If your physician suggests psychiatric treatment, don’t be afraid. If you are troubled and feel that you need help, take the risk and make an appointment. We will not embarrass you. We will not criticize you. We will not diminish you. We are just going to talk. Give it a chance. If you just come and tell us about yourself and your life, whatever has to come out will come to the surface. We can help you connect the dots. You may just find out that you are not alone and perhaps more normal than you think. Hopefully you will realize that your parents did the best that they could and that you have more control over your life than you think. If anything, this experience may start you on the road to emotional maturity, allow you to live up to your full potential and be more content with yourself and your life. Sometimes even the strongest people need someone to talk to, someone who can offer support and light the way. Let a psychiatrist be your guide.
Contents
A GAD Case History: Paul’s Story
Part I: Steps to Relieve Anxiety
Chapter 4 Step 4: Lower Your Expectations
Chapter 5 Step 5: Express Negative Feelings
Chapter 6 Step 6: Take a More Positive View
Chapter 7 Step 7: Don’t Worry
Chapter 8 Step 8: Take Action
Chapter 9 Step 9: Take Things as They Are
Chapter 10 Step 10: Take Care of Yourself
Part II: Treatment Options
Chapter 11 Therapy
Chapter 12 Medication
Part III: High Stress Situations
Chapter 13 Anxiety and Adult Attention Deficit Disorder
Chapter 14 Anxiety and Chronic Illness
Chapter 15 Anxiety in the Elderly
Chapter 16 Holiday Anxiety
Conclusion: The Road to Contentment
Acknowledgments
Helpful Resources
About the Author
Notes
Ten Steps to Relieve Anxiety is the rare book which provides help and understanding to anxious clients, as well as general guidance to their treating psychiatrist. The reader experiences in a very real way how a chronically anxious client suffers and tries to cope with this very disturbing illness known as generalized anxiety disorder (GAD). While reading this book, I could hardly put it down. I was particularly struck by two themes which transcend the whole book and which frequently intersect.
Throughout the entire book, we can actually feel and experience the client’s suffering and his or her attempts to deal with the anxiety on his or her own. We also become aware of the fact that most anxious people not only suffer from anxiety and worry, but also from other depressive symptoms. They may, for example, suffer from panic attacks, shyness, compulsiveness and, at least to some degree, depression.
Clients appear on Dr. Zal’s doorstep, anxious to an extreme, with very little hope for healthier lives and not knowing what to expect. Whom do they see? A warm, caring, cautious psychiatrist, trained in psychoanalysis as well as other psychotherapeutic approaches and, very importantly, also in the appropriate use of psychiatric medication. Most importantly, Dr. Zal prescribes psychiatric medications not as a panacea to solve all of his client’s problems, but as a tool for the client to help him or herself with the psychiatrist’s guidance and assistance. In fact, this holistic approach to treatment of GAD is what makes Dr. Zal so helpful and so successful in treating his anxious clients.
It is because of this holistic approach that I am so pleased that Dr. Zal asked me, an academic biological psychiatrist, to write this foreword. Dr. Zal’s approach to treating his clients is exactly the approach that I have employed in my private practice. While I was heavily involved from the late 1950s on in controlled, academic research to find new antianxiety and antidepressant medications to improve my clients’ suffering, I swiftly realized that medications, no matter how effective, were only tools to allow my clients to help themselves, preferably within the context of a warm psychotherapeutic counselor-client relationship.
Every client is a different individual and that is the way Dr. Zal approaches the treatment of all his clients. It is also quite clear to the reader that taking a good and extensive psychiatric and medical history is the foundation of any good treatment approach. Here we see Dr. Zal’s success with his clients. He allows them to take their time to share with him their innermost thoughts. If I would be in need of a psychiatrist, Dr. Zal would be my choice.
Throughout the book, Dr. Zal espouses a realistic approach in helping his clients. He stresses the point that GAD is a chronic biological illness that has a genetic vulnerability and runs in families. At times of stress, it can escalate. Dr. Zal explains many of the common personality traits that anxious people often have, and I particularly like his concept of seeking contentment and not just happiness. He shows us that anxiety and worry can be handled and reduced, and he teaches his anxious clients which approaches are best for them to decrease their anxiety and become more functional and productive in their lives.
I have known Dr. Zal since the late 1970s, and over a period of ten years we conducted joint research in the pharmacological treatment of anxiety and depression. I have followed his professional career ever since. Dr. Zal has published three prior books in the field of mental health, including Panic Disorder: The Great Pretender. Dr. Zal has assumed leadership roles in Philadelphia psychiatry, is a much respected lecturer, medical writer and editor on mental health topics and, most importantly, is one of the most outstanding clinicians I have ever known.
—Karl Rickels, MD
Stuart and Emily B. H. Mudd Professor of Psychiatry, University of Pennsylvania Founder, University of Pennsylvania Private Practice Research Group
Forty million adults suffer from anxiety disorders in the United States today. Of this, 6.8 million people have generalized anxiety disorder (GAD), which is our most common mental health problem. GAD is an inherited