Anxiety

Summary

Anxiety can create health issues because of the way the body handles fear. Adrenalin and other stress hormones play a role in health problems

If you are anxious, you may recognize that anxiety causes body symptoms. When anxiety is intense, many people report symptoms such as:

• Sweating
• Heart pounding
• Nausea
• Racing thoughts
• Poor sleep
• Stomachaches and headaches
• Scary thoughts
• Tingling legs and arms

You may wonder what is really happening inside your body. You may wonder if you could be worrying yourself into real medical problems. There are health issues that can be made worse by anxiety. There are also health conditions that develop as a result of anxiety.

Common medical issues that can result from anxiety are:

• High blood pressure
• Tension headaches
• Migraine headaches
• Digestive problems
• Allergies
• Eczema
• Unwanted weight loss

Your doctor may recommend that you get treatment for anxiety when you present with the above problems. These problems can be caused by other factors such as genetics, but they also can result from anxiety.

Understanding “fight or flight”

When you have anxiety, your body prepares for “fight or flight.” This means that your body senses there is something to fear, and releases adrenalin into your bloodstream. When our ancestors were cavemen, this was a necessary body response. It allowed them to fight predators or run from danger. Other stress hormones as well are released into the bloodstream when the body senses fear.

Presently, we have much less need for the fight-or-flight response, except for rare situations. If you are a victim of crime, this is a good body response to have. Often our fearful thoughts trigger this response when it is not needed. Adrenalin is what causes you to feel jumpy and allows your heart to work harder to pump blood. It also directs blood flow from your digestive system (because you probably won’t feel hungry) to your arms and legs (to allow you to run). This is why anxiety symptoms can feel exactly like how you would feel if someone broke into your home, or attacked you in an alley.

If anxiety symptoms continue and you notice you are having difficulty living your life, imagine the effect it can have on your body over time. We are not meant to be in a fight-or-flight state for long periods of time. When this happens, anxiety can very much interfere with good health. The immune system can overreact to stress. Breathing and blood flow can be affected. Muscle tension and stomachaches can become more common. You can learn more about how your body responds to anxiety by talking to your doctor, and paying attention to signs of sickness.

Having anxiety now and then is normal. Some life events are sure to cause some anxiety symptoms. Often people experience anxiety in situations like:

• Getting married
• Getting divorced
• Starting a job
• Losing a job
• Having a new baby
• Losing a loved one
• Taking an exam
• Fighting with a friend
• Facing legal problems
• Facing financial problems
• Adjusting to a new diagnosis/being ill
• Recovering from trauma or crime

You may realize you are struggling with a stressful situation and experiencing anxious thoughts. There are ways to protect and nurture yourself when having a hard time. Some suggestions are:

• Spend time with trusted friends and family.
• Talk with a therapist about your feelings.
• Get regular exercise.
• Eat nutritious foods.
• Get plenty of sleep.
• Avoid drugs, alcohol, and caffeine.
• Learn relaxation exercises or meditation.
• Focus on the positive.

By Rebecca Steil-Lambert, M.S.W., L.I.C.S.W., M.P.H.

©2012-2019 Carelon Behavioral Health

Source: http://www.helpguide.org/mental/anxiety_self_help.htm; http://www.nimh.nih.gov/health/publications/anxiety-disorders/complete-index.shtml; http://www.adaa.org/finding-help/treatment/

Reviewed by Charles Weber, DO, VP Medical Director, Beacon Health Options

Summary

In addition to therapy and medications, you can take steps to make life with chronic illness meaningful and manageable. There are ways you can live your life to minimize anxiety

Mental health and physical health are connected. When someone has physical health issues, it is not surprising that they also might have mental health problems. In particular, anxiety and depression are very common in people who live with chronic health conditions.

Examples of chronic health conditions

• Diabetes
• Chronic pain
• Heart disease
• Chronic obstructive pulmonary disease
• Asthma
• Epilepsy
• Multiple sclerosis
• Lupus
• Crohn’s disease
• Hepatitis
• Kidney disease
• Arthritis

These are illnesses for which there is treatment; however, there is no cure. Very often, these illnesses mean living each day with many health demands. Perhaps also there’s a growing list of activities that become more difficult as a disease progresses or a condition enters a more challenging stage.

It is normal to feel fearful when facing illness. Some could argue it is expected that when living with major health stresses, there are going to be hard times emotionally. Mood issues and especially anxiety may become another challenge to tackle. Feeling unwell creates discomfort physically and emotionally. No one knows what the future holds. Wondering about the future through the eyes of someone with chronic illness is to look at fear and know you will have to one day make friends with it.

When we don’t feel well, we tend to isolate ourselves. Most mammals do this when they are sick. It is a natural response to retreat and rest. However, humans are social creatures, and also thrive from sharing burdens and being in the company of others. Times of feeling unwell can result in increasing isolation. Isolation can affect mood and how available support becomes.

Tips to decrease anxiety

There are ways to manage worried thoughts, even when they seem to be constant and overwhelming.

1. Remember it is normal to have sadness and anxiety when managing a chronic health problem. Allow yourself some grace and practice positive self-talk.
2. Connect with support groups, in person, or online, aimed at helping people with your health issues. Nothing feels better than another person truly understanding what you think and feel. “I get it” is powerful.
3. Write down your fears, and create an action plan. Put all worried scenarios down on paper. Then create a brief plan for managing each one. (If this problem gets worse, these are the adjustments I will make. If this happens, these are the people I can call.)
4. Ask your doctor all of your questions. Be sure to mention how your medical challenges are affecting your mental health. There may be professionals your doctor can refer you to. Some therapists specialize in helping people with specific illnesses.
5. Read inspiring stories. Whether you can relate to Michael J. Fox who lives with Parkinson’s disease, Elizabeth Hasselbeck who lives with celiac disease, or Montel Williams who lives with multiple sclerosis, find someone who inspires you. Read their story. Find out how they cope with their challenges.
6. Live one day at a time. Stay in the present moment; it is all you will ever have to manage. Live your life now. When your mind wanders into fears about the future, anxiety is taking you from the present. Come back into the present moment. Be here now. 
7. Break big challenges into small tasks. We become overwhelmed when we think of too many things at once. Do one thing at a time, and if it creates anxiety, break it into smaller bits.
8. If you find yourself constantly worrying, set aside a daily chunk of time for worrying. It can help contain anxiety to know that there is a specific time during which you can worry. Set a timer, and indulge your worried thoughts for a set period of time: 15 to 30 minutes is enough. By scheduling worry-time, you can reject worried thoughts throughout the day and shelve them for later.  
9. Learn the serenity prayer. Consider what you can control and what is outside your control. Let go of anything outside your control. Embrace what you do have the power to change. Health issues may be here to stay, but grab hold of a healthy lifestyle.
10. Practice gratitude. There are times to grieve losses, and there are times to take stock of all that is right and good. Make a daily practice of noticing what brings you happiness or satisfaction.

Anxiety is treatable. There are therapies, medications, relaxation techniques, and other ways to address it. It gets better the more you learn about it. Having a chronic medical condition is hard enough. Find a way to master your anxiety so that you can put your energy into things that matter to you.

By Rebecca Steil-Lambert, MSW, LICSW, MPH

©2012-2019 Carelon Behavioral Health

Source: http://www.healthcentral.com/anxiety/c/157571/110222/chronic-illness; http://www.nimh.nih.gov/health/publications/anxiety-disorders/complete-index.shtml

Reviewed by Charles Weber, DO, VP Medical Director, Beacon Health Options

Summary

You can learn to identify anxious thoughts, rethink them, and lessen feelings of anxiety.

Do you tend to worry and feel anxious often? Your thoughts might be stirring up anxiety.

Thoughts can be distorted

David Burns, M.D writes in The Feeling Good Handbook that distorted thoughts, not realistic ones, cause anxiety.

Catch your thoughts

The next time you feel anxious, try to write down everything running through your mind. See if you catch any distortions that Burns identifies:

Emotional reasoning: You assume that your negative emotions reflect the way things really are.

• “I feel afraid, so something really bad must be about to happen.”
• “My heart races when I’m on the elevator, so I must be in danger.”

Fortune-telling: You predict that things will turn out badly.

• “I feel out of control, so I must be about to go insane or die.”
• “This bad circumstance will result in disaster.”

Mental filter: You pick out a single negative detail and dwell on it exclusively.

• Obsessing on a body sensation such as “butterflies” in your stomach or on a bizarre, socially unacceptable thought that flits into your mind.

Magnification: You exaggerate the importance of your problems and shortcomings.

• “It’s a disaster if others don’t approve of me.”
• “Feeling anxious is so unbearable, I can’t survive it!”

Think new thoughts

If a distorted thought makes you feel anxious, rethink it. This takes practice. Don’t just accept that all your thoughts are true. Be willing to write down the ones that upset you and challenge them:

Examine the evidence: Is there any proof that your thought is valid?

• Anxiety doesn’t make you go insane or die suddenly. The symptoms just feel threatening.
• Research what the actual symptoms of cardiac arrest or insanity are.

The experimental technique: Is there a way to test whether your thought is really true?

• If your doctor says your heart is healthy, test thoughts of near death when you feel anxious. Go for a walk or jump up and down. A person in cardiac arrest can’t do that.
• Challenge your fear that you’re insane or losing control. Stand up on a park bench and belt out a tune, or waddle around making duck noises. Chances are you won’t be willing to do that. This shows you are in control.

The double-standard method: What would you say to a close friend who had a similar problem?

• Would you believe it’s the end of the world if someone disapproved of your friend?

The survey method: Ask those you trust if they believe your thought is valid.

• You will learn that everyone has weird thoughts on occasion.
• You will discover that everyone has felt anxious before.

Practice and be patient

Be patient and keep working on catching thoughts that make you feel anxious. As you retrain your thoughts, the physical feelings of “threat” will become more manageable over time.

Be sure to tell your doctor or a mental health professional about anxiety and other symptoms that concern you. Look for someone trained in cognitive-behavioral psychology if you want to try the above suggestions but need help getting started.

By Laurie M. Stewart

©2004-2019 Carelon Behavioral Health

Source: The Feeling Good Handbook by David D. Burns, MD. William Morrow and Company Inc.,1989; Dr. Robert P. Miller, The Cognitive Behavioral Health Center, Charlottesville, VA.

Summary

Many alternative treatments can add other helpful elements to your recovery

It is important to have your anxiety assessed first by your doctor. Sometimes symptoms of anxiety are confused with those of a medical problem. If you and your doctor figure out that your symptoms are anxiety-related, then together you can decide on the next steps. It can be helpful to add other options to your treatment plan. There are non-drug approaches to managing anxiety.

Types of alternative treatments

• Massage and other body work
• Yoga or other exercise
• Meditation and other relaxation strategies
• Acupuncture
• Aromatherapy
• Diet changes and herbs/supplements
• Spiritual practices

Often people who struggle with anxiety feel a sense of relief once they talk to a licensed therapist or to a doctor. Adding non-traditional approaches to anxiety may improve recovery by reinforcing healthy lifestyle changes. These changes can even help prevent episodes of intense worrying, especially if used regularly. Proven usefulness of some of these treatments has not been established with traditional study. This is one reason they are considered alternative.

Massage and body work may be the easiest approach to understand. Most people find massage to be a very relaxing experience. On a basic level, it feels good. It can be quite powerful in releasing muscle tension. Different types of massage have been used across many cultures for centuries. It can remind the body how to relax. It has been shown to slow the heart rate, reduce blood pressure, and improve circulation. Massage is good for those who have poor sleep, aching muscles, and headaches from anxiety. Reiki is another type of body work that involves compassionate healing touch.

Yoga can be just as physically rewarding in terms of stress relief. It often combines stretching and physical poses with breathing and meditation. Yoga can be challenging or calming and gentle. Depending on how fit you are, you can choose a type that meets your needs. It can help slow breathing, encourage a relaxed state within, improve focus, and help emotional balance.

Meditation can take many forms. Anxiety can spring from a sense that nothing matters or has any meaning. Those with a lack of belief in self can deeply benefit from meditation. It can also help stop worried thoughts. Meditation can be enhanced with soothing music or nature sounds. Some people like listening to ocean waves or birds singing. Choosing a spot where you are able to sit quietly for 10 to 30 minutes is important. The mind begins to learn how to become quiet and relaxed while awake. There are many tools to help learn meditation. Progressive muscle relaxation and positive visualization are two forms that are recommended for anxiety. You can look these up online, or find for books or classes to learn more.

Acupuncture uses tiny needles to stimulate meridians or energy fields in the body. It is a form of Chinese medicine that has been practiced for centuries. Most people hardly feel the needles involved in acupuncture. Many people feel calmer after acupuncture treatment. It may especially help those with pain and nausea related to anxiety. If your health insurance does not cover it, or your health insurance provider can’t refer you to an acupuncturist, you may ask another alternative health practitioner. Look for recommendations and local listings. Choose those who have completed formal training. A trained acupuncturist will use sterile needles. They should be able to explain the theory of how it corrects imbalances in the body.

Aromatherapy is used for enhancing the relaxation experience. It involves using the sense of smell to induce relaxation. Essential oils are put on a cotton swab and inhaled or put into a diffuser. Sometimes they are added to body creams or oils. You can usually smell a number of different essential oils until you find one that is relaxing to you. Try scents such as sandalwood, tangerine, neroli, ylang-ylang, or eucalyptus. A good place to look for essential oils is at a local health food store.

Diet changes can also allow you to start feeling more balanced. The most notable diet change that can help anxiety is to give up caffeine. Try decaffeinated coffees, teas, or cool drinks such as seltzer water. Caffeine can make anxiety symptoms worse, so start with giving it up. You may wake up more slowly, but feeling less anxious may be worth it. Try eating a more balanced diet, rich in fruits and vegetables. Also eat more plant forms of protein (nuts, seeds, beans, soy). Add more fiber by selecting fruits such as apples or raisins and eating more vegetables. Try giving up white flour and sugar and see if your mood feels less tense. You may notice more stable energy from eating less refined foods and more fiber. These changes in diet can slow the absorption of energy from the food you eat.

There may also be herbs and homeopathic preparations that can help with anxiety. Some practitioners use flower essences and some use Chinese herbs. Be sure to check with your doctor before using them. There are some that have been studied, such as Saint John’s wort. Others have been studied very little.

Finally, use spirituality to enhance your sense of well-being. Whether it is prayer or being out in nature, use whatever practices bring you peace. You don’t have to have a religion to have spirituality. If being in nature soothes your senses, be sure to spend time each day outside. Experience gratitude for the warmth of the sun on your skin, or the feel of the breeze on your face. Spirituality can be about connecting with the world in calm, basic ways. Some people feel peaceful near the ocean. It can be a reminder that there are forces of nature much greater than we are. Knowing that you have no control over many things can free you to focus on what you do have the power to change. It may relax you to put faith in the other forces at work.

By Rebecca Steil-Lambert, MSW, LICSW, MPH

©2012-2019 Carelon Behavioral Health

Source: http://www.massagetherapy.com/articles/index.php?article_id=468; http://www.nimh.nih.gov/health/publications/anxiety-disorders/complete-index.shtml; The Anxiety and Phobia Workbook, fifth edition, by Edmund J Bourne, PhD, New Harbinger Publications, 2011; Natural Relief for Anxiety: Complementary Strategies for Easing Fear, Panic, and Worry by Edmund J. Bourne, PhD, Arlen Brownstein, ND, and Lorna Garano. New Harbinger Publications, 2004.

Reviewed by Charles Weber, DO, VP Medical Director, Beacon Health Options

Eco anxiety is an individual’s emotional response to real or perceived threats to one’s environment, causing chronic fear of environmental doom and resulting in anxious behaviors. This could be due to natural disasters such as fires, tsunamis, hurricanes, flooding or global warming.

One of the first things you can do for yourself and any loved ones who may be experiencing anxiety over environmental concerns is to acknowledge these worries and have a plan for emergencies. Consider watching disaster preparedness videos as suitable for your location. The following tips may also help.

Manage anxiety by impacting change in your environment

Recognize that you are in control and can do things to make a difference. If you’re a parent, help your kids find volunteer opportunities or other ways to feel that they are making a difference. Below are examples of things that people can do to alleviate the fear of environmental doom.

General disaster preparedness: Install mobile apps that alert you to severe weather, wildfires, etc. Stock bottled water, non-perishable foods and a first aid kit. Consider buying a generator to help cope with power outages. Stock board games and puzzles to help you pass the time if you’re stuck indoors. Stock an emergency evacuation bag.

Global warming: Plant trees, recycle and engage in advocacy efforts to educate others about global warming.

Tsunami/flood: Learn to swim, identify a safe place to go to that is inland and on high ground in the event of a tsunami/flood, and (if you can) purchase a boat and safety gear.

Heat wave: Check air conditioning ducts, drink plenty of water, limit time outdoors.

Winter storm: Check your heating system. Take steps to prevent pipes from freezing. Have tools ready to clear snow, de-ice sidewalks and cars, etc.

Tornado: Monitor severe weather reports. Plan the safest place to go in your home or surrounding area.

Hurricane: Monitor weather reports. Learn how to secure your home as best as possible. Evacuate your area if directed.

Wildfire: Monitor fire risks and air quality conditions. Learn how to secure your home as best as possible.  Evacuate your area if directed.

Manage anxiety with grounding techniques

Grounding techniques are relaxing and pleasurable activities that decrease stress and anxiety. When you feel anxious about possible environmental threats, you are out of touch with the present moment. The following techniques help you reconnect to the present and feel calmer and safer in the here and now:

• Carry a polished stone or soft piece of cloth with you to touch.
• Find your pulse on your wrist or neck, and count the beats per minute.
• Get active. Do the dishes, clean your room or redecorate. Organize your living area.
• Watch a favorite TV program, or go to your favorite website.
• Pet or play with an animal (or stuffed animal).
• Visit a friend.
• Look up pictures or paintings online that you find beautiful. Save them as your computer background image, or hang them in your room.
• Go to the park.
• Visit a place with enjoyable smells (e.g. bakery, candle shop).
• Press your feet firmly to the ground to remind yourself where you are.
• Recite a positive affirmation that you selected ahead of time. “I control what I think about.”
• Take a warm bubble bath or shower, and pay attention to the water touching your body.
• Color in a coloring book (there are adult and child coloring books that focus on meditation).
• Realize that no matter how small you feel, you are in control of your body. Envision yourself being safe, strong and capable.

©2021 Workplace Options

Summary

When a problem has an impact on functioning, it is important to seek the help of a doctor or professional therapist. Consider how the problem is affecting the child’s everyday life.

All children feel worried and fearful from time to time. Part of growing up is going through new experiences that can cause anxiety. For instance, the first time a child goes to preschool, or rides the school bus, or sleeps over at a friend’s house can create worry. All of these new life events can cause children to feel anxious or fearful. One difference in anxiety in a child and anxiety in an adult is that children may not use the word anxiety. They may not have the vocabulary to talk about their sense of anxiety. We need to listen to what children are able to say about their feelings, and also look at their behaviors.

A child with normal anxiety may worry for a period of time, but will respond to an adult’s soothing and support. After the child hears reassurance, worries tend to go away. An example is a child anxious about a thunder and lightning storm. A parent might say to the child that the thunder sounds loud, but it doesn’t mean bad things are happening. The flowers and trees will like the rain, and the storm will pass quickly. A parent may voice the idea that although you feel scared or anxious, I will keep you safe. A child with normal levels of anxiety will respond to this and settle down.

Recognizing anxiety disorders

In children with anxiety disorders, often the amount of worry is much greater than you would expect given what causes it. Separation anxiety disorder is the primary children’s anxiety disorder. It’s the fear of being away from home or from their family. It is normal for children between the ages of 6 months and 3 years. However, it is thought to be a disorder if it happens to a child who is preschool age or older. Children with anxiety may not respond to parental reassurances. There may be no relief from the child’s sense of anxiety, even with a parent or caregiver offering reassurance.

When anxiety is a disorder, usually it is affecting the child’s functioning at school, at home and with friends. Usually when there is an anxiety disorder the signs of the problem last more than six months. Most children go through tough periods of time where they are more worried or fearful. However, a child with an anxiety disorder is not able to set worries aside. If the worry seems excessive and persists over many months it should be treated. You may want to ask your pediatrician about referral to a licensed child therapist.

Sometimes it is helpful to ask the following questions:

• What is the actual impact of the problem?
• How does my child respond to adult reassurance?
• How does worry affect a child’s ability to make friends?
• How much does a child’s worrying affect the family as a whole?
• How is school going?

When a problem is changing how a child is functioning, it may be time to seek professional help.

Signs that may indicate a child has an anxiety problem

• Repeated toileting accidents
• Overly clingy behavior
• Asks lots of “What if..” questions
• Difficulty with transitions (going places, visiting others, leaving)
• Difficulty relaxing or concentrating
• Big startle response
• Worrying about things before they happen
• Irritability and tiredness
• Constant fearful thoughts
• Frequent complaints of stomachaches and headaches
• Fear about making mistakes or things not being perfect

If a child is experiencing some of the above signs, it may be a good time to tell your pediatrician you are concerned, and ask for help. In addition to finding help, such as a licensed therapist, you can also take action yourself. Consider enhancing your parenting skills to help your child deal with anxiety better.

What parents can do

Think about whether there has been an upsetting event recently, such as divorce, fighting, death, or family illness. If so, learn more or talk to a counselor about how to help your child adjust to difficult life events.

• Remind your child regularly of your love and support and belief in her.
• Establish more structure in your child’s day so that there is a predictable routine the child follows on a daily basis. Keep the same bedtime routine every day.
• If you work, call and check in on a regular basis with school or daycare providers.
• Join a parenting support group.
• Build your own self-confidence so you can model it to your child.

Trust your feelings and take action if you notice your child is overly anxious. Meeting with a licensed therapist with your child can help you understand your child’s worries. A therapist can provide suggestions for helping your child become less anxious.

By Rebecca Steil-Lambert, M.S.W., L.I.C.S.W., M.P.H.

©2012-2019 Carelon Behavioral Health

Source: http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/The-Anxious-Child-047.aspx; http://www.nami.org/

Reviewed by Charles Weber, D.O., VP Medical Director, Beacon Health Options

Summary

When anxious thinking affects functioning, it is important to seek the help of a doctor or professional therapist. Consider how the problem is affecting health, relationships, work, parenting, and spirituality

Everyone worries from time to time about all kinds of things. Worry itself is quite normal. Generalized anxiety disorder (GAD) is a condition of too much worrying. If anxious thoughts seem to be increasing, it may signal a problem. Worry has to do with fears. Sometimes worrying can occur even when there is no clear cause. Fears can be confusing and may not make sense to the person who has them.

Fears may be based on real issues, but when worry becomes troubling enough that it is affecting sleep, appetite, concentration, ability to work, or ability to have relationships, it may be GAD.

How do I know if I have it?

One way to think about the severity of worry or anxiety is to ask the following questions:

• “How is anxiety affecting my ability to function?”
• “Is it interfering with how I interact with people I love?”
• “Is it creating health concerns?”
• “Is it impairing parenting or work or school?” 
• “How much time do I spend worrying each day?”

If anxiety is leading to constant worrying it may be GAD. Perhaps thoughts often become negative and frightening. GAD occurs more often in women than in men. It can be a condition passed on from one generation to the next.

There are some common traits that most people with GAD share. They include: a negative outlook on how things will turn out, a desire to be accepted by everyone, and a feeling that things must be “perfect.” Anxious people tend to feel there is a way that they “should” be. Also, often people with anxiety lack stress management skills. People with GAD often have exhaustion from ignoring body signs that stress is building and resulting in constant anxious thinking.

Examples of anxious thinking:

• “I will never finish this work, and my job depends on it.”
• “What if he doesn’t like me?”
• “Nothing I do ever turns out well. What if I can’t cope?”
• “I can’t concentrate or get anything done.”

In addition to anxious thoughts, people with GAD experience some of these symptoms:

• Inability to fall asleep, stay asleep, or awakening too early
• Feeling fearful and engaging in behaviors like use of drugs or alcohol to avoid problems
• Experiencing stomachaches, headaches, tense muscles, and teeth grinding at night
• Taking no enjoyment or satisfaction in activities you normally enjoy because of worrying about the future
• Appetite change
• Rapid heartbeat even when sitting or resting
• Difficulty making decisions because of worry
• Scary and overwhelming thoughts

GAD is fairly common, and there are lots of reasons to be hopeful. It is treatable and can get better. Reaching out for help is an important first step in recovering from GAD.

Treatment for GAD can involve taking medicine and/or talk therapy. Recovery may also mean learning relaxation techniques and other stress management skills. Some people find help from spiritual practices. Improving self-esteem and changing inaccurate thoughts can also be helpful in overcoming GAD. Most people recover from GAD with a combination of therapy and medication. GAD may feel overwhelming, but there are many ways the condition can improve.

By Rebecca Steil-Lambert, MSW, LICSW, MPH

©2012-2019 Carelon Behavioral Health

Source: http://www.nimh.nih.gov/health/topics/generalized-anxiety-disorder-gad/index.shtml

Reviewed by Charles Weber, DO, VP Medical Director, Beacon Health Options