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CategoriesAnxity,  Panic Causes

How to Prevent Anxiety Attacks

by Janie Stewart

It has been said preparation is the key to success in any endeavor. When you think about it, you can see how true this is. It is like taking a test in school. If you study hard, there is a good chance you’ll pass the test. If you study very hard there’s a pretty good chance you’ll ace the test. However, if you don’t prepare for the test at all you will probably fail!

It is likewise true of anyone who is entering in to a business. He who does his homework and prepares to run the business before he actually starts doing this business will be much more likely to succeed than someone who simply tries to wing it.

So, you can see how preparation is a very key ingredient to having success in almost everything you do. However, preparation can actually be what is causing your anxiety attacks. While this seems like an outrageous statement, I have seen how preparation can actually bring on a panic attack. The more we prepare for something, the more respect we are giving it. Yes, we must respect the difficulty of that test we are going to have in school or we will probably fail. Likewise, we have to respect how difficult running a business can be. If we don’t we will truly get chewed up in the business world!

However, it is respect anxiety thrives upon. The more respect we give it, the harder its fires will burn. If we give it little respect we will not be tense and we will not giving it as much fear as we would be if we were giving it plenty of respect. Of course, if we are not tense and we are not in the state of fear, anxiety will not invade our lives.

Therefore, when considering how to prevent anxiety attacks, we should consider not preparing for them at all. By not preparing we are not giving anxiety any respect. Without giving any respect to anxiety attacks, or a potential oncoming anxiety attack, we will not be preparing for it and therefore we will not be tensing our bodies and we will not be working ourselves into a state of fear about the possibility of anxiety coming on.

Without fear and tenseness present in are being, we will be starving anxiety of the fuel it needs to get started. So, how do you prevent anxiety attacks? In short, a good way to start is by refusing to ever prepare for one.

CategoriesAnxity,  Panic Causes

Panic Attack Triggers

by Janie Stewart
Teenage Girl in Elevator

Sometimes panic attacks seem to come right out of the blue. It is as if nothing has happened but suddenly our life has changed because now instead of living normally we are overwhelmed by anxiety and panic. When this happens it is the center point of our existence because we have all we can do to simply live through this period of time as we hope and try to gather all strength together to try to get through it.

When panic strikes, it is often in response to some little event or even a mere thought that triggers its onset. These little events or mere thoughts are what we refer to as panic attack triggers. Often it is a physical sensation, such as a quick pain, especially if it is to the head or chest region that provides the trigger.

Of course, pains to head and the chest should be checked out by a medical professional. What we’re talking about here is a situation where you have already found out what you are experiencing is panic and not a different medical issue such as migraines or heart problems.

Other than true physical feelings, another thing that often times provides a panic attract trigger is a very unpleasant thought like “what if this elevator door doesn’t open?”

Panic attack triggers simply start the panic ball rolling. These triggers are what start the adrenaline shooting through every part of our body. Adrenaline, in turn, brings on more feelings and thoughts that provide triggers to more panic. As this occurs, an even heavier dosage of panic gets added into the bloodstream!

One school of thought is; if we can avoid panic attack triggers we can avoid panic attacks. This way of thinking, while it seems reasonable, actually presents a bigger problem. This is due to the fact that if we try to avoid situations which bring on certain thoughts, like the one about the elevator door not opening, we will actually be creating more problems for ourselves. In other words, we will be bringing about more obstacles to a happy existence.

In order to prevent panic attacks we should actually learn to live through the triggers that tended to provided us with panic attacks in the past. In other words, certain places or situations that bring on panic should not be avoided. Also, though it may seem somewhat ironic, we should actually think about things that usually bring on panic attacks and make these thoughts so commonplace that they no longer carry with them the fear of the unknown.

While this is a very simplified version of a lesson in avoiding panic attacks, it has the basic elements that need understand in order to be successful in fending off panic and overcoming anxiety altogether. These basic elements are:

  • Learn not to shy away from panic attack triggers
  • Be as relaxed as you can without trying to force relaxation
  • Know that millions of people have gone through the same thing you’re going through now
  • Understand that while you are in the recovery phase, panic attacks will come from time to time but they will be less and less severe if you don’t try to fight them off or run from them
  • Make sure to live your life as normal as possible and go through the motions the best you can even if you feel you are unable to give it your all.

It is true you may not be able to do everything you can when you’re feeling well. For instance, by all means, don’t drive a car if you feel you’re unable to and don’t push yourself too hard. Just accept the fact you will get better if you let your panic attack disorder run its course.

CategoriesAnxity,  Panic Causes

Anxiety Attacks Treatment

by Janie Stewart

Agoraphobia is, like any other phobia, an affliction based on fear. Namely, agoraphobia is the fear of leaving the home. There are other complicating factors with agoraphobia and other symptoms as well. However, i

n the truest technical term agoraphobia is the fear of the marketplace. Though this is the most technical definition of the term it is still true that many people who are suffering from this affliction experience their greatest bouts of fear when they are shopping.

Other times, people suffering from agoraphobia fear wide-open spaces or simply being outside. Others experience problems when they are driving, or driving under certain conditions. For instance, many people experience their greatest fear when they’re driving over bridges. The progression people suffering from this ailment experience, is they generally fear one place in particular and subsequently stay away from visiting this place.

Unfortunately, the problem doesn’t stop there as they will eventually become afraid to venture into different areas and they will likewise prevent going to these places. When a person becomes afraid of more and more places he or she will eventually choose to stay home because so many places have become too difficult for them to venture out into.

The underlying cause to all of this is the fact these people experience panic attacks. In short, most people develop agoraphobia because repeated panic attacks have led them to become fearful of more and more places and eventually the only place they feel comfortable is in their own homes.

It stands to reason that overcoming agoraphobia requires overcoming panic attacks. Though many people try to overcome the agoraphobia first it will only be temporary if they do succeed and don’t bother to deal with the panic attacks. The reason this is true is because the panic attacks will cause these people to become afraid of different places or even places they have recently their fear of visiting.

As this happens they will become more and more apprehensive to visit more and more places and therefore they will develop agoraphobia once again. It is considered common knowledge that people can overcome agoraphobia by being helped out of their homes and little by little, day by day, led further away from their domicile. Then, as time goes on, these people will once again become comfortable with the outside world.

The problem is this technique does not help them overcome panic attacks and usually it is the panic attacks that have caused the fear of leaving home in the first place. Therefore, trying to cure agoraphobia before curing panic attacks is putting the cart in front of the horse.

CategoriesAnxity

Panic Disorder – Onset and Symptoms

by Janie Stewart

Panic Disorder
Panic attacks and panic disorders are disabling conditions for the people who suffer from them. Panic attacks are not physically harmful, but they are often so frightening to sufferers that sometimes the attacks will lead to the avoidance of any activity or environment that have been associated with feelings of panic in the past. This in turn leads to the more severe and disabling disorder of agoraphobia.

Onset and symptoms
Panic attacks usually start in young adulthood, but can occur at any stage of an adult’s life. A panic episode usually starts without any warning, and peaks after about 10 minutes. The duration can be anywhere from a few minutes to a half hour or longer. The sufferer will experience rapid heartbeat, trembling, sweating, and acute shortness of breath. Other symptoms may include chills, cramps, nausea, hot flashes, pain or tightness in the chest, derealization or depersonalization, a feeling that there is a lump in the throat, trouble swallowing and dizziness. Women are more likely to experience panic attacks, since they are caused by the body’s natural fight-or-flight response to danger, but in an exaggerated and inappropriate form. If a person was attacked by a dangerous wild animal, their body would react instinctively, and their heart and breathing would speed up as their body prepared for a life-threatening situation. A panic attack is the body’s flight-or-fight response system being triggered without the presence of an actual external threat.

Panic disorders develop in people who have an overly sensitive central nervous system. When such an individual is exposed to a highly threatening external stressor, it causes a panic attack. The most common stressors to cause an initial panic attack include a traumatic event such as a rape or assault, an earthquake, or the death of a loved one. A long period of chronic stress such as pressures at work, family, friends, academic pressures and health concerns, to name a few. A medical procedure that causes the person to become overly conscious of their body. An adverse reaction to a drug, usually marijuana, or to a prescription medication.

The first panic attack sensitises the central nervous system to the symptoms of slight physiological arousal that is normally experienced during typical daily anxiety. Once the nervous system is sensitised, the subject begins to have anxiety/panic symptoms without the presence of a threat. When the subject starts to have symptoms like dizziness or chest pain, he or she interprets it as something internally wrong with them since there is no external threat causing them to feel anxious.

Without an external threat to explain the anxiety symptoms, the subject becomes frightened of the anxiety symptoms themselves, thinking that they are having a heart attack or going crazy. This fear adds to the problem, and they have a full-blown panic attack. Panic attacks are terrifying for most people, and the fear then becomes about the prospect of another panic attack, which becomes a self-fulfilling prophecy. The intense fear of having another panic attack leads to more panic attacks, and a vicious cycle evolves into a fully-fledged panic disorder. With highly effective cognitive behavioural treatment interventions available today, panic disorder is a treatable problem.

A three-pronged treatment is highly effective in helping people to overcome this disorder. This consists of education and information about panic disorder, cognitive-behavioural psychotherapy, and medication depending upon the severity and frequency of the panic attacks.

Common misspellings of popular drugs and terms : Carosoprodol, casiroprodol, carisprodol, carosiprodol, lorazepan, codiene, adepix, pian, anxeity, depresion, perscription, presciption, prescriptoin, medicatoins.

CategoriesAnxity

Information on the treatment of Panic-Related Anxiety Disorders

by Janie Stewart

Most anxiety disorders are treatable with a combination of psychotherapy and medication. You should learn the details of these treatments and other treatment options for generalized anxiety disorder, specific phobia, social phobia, panic disorder, agoraphobia, and post-traumatic stress disorder/acute stress disorder. Treatments depend upon the specific disorder diagnosed by a mental health professional.

Reputable post traumatic stress centres and therapists can be a bit hard to locate. Some local disaster relief offices, rape crisis hotlines, and state attorney general offices will be able to direct you to local therapy centres. If this does not help, you can try contacting your nearest university-based department of psychiatry or psychology, many of which have anxiety disorder or post-traumatic stress treatment centres, or can recommend centres or therapists. No matter who recommends a centre or therapist, the final choice of which one you select is entirely up to you, and should be one with whom you feel comfortable.

Generally anxiety disorder and post-traumatic stress treatment centres are found in large cities, so most people will, in all likelihood, seek treatment from a private therapist. However, even if you are seeking treatment at a centre, most of the issues that you will be dealing with are the same if you are selecting a private therapist.

Remember that some therapists do not have proven track records in diagnosing and treating anxiety disorders or post traumatic stress. Unfortunately, not many therapists will admit that they lack experience in this field. You should ask about the extent of a therapist’s experience with your problem before engaging their services, or you could end up getting second-rate help from an otherwise top-notch therapist.

Another thing to remember is that people who are in a state of emotional turmoil are rarely capable of being cool and objective about diagnosing their problems, even though they are the best person for the job. It is advisable therefore to give the therapist a complete list of your symptoms during the first session, rather than informing the them of your own conclusions and then grilling them about their experience in treating your illness. The therapist should give you a diagnosis based on your symptoms, and if you find their diagnosis surprising, ask for an explanation. There is always the option of a second opinion.

Using drugs to treat Anxiety Disorders

Before you start psychological or drug therapy, have a complete medical examination, which will help to determine whether or not your anxiety symptoms are caused by a medical condition. In addition, your doctor will most likely also be able to discover whether certain prescription or over-the-counter medications might be causing your symptoms. Heart conditions, thyroid disease or medications, and cold remedies can all be causes of the psychological and bodily symptoms of an anxiety disorder.

Usually some combination of the psychological and drug therapies that are particularly good at relieving the symptoms of anxiety disorders are to be found at anxiety disorder and post-traumatic stress treatment centres. A lot of private therapists specialise in anxiety disorders and in post-traumatic therapy.

Once you have been diagnosed, try asking your potential therapist a few questions, such as what is their approach to treatment, how do they define recovery, what are your chances of recovery, and what is their rate of success with patients who suffer from your illness? Enquire about their experience in treating your illness, how often you will meet, and for how long, how long before you start to feel better, what happens if you have a set-back during treatment, or a relapse after the treatment and does the therapist provide follow-ups? Also ask if you can talk to a former patient about his or her experience in the treatment program. If the therapist is unwilling to give you any hints of a diagnosis or does not take your questions seriously, you might be well advised to look elsewhere.

You should also enquire about the cost of the proposed treatment programme, and whether or not the therapist is state-certified so that their clients are reimbursed by their insurance companies. The majority of medical insurance plans have some compensation for treatment by licensed professionals, and a lot of therapists offer sliding scales based on what you can afford.

Take heart, help is not necessarily out of reach, even if your financial resources are very limited. Drug treatment is usually quite economical and is successful in a lot of patients, controlling or containing troubling symptoms. Behaviour and cognitive therapy can be self-administered to a certain extent, with the aid and support of self-help groups.

CategoriesAnxity

Social Anxiety Disorder or just Shyness?

by Janie Stewart

A smart businessman with a bright future had quickly climbed the corporate ladder, but when he was offered a promotion that would put him at the top of his division, he turned it down, jeopardising his career. The thought of being the centre of attention in a major meeting threw him into a blind, desperate panic with flushing, sweating, and heart palpitations.

He has circumscribed Social Anxiety Disorder (SAD), which is an intense, irrational, and persistent fear of being scrutinised or negatively evaluated by other people. People with SAD, or Social Phobia, are sensitive to criticism and rejection, have difficulty asserting themselves, and suffer from low self-esteem. Social anxiety disorder can be circumscribed, in which the sufferer only fears being scrutinised at work, or generalized, a far more debilitating condition that can make everything from walking to a table at a restaurant to attending your best friend’s wedding a cause for sheer terror.

Two antidepressant drugs, Effexor and Zoloft, have been added to a list of about a dozen approved medications for social anxiety disorder, sparking renewed interest in this little-known condition. Is social anxiety disorder just another name for being really shy?

Putting the Brakes on Life

Many people are a little shy, and they might be somewhat uncomfortable in situations such as going to a party where they don’t know anyone, but they can do it. They give themselves a push, and go to the party, after a while they relax and talk to people. The social phobic person would be overwhelmed by such anxiety that they might have nausea, sweating, heart racing, dizziness, and would avoid it if at all possible.

So while being shy can complicate your life, having social phobia can stop it dead. The hallmark of social anxiety disorder is that it impairs your function. Many adolescents have social anxiety disorder, and might be so overwhelmed by the fear of standing up to give a report that they can’t complete assignments and fail classes. For the businessman, social anxiety disorder endangered his career advancement.

Some patients are very competent, but have jobs well below their capacity because they’re afraid of asking for a promotion or going out and looking for a better job. This might explain why some 70% of people with SAD are on the lower end of the socioeconomic scale and nearly 50% fail to finish high school.

Causes Of Anxiety Disorder

Some anxiety disorders seem to affect men and women in equal numbers but others are more common in one sex. Panic disorders, phobias, and generalised anxiety are twice as common in women than in men, but obsessive-compulsive disorder and social anxiety affect both sexes equally. Also, panic disorders, social anxiety and obsessive-compulsive disorders tend to start early in life, but generalised anxiety disorders start a bit later.

The effects can also vary according to how old a person is. If they can’t go to work or school because avoidance is part of their anxiety, it can have a huge impact on their development, so having anxiety early in life can have a major effect. The behaviour associated with the disorder then has more of an effect on the person’s life.

Anxiety Disorder is called the Great Pretender, because it frequently looks like other illnesses, but with a good screening by a health professional and care these complications are treatable. Stress can contribute to all sorts of illnesses, and has a minor effect in some conditions and a major impact on others. Gastrointestinal disorders are highly stress sensitive, but gall bladder disease, for example, is not usually affected by stress levels.

The relationship between anxiety and health is known as Health Anxiety, and consists of excessive worries about health which are usually based on a symptom that a person has a hard time being reassured about. There may be an underlying cause that hasn’t been fully explained, but this is highly treatable. Some people may also have an anxiety disorder that makes them excessively fearful of catching an illness. Hypochondria is when you fear that you have an illness that has not been detected, Health Anxiety is being afraid that you might contract an illness.

Anxiety/panic attacks may be due to something terrible that happened as a child. The trigger can be a remembered event, a vaguely remembered event, or even a forgotten early childhood experience that makes the body prone to anxiety. Remember that this type of anxiety is also treatable without having to go back into the past and find out what happened.

CategoriesAnxity

Using drugs to treat Anxiety Disorders.

by Janie Stewart

Many people are reluctant to try drug therapy to alleviate the symptoms of their anxiety disorder for a variety of reasons. Some are put off by the expense of doctor’s visits and prescriptions. Others have heard unpleasant tales about the side effects and addiction. A few think that using a medicinal remedy to treat a psychological illness is ridiculous.

By the same token, a lot of people prefer anxiety drug therapy for equally numerous and sound reasons. As a short term solution, it is far less expensive and time-consuming than traditional psychological therapies. Results are fast and concrete, alleviating the symptoms completely or to a great degree. Many anxiety medications for anxeity disorders have no troublesome side effects and a lot are non-addictive. The medication option can be very helpful for sufferers for whom other therapies have proven useless. In addition, to address the debate about using a medicinal remedy to alleviate a psychological illness, data indicates that biology forms an important part of the factors which cause anxiety disorders. Thoughts and feelings are neurobiological events, and therefor it is quite reasonable to say that a psychological problem can be treated successfuly with a medicinal anxiety remedy.

A great deal of evidence now suggests that the best way to treat the acute stages of anxiety disorders is to combine anxiety drug treatments and psychological treatments like behaviour therapy and cognitive therapy. Often, when the patient is past the worst stages of the illness, and is making good strides towards recovery with psychological therapy, the drugs can be reduced or ultimately discontinued, although a large number of sufferers stay on the medications indefinitely, and lead a normal life because of them.

Ask your doctor for all the information about the prescription amxiety drug that he has given you. If you ask the pharmacist, he or she will usually give you the leaflet that comes with the drug, which lists the medication’s various uses, possible side effects, and any other dangers that might be associated with it. This is a technical document, so you may need to refer to a medical dictionary while you are reading it. Medical dictionaries are available at many bookstores and libraries. Keep in mind that that such packaging inserts list every side effect ever reported for a drug are not clear on how common such side effects are, which can make reading them alarming and confusing. Try to consult your doctor or pharmacist about the information in the packaging insert.

CategoriesAnxity

Selective Mutism and Generalised Anxiety Disorder

by Janie Stewart

Some signs of Selective Mutism are the child standing motionless and expressionless, turning his/her head away, chewing or twirling her/his hair, avoiding eye contact or withdrawing into a corner. They become anxious before entering an unfamiliar situation and suffer the common symptoms of anxiety beforehand, which include stomach aches, headaches, etc. Selective Mutism sufferers will often display more symptoms of severe anxiety such as separation anxiety, moodiness, inflexibility, tantrums and crying, insomnia and unnatural shyness, which can manifest in infancy.

A specific phobias are extreme, irrational terror of an animal or situation. Fears of such things are common in childhood, and often go away. They are diagnosed as phobias if the fear continues for at least 6 months and interferes with a child’s life, such as a child who will not play outside for fear of encountering a dog. Some common childhood phobias are animals, storms, heights, water, blood, darkness and medical procedures.

Most of these are instincts from primordial times when they were necessary to preserve the child’s life, and are still useful today. A child who does not fear water is in danger of drowning, and one which has no fear of heights is liable to fall. These children do not often recognize that their fear is irrational or extreme, and they may not voice their fears. Such children will avoid the situations or things that they fear, or endure them with anxiety which can manifest as crying, tantrums, freezing, clinging, avoidance, headache or stomachache.

Generalized Anxiety Disorder mostly affects children between the ages of six and eleven, causing excessive worry and anxiety over a variety of things, which include, among others, grades, performance in sports, punctuality, family issues, earthquakes and health. The sufferer cannot control their worry, which then interferes with their life. Some physical symptoms are restlessness, fatigue/insomnia, attention deficit, irritability and muscle tension. Child GAD sufferers are usually very hard on themselves and strive for perfection to a ridiculous degree, whilst seeking constant approval or reassurance.

A child is diagnosed with Panic Disorder after suffering from at least two unexpected attacks, followed by a month of anxiety over having another attack, “going crazy” or losing control. Panic Disorder usually starts in the early to mid twenties, and is uncommon in young children, but can begin in adolescence. A Panic Attack is the abrupt manifestation of intense fear and discomfort, which peaks in about 10 minutes and includes at least four of these symptoms. A feeling of imminent danger or doom, the need to escape, sweating, trembling, palpitations, shortness of breath or a smothering feeling, a sensation of choking, chest pain or discomfort, nausea or abdominal discomfort, dizziness or lightheadedness, a sense of things being unreal, depersonalization, a fear of losing control or “going crazy”, a fear of dying, tingling sensations and chills or hot flushes.

Children will become anxious in situations or places where they have had attacks, and may try to avoid them. Agoraphobia sometimes develops when the child starts to avoid places or circumstances where he/she has had a panic attack before, or from which the child feels that they would not be able to escape if they had an attack.

CategoriesAnxity

Separation Anxiety Disorder

by Janie Stewart

Separation Anxiety Disorder

Most children of between 18 months and three years old become anxious when a parent leaves the room or goes out of sight, and this is normal. Crying on the first day in daycare or pre-school is also normal and subsides when the child becomes distracted by their surroundings.

If a four year old is unable to leave his/her parents, the problem could be Separation Anxiety Disorder, which affects about 4% of children. The child experiences unreasonable anxiety when taken away from home or family, and the desire to be in contact with the missing people is excessive, and usually includes extreme homesickness and misery. While separated, these children are often anxious about the health and safety of their parents.

Separation Anxiety Disorder may cause a child to attempt to avoid going anywhere alone, refuse to go to school or camp, be unwilling or refuse to go on sleepovers, demand that someone stay with them at bedtime, follow a parent around, or go into their parent’s bedroom during the night or have nightmares about being separated from their family. Separation Anxiety Disorder can start at anytime during childhood, but it is most often found in children between the ages of seven and nine.

Selective Mutism is when a child fails to respond verbally to normal stimuli that should bring about a vocal reaction. When their reluctance or failure to do so interferes with school and social interactions, they may have Selective Mutism, considered to be an extreme form of Social Anxiety Disorder. Selective Mutism most often starts before five years of age, but it usually becomes a problem when the child enters school. Diagnosis usually occurs between 4-8 years old, but these children were probably extremely shy from an early age. The behaviour must persist for at least one month before Selective Mutism can be diagnosed. These children can be perfectly normal and talkative, even boisterous at home or in a familiar place.

CategoriesAnxity

Childhood Anxiety Disorder and Phobias

by Janie Stewart

Children also have anxiety in their lives, and can suffer from the same disorders. Stressful times, like starting school, the loss of a parent, or moving, can cause an anxiety disorder, especially if such events happen in conjunction or rapid succession, but disorders can develop with no apparent catalyst as well.

Children are susceptible to all of the recognised anxiety disorders, but some are more common in childhood, and a few can be specific to certain ages. Separation Anxiety Disorder and Specific Phobia are more common in children of about 6-9 years old. Generalized Anxiety Disorder (GAD), Panic Disorder and Social Anxiety Disorder (SAD) are inclined to manifest in middle childhood and adolescence. Depression is also common in children, especially teenagers.

Children display and react to Anxiety Disorder symptoms differently to adults, and this can make it difficult to diagnose. Such symptoms are often dismissed as a phase brought on by puberty, which makes it hard to ascertain if the problem is actually a disorder.

Social Anxiety Disorder is most often diagnosed in the mid-teens, but can occur in preschool or grade school children. Left untreated, SAD can continue into adulthood, bringing with it an increased risk of depression and alcohol abuse.

Signs may include an unreasonable fear of at least one social or performance situation. An obvious dread of dealing with peers or interacting with adults. The symptoms are sweating, racing heart, stomachache, dizziness, crying, tantrums, and freezing. The child will tend to avoid or have intense dread of feared situations. Poor performance at school and bad attendance, a lack of ability to handle social situations with peers or develop and maintain friendships. Childhood SAD can appear as Separation Anxiety Disorder, Selective Mutism or School Refusal/Avoidance.

Phobias – illogical yet powerful fears – affect more than one in eight Americans at some time. Phobias are the most common kind of anxiety disorder. If you suspect that you might suffer from a phobia, complete the following self-test and show the results to your health care professional.

Do you suffer from a phobia? Answer the questions below to find out.

Do you suffer from a shortness of breath or rapid heart beat with no obvious cause?
Do you have a strong, ongoing dread of social interactions with strangers?
Can you travel without a companion?
Do everyday situations or domestic animals frighten you?
Are you afraid of places or situations in which finding help or escaping the situation would be difficult, like crowds or boats?
Are you afraid of anything which other people don’t seem to have a problem with?

People who have more than one illness are difficult to diagnose and treat, depression and substance abuse commonly complicate phobias, and should be taken into account when answering the next set of questions.

Have your sleeping or eating habits changed at all?
Do you often feel sad or depressed?
Do you lack interest in life or feel worthless or guilty?

In the recent past, has the abuse of alcohol or drugs caused you to :

Fail at work, school, or family?
Endanger your life?
Be arrested?
Continue even though it caused problems for you and/or your family?

Answering yes to most of these questions would indicate an underlying problem, and you should seek medical help.

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