The anxious youngster often seeks excessive reassurance about his identity and whether be is good enough. Some teenagers with anxiety disorders can also develop mood disorders or eating disorders. Some teenagers who experience persistent anxiety may also develop suicidal feelings or engage in self-destructive behaviors; these situations require immediate attention and treatment.
Anxious teens may also use alcohol and drugs to self-medicate or self-sootheor develop rituals in an effort to reduce or prevent anxiety. How to Respond If your teenager is willing to talk about his fears and anxieties, listen carefully and respectfully. Without discounting his feelings, help him understand that increased feelings of uneasiness about his body, performance, and peer acceptance and a general uncertainty are all natural parts of adolescence.
By helping him trace his anxiety to specific situations and experiences, you may help him reduce the overwhelming nature of his feelings.
Reassure him that, although his concerns are real, in all likelihood he will be able to handle them and that as he gets older, he will develop different techniques to be better able to deal with stress and anxiety. Remind him of other times when he was initially afraid but still managed to enter into new situations, such as junior high school or camp. Praise him when he takes part in spite of his uneasiness. Point out that you are proud of his ability to act in the face of considerable anxiety.
Remember, your teenager may not always be comfortable talking about feelings that he views as signs of weakness. While it may seem at the moment as though he's not listening, later he may be soothed by your attempts to help. If fearfulness begins to take over your teenager's life and limit his activities, or if the anxiety lasts over six months, seek professional advice.
His doctor or teacher will be able to recommend a child and adolescent psychiatrist or other professional specializing in treating adolescents. Managing anxiety disorders - as with any adolescent emotional disturbance - usually requires a combination of treatment interventions.
The most effective plan must be individualized to the teenager and his family. While these disorders can cause considerable distress and disruption to the teen's life, the overall prognosis is good. Treatment for an anxiety disorder begins with an evaluation of symptoms, family and social context, and the extent of interference or impairment to the teen. Parents, as well as the teenager, should be included in this process.
School records and personnel may be consulted to identify how the teen's performance and function in school has been affected by the disorder. The evaluating clinician will also consider any underlying physical illnesses or diseases, such as diabetes, that could be causing the anxiety symptoms. Medications that might cause anxiety such as some drugs used in treating asthma will be reviewed. Since large amounts of caffeine, in coffee or soft drinks, can cause agitation, a clinician might look at the youngster's diet as well.
Other biological, psychological, family, and social factors that might predispose the youngster to undue anxiety will also be considered. If a teenager refuses to go to school, a clinician will explore other possible explanations before labeling it school avoidance.
Perhaps the teen is being threatened or harassed, is depressed, or has an unrecognized learning disability. He may also be skipping school in order to be with friends, not from anxiety about performance or separation. If the teenager has engaged in suicidal or self-endangering behavior, is trying to self medicate through alcohol or drug use, or is seriously depressed, these problems should be addressed immediately.
In such cases, hospitalization may be recommended to protect the youngster. In most cases, treatment of anxiety disorders focuses on reducing the symptoms of anxiety, relieving distress, preventing complications associated with the disorder, and minimizing the effects on the teen's social, school, and developmental progress.
If the problem manifests in school avoidance, the initial goal will be to get the youngster back to school as soon as possible. Cognitive-Behavioral Therapy In many cases, cognitive-behavioral psychotherapy techniques are effective in addressing adolescent anxiety disorders. Such approaches help the teenager examine his anxiety, anticipate situations in which it is likely to occur, and understand its effects.
This can help a youngster recognize the exaggerated nature of his fears and develop a corrective approach to the problem. Moreover, cognitive-behavioral therapy tends to be specific to the anxiety problem, and the teen actively participates, which usually enhances the youngster's understanding. Therapeutic response to phenelzine in patients with panic disorder and agoraphobia with panic attacks. Drug treatment of panic disorder. Comparative efficacy of alprazolam, imipramine, and placebo.
Alprazolam in panic disorder and agoraphobia: Patient acceptance, side effects, and safety. Use of benzodiazepines in panic disorder. Owen RT, Tyrer P. A review of the evidence. Does cognitive behavior therapy assist slow-taper alprazolam discontinuation in panic disorder? Panic disorder and agoraphobia. Treatments of psychiatric disorders. An open-label trial of nefazodone in high comorbidity panic disorder.
Venlafaxine treatment of panic disorder: Double-blind, placebo-controlled, crossover trial of inositol treatment for panic disorder.
Drug treatment of panic disorder: Trazodone in the treatment of panic disorder and agoraphobia with panic attacks. Many "primary care" physicians GPs have not been trained in the anxiety disorders and see the anti-anxiety medications as being "addictive". However, these medications are NOT addictive for people with clinical anxiety disorders, such as panic disorder. Another medication will work better. Over three dozen research studies report that people with clinical anxiety disorders do not become drug addicts as a result of temporary anti-anxiety use.
Find a psychiatrist who understands this. These medications almost always help and are tolerated well. There are few side effects e. There seems to be more research support for the use of Klonopin clonazepam and Ativan lorazepam in the treatment of anxiety than for the other anti-anxiety medications. Xanax, for reasons we can't go into here, is not a good choice for an anti-anxiety agent in general. If a professional tells a person with a definable, DSM-IV anxiety disorder that the anti-anxiety agents may prove "addictive" to them, the professional a is not aware of research in the area of anxiety, and b should probably not be treating you.
The anti-anxiety agents work, they complement CBT treatment, and they are among the safest drugs on the market. People with anxiety disorders stay on a low dosage while going through CBT and have no need to "up" their dosages once an effective level is found. These medications are nothing to worry about. When stopping anti-anxiety use, it is necessary to taper off the medication slowly, by reducing the dose over a period of 3 to 4 weeks.
This is also true when getting off SSRIs, despite advice to the contrary. It is important you slowly taper off these medications, too. These drugs, in general, have been shown to work effectively for a majority of people with clinical anxiety disorders.
Although most of our anxiety people do NOT need to be on these medications, some of our people, especially people with agoraphobia, DO need the added benefits and strength of an MAOI. We have found that, in general, Parnate, as opposed to Nardil, is more effective with many of the anxiety disorders, provided there are no other anxiety or mental health care complications.
Although these medications require slight food restrictions, the current list February is quite small. No responsible adult who needs to be on an MAOI has ever complained about the food restrictions.
N Engl J Med. It's also a good idea to know your test results and keep a list of the medicines you take. Wongproposed to retest the series for the in vitro reuptake of serotonin, norepinephrine and dopamine. In effective patient was there an unequivocal diagnosis, but one was considered to have a leukocytoclastic vasculitisand the other, a severe desquamating prozac that was considered variously to be a vasculitis or erythema multiforme. Families and caregivers of patients being treated with antidepressants for Major Depressive Disorder or other indications, both psychiatric and nonpsychiatric, should be alerted about the need to monitor patients for the emergence of agitation, irritability, unusual changes in behavior, and the other symptoms described above, as well as the emergence of suicidality, and to report such symptoms immediately to health care providers. Therefore it is important that people who are taking benzos only take them if absolutely necessary. Other studies, however, have failed to show a difference in panic-free status at end-point Pollack et al, is prozac effective in panic disorder, or have shown greater treatment differences for this variable between active drug and placebo Ballenger et al, Glutamate transporter gene SLC1A1 associated with obsessive-compulsive disorder. Associated with a risk of agranulocytosis when used at doses required for treatment of patients with schizophrenia whose symptoms are refractory to standard neuroleptics. This understanding can allow the patient to visualize the underlying cause of their anxiety. Concomitant use of aspirin, nonsteroidal anti-inflammatory drugs, warfarin, and other anti-coagulants may add to this risk. Safety and effectiveness of PROZAC and olanzapine in combination in patients less than 10 years of age have not been established. It is panic to treat anxiety disorder, is prozac effective in panic disorder, depression, and insomnia. If left untreated, anxiety can become so disorder that a person can becomes afraid to leave the house, form social bonds, and hold down a job.
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