Cognitive-Behavioural Therapy

Copyright (c) 2007 Mary Ann Copson

If you have ever had a panic attack, you don’t want another one. The “fight-or flight” response in your body is involuntarily turned on and your nervous system signals your adrenal glands to start pumping out stress hormones to get you ready to either run away or turn and fight.

Your muscles tense, your heartbeat speeds up, and your breathing becomes more rapid. You might feel like you are smothering, claustrophobic or you may experience an urgency to get away. On top of that, you may get hot flashes, sweating, and/or chills and trembling, plus numbness, tingling sensations, dizziness, and nausea.

You become overwhelmed by an extreme sense of fear and impending disaster and you lose your ability to think calmly and clearly while experiencing a distorted sense of time and a feeling of unreality.

In the face of a physical threat, accident, or natural disaster, this type of response is normal and can be life-saving. But panic attacks that occur unexpectedly in the presence of normal events can be debilitating. They may happen with no forewarning, at any time of the day or night, and last several seconds or more than half an hour.

The triggers for panic attacks are unpredictable. Most panic attacks are set off by some minor or major stressor. But panic attacks can also be triggered by changes in emotions, or as a response to certain drugs, foods, allergies (including hidden food allergies), hypoglycemia, and illnesses.

A panic attack is an example of an acute anxiety disorder and can affect teens to middle-agers and beyond. Women are reported to experience panic attacks twice as often as men but some believe that is only because men are more reticent to report panic attacks.

Recent studies point to a complex set of causes and panic attacks are regarded as a treatable psychobiological condition (i.e. having both psychological and biological causes). Successful resolution of panic attacks requires an integrated, multi-modality approach.

Even though panic attacks are not a simple condition and there are no simple answers for their successful resolution, herbal therapy can be useful as part of an integrated, multi-modality approach.

When you experience anxiety, your body releases a set of neurotransmitters called catecholamines, which stimulate your central nervous system and activate your sympathetic nervous system. Sometimes your sympathetic nervous system (the high alert part of your nervous system) can get stuck in the ?on? mode leaving you in an ongoing state of anxiety – a fertile ground for panic attacks.

A class of herbs called nervines helps to turn off the sympathetic nervous system by gently facilitating the functioning of the parasympathetic nervous system ? the part of the nervous system that prompts relaxation – helping us to wind down and come off ?high alert?.

It is a good idea to experiment with different anti-anxiety herbs before you are in a crisis or panic situation. Try out several herbs in varying doses. Start with a low dose and increase if needed so that you will know how the herb affects you and how to use it when you need it.

Some effective herbal nervines to consider using:

Oatstraw (Avena sativa) ? the green milky tops of oatstraw provide a wonderful soothing, nourishing and gentle herb for frayed and stressed nervous systems. Oatstraw has a restorative effect on an exhausted nervous system reliably strengthening the whole nervous system after prolong stress. Oatstraw has both an immediate effect (useful when experiencing extreme nervousness and anxiety) and a more long-term restorative effect. Oatstraw is well tolerated by even highly sensitive people and is used for nervous debility, stress, weak nerve and energy force, anxiety, depression, exhaustion, and general fatigue.

German Chamomile (Matricaria chamomilla/ Matricaria recutita) ? an all time favorite ?because it works. Chamomile tones the nervous system, relaxes your muscles and calms nervous digestion. It has mild sedating properties and is not as strong an herbal sedative as valerian or passionflower. However, chamomile is a great option for anxiety in children or teens and for anxiety associated with mild sleep problems. If you are allergic to ragweed, asters, or chrysanthemums you are better off choosing another anti-anxiety herb.

Lemon Balm (Melissa officinalis) ?has mild sedative properties and is useful in conditions of nervous agitation with sleep problems and digestive complaints. Lemon balm is especially useful for over-anxiety that causes digestive problems such as nausea, bloating, and colic like pains. Traditionally lemon balm was used to lift the spirits and encourage longevity. Lemon balm is a relaxing tonic for anxiety, restlessness, irritability, and mild depression and its actions will quiet the racing heart that often accompanies anxiety. It has mild anti-thyroid effects and is best avoided by people with hypothyroid problems.

Skullcap (Scutellaria laterifolia) ?tonifies and relaxes the nervous system and is useful for anxiety of all types especially anxiety and irritability that is hormonally based such as premenstrual syndrome. It is a sedative nervine and has mild anti-spasmodic and anti-hypertensive effects. Skullcap is a great herb to use when your anxiety is accompanied by a runaway mind that is stuck on worry. It is tolerated well by most people and has few side effects.

Valerian (Valeriana officinalis) ? one of the most well known anti-anxiety herbs, valerian is a potent herb whose active ingredients, valepotriates, bind to benzodiazepine receptors in the brain (similarly to the drug Valium). The use of valerian does not, however, result in dependence or the development of tolerance but instead tones the nervous system.

Valerian can be used to improve the sleep quality and relax both the skeletal and smooth muscles. Valerian should not be used for those with chronic exhaustion, adrenal fatigue, thyroid disorders, and depression as it may increase anxiety, worsen present symptoms, and/or result in excessive restlessness in these conditions.

Passionflower (Passiflora incarnata) ? a strong calming, anti-spasmodic herb that is good for severe daytime anxiety. Passionflower is also a good choice for middle of the night waking terrors, nightmares, and the onset of sudden anxiety feelings. It acts as a central nervous system depressant giving a calming, relaxing and anti-anxiety effect and is specific for anxiety related to insomnia, muscle tension, restlessness, and nervousness due to worry, overwork, hysteria, or excessive excitement. If you are taking an MAO inhibitor, you should avoid taking passionflower except under supervision.

Stress Relief Tea

Here is a simple herbal tea mixture that I have found effective in my private practice working with women having mood and energy problems.

Mix together equal parts of the following dry herbs:

?Oatstraw

?Lemon Balm

?Skullcap

?Nettles

?Orange

?Chamomile

Use 1-2 teaspoons of the mixture and steep covered in 8 oz. of boiling water for 5-10 minutes.

The use of herbal nervines as part of an integrative program can help restore a sense of calm and well being, soothe distress, stabilize a confused and overwhelmed energy system, and foster clear thinking.

If you are taking anti-anxiety and/or anti-depressant medications or other medications, have a diagnosed condition or illness, are pregnant, breastfeeding, elderly or very young it is important to consult a knowledgeable health care practitioner before using herbs. Consult a licensed physician for diagnosis and treatment of any medical conditions.

Unfortunately, many of us feel as if we are on the verge of burnout. We feel as if we have to worry about our children, our jobs, and our relationships.At times, we may feel as if we are spinning out of control.
It is as if we are engaging in a high wire act without a net. We become frustrated and angry with ourselves because we don’t think we’re achieving our potential. We can literally become lost in a sea of worry.
At one time, seeking therapy for such feelings of anxiety would have been considered socially unacceptable. A few decades ago, many people considered therapy to be an indulgence.
Mental health counseling had an incredible stigma attached to it. However, today we see celebrities including Brooke Shields, Anne Heche, Marie Osmond, and Jane Pauley who speak openly about seeking counseling for their problems.Cognitive Behavior Therapy is no longer considered the domain of the crazy and the weak.
Therapy can come in a variety of forms. It can involve face-to-face counseling, self-help books, CDs, and online forums. It has been said that there are as many as 100 therapy programs on the market today.
These programs share some common traits. First, they assess how the individual is thinking and identify any disruptions in thought patterns. It is important to get these thoughts out into the open in order to deal with them effectively.
Second, the programs attempt to figure out an individual’s basic beliefs and whether these beliefs are founded on reliable principles. Say, for instance, you become anxious about flying.
Through talk therapy, it is determined that this fear can be traced back to your concerns about your grandmother, who once had an unpleasant flying experience en route to Oklahoma.You might have been worried about your grandmother’s safety and that, in turn, has led to an irrational fear of flying.
The next step is to gather evidence in order to combat negative thinking. For instance, you might look for a statistic indicating how many crashes a given airline has during a year.
When you discover how infrequently accidents occur, your belief that flying is dangerous may be thrown out the window. The one sure-fire way to fight negative thinking is to counteract it with reliable facts.
Another technique you can use to combat anxiety is to develop coping mechanisms. In other words, in order to not let your worry get the best of you, you might try prayer and meditation, exercise, dancing, reading a good book, or soaking in a hot tub.
You should keep a list of relaxation techniques handy so that you can turn to them any time you are feeling particularly stressed out.You will have to get into the habit of relaxation. This can be quite difficult, especially for those with high-stress jobs. You may even consider taking a class in relaxation techniques. Once you utilize these techniques, you are likely to find yourself better able to concentrate better able to manage your feelings and better able to cope.
Literally millions of people have been assisted through cognitive behavioral therapy. While herbal remedies and prescription medications can alleviate symptoms, they do not address the root causes of anxiety. Until we begin to think positively, we cannot hope to attack the crux of our anxious feelings.
How do you find the therapist that’s right for you? To begin with, consult some of your trusted friends. Chances are someone in their families has been to a counselor within the past six months.
You’ll want someone who is easy to talk to, with whom you can share your innermost thoughts and feelings. If you try a therapist and you feel uncomfortable, by all means switch to someone else.Sometimes, finding the right counselor is a matter of trial and error.
Going through therapy can be a tough experience. You may have to delve into areas that you find to be uncomfortable. But it can be highly rewarding in the end.
You may find that you gain greater insight into your thought patterns, that you are better able to communicate effectively, and that you are feeling much less anxious. There is no reason to apologize for undergoing therapy. Seeking help is actually a sign of strength.