Cognitive
Behavioral Therapy
Resources /Articles
Anxiety
It is estimated that 3-4% of the general population suffers from Generalized Anxiety Disorder (GAD). GAD is characterized by excessive worry that occurs more often than not for a period of at least 6 months. The person usually has a specific fear that has become generalized to cover many different areas (family, work, school), and the person finds it difficult to control or manage the worry. The anxiety is associated with at least three of the following: restlessness, being easily fatigued, difficulty concentrating, irritability, sleep disturbance, and muscle tension. The worry causes impairment in social, occupational, or other areas of functioning.
Anxiety often co-occurs with other disorders such as panic attacks and depression. Many have somatic complaints, such as headaches, cold and clammy hands, dry mouth, and sweating. They may also have an exaggerated, startle response, frequent urination, and diarrhea, as well as trembling, twitching, feeling shaky, or muscle aches. In children, there may be excessive concern about issues such as punctuality, or catastrophic events (such as earthquakes). They may also be perfectionistic, unsure of themselves, and even overly conforming -- requiring frequent reassurance of their performance. The worry becomes so significant that it impacts their school or social functioning.
Adults with the disorder often worry about job responsibilities, finances, the health of family members or even more minor matters. However, the worry is out of proportion to the likelihood of the feared event, and this worry interferes with everyday life. For example, a person may worry so much about the safety of their child that they do not allow their child to participate in normal activities or events. Generalized Anxiety Disorder tends to worsen with stress.
Many with Generalized Anxiety Disorder report feeling nervous or anxious most of their lives, but the disorder can first present itself after the age of 20. It is believed that anxiety has a familial association, but there are no specific reports that find a familial relationship with Generalized Anxiety Disorder. The disorder does occur more often in females than males. It is caused by a combination of genetics, brain chemistry, life events, and personality factors.
Treatment for Generalized Anxiety Disorder may consist of behavioral interventions, such as counseling. It may also involve medical intervention with psychotropic drugs that can be used in combination with behavioral therapy. With treatment, a person can return to their daily functioning, resolve the key issues that contribute to the anxiety, and interact with the world without excessive worry.
The most important factor in treating anxiety is also often the most difficult - taking that first step and asking for help. If you don’t know where to begin, talk to friends and family members and let them know that you are looking for professional support. You may want to speak with your physician and ask for a recommendation on which mental health counselor to choose. If you aren’t comfortable with face-to-face counseling or don’t know where to start, you may consider online therapy with a licensed counselor or therapist (make sure that you can verify their credentials through State Licensing Boards).
Relationships
Sometimes relationships with family, significant others, co-workers, can be difficult to navigate. CBT can help people to understand their role in relationship conflict. With this understanding, they can learn to accept responsibility and make changes in the thoughts, feelings and behaviors that contribute to the conflict.
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Ideally, when couples, parents, or families decide to make changes and participate in therapy, each person can help to change the dynamics of the relationship. Even if only one person in the relationship seeks therapy, the dynamics can often change for the better.
Forms
Depression
Depression is a mood disorder that can impact your feelings, thoughts, relationships with other people, and even your day-to-day functioning. It is much more common than many people realize, affecting approximately 18 million Americans every year.
The symptoms of depression include sadness or emptiness (in children and adolescents, this may appear as irritability), decreased interest in activities, changes in eating habits, difficulty sleeping or excessive sleeping, and fatigue or loss of energy. Some individuals with depression also feel restless, or may even feel sluggish and lethargic. Symptoms may include somatic complaints such as headaches or other aches and pains. Depression may also present as feelings of worthlessness or guilt, difficulty concentrating or making everyday decisions, and possibly thoughts of suicide.
Many people experience the above symptoms only briefly, or in response to some type of event. However, with clinical depression, several of the above symptoms are present most of the day, nearly every day over the course of at least two weeks. People who are suffering from clinical depression also experience significant impairment in their social life, family life, or with their employment due to the above symptoms.
While people with depression share many of the same symptoms, the disorder can take various forms or types. For example, some people experience only one episode of depression, while others experience several episodes throughout their lives. Depression can also begin very suddenly and unexpectedly for some people, but may follow a life change or specific situation for others. Further, some people have difficulty performing even the most basic tasks when they are depressed, while others seem to manage but obviously don’t appear to be their "usual" selves. Depression can also present as bipolar depression, in which their moods fluctuate between the extremes of despair and mania/euphoria. While both men and women suffer from depression, women appear to experience it twice as frequently as men. Further, though symptoms or complaints may take different forms, depression does exist across cultures and ethnic groups.
Depression is a biopsychosocial disease, which means that it is caused by several physical, psychological, and social factors. There appears to be a genetic link to depression, meaning that one may have inherited a predisposition for the disease from family members. Other physical causes include that there may be a disturbance in the way a person’s neurotransmitters (chemicals that play a role in the transmission of signals in the brain) work. Certain medical diseases and psychiatric disorders can also contribute to depression. Some of the psychological factors that can contribute to depression include engaging in negative self-talk (thinking badly about yourself), and having a negative or pessimistic view of the world. Those who do not handle stress well or do not use coping techniques to deal with stress are also more prone to depression.
Social factors that can contribute to depression include being raised in an abusive household, or experiencing some other type of abuse. Having few close friends or being in a dysfunctional relationship can also contribute to developing depression.
Fortunately, depression is a treatable disease. There are many therapies and treatments available to help those who suffer from depression. Some people will benefit from individual therapy alone. Working with a licensed counselor or therapist may be all that is needed for some people to alleviate their depression. Others may require psychotropic medication, or antidepressants, in combination with mental health counseling. Because family members can also be affected by depression, it may be helpful to include family therapy in the treatment program. A further source of help for those who are depressed may be group therapy, particularly if there are other issues, such as abuse or substance abuse, that the individual has experienced.
The most important factor in treating depression is also often the most difficult - taking that first step and asking for help. If you don’t know where to begin, talk to friends and family members and let them know that you are looking for professional support. You may want to speak with your physician and ask for a recommendation on which mental health counselor to choose. If you aren’t comfortable with face-to-face counseling or don’t know where to start, you may consider online therapy with a licensed counselor or therapist (make sure that you can verify their credentials through State Licensing Boards). If you are feeling suicidal or overwhelmed, contact a local or national crisis hotline, such as The National Suicide Hotline at 1-800-784-2433.