Anxiety disorders

CBT and anxiety disorders

In the NHS, CBT is the treatment of choice for anxiety disorders. NICE guidelines are that CBT should be tried and failed or offered and refused before other talking therapies are used. Why? Because CBT has a huge evidence base for showing that it is effective, providing comparatively quick and cost-effective cures.

What are anxiety disorders?

Anxiety is an emotion with a number of causes. You'll know it because you'll be scared about doing something and may as a result have a habit of avoiding whatever is scary. Anxiety is normal and everyone feels anxious about something at some time; it becomes a disorder when it prevents you living your life to the full.

IAPT (NHS) figures are that in June 2011, there were 6.1 million people in the UK with depression or an anxiety disorder. There are a number of models that are suitable for treating the different forms of anxiety. The common forms of anxiety are as follows.

Social anxiety (sometimes called social phobia) is a specific or general fear of something to do with interacting with people. It might be a specific presentation that you have to give or might be a general fear of social events. People with this condition get themselves in a state beforehand, then think they are being more obviously anxious than is apparent, become tongue-tied and afterwards berate themselves about all that apparently went wrong. Getting treatment for social anxiety can in itself be scary because of the imagined difficulties of having to meet people for therapy – therapy is never as bad as you imagine it is going to be.

Agoraphobia is often thought of as being the opposite of claustrophobia, but that's not quite right. It's not "fear of open spaces" but fear of the marketplace (from the Latin agora, a market). People with agoraphobia become scared in public places where there are a lot of people, such as shopping centres or buses in the rush hour. There seem to be two underlying beliefs, either that the anxious person can't cope and that others won't help out, or that others are mocking them. It is often accompanied by panic attacks, though people can have panic attacks without agoraphobia. Getting treatment for this can simply be too scary, and if necessary I will start with a few home visits.

Worrying is a word with more than one meaning in everyday life. If someone says they are worrying about something then they might mean they are concerned about it. But think of worry more in the sense of a dog worrying a bone and this is closer to this condition - thoughts invade and can't be controlled and the person obsessively considers everything that might happen, attempting to plan for each of them. The end result is that all possible catastrophes are considered and the anxiety is experienced for each. This is one of the forms of obsessive or intrusive thoughts or images.

Generalized anxiety disorder is (to a CBT therapist or counsellor), just another name for worrying and that is what we will treat.

Health anxiety (sometimes referred to as hypochondriasis) is the fear of having a serious illness now or in the future, and causes a great deal of distress both to those who have it and to those who care for them. THe result tends to be numerous consultations associated with the fear that the patient is not being looked after, that the doctors don't know what is wrong, and that because they are being sent for repeated tests, that there really must be something seriously wrong. Health anxiety can be about either a physical or a mental condition (or both).

Claustrophobia is the fear of confined spaces or of being trapped; fear of flying may be a version of this.

Post-traumatic stress disorder (PTSD) is a response to a profoundly distressing event; it involves re-experiencing, avoidance, numbing and hyper-arousal. THe emotional experience is one of intense fear, helplessness or horror.

Procrastination may be caused by anxiety (though there are many other causes) and is the repeated putting off of feared actions.

People with anxiety disorders often define themselves as being stressed and there may well be external pressures - but even these can be beaten.

So to beat your anxiety problem, if you're looking for an anxiety therapist in London, or to learn to deal with stress, get in touch.