Cognitive-Behavioural Therapy

People with generalized anxiety disorder (GAD) go through the day filled with exaggerated worry and tension, even though there is little or nothing to provoke it. They anticipate disaster and are overly concerned about health issues, money, family problems, or difficulties at work.
People with GAD cannot get rid of their concerns, even though they usually realize that their anxiety is more intense than the situation warrants. They are unable relax, startle easily and have difficulty concentrating.
Physical symptoms that often accompany the anxiety include, but are not limited to, fatigue, headaches, muscle tension, muscle aches, difficulty swallowing, trembling, twitching, irritability, sweating, nausea, lightheadedness, having to go to the bathroom frequently, feeling out of breath and hot flashes.
GAD affects about 6.8 million Americans and about twice as many women as men. It comes on gradually and can begin across the life cycle, though the risk is highest between childhood and middle age.
It is diagnosed when someone spends at least 6 months worrying excessively about a number of everyday problems. There is evidence that genes play a modest role in GAD.
Other anxiety disorders, depression, or substance abuse often accompany GAD, which rarely occurs alone. It is commonly treated with medication an/or cognitive-behavioral therapy.
Treatment of Anxiety Disorders
Anxiety disorders are typically treated with medication, specific types of psychotherapy, or both. Treatment choices depend on the problem and the persons preference.
Before treatment, a doctor must conduct a careful diagnostic evaluation to determine whether the symptoms are caused by an anxiety disorder or a physical problem. If an anxiety disorder is diagnosed, the type of disorder must be identified, as well as any coexisting conditions, such as depression or substance abuse.
Sometimes alcoholism, depression or other coexisting conditions have such a strong effect on the individual that treating the anxiety disorder must wait until the coexisting conditions are brought under control.
People with anxiety disorders who have already received treatment should tell their current doctor about that treatment.
If they received medication, they should tell their doctor what medication was used, what the dosage was at the beginning of treatment, whether it was ever increased or decreased, what side effects occurred and whether the treatment helped them significantly. If they received psychotherapy, they should describe the type of therapy, how often they attended sessions and how much the therapy helped.
Often people believe that they have failed at treatment or that the treatment did not work for them when, in fact, it was not given for an adequate length of time or was administered incorrectly. Sometimes people must try several different treatments or combinations before they find the one that works for them.
Medications
Medication will not cure anxiety disorders, but it can keep them under control while the person receives psychotherapy, often from a psychologist. The principal medications used to treat anxiety disorders are antidepressants, anti-anxiety drugs and beta-blockers which control some of the physical symptoms.
With proper treatment, many people with anxiety disorders can lead normal, fulfilling lives.
Antidepressants
Antidepressants were developed to treat depression but are also effective for anxiety disorders. Although these medications begin to alter brain chemistry after the very first dose, their full effect requires about 4 to 6 weeks before symptoms start to fade. It is important to continue taking these medications long enough to let them work.
SSRIs
Some of the newest antidepressants are called selective serotonin reuptake inhibitors, or SSRIs. SSRIs alter the levels of the neurotransmitter serotonin in the brain, which, like other neurotransmitters, helps brain cells communicate with one another.
Fluoxetine (Prozac), sertraline (Zoloft), escitalopram (Lexapro), paroxetine (Paxil) and citalopram (Celexa) are some of the SSRIs commonly prescribed for panic disorder, OCD, PTSD, and social phobia. These drugs are also used to treat panic disorder when it occurs in combination with OCD, social phobia or depression.
Venlafaxine (Effexor), a drug closely related to the SSRIs, is also used to treat GAD. These medications are started at low doses and gradually increased until they cause side effects or produce a beneficial effect.
SSRIs have fewer side effects than older antidepressants, but they sometimes produce slight nausea or jitters when people first start to take them. These symptoms fade with time, however.
Some people also experience sexual dysfunction with SSRIs, which may be helped by adjusting the dosage or switching to another medication.
Tricyclics
Tricyclics are older than SSRIs and work as well as SSRIs for anxiety disorders other than OCD. They are also started at low doses that are gradually increased.
They sometimes cause dizziness, drowsiness, dry mouth and weight gain, which can usually be corrected by changing the dosage or switching to another medication.
Tricyclics include imipramine (Tofranil), which is prescribed for panic disorder and GAD and clomipramine (Anafranil), which is the only tricyclic antidepressant useful for treating OCD.
MAOIs
Monoamine oxidase inhibitors (MAOIs) are the oldest class of antidepressant medications and the ones most commonly prescribed for anxiety are phenelzine (Nardil), followed by tranylcypromine (Parnate) and isocarboxazid (Marplan), which are useful in treating panic disorder and social phobia.
People who take MAOIs cannot eat a variety of foods and beverages (including cheese and red wine) that contain tyramine or take certain medications, including some types of birth control pills, pain relievers (such as Advil, Motrin and Tylenol, cold and allergy medications and herbal supplements; these substances can interact with MAOIs to cause dangerous increases in blood pressure.
MAOIs can also react with SSRIs to produce a serious condition called serotonin syndrome, which can cause confusion, hallucinations, increased sweating, muscle stiffness, seizures, changes in blood pressure or heart rhythm and other potentially life-threatening conditions.
Anti-Anxiety Drugs
High-potency benzodiazepines combat anxiety and have few side effects other than drowsiness. Because people can develop a tolerance to them and may need higher and higher doses to get the same effect, benzodiazepines are generally prescribed for short periods of time, especially for people who have abused drugs or alcohol or who become dependent on medication easily.
One exception to this rule, however, is people with panic disorder, who can take benzodiazepines for up to a year without harm. Clonazepam (Klonopin) is used for social phobia and GAD, lorazepam (Ativan) is helpful for panic disorder and alprazolam (Xanax) is useful for both panic disorder and GAD.
Some people experience withdrawal symptoms if they stop taking benzodiazepines abruptly instead of tapering off, and anxiety can return once the medication is stopped. These potential problems have led some physicians to shy away from using these drugs or to use them in inadequate doses.
Buspirone (Buspar), an azapirone, is a newer anti-anxiety medication used to treat GAD. Possible side effects include dizziness, headaches, and nausea. Unlike benzodiazepines, buspirone must be taken consistently for at least 2 weeks to achieve an anti-anxiety effect.
Psychotherapy
Psychotherapy involves talking with a trained mental health professional, such as a psychologist, social worker, or counselor, to discover what caused an anxiety disorder and how to deal with its symptoms.
Cognitive-Behavioral Therapy
Cognitive-Behavioral Therapy (CBT) is very useful in treating anxiety disorders. The cognitive part helps people change the thinking patterns that support their fears and the behavioral part helps people change the way they react to anxiety-provoking situations.
For example, CBT can help people with panic disorder learn that their panic attacks are not really heart attacks and help people with social phobia learn how to overcome the belief that others are always watching and judging them. When people are ready to confront their fears, they are shown how to use exposure techniques to desensitize themselves to situations that trigger their anxieties.
People with OCD who fear dirt and germs are encouraged to get their hands dirty and wait increasing amounts of time before washing them. The therapist helps the person cope with the anxiety that waiting produces; after the exercise has been repeated a number of times, the anxiety diminishes.
People with social phobia may be encouraged to spend time in feared social situations without giving in to the temptation to flee and to make small social blunders and observe how people respond to them. Since the response is usually far less harsh than the person fears, these anxieties are lessened.
People with PTSD may be supported through recalling their traumatic event in a safe situation, which helps reduce the fear it produces. CBT therapists also teach deep breathing and other types of exercises to relieve anxiety and encourage relaxation.
Exposure-based behavioral therapy has been used for many years to treat specific phobias. The person gradually encounters the object or situation that is feared, perhaps at first only through pictures or tapes, then later face-to-face.
Group therapy is particularly effective for social phobia. Often homework is assigned for participants to complete between sessions.
There is some evidence that the benefits of CBT last longer than those of medication for people with panic disorder, and the same may be true for OCD, PTSD, and social phobia. If a disorder recurs at a later date, the same therapy can be used to treat it successfully a second time.
Medication can be combined with psychotherapy for specific anxiety disorders, and this is the best treatment approach for many people.
Taking Medications
Before taking medication for an anxiety disorder:
1. Ask your doctor to tell you about the effects and side effects of the drug.
2. Tell your doctor about any alternative therapies or over-the-counter medications you are using.
3. Ask your doctor when and how the medication should be stopped. Some drugs cannot be stopped abruptly but must be tapered off slowly under a doctors supervision.
4. Work with your doctor to determine which medication is right for you and what dosage is best.
5. Be aware that some medications are effective only if they are taken regularly and that symptoms may recur if the medication is stopped.
How to Get Help for Anxiety Disorders
If you think you have an anxiety disorder, the first person you should see is a psychologist, psychiatrist or your family doctor. It must be determined whether the symptoms that alarm you are due to an anxiety disorder, another medical condition or both.
If an anxiety disorder is diagnosed, the next step is usually contracting with a mental health professional to provide treatment. The practitioners who are most helpful with anxiety disorders are psychologists and therapists who have training in cognitive-behavioral therapy and/or behavioral therapy and who are open to using medication if it is needed.
You should feel comfortable talking with the mental health professional you choose. If you do not, you should seek help elsewhere.
Once you find a mental health professional with whom you are comfortable, the two of you should work as a team and make a plan to treat your anxiety disorder.
Remember that once you start on medication, it is important not to stop taking it abruptly.
Certain drugs must be tapered off under the supervision of a doctor or bad reactions can occur. Make sure you talk to the doctor who prescribed your medication before you stop taking it.
If you are having trouble with side effects, it is possible that they can be eliminated by adjusting how much medication you take and when you take it.
Most insurance plans, including health maintenance organizations (HMOs), will cover treatment for anxiety disorders. Check with your insurance company and find out.
If you do not have insurance, the Health and Human Services division of your county government may offer mental health care at a public mental health center that charges people according to how much they are able to pay. If you are on public assistance, you may be able to get care through your state Medicaid plan.
Ways to Make Treatment More Effective
Many people with anxiety disorders benefit from joining a self-help or support group and sharing their problems and achievements with others. Internet chat rooms can also be useful in this regard, but any advice received over the Internet should be used with caution, as Internet acquaintances have usually never seen each other and false identities are common.
Talking with a trusted friend or member of the clergy can also provide support, but it is not a substitute for care from a psychologist or other mental health professional. Stress management techniques and meditation can help people with anxiety disorders calm themselves and may enhance the effects of their therapy.
There is preliminary evidence that aerobic exercise may have a calming effect. Since caffeine, certain illicit drugs and even some over-the-counter cold medications can aggravate anxiety disorders, they should be avoided.
Check with your physician or pharmacist before taking any additional medications. Also, the family is very important in ones recovery. Ideally, the family should be supportive and should not trivialize the disorder or demand improvement without treatment.

The word ‘trauma’ originates from the Greek ‘wound’, and it is commonly defined as being of psychological or physical nature. Trauma occurs as a result of an event, and it has deep roots in various levels of the human mind and behaviour. In a world with excessive reasons to experience a traumatic event, understanding this condition may be the key approach to combat its symptoms.The Causality of Trauma

Psychological trauma is a broad concept, and its origins are co-related with two well-know mechanisms of the human mind: stress and memory. In order to fully understand this relationship, we’ll briefly explain these two processes:

Stress

Albeit commonly associated with negativeness, stress is an evolutionary advantage. The stress triggering mechanism allows most people to react to dangerous situations prior to consciously detecting it. The level of a stress response generally dictates the intensity of psychological trauma in an individual.

Primarily, the Hypothalamus (region of the brain responsible for controlling the Autonomic Nervous System) identifies a stressor (an event which triggers stress) and automatically prepares the body to react to that event. This is done through sending signals to both the ANS and the Pituitary Gland (limbic system) – which in turn, activate a ‘response mechanism’ by stimulating body organs to change their regular activity.

This response mechanism is identified by: increase of blood pressure, heart rate, sugar levels and re-direction of blood flow to major organs. The body also improves respiration by dilating air passages, stopping digestion in order to direct focus (energy) to other parts of the body and increasingly producing adrenaline (epinephrine).

All these processes transpire in a few seconds – and they were particularly ‘designed’ to increase survival chances either by challenging a situation, or by escaping from it.

Memory

Memory and trauma are interrelated processes – without the memory of a traumatic event, psychological trauma is inexistent. In addition, memory also plays an active role in the incidence and intensity of stressful responses.

Once stress is triggered by an event (a stressor), the prefrontal cortex (region of the brain responsible for decision-making) promptly receives a message from the limbic system. This process instigates the assessment of the situation by higher functions of the mind.

If the situation does not constitute danger, the stressing mechanism will gradually shut down and the body will return to normal functioning.

If the situation reflects danger, the individual will need to decide what to do – and in that process – the amygdala (a part of the limbic system which plays a key role in human emotions, particularly fear) directs the hippocampus (a central region of human memory) to imprint that information differently from other events. This long-term storage of the memory is explained by its emotionally attached significance.

Such mechanism is another ’smart’ human feature. Next time the same stressor (or similar) is identified, that memory will be instantly retrieved in order to assist in the individual’s reaction. At a subconscious level, there will be an overstressed response to the event. At a conscious level, comparison and previous experience will induce better decision making.The Effects of Trauma

Trauma is inevitable in our lives. From the birth of a child, to all stages of its development – traumatic events are common and also part of the ‘human experience’. However, the level of trauma caused by an event dictates the short and long-term effects of that occurrence.

For instance, trauma can be related to several mental illnesses. Conditions such as Schizophrenia, Depression, and Bipolar Disease can be triggered by traumatic events. One condition in particular, is directly related to trauma: Post Traumatic Stress Disorder (PTSD).

Post Traumatic Stress Disorder

PTSD occurs when an individual develops a set of behaviours and reactions based on a traumatic event. The traumatic experience interferes with normal functioning, causing the affected person to present avoidance behaviour (avoid activities, people, context, or other things that can associate with the trauma).

This condition can occur at any age and traumatic stress can be cumulative over a lifetime. Responses to trauma include feelings of intense fear, helplessness, and/or horror. This condition has roots in the relationship between stress, trauma and memory.

It is perceived that PTSDs are originated from a ‘defect’ in the brain memory processing functions. As previously described, emotionally attached events are stored differently (at a ‘deeper’ level). These memories include stressful and traumatic events, particularly those which resulted in some kind of harm and emotional distress to the person.

Upon the identification of the same stressor (or similar) that caused a reaction for the previous situation, the body would instantly trigger an overstressed response. However, in most cases, the new event will not constitute a threat. For instance, a noise could be a stressor from a situation in which a person ended up being assaulted. The same noise, or something similar, could occur in other situations which are harmless. Unless that stressor is reinforced (results in danger overtime), your brain will adapt to the stimulus and gradually reduce the stressful response. This process is called ‘extinction’ (Pavlov’s theory).

If extinction fails to take place, the individual will continue to react (stressfully) to the original stimulus, or similar ones. This is the case for PTSD sufferers. Because the human body is not prepared to maintain stressful status continually, side effects will appear. These effects are both physiological (Coronary Heart Disease, ageing acceleration, etc) and psychological (fear, avoidance, etc).

This explains the occurrence of PTSD in war veterans (individuals who were exposed to stress over a long period of time) and accident survivors (individuals who were exposed to a highly stressful and traumatic situation).Combating Trauma: Current Treatments

The effects of trauma may vary greatly among people. The extent, frequency and intensity of each event are presented according to each person’s mind frame and previous experiences – and because traumatic events are cumulative over life, it can be quite difficult to provide a treatment that comprises all problems derived from separate traumas.

Most people adapt to trauma in their lives, and through the extinction process, do not experience much psychological harm derived from past events. However, for patients with PTSD, and other stress-triggered conditions, the situation requires further attention.

Currently, most treatments for PTSD are based in psychotherapy, introspection and conditioning. These treatments attempt to identify the major traumatic events or associations which are predominant in the individual’s life:

Cognitive Behaviour Therapy

CBT is a form of psychotherapy which works in the perspective of the individual towards a memory and traumatic event. By working the way the person perceives that event, therapists believe that the trauma can be coped with. This form of treatment is recommended by the World Health Organisation and it is widely used to combat PTSD symptoms.

Debriefing

A single section-based treatment which occurs shortly after the traumatic event. The debriefing process evolves on the ‘traumatized’ individual’s verbal expression of the event. It is suggested that by ‘letting out’ those memories and feelings, the person is more unlikely develop suppressed emotions, which reduces the effects of trauma. Debriefing is widely used for professionals that deal with traumatic events on a daily basis (e.g. paramedics).

Eye Movement Desensitisation and Reprocessing

This treatment is based in a psychophysiological approach. According to the theory, the overload of emotions derived from traumatic events interferes with the individual’s information processing episode. That interference, in a physiological level, produces ‘flawed’ pathways of memory retrieval, which in turn, results in the non-logical perception of the event. For instance, a victim of rape, albeit aware that the fault was of the perpetrator, continually invokes self-blame for the incident. The process of desensitisation and reprocessing would serve to reprogram those pathways, resulting in the extinction or partial extinction of negative symptoms.Combating Trauma: A New Approach

The issue of trauma has generated several different treatment approaches. While some researchers focus in the psychological processes, such as psychotherapy and conditioning, others are studying the possibility of tackling the problem at a physiological level. This division of focus has caused much discussion in this field, and each individual’s pool of experience complicates the process of targeting the causes of a trauma, and particularly to define the extent of one single event.

A new proposition attempts to provide the solution at a molecular level. Increased research in the field of memory, particularly the formation and storage processes, is instigating scientists to develop this new approach. This time, instead of taking a passive stance towards the development of a trauma, researchers are intending to eliminate the most prominent element of the trauma: the event itself.

The idea is to administer beta-blockers to act in the molecular level of memory formation. Beta-Blockers are commonly used drugs to control blood pressure (hypertension). They block the action of epinephrine (adrenaline) and norepinephrine, which slows the heart rate. This effect seems to dissociate stress with traumatic memories by ‘reducing’ that memory to a regular response level.

This ‘reduction’ would result in a varied pathway to access a particular memory, invoking altered production of substances such as epinephrine and, in the end, a memory which does not cause overstressed responses in an individual suffering from PTSD.

However, this research, along with other similar methods of combating PTSD at a molecular level, is still in its infant stages. It has been suggested that this procedure could affect other memories or memory retrieving processes and scientists have not been able to deny that possibility.

Much discussion is expected for the next few months. According to Richard Glen Boire from the Center for Cognitive Liberty and Ethics (New Scientist – 03/12/2005), these kind of drugs should be available within 5 to 10 years. Further research in the field of memory and general neuropsychiatry should also play a major role in refining and expanding current evaluation of beta-blockers and their effects in the human mind. The “Human Connectome” project – a worldwide project which aims to create a 4-dimensional map of neuronal connections in our brain – is an example of those.Subscribe to our FREE eZine.

“Therapy (in Greek: θεραπεία) or treatment is the attempted remediation of a health problem, usually following a diagnosis.” (WIKIPEDIA)

In the context of mental health, therapy has vastly changed over time. Long before the scientific approach to the treatment of mental health prevailed, attempts to discover the underpinnings of the human mind produced a wide range of therapies and theories. For many centuries, the therapeutic approach to the human mind was mostly based on supernatural and religious beliefs.

This approach began to change when Phillipe Pinel, in 1793, introduced his methods in Paris. Pinel believed that switching from a commonly violent and medicine-based treatment to a strictly non-violent and observational approach could produce a better outcome for patients. At this point, the history of the counselling therapy had begun to be shaped.Therapy in Counselling

The general concept of therapy has its differentiations from the counselling approach to therapy. In counselling, providing therapy does not mean providing a cure to a patient’s illness. Counselling’s general objective is to help improve the client’s quality of life, and in many instances that could mean to simply explore a relationship issue or the perception towards oneself. The varied types of counselling therapies reflect many approaches to solve similar issues – and these approaches can work differently depending on the individual. In order to better understand this concept, we’ve gathered some information about some counselling treatments used nowadays.Cognitive Behaviour Therapy

CBT is an insight-focused therapy that emphasises recognising and changing negative thoughts and maladaptative beliefs. The approach is based on the theoretical rationale that the way people feel and behave is determined by how they perceive and structure their experience. CBT proposes that change comes about by changing the client’s thinking about the situation. Once the client has converted his/her point of view, the problem-perception switches to a clearer context. Some basic concepts within the CBT schools of thought include:

Arbitrary Inferences: refers to making conclusions without supporting and relevant evidence. This includes “catastrophising”, or thinking of the absolute worst scenario and outcomes for most situations.

Selective Abstraction: consists of forming conclusions based on isolated details of an event (and ignoring other information).

Overgeneralisation: a process of holding extreme beliefs on the basis of a single incident and applying them inappropriately to dissimilar events or settings. Personalisation is a tendency for individuals to relate external events to themselves, even when there is no basis for making this connection.

Labelling or mislabelling: involves portraying one’s identity on the basis of imperfections and mistakes made in the past and allowing them to define one’s true identity.The Gestalt Therapy

An existential/phenomenological approach based on the premise that individuals must be understood in the context of their ongoing relationship with the environment. Gestalt proposes that change comes about by the client being aware of what he/she is experiencing and resolving the situation. Gestalt promotes direct experience and testing in order to adapt to the environment; express different behaviour; and instigate awareness of action and further responsible recognition of the results. Some basic concepts of the Gestalt approach include:

Holism: all nature is seen as unified and as a coherent whole, and the whole is different from the sum of its parts.

Field Theory: the organism must be seen in its environment, or in its context, a part of the constantly changing field.

The Field-Formation Process: it describes how the individual organises the environment from moment to moment. The figure-formation process tracks how some aspect of the environmental field emerges from the background and becomes the focal point of the individual’s attention and interest.

Organismic Self-Regulation: The figure-formation process is intertwined with the principle of ‘Organismic self-regulation’, a process by which equilibrium is ‘disturbed’ by the emergence of a need, a sensation, or an interest. Gestalt therapists direct the client’s awareness to the figures that emerge from the background during a therapy session and use the figure-formation process as a guide for the focus of the therapeutic work.Person-Centred Therapy

Person-Centred Therapy is “an approach to helping individuals and groups in conflict. A clearly stated theory (developed by psychologist Carl R. Rogers), accompanied by the introduction of verbatim transcriptions of psychotherapy, stimulated a vast amount of research on a revolutionary hypothesis: that a self-directed growth process would follow the provision and reception of a particular kind of relationship characterised by genuineness, non-judgemental caring, and empathy.” (Corsini 1995).

In Person-Centred therapy, the focus is on the client. The objective is to achieve progress by self-directed growth, emphasizing on the ‘here-and-now’ of the individual’s life. This emphasis on the present replaces the diagnostic perspective in counselling. Here, individuals are not products of their past experiences – instead, they are able to determine what is right for them (self-diagnosis and remediation). The person-centred approach is intrinsic to most therapies as it aims to establish an affective relationship between client and counsellor.Solution-Focused Therapy

This therapeutic focus is on exploring the client’s perspective towards a problem. The client is assisted to develop a different perspective towards the future, and through that perspective, work on their current situation. The goal-driven process is similar to coaching – the counsellor’s role is to build initial rapport and then use questioning techniques to direct the process of therapy (in order to enhance the client’s understanding of his/her strengths and successes in already overcoming his/her problems). The solution-focused approach can be defined in five different stages: describing the problem, developing well-formed goals, exploring for exceptions, end-of-session feedback, and evaluating client progress.Subscribe to our FREE eZine.

Teen suicides are on the rise and they are related to myriad reasons. Depression is the most common cause that leads many healthy teenagers taking to anti-depressants and attempting suicides at the prime of their lives. Either they suffer from some mental and severe personality disorder and take to drugs or alcohol and kill themselves knowingly or while driving too fast while living life in the fast lane. It is not easy to tackle depression related problems of teens and all parents know about the arduous task of parenting them. Even though a few years back the FDA made it mandatory to print warnings on the labels of anti-depressants, the suicide rate hasn’t gone down. But is seen that suicide rates are down in countries where the drug Prozac is used with cognitive behavior therapy. It has managed to improve the skills of coping remarkably. As CBT aims at the thinking process and the mapping of the thought process to reorient it to more positive domains, the drug taking teenager prone to suicidal tendencies can see hope. In the US, research on suicidal teenagers revealed that the combination of the drug Prozac and CBT was the best cure available. It enhanced the skills of coping among teenagers. The worst case scenario during depression is to leave it as it is and not do anything about it. Dr. John March, professor at Duke University, the leader of the study conducted a few years ago maintained that the combination treatment to battle teenage suicide was the best possible available. He felt it was the most effective way to tackle those teenagers with heightened levels of suicidal tendencies. If your child is suffering from this tendency, then instead of stopping the depressant right away, it is better to try out CBT with an experienced therapist. The best approach is to watch your child while he or she is under medication and when the therapy has started. Usually for CBT to be successful, it has to be a hands-on treatment where the therapist is in close consultation with the patient. Your child should not be made to feel alone and lonely during the critical stages of the treatment. To be successful, the CBT has to be regular and the therapist knows the regularity and the intensity. Just last year a national review was again conducted for adolescents who are depressed and in the age group of 13 to 17. It gave major focus and attention to the high incidence of suicides in that age group. It was found that the use of CBT was the best cure available and highly effective. Among the youth, the remission rate was far higher at 60% than in any other forms of cure like family therapy or support from other sources. The great benefit of the CBT is to reorient from the negative angle to the positive. symptoms social anxiety can be prevented. Learn more about facts on buddhism.Learn more on Mindfulness meditation for perfect happiness