (Vol. 23, Issue 3, Pages 519-533)

March JS (1995), Cognitive-behavioral psychotherapy for children and adolescents with OCD: a review and recommendations for treatment. Journal of the American Academy of Child and Adolescent Psychiatry 34:7-18
The use of imaging Technology and Physiological Measurements to Investigate Changes in Biological Stress Systems and Brain Development in Maltreated Children with PTSD
2015 Annual Meeting Sessions
Click here to search the Annual Meeting Sessions.

IACAPAP Textbook of Child and Adolescent Mental Health
IACAPAP

Your Adolescent - Anxiety and Avoidant Disorders
AACAP

What You Must Think of Me: A First Hand Account of One Teenager's Experience with Social Anxiety Disorder
Emily Ford

For more bibliotherapy resources, visit Living with Mental Illness: Books, Stories and Memoirs.

Not all children who have experienced anxiety will need treatment. However, treatment can help minimize anxiety. To obtain help, parents should try to find a mental health professional who has advanced training and experience with evaluating and treating children, adolescents, and families. It is important to find a comfortable match between your child, your family, and the mental health professional.

A child and adolescent psychiatrist is a physician who specializes in the diagnosis and treatment of disorders of thinking, feeling and behavior that affect children, adolescents, and their families. Child and adolescent psychiatrists have completed four years of medical school, at least three years of residency training in medicine, neurology, or general psychiatry with adults, and two years of additional training in psychiatric work with children, adolescents, and their families.

Click here to find a child and adolescent psychiatrist in your area.

Facts for Families:
Providing up-to-date information on issues that affect children, teenagers, and their families. These fact sheets are relevant to anxiety disorders.
Related Support Group Web Sites

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Anxiety Disorders Resource Center Last updated July 2016 All children experience anxiety. Anxiety in children is expected and normal at specific times in development. For example, from approximately age 8 months through the preschool years, healthy youngsters may show intense distress (anxiety) at times of separation from their parents or other caregivers with whom they are close.

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Signs you or someone you know has anxiety

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Signs you or someone you know has anxiety

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- Constantly tense or worried
- Plagued by fears that you know are irrational
- Believing bad things will happen if you don't do something the right way.
- Avoiding everyday situations because they cause you to worry something will go wrong.
- Feeling like your mind has gone blank
Source:
https://www.healthcentral.com/article/five-signs-that-it-is-time-to-get-help-for-your-anxiety

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-The Anxiety and Depression Association of America have a list of resources on their website
-People to reach out to could be your parents, teachers, school counselors and social workers, and any trusted adult

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Additional online informational websites*

Children and Adolescents

Child Mind Institute
Families for Depression Awareness
Families USA
Georgetown Center for Children and Families
National Child Traumatic Stress Network
The Balanced Mind Foundation
The Henry J. Kaiser Family Foundation
Selective Mutism Group
Selective Mutism Foundation
WorryWiseKids.org
Red Sox Foundation and Massachusetts General Hospital Home Base Program - for military families in New England

Teens and College Students

Active Minds
Guide to College Student Mental Health
Minding Your Mind
National Eating Disorders Association
Promoting Student Mental Health
Start Your Recovery
Student Mental Health: A Guide to Identifying Disorders and Promoting Wellness
The Jed Foundation

Women
Food and Drug Administration Office of Women's Health provides these links:
Men

Military and Military Families

Helping Children Cope During Deployment - Real Warriors Campaign, Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE)
BraveHeart: Welcome Back Veterans Southeast Initiative - Emory University and the Atlanta Braves have teamed up to offer veterans of the wars in Iraq and Afghanistan and their family members a variety of expert support resources. Mission: Help people in the Southeastern United States get help for PTSD.

Mental Health - General

Make It Ok
Community Conversations About Mental Health
Academy of Cognitive Therapy
American Foundation for Suicide Prevention
American Psychiatric Association
American Psychological Association
Andrew Kukes Foundation for Social Anxiety
Bazelon Center for Mental Health Law
BrainFacts.org
Brain and Behavior Research Foundation
Research Match
Centers for Disease Control and Prevention (CDC)
Depression and Bipolar Support Alliance (DBSA)
International Bipolar Foundation
DualDiagnosis.org (depression and addiction)
Freedom From Fear
Helping Others Live Sober [Service to Others in Sobriety (SOS) Questionnaire]
MentalHealth.gov
Mental Health America
NAMI (National Alliance on Mental Illness)
National Association of Free and Charitable Clinics (NAFC) focuses on the issues and needs of more than 1,200 free and charitable clinics and the people they serve in the United States; offers an application for discount pharmacy card.
National Institute of Mental Health
Care for Your Mind
NoStigmas.org: A voice for mental health equality, or when all people have the same rights, treatment, and access to care regardless of mental illness or condition.

Social Security Disability benefits: Learn how to apply if you have an anxiety disorder, depression, or other mental disorders.
Thero.org, a collective of mental health care providers and consumers of mental health services
Treatment Advocacy Center: Eliminating barriers to the treatment of mental illness
World Federation for Mental Health

Medication

Drugalert.org is a comprehensive database with information and news alerts about potentially dangerous drugs currently on the market or previously available worldwide.
DrugNews.net provides the latest research, warnings, FDA recalls and legal news to those who use popular drugs or medical devices.
DrugWatch.com provides up-to-date information about prescription and over-the-counter medications, including details about associated side effects.
Patient Safety Alerts offers real-time email notifications about drug recalls and safety alerts.

Mindfulness

Mindfulness for Healthy Living (University of Southern California School of Social Work)

Obsessive-Compulsive Disorder (OCD)

International OCD Foundation
The TLC Foundation for Body-Focused Repetitive Behaviors (BFRBs)

Posttraumatic Stress Disorder (PTSD)

Addiction Center
Give an Hour - for veterans and their families
National Center for PTSD
Real Warriors (U.S. Department of Defense) - for veterans and their families

Specific Phobias

International Paruresis Association - shy bladder syndrome

Suicide Prevention

American Foundation for Suicide Prevention
1-800-273-TALK (8255) National Suicide Prevention Lifeline
Sources of Strength
The Carson J. Spencer Foundation
Working Minds

Related Resources

Addiction Resource
Employer Guide for Compliance with the Mental Health Parity and Addiction Equity Act(A concise guide to the parity law, its final regulations, and how it is affected by the Affordable Care Act)
National Eating Disorders Association
National Sleep Foundation
National Women's Health Resource Center
Talking to Children About Terrorism and War
The Substance Abuse and Mental Health Services Administration
The National Child Traumatic Stress Network
Children and Grief

International Organizations

A Guide to UK-based Anxiety Disorders Association of Canada
Anxiety Disorders Association of Manitoba
Anxiety UK
Free Mental Health Helplines by Cassiobury Court.

ADAA has not investigated these sites nor does it have the facilities to evaluate their recommendations in regards to treating anxiety, depression or co-occurring disorders. This list is a compilation of websites who have requested that their links appear on ADAA's website. ADAA doesn't recommend or endorse the competence or expertise of the information on any of these sites. The listing of a website is not an endorsement, but merely a source listing of informational sites that ADAA's website visitors might find helpful.

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Additional online informational websites* Child Mind Institute Families for Depression Awareness Families USA Georgetown Center for Children and Families National Child Traumatic Stress Network The Balanced Mind Foundation The Henry J.

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Anxiety can mainly be treated by therapy. Sometimes prescription medicine is advised. In some cases people use hypnosis to help.