Misunderstood: How To Treat Anxiety

Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States or 18% of the population especially young adults, according to the Anxiety and Depression Association of America, but it is often misunderstood.

Therapist Patrick McGrath, Ph.D. McGrath has treated obsessive compulsive disorder and other forms of anxiety for two decades and says the condition can feel like you're living in a constant state of "what if this really bad thing happened."

People often mislabel someone who suffers from anxiety, throwing out words like hypochondriac, antisocial, paranoid or weak, but using these labels so loosely can elevate the person's anxiety. A hypochondriac, for instance, is someone who lives with the fear that they have a serious medical condition, even though diagnostic tests show there is nothing wrong with them.

McGrath says people with somatic symptom disorder create symptoms by looking for them and think that "no one cares enough" or takes them seriously, and say "why would I have these symptoms if there wasn't something wrong with me?" The symptoms are linked--a headache must mean a brain tumor or a scratchy throat must mean throat cancer.

Acknowledgement As Treatment

McGrath says he always starts with a medical diagnostic workup with a person with health anxiety disorder, because otherwise you have nothing to stand on and the patient can argue everything away since a therapist is not a "medical" doctor. The patient thinks "why should I trust you?"

What To Do When Thoughts Control

McGrath says intrusive thoughts, images or urges often happen in someone suffering from anxiety. These can be obsessions and even compulsions like in someone dealing with OCD.

"A thought or image or urge is not real and it doesn't have to be reality," says McGrath. He advises people suffering from these conditions to do things the things that are uncomfortable because they need to believe they can handle it.

For example, take a person who is driving and suddenly has a thought to drive off the road or perhaps a person eating lunch with a friend but a thought pops into their of hurting them. Don't avoid these thoughts, McGrath warns, because avoiding makes it more scary.  To treat this, McGrath will put the person in that situation. He'll go driving with them and say, "Okay now drive off the side of the road."  He says this tactic makes the person realize they won't actually do the thing they are afraid of. Facing it head on it can be effective at shrinking the thought in their minds.

PTSD trauma is another condition featuring nightmares and flashbacks. McGrath uses a virtual reality simulator for veterans that puts them directly into the reality of being in war. They watch it over and over again, he says, and while vets don't enjoy the experience it can work.

"Trying not to think of something makes it bigger," McGrath says. "As a therapist I think about how do we put people in the situations that they're afraid of?" -EO