Alternatively, you may want to coach your loved one through the problem. That strategy actually works sometimes, but it’s very tricky and we recommend professional guidance for both yourself and your loved ones if you want to become their coach.

Coaching, like reassurance, can easily backfire, cause arguments, or be perceived as criticism by people you’re trying to help.

Perhaps you’re tempted to try a confrontation or so-called “intervention” in which you and other family members tell the person how badly she needs help. That too is at least as likely to backfire as it is to help. Confrontations usually cause defensiveness and often, anger.

Instead, consider fully and unconditionally accepting your loved one and all of his problems with anxiety. After all, you likely fell in love with this person as a whole package that included issues with anxiety. And you probably have a few flaws and struggles yourself. Who doesn’t? So instead of forcing the issue to a head, consider embracing and loving the one you care about “as is.”

Acceptance delivers a positive message that may allow you and your loved one to actually become closer. When you drop pressuring people to change, it sometimes actually frees them up to make changes. When you convey the message that you’ll care about someone no matter what, it can actually enable them to start taking risks which is one of the things they’ll have to do if they want to overcome their anxiety.

In fact, change always requires being able to take risks, be vulnerable, and make mistakes. When people feel safe, they can do these things more easily. So, try letting go of your need to see your loved one make changes. Realize that whether the one you care about changes isn’t really about you anyway. Acceptance just may take you further than you think, but changing your loved one shouldn’t be your goal. Let go of that need and it just “may” happen a little more easily.

Open hands photo available from Shutterstock.

Well, yes and no. Of course most therapists would love for you to be able to feel calm, relaxed, and peaceful all of the time. However, that goal isn’t possible for anybody. Life is full of unpredictable, often random, dangers, hassles, and perils. Therefore, if you have the goal of eliminating these things, you will almost certainly fail.

So, I first recommend that you give up on the unrealistic goal of purging distress from your life. But then, I have something far more radical to suggest: Welcome anxiety, uncertainty, doubts, and distress into your life! Walk right up to anxiety and let it know that you’re ready to take it on. Seek every single opportunity you can to actually feel and experience anxiety!

What, you say? Have I lost my mind? Am I failing to understand how horrible anxiety is for you?

Actually, I think I do understand how uncomfortable anxiety can be. And I know how much those with anxiety wish to be rid of it. But the only sure fire way to master anxiety is through a process known as habituation. Habituation occurs whenever you encounter a feared situation, event, or object over and over and over again. Ever so slowly, but just as surely, your distress decreases as you go through this process. And it does so by gradually increasing your exposure to your fears.

The key term here is “gradually.” Take a simple case of someone who gravely fears spiders to the extent that she avoids going outside, has her apartment sprayed with toxic chemicals every week, and sprays insecticide around her desk every day. Clearly, her spider phobia is costing her dearly—her health may suffer; she likely annoys her coworkers, and she suffers miserably from worries and anxiety about spiders.

The treatment for spider phobics is much the same as it is for other anxiety problems. I would have this patient ever so gradually expose herself to small spiders (at first encased in a cage) and then move on to looking at pictures of fearsome spiders, then deal with small spiders at a short distance, and so on. Eventually, most people who go through graduated exposure find themselves no longer controlled and dominated by their anxiety. But this improvement comes from their willingness to actively confront their fears one step at a time.

If you have mild problems with anxiety, you may wish to try this approach on your own. Break your fears into a series of gradual steps and then start confronting them one at a time. Remain in contact with each step until your anxiety drops some. We discuss this process in Overcoming Anxiety For Dummies (2^nd Edition) in great detail, but you can also find a lot of information about the approach by Googling.

Make a game out of confronting your anxieties. Rate every fear and anxiety on a scale of 1 to 100 and then go out and rack up as many points as you can. Welcome anxiety! Embrace it. Tell it to give you its best shot. Go into the ring and confront your anxiety. You can’t win by running away—that just makes things worse.

Finally, If your anxiety problems are serious, seek a professional for help and guidance with this approach.

Young man in park photo available from Shutterstock.

Therefore, we can substantially reduce a variety of risks by learning to drive the speed limit, use seat belts, avoid excessive sun exposure, avoid known toxins, engage in regular exercise, and eat healthy.

All of these things are great to do. Unfortunately, humans also have a habit of taking things too far. We exaggerate our minds’ ability to predict the future and prevent what we fear from happening. For example, some people refuse to consider locating to the southwest (including our lovely part of the country New Mexico) because they are afraid of snakes. Well in the 25 years of my residency, I’ve only seen two snakes and I walk or jog quite frequently. The chances of actually getting bit by a snake are extremely unlikely—much less than getting hit by a car or having a heart attack.

People also spend time worrying about natural disasters like earthquakes, floods, hurricanes, or avalanches. These disasters are real and can lead to death, injury, financial loss, and emotional distress. However in the scheme of things the bigger worry for most people are clogged arteries, high levels of daily stress, bad habits like smoking, pollution, lack of will power, or not enough social support. These personal issues are much more likely to lead to death, injury, illness, financial loss, or emotional distress.

So the good news is that you can do much to lead a healthier life and avoid various types of disasters. The bad news comes from dwelling upon every imaginable worst case scenario and believing that your worry, in and of itself, will prevent them from happening. So for 2012, I recommend that you vow to do what you can about health concerns and safety. But try to realize that worry by itself will do nothing but make you anxious and distressed. Here are a six items I think are worth putting on the shelf and totally not worrying about for this coming year (although they can and do happen!):

1. Asteroids
2. Falling junk from outer space
3. Limnic eruptions (a sudden release of huge amounts of carbon dioxide from deep lakes that can actually suffocate you if you happen to be around at the time)
4. Tsunamis
5. Volcanic eruptions
6. Gamma ray bursts

Finally, try to do the same with more realistic worries once you’ve done what you can to prevent them. Eat healthy, exercise, and avoid obvious toxins, then stop worrying about cancer because there isn’t a lot more you can do to prevent it. I could give you more examples, but I assume you get the idea.

Volcano photo available from Shutterstock.

True panic attacks of this sort involve anxiety and fear of stunning intensity. The actual attacks usually peak within ten minutes and slowly fade, but it’s common for people to actually think they could die during one of these attacks. Common symptoms of these attacks include:

• Profuse sweating
• Rapid, irregular heartbeat
• Shortness of breath or sense of suffocation
• A sense of unreality or detachment
• Fear of impending death without any real basis
• Nausea
• Fear of losing control or “going insane”
• Trembling and shaking
• Chills and hot flashes
• Dizziness

When such attacks reoccur, the person worries about future attacks, has considerable concerns about the meaning of the attacks, or changes his or her behavior in order to avoid attacks, the odds are that a Panic Disorder is in play. Frequently, but not always, people with Panic Disorder also have Agoraphobia (fears of being in places that would be difficult or highly embarrassing to leave or escape from), but that’s a topic for another blog.

Trust me; if you’ve never had a panic attack, you don’t want to. But if you have such attacks from time to time or if you worry a lot about getting them, what can you do? Well, there’s a reason we titled our blog Anxiety and OCD Exposed. The term “exposed” or “exposure,” forms the foundation for most treatments of anxiety.

First, as with most emotional problems, you should see a physician to rule out physical problems that could be causing your anxiety. Try to avoid the temptation, however, of going to the doctor over and over and over again. In all but the rarest exceptions, a thorough physical once a year should be sufficient for moving ahead with exposure therapies.

Second, look for a cognitive behaviorally trained therapist who has expertise in treating Panic Disorder with Exposure techniques. That therapist will work with you on developing a hierarchy of items that tend to trigger your concerns about having panic attacks. You will gradually work your way through the easiest items, up to the most difficult.

In addition, your therapist may suggest exposure to the actual sensations of panic attacks themselves. This task is accomplished by intentionally bringing on these sensations by engaging in various tasks such as:

Breathing through a straw: You’ll usually breathe this way for about a minute each time. You feel like you aren’t getting enough air, your heart may race, and you may have feelings of choking, all of which mimic some types of panic for many people.

Spinning yourself around: This strategy induces dizziness and lightheadedness as well as an increased heart rate. Generally, sixty seconds or so works for this technique as well.

Hyperventilation: You breathe in and out very rapidly for about a minute which often induces feelings of shortness of breath, dizziness, of a racing heart.

There are various additional techniques for creating similar sensations. By repeating these exercises over and over again, you gradually learn that you won’t go crazy; you’re not going to die, and most importantly, that you can cope with anxious feelings. That knowledge allows you to quit worrying about having panic attacks which usually helps them fade from the scene.

Panicked woman photo available at Shutterstock

I was alert and aware of the snake behind us. I distinctly heard a rattle as we moved quickly and silently away. I was not thinking, only acting.

When your body responds to a dangerous situation like a snake in your path, you’re preparing to fight or flee. In the case of a snake, getting away makes more sense than making a stand to fight. The response to danger is hard wired and immediate. The brain responds to a perceived threat by releasing chemicals that surge to all parts of the body. These chemicals help protect you in the face of danger. You instantly become stronger and faster; your senses are all in hyperarousal; your focus intensifies. The body also responds when the danger is gone and the chemicals subside. After danger passes, there is usually a feeling of relaxation or fatigue.

The chemicals released during times of anxiety surge through the whole body. That’s why people who experience high levels of anxiety often have lots of physical symptoms. Anxious people can get cold or hot, have trouble getting enough air, or breathe too quickly, they may have muscle aches, or muscle weakness, upset stomachs, headaches, diarrhea, or constipation. These physical sensations can be frightening in and of themselves.

The fear of anxiety is the basis of panic disorder. People who develop panic disorder are first plagued by the physical symptoms of anxiety. When those symptoms are intense, people fear they might lose control, die, or embarrass themselves. The first step to treating panic is the understanding that panic attacks involve high levels of physiological symptoms in response to a perceived dangerous situation. More about actual panic attacks and Panic Disorder in a couple of days. Stay tuned.

Rattlesnake photo available from Shutterstock

People who have panic attacks frequently describe their experiences as horrible. Some say that they felt like they were dying; others say they thought they were going crazy; some say that they worried about losing control of themselves; still others report that they felt like they were outside of their bodies. It is quite understandable that, after experiencing a panic attack, people want to avoid another one.

But, it’s that attempt to avoid panic that actually makes panic grow. When people with panic avoid going places that might be associated with their panic attacks, they experience relief. Feeling relief for avoiding something makes it more difficult to either imagine or actually go to those places. As panic grows, more and more places are avoided.

The holiday season can be tough on those who experience panic attacks. People with panic often fear going out in crowded places or driving on busy roads. Yet, crowds and traffic can be rather hard to avoid during the holidays. Here’s an example of how one panic attack can become a major issue during the holiday season.

Jamie is shopping for Christmas presents for her kids early in the morning on black Friday. The mall is packed with people. Jamie tries to get to the counter to buy a toy car for her son when a man walks right in front of her. He rudely pushes her aside and Jamie almost falls down. Jamie feels a flush of anger and her face gets hot. She’s about to say something to the man when he abruptly leaves the store. Suddenly, Jamie can’t catch her breath. She’s feeling faint and nauseous. A tremendous feeling of dread overwhelms her. She puts down the toy and staggers out of the store. She finds a seat in the middle of the mall and fumbles for her cell phone in her purse. She calls her best friend, “I can’t breathe,” she says, “help me.”

Her friend calls 911 and Jamie is rushed to the hospital. After many hours in the ER, she feels better. The doctor tells her she must have become overheated and stressed out by the holiday crowds. He can’t find anything wrong with her. He tells Jamie to rest and drink lots of fluids.

After an uneventful week, Jamie decides to return to the mall to start her Christmas shopping. But the minute she decides, her stomach starts to churn, her heart pounds, and she begins to sweat. Frightened, she calls her friend to ask her for a ride to the urgent care center. She’s sure that she must be very sick to feel this bad. The urgent care center is packed with people. Jamie and her friend wait almost two hours. Again, the doctor says that everything checks out. He encourages Jamie to get more rest and drink lots of water.

Instead of going to the mall again, Jamie orders all of her gifts online. Jamie may be in the early stages of developing a panic disorder. Her initial bout was likely caused by a combination of stress, crowding, anger, and fear. Panic starts small and grows. If Jamie keeps on avoiding what is causing her distress, her fears will only grow. Tune in later to read about the treatment of panic disorders.

Worried woman photo available from Shutterstock.

If you’re a parent or someone who cares about kids, you just might want to know what type of messages instill insecurity. I’ll start by laying out three common mistakes that parents make; in other words, the kinds of messages you “don’t” want to give them:

1. Invalidating or Denying Your Children’s Feelings. If your kids seem worried, fearful, upset, or distraught, sometimes it’s tempting to tell them “there’s no reason that they should feel that way” or even that they “shouldn’t” be feeling what they are obviously feeling. Parents give these messages because they don’t want their kids to feel distress. So, they reason that their kids will understand, if their bad feelings have no real basis, they won’t feel the way they do. Big mistake. Children need to hear that it’s normal and OK to have a little fear or distress sometimes.
2. Providing Incessant Reassurance. Messages that “everything will turn out OK” sound so very much like what you should tell kids, and if you don’t say them too often, there’ll probably be no problem. However, when you frequently reassure your kids, you end up giving them the message that they need to turn to you (as an adult or parent) to help them see that things will turn out alright. They fail to learn that they can get through fear on their own. We wrote about this issue in detail in our earlier book, Obsessive Compulsive Disorder For Dummies and if you find yourself reassuring your kids a lot, we urge you to read it.
3. Protecting Your Kids from All Harm. No one ever wants to see a child come into harm’s way. However, growing, developing and learning require kids to face challenges and even take a few small risks along the way. Parents that try to constantly clear all dangers and risks that their kids confront teach them that the world is a scary place and that they need their parents to guide them through it. That message hardly fosters the independence and maturity they’ll need as adolescents and young adults.

So what’s a parent to do instead? One of the best ways to help prevent kids from developing anxiety disorders is to model how to cope.

I recommend that parents express when they’re feeling anxious and tell their kids how they plan to cope with it. For example, you might say, “Sometimes I feel nervous when I have to climb a ladder, but I just need to take a deep breath, be careful, and do it. If I get too nervous, I can always climb back down, but it feels good to get through difficult tasks.” Another good strategy is for parents to praise their kids when they make efforts to do things that are a little anxiety arousing for them.

The bottom line: Gently encourage your kids to confront their fears, let them know that a little anxiety is normal, and don’t try to keep them away from all challenges and risks.

Photo by Juliakoz, available under a Creative Commons attribution license.

Obsessions: Intense worries, thoughts, and images that pop into the mind and create a great deal of distress. Worries about becoming contaminated with germs are an example of a particularly common obsession.

Compulsions: Various behaviors or actions that temporarily reduce the distress obsessions cause. For example, people with contamination obsessions would be likely to wash their hands excessively to deal with their worries about becoming contaminated.

OCD can be fairly mild, but it’s quite common for it to be severe and substantially reduce the quality of life for those who have it. Sufferers often spend many hours a day carrying out their compulsions and feel helpless to do anything about their OCD. The good news is that OCD is highly treatable. The bad news is that a diagnosis of OCD often raises the risk of other emotional problems such as the ones that follow.

• Mood Disorders: Some studies have found that more than twenty-five percent of people who have OCD also have a disturbance in their moods. Left untreated, mood disorders can lead to serious problems. If you have intense feelings of sadness, low moods, fatigue, and/or feelings of worthlessness, it’s important to have it checked out. Conversely, if your moods become extremely high and are accompanied by things such as inflated self-esteem, rapid speech, excessive energy, decreased need for sleep, and/or excessive indulgences, that needs to be looked into as well.

• Anxiety Disorders: OCD has generally been thought to be a type of anxiety disorder although some professionals feel otherwise. In either event, problems with anxiety often go along with OCD. Signs of anxiety include avoidance of people, fears of losing control, intense fears, panic attacks, and tension.

• Attention Deficit Disorders (ADD): The various types of ADD often involve problems with attention, hyperactivity, and impulsivity. Additional problems include troubles staying focused, losing various items, forgetfulness, trouble remaining still, and talking without thinking. Those who have OCD are at increased risk of having ADD, but they also may merely “look” like they have ADD because their OCD requires much of their attentional resources. The good news here is that successful treatment of OCD sometimes results in an abatement of their ADD like symptoms.

• Substance Abuse: Given that OCD causes huge distress for many of its sufferers, it’s not surprising that some of them try abusing substances (alcohol, prescription drugs, and illegal drugs) to quell their anxiety and upset. Unfortunately, the relief provided by substances is fleeting. Treatment should be sought for both problems when they co-occur.

The bottom line is that if you have OCD, you probably feel great distress. That distress can escalate if you also have one or more additional emotional problems such as the ones discussed above. However, OCD as well as these accompanying problems can be alleviated by treatment that’s been designed and empirically validated for these issues.

Just a reminder—when you seek treatment for any of these problems, be sure to ask the mental health professional if he or she has experience and training in treating these disorders.

Since the signs differ a little for kids versus adults, here’s a list of seven signs that tell you if your child needs further assessment:

1. Delayed development: Lists of what to expect in terms of behavior, emotions, and learning at various ages abound on the Internet. We even include a checklist in our recent book Child Psychology and Development For Dummies. Consult a few of these lists. If you see that your child seems to be falling significantly behind (not just a few weeks or one or two months), a screening evaluation is worth getting. Early intervention for kids’ problems has been found to work far more effectively than professionals used to believe for many delays in childhood development. Ignoring delays can cost your child a great deal in potential gains.

2. Feeling fatigued or lacking interest: Parents, teachers, and caregivers should not ignore signs that a child appears to lack interest and engagement with the world or others. Kids who are oblivious to parents or peers, or who look fatigued or lethargic for more than a few weeks should be looked at. Kids who are doing OK are naturally enthusiastic and engaged.

On the other hand, a little lack of interest and withdrawal from families and parents during brief phases in adolescence is fairly common. However, if that withdrawal is pronounced or prolonged, it should be checked since it could indicate a problem with substance abuse, gangs, bullying (either as victim or perpetrator), or depression.

3. Poor Grades: Kids drag home poor report cards for lots of reasons. Sometimes poor performance in school indicates a specific type of learning problem. Other times, it could suggest an emotional disorder is getting in the way of achievement. Occasionally, poor grades could be caused by an intellectual disability; when that’s the case, it’s usually apparent fairly early on. Whether poor school performance starts early or comes later, it’s always worth finding out what’s going on. Grades have a lot of predictive power in terms of later life success so they should never be ignored.

4. Falling back: When children appear to master a particular skill like riding a bike, reading, language, or simply stacking blocks, they really shouldn’t start sliding downhill significantly (at least for very long). If you see a kid regress or backslide from skills learned earlier, consider have the problem checked out. Perhaps it’s a temporary glitch, but we believe it’s better to be safe than sorry.

5. Excessive complaints about aches and pains: Every kid on the planet complains about aches and pains here and there—stomachaches, earaches, leg pains, and more are as common as kids leaving their toys in the living room. However, when these complaints become repeated, intense, or frequently involve vague pains like “not feeling well,” it’s time to consult your medical doctor. Sometimes the physician is going to suggest the problem may relate to anxiety at school or trouble getting along with other kids. In those instances, it’s time to seek a mental health consultation.

6. Feeling over the top anger: OK, it’s true that all kids get angry. Toddlers especially have temper tantrums from time to time. However, when these tantrums start occurring every day or continue much past toddlerhood, or if your child starts hurting others, you need to have things checked out by a mental health professional. This is one problem that can usually be resolved fairly quickly if you don’t wait too long.

7. Feeling excessive fear: Again, fear is a totally normal part of childhood, especially from the ages of six months to 6 years when kids often exhibit fears of strangers, upset when separated from their parents, fears of strange kids, fears of the dark and monsters, and fears of school. However, if such fears continue much beyond the age of 6 or if they seem excessive compared to other kids, consider seeking an evaluation.

The bottom line is that kids’ emotional problems frequently respond to early intervention surprisingly well and quickly. Some problems require more intense interventions than others, but early help is always better than delayed.

Photo by GPL Photos, available under a Creative Commons attribution license.

In today’s economy, millions of people are out of work and rightly worry about how to get by. And we’ve written about coping with money worries in previous blogs. If you have experienced serious financial setbacks, I recommend that you read books on the topic, watch a few of those television shows noted above, and do everything you can to address the problem. Sometimes that will mean making serious sacrifices or major adjustments in lifestyle. Economic conditions right now aren’t pretty and they don’t show signs of making rapid improvement in the near future.

However, today’s blog is about people who are actually doing fairly well. They are bringing in a decent income and getting by. But they feel that they never have enough. In fact, my wife (Dr. Laura Smith, coauthor of this blog series) and I were at a friend’s house the other day and they noted that their daughter was unable to afford the co-pays for speech therapy for their granddaughter. Our friend empathized with her daughter and was sorely tempted to provide help.

We would have felt similarly, but we knew a few things about their daughter. For one, she had recently gone on a vacation to the Caribbean (I never have figured out how to pronounce Caribbean the “right” way, but I guess it doesn’t matter for a blog!). For another, this young woman had spent lots of money on things for her and her husband recently. Something felt missing from this picture.

Upon reflection, I figured out the missing piece of the puzzle. Values and priorities. Our friend’s daughter certainly could afford the co-pays for her daughter. All she had to do was take the items she had felt she “needed,” (but didn’t really) and put the money into an emergency fund. Vacations, cars, home improvements, new furniture, fancy devices, and more could have been put off.

The truth is, for all too many people, “I can’t afford it,” means that they value luxuries and self-indulgence more than other things. Then they feel justified in turning to friends or relatives to help them on more urgent items. When those friends and relatives pitch in, they merely encourage (or “enable”) these misplaced priorities to continue.

If you find yourself in the “I Can’t Afford It” mode or in the “Tempted to Help” position, step back. Ask yourself if the values and priorities have seemed reasonable. Then you can know if you really “can’t afford it” and/or if giving help looks like the right thing to do.

Photo from taxbrackets.org, available under a Creative Commons attribution license.