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  • Depression blog

  • July 3, 2008

    Managing depression by understanding anxiety

    By Gabrielle J. Melin, M.D.

67 comments posted

Need more help?
  • National Suicide Prevention Lifeline
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Depression can be a challenge to manage. Anxiety and depression may occur together but certainly not always. Be assured that if anxiety accompanies depression, it can be treated.

Anxiety may manifest itself in a multitude of ways including fear, helplessness, a feeling of panic, feeling that something bad may happen, as well as possible physical symptoms. We wouldn't be human if we didn't experience anxiety.

Anxiety is a general term. Anxiety disorders include a number of different specific disorders that includes panic disorder (panic attacks plus other symptoms), generalized anxiety disorder, post-traumatic stress disorder (PTSD), phobias (for example, heights, flying, needles), to name a few.

The diagnosis of panic disorder is made when a person has recurring panic attacks accompanied by other specific symptoms and criteria. Therefore, a panic attack is a cluster of symptoms that signify anxiety. A panic attack can include some or all of the following symptoms: sudden onset of extreme fear (panic), shortness of breath, dizziness, feeling hot/cold, a choking sensation, numbness or tingling in the fingers and/or toes, sweating, nausea and/or vomiting, and palpitations or a sensation of heart pounding.

Panic attacks typically last for a few minutes, reach a peak intensity, and then resolve with time. If you do have panic attacks, here are a couple of basic self-management tools:

  • Although you may feel completely powerless, anxiety is nothing more than an exaggeration of normal body reactions to stress.
  • Tell yourself in a positive tone of voice that this will pass and it is not dangerous.
  • Refrain from escalating your panic with frightening thoughts about what is happening and where it will lead ("what if").
  • Don't fight the feeling of panic, accept it. Get as comfortable as possible without fleeing. You could sit or lean on something.

Many medical illnesses can cause anxiety symptoms, so seeing a professional is important for the right diagnosis.

Finally, we want you to know that we do read through all of the comments you send, but cannot answer all of them. Our goal is to provide accurate information and stimulate conversations amongst visitors. Thanks for visiting our blog and have a great week.

67 comments posted

blog index
  • July 22, 2008 4:06 p.m.

    Hello- Thanks for your interest and we are glad that you are helping each other out! Your individual experiences are important. We do not have the capacity to publish summary notes, journals, etc. from individuals. If we did this for one person, where would we draw the line? Thanks for understanding. We definitely recommend David Burns, MD material and Mind Over Mood by Greenberger/Padesky-both are excellent resources for cognitive behavioral therapy. (CBT)

    - MC.Com Staff

  • July 21, 2008 8:49 p.m.

    I am being treated for anxiety and panic attacks and my counselor suggested that I read Dr. Burns book. I have started it this past week and I think it may help me also. I too worry about all the medications that I have been taking.I would like to read Rick Beatty's summary notes. Is that possible?

    - CK

  • July 20, 2008 7:03 a.m.

    Dr Burns book is available in book stores.Try the self help sections

    - sam

  • July 19, 2008 11:23 a.m.

    Thank you to all who have shared their experiences. I don't feel so alone. My story is similar to most of yours and I suppose one of the hardest things is to see and feel myself acting in ways that are not really me. Which in turn, is slowly distroying all my relationships, because I simply can not trust anyone anymore. I don't want to be this way. I read and educate myself as much as possible so that I can find a way to be the real me again. Is Dr. David Burn's book "Feeling Good" still in print? Thank you again to eveyone who has the courage to reach out. Namaste.

    - Val

  • July 17, 2008 12:13 a.m.

    Will your notes fit on this blog? I'd be very interested in seeing them. My counselor keeps advising against cognitive therapy, but I keep seeing it recommended as the best approach to anxiety. Thanks, Greg

    - Greg

  • July 16, 2008 12:01 p.m.

    Like many others who have commented upon this article, I too suffered from anxiety and panic attacks for 20 years before they culminated into Clinical Depression. My anxiety and panic attacks were miss-diagnosed by the medical profession for 20 years. During my panic attacks my chest muscles would contract so tightly that I could not breath and felt like an elephant was standing on my chest. Doctors told me to relax and excersise more to reduce the frequency of these attacks? Then they gave me the same simple advice that appeared in your recent article entitled "Recover from Depression One Step at a Time". These simple panaceas did not help me one iota. The long term cure for anxiety and clinical depression is set out in the book by Dr. David Burns entitled "Feeling Good" the New Cognitive Therapy. I read and summarized the contents of this book and then attended a Cognitive Therapy Clinic sponsored by a hospital (part-time) over six weeks. I no longer suffer from either anxiety or clinical depression but continue to rely on Cognitive Therapy daily to challenge and dismiss those automatic negative thoughts that caused my anxiety/panic attacks and immobilized me in a state of clinical depression. Please let me know if there is a way I can send you a copy of my Summary Notes on Dr. Burn's book "Feeling Good", so that others may share my experience. Thank you.

    - Rick Beatty

  • July 15, 2008 10:23 p.m.

    I've experienced anxiety off and on for years starting with a real life event, a marriage problem. After counseling and recommitting to each other, I was well for a long period of time. I continued to see counselors off and on because I felt I was becoming more aware, more in touch. After some years of no unusual or almost debilitating anxiety, I started to experience anxiety again, but not over real life events, but over what if events. I went through more counseling and I went for several years without excessive anxiety. Now I've been feeling overally anxious for about three years, a good week here and there, then almost debilitating anxiety. I sometimes feel like I could burn up and expire or have a heart attack. I am trying Somatic Experiencing in counseling. It moderates my anxiety, but it does not cure me. I've tried 4 or 5 antidepressants, none seeming to work. Clonazepam helps me calm down, but I don't like taking it; I'm afraid of becoming a pill popper. So, when I'm really breathlessly edgy, feeling like I could have a heart attack, I'll take 1/4 or 1/2 a tablet. If I'm still burning up in 45-60 minutes, I'll take another 1/4 tab. Eventually it works and I can breathe slowly again. I wish I could find another way. I meditate and exercise, both of which help, but again, they are not a cure. I really want to be my creative, laughing self again.

    - Greg

  • July 10, 2008 3:25 p.m.

    Is it normal to take an antidepressant that helps with anxiety,plus another medication for anxiety too?It's not that I don't trust my Doctor,but they make mistakes too.He brought me out of the deepest darkest hole I can remember.I was home bound,petrified of people,when the phone would ring I couldn't answer it.I Thank God,my husband and my Doctor.I still go on a roller coaster ride,but at least I can go outside and answer the phone.I too,feel like I would benefit from cognitive Therepy.

    - Trisha

  • July 10, 2008 1:16 p.m.

    I had anxiety back in 1973. The Drs. didn't know what it was. It was horrible, I suffered through it. I took some antidepressants and it helped a bit. My anxiety came back in force in 1993. Fortunately I was diagnosed with anxiety right away. I took some meds but mainly I did Cognitive Theraphy based on a book by Dr. David Burns, and I went to a support group every week for two years and gradually I got well. I have been o.k. since then. The key was cognitive theraphy and physical exercise. I used to be afraid of daily things like driving. Please don't dispair, with perseverance, YES you can get better.

    - A Brown

  • July 10, 2008 8:31 a.m.

    I've had trouble with anxiety and depression for as long as I can remember. I started doing relaxation exercises regularly for chronic pain. By regularly, I mean every day and sometimes twice/day whether I was in pain or not...they really do have to be practiced continually. Then the group ended and I became less conscientious. I had one horrible day, horrible. It's harder now for me to keep up the practice but I know the consequences. I take medications too. The exercises are free and they help me. I don't know how much they'll help anyone else but they might be worth a try. Full Catastrophe Living is one book that I found helpful. I also recommend the website Howtocopewithpain.

    - EGrace

  • July 9, 2008 8:03 p.m.

    I have never been diagnosed with anxiety or depression though I have numerous problems with panic. Sometimes when I am sitting down doing something I get this quick a almost shocking lapse of (what it may or not be) heart palpitations and it creates a wave of goosebumps and pure energy all over my body and at that time it feels like I can't take a deep breath. Before this I used to have panic attacks that happened anywhere like before I went to bed, during large family dinners, out running errands and I really thought that I had it under control.. Now I feel so stuck because I don't know if it's a medical or physical thing and I can't afford going to both a therapist and a cardiologist. I just feel so stuck right now.

    - Jessica Malone

  • July 9, 2008 7:32 a.m.

    I used to have regular attacks a few years ago and was getting so stressed out over them I almost got to the stage of secluding myself indoors. Knowing this is not the answer I got this idea of wearing a rubber band around my wrist when out shopping etc. If and when an attack happened I stretched the band and let it go (ouch) on the back of the wrist. It most certainly hurt, but it also used to pull me out of the attack. Because of the physical pain, my therory was it gave something else for the Brain to think about: Try it, it may work for you too: C.L.

    - Cheryl Laurence

  • July 8, 2008 10:08 p.m.

    I had problems and sought medical help. Also I had many family and friends that were helping. You can help your self if you do just that.

    - Al

  • July 8, 2008 9:39 p.m.

    I have a bipolar and anxiety disorder. Some of my fears I faced, during a major summer storm, but I had family members with me. Others I avoid. I take klonopin. I try to think positively, pray, sing, review Bible verses I have memorized. It helps.

    - ER

  • July 4, 2008 4:11 p.m.

    Chris,yo have to get your self to a profesional,get on some meds that give you some relieve and peace.than yo can start to do some research on how to manage your condition(you are not along in this)YES YOU CAN DO IT!!

    - ap

  • July 4, 2008 8:38 a.m.

    Although I do not have an anxiety disorder, Ido face a lot of anxiety during and after flashbacks. During flashbacks, I can feel, hear and sometimes smell/taste everything that happened during the period the flashbacks bring to mind. When I emerge, the feelings of helplessness, inadequacy or fear remain. What are coping mechanisms I can use during and after flashbacks?

    - NativeRose

  • July 3, 2008 6:09 p.m.

    I have anxiety and i have found nothing that helps i was takeing meds and they where helping but i got to where i could not afford them i cannot even afford my doctor so not i am trying excercise and i have strange thoughts not about death or anything like that but like being outside my body watching myself always afraid i am going crazy or i am going to die of a heart attack or a stroke silent killers i think i am a hypercondriac but i am not sure my feelings are like a roller coaster one day i feel great and the next i am grouchy and mad all the time almost like i am bipolar but i am not sure i have tried to get in to see a docter and a mental health doctor but no luck and one resone i qhit takeing meds is i do not want to be on them the rest of my life

    - chris

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