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“The prospect of a long day at the beach makes me panic. There is no harder work I can think of than taking myself off to somewhere pleasant, where I am forced to stay for hours and ‘have fun’.”

— Phillip Lopate

A common argument in favor of medication is that, like any other illness, there’s no shame in taking medication for anxiety. It’s true that medications, especially SSRIs like Prozac, Zoloft, and Lexapro, adjust the brain chemistry in a way that reduces anxiety. Whether this “chemical imbalance” is naturally occuring or the result of our bad habits is a common source of contention, but we won’t go into that in this article. Rather, we will focus on a particular attitude that’s seen among the anxious. That attitude is best defined as “weakness.”

Disregarding medication because one doesn’t want to be “weak” is no different from any other fear. In this case, the fear is that we’re inherently unable to cope with life and that we need medication to help us get by. How many times have we heard others say, “I don’t want to be weak. I don’t want to take medications forever. I can do this on my own.” If you’ve made any progress in your recovery then you already know that what you want is completely irrelevant. The only thing that matters is what is. As with all fears, this fear of weakness is something that must be confronted. If you support this attitude, you’re likely supporting it with the same negative thought patterns that create your fears in the first place; this, in turn, only contributes to your anxiety.

Your ego is your greatest obstacle. Your ego tells you to be strong. Your ego tells you that you need not resort to medication. Your ego tells you that you’ll never recover. Your ego tells you that you need to do this, or that, or the other thing. In short, your ego is a non-stop source of worthless jabber. The sooner you stop listening to these irrational ramblings the sooner you’ll be able to see reality. The truth of what you’re dealing with is right in front of your face, but your ego wants to protect you from that truth.

Think of it this way: if your ego is telling you to be strong, that’s because you feel weak; otherwise, you wouldn’t need to feel strong. You’d know you were strong. Your ego is very adept at lying to you. The best solution to this is to learn to distance yourself from your ego’s incessant chatter. Question it at every opportunity. For example, if you catch yourself thinking, “I don’t want to take medications, I need to be strong,” then look at this closely. The only reason you’re telling yourself this is because you know you’re weak and you’re denying this. Instead, acknowledge that you’re suffering and that you need help. Yes, you may be weak right now, but strength is something that can be built and the first step in building strength is in embracing yourself, weakness and all.

If you allow your pride to get in the way of your recovery, you’re playing right into the hands of your “anxiety factory.” Forget pride. There’s no place for it here. You’re in the business of recovering from chronic anxiety and this requires a delicate, compassionate view toward yourself. You cannot be compassionate so long as you continuously reinforce your fears with nonsense about “being strong” or doing this “on my own.” These types of thoughts are the antithesis to compassion. They are, in essence, you beating up on yourself.

There is no shame in taking medications. When someone breaks a leg, they need a crutch to keep the weight off while their body does the difficult work of healing. The same goes for your mind and your emotions. When you’re suffering from chronic anxiety, there is absolutely no shame in using medications as a crutch while you’re in the process of recovery. We wouldn’t berate someone with a broken leg for using a crutch. There’s no weakness in it. The leg can’t heal without the crutch. Just the same, your mind can’t heal without a crutch. That doesn’t necessarily mean that you need medications, but one crutch is as good as another.

However, if you use medications as a way to avoid acknowledging your fears, then you’re again doing yourself a disservice. The trick is in finding a balance. We should never use medications (or alcohol, drugs, religion, or anything else) as a shield to protect us from what we fear. This behavior, in turn, forces the fear to dive below the surface where it will do more damage, only to surface at a later time of weakness. Rather, we use them as a way to help us develop the proper attitude, the proper perspective, and the proper coping mechanisms to deal with our fears. It’s incredibly difficult to do this while one is in the midst of constant panic attacks or chronic anxiety. You need a crutch to take the weight off while you’re in the process of recovery. If you use no crutch, you will make little progress.

Even if you end up taking medication for the rest of your life, so be it. Sometimes the leg just won’t heal and we may need a crutch for life. So long as you’re always focused on recovery — in the sense that you recognize that recovery requires that we work and not become complacent or lazy — then you’re doing your part and there’s no shame in it. Similarly, if you continually tell yourself that it’s okay to take medications because you’re “broken” then you’re again falling into the traps of egoism. You’re not broken, your ego just tells you this to keep you from feeling the sting of the truth that you’re not as strong you think you are and that you need help. It’s okay to admit that we need help. Be compassionate with yourself.

In summary, if your ego is getting in your way, push it aside. Free yourself from the bonds of pride. Medications are a viable treatment and they work surprisingly well for many people. There’s no shame in using crutches to give the mind and body time to heal. So feel free to explore whatever options are available to you.

I’m 48 hours in front of a beautifully planned trip. On Monday morning I fly from my home in Florida to New York City (with a stop in Atlanta just for good measure). After five fabulous days in the Big Apple it’s off to London, England for another few days. There are all kinds of cultural delights in store: opera, Broadway, the West End, sightseeing and shopping. What could be better?

Would cowering in the corner of my bedroom really be better? Would being glued to my computer answering emails and posting on anxiety websites really be a higher quality life? Would staying tethered to car, house and familiar streets really be the best participation in an abundant world?

For someone who values her intellect these should be easy questions. However, since I’ve got a nice, healthy dose of Panic and Anxiety Disorder, these questions loom in my mind like real, serious discussion points.

Somewhere in my brain there is a single thought – posing as a rational idea– that says I’d be better off not to go. It is as if that thought-cell has some secret information and is trying to warn the rest of the cells in my body to avoid inevitable and imminent danger.

This is just not true!

I know that once I’m in the flow of the experience I’ll be okay. I will realize that I’m fine, and that I’m actually enjoying myself. I also know that the inexorable march of time will have this trip behind me before I can really experience it. (In my late 40’s I’m seeing the reality of this time-march and its rapidly increasing speed!)

However, those are future things - right now I’m simply in the anticipatory stage. And this, for me, is the most dangerous and most painful part of my life with Panic and Anxiety. It is never the crisis itself, or even the experience or event.

No, it is the lead-up, the anticipation. The underlying, gnawing “knowledge” that it is coming!

Like some B-movie out for Halloween this fabulous trip gets to dress up like an ancient mummy and lurch its way into my presence.

So, I’m going to practice my breathing, do some more laundry and maybe go to a REAL movie today.

So far, the actual sweaty, shaky panic is just an idea.

I’d like to keep it that way.

Here are three very powerful and very easy things I try to do on a regular basis to reduce stress and control my anxiety. These have worked for me and I know that these methods have even been scientifically proven - they reduce blood pressure, reduce stress hormones and increase the release of other chemicals in the body that create a feeling of wellness. I’ll write more about these scientific measures at a later date, though.

For now I just want to introduce you to three of my favorite methods for dealing with stress, anxiety and life, in general. They are all completely free and incredibly easy to learn (because you know them already). The key to make these methods work for you is practice. Like with everything else, practice makes perfect.

1. Belly Breathing - A few deep breaths can instantly relieve stress. Take a slow, deep breath and try to imagine that you are inflating a balloon in your stomach. When “the balloon is full” hold your breath for approximately 4 seconds and then release your breath slowly. Repeat 10 times. Some people (even scholars) think this is the quickest, most efficient way to relax. It can even help with high blood pressure. Daily practice can reduce overall stress and anxiety. Try to begin and end each day by doing this.
2. Smile - A smile is a very powerful thing - even when it is forced. The brain somehow tries to authenticate a forced smile so within a few seconds it has conjured up happy memories that turn that fake and forced smile into a genuine reflection of feeling good. Just try it out. And smiling is an instant relief for pain, anxiety and stress. Thinking about a loved one, a happy moment, a wonderful time. It brings a smile and makes it impossible to be bothered by stress.
3. Slowing down - It is really important to learn how to slow down. Take the time to enjoy each moment. To focus on what you are doing right now. Look at something - a flower or running water, for instance - and focus on it completely. Direct all your attention towards it. Listen to it. Smell it. Feel it. Let your mind wander. Accept the world - at that moment - for what it is, with all its pain and all its pleasure. Embrace the moment and just feel calm. Don’t think about what you’ll have to do next or what is waiting for you. Just think about your point of focus. Try to notice the taste of your food, the next time you eat. Really focus on the taste and think about the texture, the flavor, the toughness, etc. Slow down. Relax. Enjoy this moment, for it too will pass.

A recent study has found that anxiety, depression, and memory-problems are not a significant reason to treat subclinical thyroid dysfunction in the elderly (”subclinical” meaning exactly what it sounds like: mild). You can find the results of the study here.

I doubt this will apply to most individuals living with chronic anxiety considering that the vast majority of anxiety sufferers are under the age of 65 (the elderly threshold for this study), but if I’m not mistaken, studies like this usually have implications that extend beyond the reach of the study. We’ll see if anything more comes of it.

“Worry is a thin stream of fear trickling through the mind. If encouraged, it cuts a channel into which all other thoughts are drained.” — Arthur Somers Roche

I just have to say that I’m really becoming aware of how closely linked conflict and panic are in my life.

Conflict of the slightest type - someone is mad, not even at me - can cause me to have heart palpitations, shallow breathing, and a fear that something dire is going to happen.

Usually nothing happens. I don’t live in a terribly chaotic style, nor am I in a war zone, a flood plain or near the San Andreas Fault. But when conflict is present I get anxious. My fear causes mental chaos. Conflict seems to suggest that some conflagration of a personal and immense nature will …. what? Destroy my life? Who knows…. I haven’t gotten it all figured out yet.

But I am able to see yet another direct correlation between events in the outer world and my reaction to them. And how this connection can lead me into panic.

More later when I try the “dog fear” suggestions on regular, run-of-the-mill conflict!

MSNBC has posted an interesting article about conquering your fear of dogs. Here’s a snippet:

“To me, big dogs looked like wolves, and little dogs are so jumpy. If I see a big dog, I’m terrified. Little dogs I avoid because they bark and I’m always afraid they’re going to nip,” she says.

Sometimes phobias develop after a bad experience with an animal or simply through lack of exposure to them, but often they originate as a type of panic disorder, for no apparent reason, says David Carbonell, author of “Panic Attacks Workbook.” “This kind of fear can be really powerful.”

I think the most interesting thing about this article is that those of us who deal with chronic anxiety on a regular basis can really relate to the symptoms and responses that are described in this article. Yet, for me, a fear of dogs seems completely irrational. I love dogs more than most humans. In fact, I honestly don’t know if I could’ve made it this far in life without my canine companions. My dogs have helped me through rough patches, and not by being soothing or caring, but by reminding me that they had no idea what was going on and they didn’t really care so long as I continued to feed them and hang out. I think the genuine simplicity of dogs is unparalleled and we could learn a lot from it.

But I’m getting off-topic.

As I was saying, one individual’s fear is another’s love. You may fear dogs but I want to approach even the most ferocious looking animals. So the core problem here isn’t the “trigger.” You’re actually not afraid of dogs per se, you’re actually afraid of your perception of dogs. Perhaps misperception is a more accurate word. When you see a dog, your mind generates thoughts, ideas, and images, and it’s this automatic response that tells the brain “beware!”

Anyway, my point is this: always keep in mind that your fear of dogs or cats or clowns or heart attacks is not actually caused by the trigger itself, but rather by your reaction to it. By changing your reaction, you can significantly alter your perception of the feared object/event.

Check out the article. It’s not too shabby.

It’s not quite as dramatic as the full-blown panic attack that sends me to the ER gasping for my last breaths, certain that my heart has attacked and killed me, but isolation seems to be a key ingredient of my panic and anxiety disorders.

Sometimes I find myself either mad at the world, or vicitimized by the world, alone, misunderstood, and baffled by the experience. Most of the time I view myself as pretty positive and pleasant, a person who tries hard to get along and “play nice,” and as fairly intelligent. So it is with surprise that I ask myself how did I end up all alone at the far end of some opinion, isolated from my fellows and nursing hurt feelings?

I think it has to do with anxiety, and it is one of the more subtle features of my disease. Over many years I have learned that anxiety can spread in an almost invisible mist over my whole psyche - and, indeed, through an entire crowd of strangers. It masquerades as common sense, a well-thought-out-opinion, a core-belief or even as a sum-of-my-experience. This giant boulder of anxiety builds itself with tiny, imperceptible bricks of “fact” - this is right, that is wrong, he is mean, she is hurtful, this pain is serious, that behavior is dangerous. I may convince myself that I don’t swallow some idea whole, but over time I may swallow enough little pieces of things to stuff myself on an anxiety-producing belief. Then,
I act on these beliefs and avoid certain activities and people. If I collect enough of these beliefs, and avoid enough people and activities I can find myself alone, and boxed in to a very tiny mental space. All in the name of self preservation.

For instance, flying is a good example. If I read enough news articles, books and stories, or watch enough TV and film versions of plane disasters, I can collect images and beliefs that flying in airplanes is dangerous - and even stupid. I can avoid traveling, going places I love, accompanying people I love, and attending functions I love. I can convince myself that I’m safer if I just stay home. Over time, I realize I have missed out on weddings, vacations, musical and artistic performances; that I have missed out on the opportunity to live life at its most abundant. Yes, I’ve been safe, but I’m now also alone, bored, resentful and misunderstood. I get sad. I get depressed. I am anxious. I think I’ll have a panic attack.

This goes with people as well. I can collect hurt feelings like other people collect pennies in a jar. And then one day I’m full of hurt feelings and so I avoid all those people, that situation. I’m alone. I’m sad. I’m bored. I’m resentful. I get anxious. What is wrong with me? Is that a pain in my chest? I think I’ll have a panic attack.

Of course I don’t consciously choose this line of thinking - nor do I consciously choose to have a panic attack. But if I allow myself to go down these many (sometimes inviting) roads of judgement, avoidance and isolation, I can find myself back to the very familiar place of a full-blown panic attack. Part of, maybe a HUGE part of, my recovery is to pursue self-awareness, in order to recognize the subtle clues that I may be putting myself in place to get slammed by the disease. I’m coming to believe that knowing and avoiding this is my responsibility.

But these warning signs are quiet and small. They are good at disguising themselves in “normal” clothes. Maybe 95% of all people would say that this person is a jerk, or that flying is dangerous. Maybe they’re right. However, I need to be careful of this kind of thinking. Like caffeine, it may be fine in small doses and it doesn’t necessarily CAUSE a panic disorder. But it is the kind of anxiety that, for me, can build into a full blown attack.

And I need to remember this about myself. It is up to me to choose something else.

Jonah’s post got me thinking - I read the title and thought one thing, read the post and realized it was about another thing. That happens alot with me and anxiety and panic. I think the pain or symptom is one thing. But really it’s all about something else.

When I first saw his title I thought of “Anxiety as stained glass” as a metaphor for equating panic and anxiety with multi-colored windows - that kind of stained glass. Immediately my mind associated with the various colors, and how different a stained glass window is from regular, clear glass windows. How the sun is still the sun outside, but the colored glass changes my perception of light. And how the beauty of the glass shapes requires a light source. It was a very comforting metaphor.

Then, I read the post, and even though it was a very different kind of stained glass, I resonated with that too. There is a sense I get sometimes that life is coming at me with a problem already inherent in the delivery.

And actually both of these perceptions are true for me - anxiety and panic fit into my life in both of these ways. It is not either/or. Life is becoming more both/and.

I guess the cool thing about this insight for me is that I am learning, in all areas of my life, that there is more than one way to look at a thing. More than one way to hear a thing. More than one way to FEEL a thing. And each different way helps me see, hear and feel with a little more wholeness.

I don’t have to view my anxiety as a totally terrible affliction. It brings some altered perceptions into my life that are actually creative and beautiful. And in dealing with it, I become more and more aware of how much it all depends on my own perception. Life and pain and fear and death is not so much an “outer” phenomenon. It is more of an inside job.

I’m not talking so much about turning all the bad things into good things, making lemonade out of lemons. I am thinking more that embracing the ’stained glass’ of Jonah’s post helps me also see the beauty of the ’stained glass’ of my imagination. The contrast holds for me a way out of my own conviction that I’m going to die immediately. It teaches me to be still, and let the feeling, the symptom or the thought express itself and then transform - because all things change.

I don’t have to hold on to just my one idea about anything - even a group of words like ’stained glass.’ I can embrace many ways. And in doing that, maybe I’ll find the middle way.

Most of us come to anxiety from the same road. The story usually goes something along the lines of, “Everything was fine until…” Anxiety disorders usually appear to pop up out of nowhere, as if one day we were “normal,” and the following day, we were “abnormal.” Others may experience anxiety at a very early age (and it appears that this is becoming more common). Regardless, the anxious often speak in terms of normality, as in, “I want to be normal.” In the practical sense, this means that we want to be able to handle anxiety in the same way that most people do. Unfortunately, many anxiety survivors fail to realize that most people don’t handle anxiety very well at all, even though most people experience less anxiety than we do. They’re just better at denying it, avoiding it, or distracting themselves. In this article, we will examine the simple question: What makes you different from them?

For many anxiety survivors, there are two stages of life: pre-anxiety and post-anxiety. Once we pass into the post-anxiety phase, we tend to romanticize the pre-anxiety stage, as if it were all flowers and hummingbirds. We easily forget that pre-anxiety, we suffered just as much, but in a different way. The transition from pre-anxiety to post-anxiety is usually made when we discover something unsettling about ourselves, our family or friends, or even reality itself.

This “discovery” is often caused by a tragic or painful event that caused severe and inescapable anxiety. It could be a death in the family, a diagnosis of a disease, a change at work or in a relationship (with the associated feelings of insecurity), the birth of a child, or any number of things. Regardless, these events or realizations have three characteristics: 1) The feeling that you are more vulnerable than others and, therefore, weaker; 2) The feeling that your well-being and your life are out of your control; and 3) The belief that something must be done to prevent or avoid negative change.

This event or realization was like a pressure cooker. It slowly cranked up the heat and pressure until you could no longer avoid it, deny it, or distract yourself from it. Even if you think your first panic attack or bout of chronic anxiety happened overnight, it had probably been building up for a while. The primary distinction here is that prior to your first acknowledgement of debilitating anxiety, you were doing a damn good job or avoiding, denying, or distracting yourself from it. Once you were no longer able to keep up the fight, your defenses crumbled and the anxiety came rushing in unchalleneged. The results were severe anxiety, panic, and a confrontation with some scary facts of life. These facts, in summary, are as follows: 1) You can and will get sick and, eventually, die; 2) You cannot control everything that happens to you and your family; 3) Loss, impermanence, and change are inherent features of life and are, therefore, unavoidable.

Pre-anxiety, you weren’t anxiety-free, you just ignored it in the same way that most people do. You weren’t as sensitive to it. You didn’t have that sense of critical vulnerability. You thought you were virtually invincible solely because you hadn’t been exposed to — or didn’t acknowledge — death, disease, old age, and loss. You didn’t die, other people died. You didn’t get sick, other people got sick. You didn’t go crazy, other people went crazy. You went through life without truly realizing its fragile nature and how vulnerable you really were.

Once we discover the fragile nature of your own existence, it scares the hell out of us, and now we’re left trying to cope with it. This realization is nothing to scoff at. It only takes a moment to recognize that our entire lives are sometimes built like a house of cards, ready to come crumbling down at any moment. Different people experience this in different ways, but the underlying fear is always the same: uncertainty. Unfortunately for us, uncertainty cannot be avoided. It too is a fact of life. To protect our house of cards from the winds of uncertainty, we often go to great lengths, and we suffer tremendously. We could tape, glue, or bind our house of cards, hoping that it will withstand time and the changes it brings. But nothing will protect it forever. Change is inevitable. The true path to recovery from anxiety is to dismantle the house of cards and rebuild our lives with a solid foundation based upon the knowledge that we are fragile. Instead of fighting natural change (which includes death and illness), we must coexist with it and learn that every moment is precious. Be here now. Right now, as you read this, you are living your life. Your life doesn’t happen tomorrow or when you get a promotion or when you buy your dream home. Your life is in this very moment. Take it as it is and stop wishing for it to be something that it is not. Acknowleding this is easy, but developing a symbiotic relationship with uncertainty is very difficult. It requires an entirely different perception of the world. We cannot continue to think in the same way, act in the same way, or live in the same way. It requires change, acceptance, and insight.

So, the next time you find yourself wishing to be “normal again,” think on this: you were never normal, at least not in the sense you think you were. Yes, you could handle anxiety and get by in life, but you were avoiding reality. You were living in ignorance of reality. As a result of this, you never developed a peaceful relationship with death, disease, old age, and loss. Instead of wishing to be normal again, it is slightly better to wish to be normal for the first time. Wishing, however, will only get us so far. We must work for recovery. The difficulty is in determing what must be done and how to do it, and for each of us the path may be different.

So, intead of going back to the “normal” delusion, the best solution is to learn to cope with reality. It is, in fact, the only solution; no matter how hard you try, you cannot change reality or protect yourself from harm forever. It’s time for you to free yourself from the bonds of chronic fear, and the only way to do this is to tighten your belt and to march straight through it.

I feel my life is like having the finest whiskey in the world served in a dirty glass. How does that make sense (you ask)? Well, if we consider the fact that I really like good whiskey but dislike dirty glasses, then the similarity to how anxiety can stain my love for life becomes clear.

I would still drink the whiskey, though. And I still love life.

“I keep the telephone of my mind open to peace, harmony, health, love and abundance. Then, whenever doubt, anxiety or fear try to call me, they keep getting a busy signal - and soon they’ll forget my number.” — Edith Armstrong

One of the most commonly heard questions on internet anxiety-support forums is some variation of: “Is this Generalized Anxiety or Panic Disorder?” Much discussion revolves around the diagnoses and their symptoms, yet the most important thing you will ever learn about your diagnosis is this: it’s largely irrelevant. Aside from the insurance companies and the FDA’s medication standards, your diagnosis has little bearing on your recovery.

The anxiety disorders fall on a spectrum and there is rarely an individual who shows signs of one without showing signs of another. Many people ultimately diagnosed with Generalized Anxiety Disorder (GAD) typically show signs of Obsessive-Compulsive Disorder (OCD). For example, many GADers experience chronic, nagging fears about their health (mental or physical); this is sometimes referred to as hypochondriasis or “health anxiety.” You may not realize it, but your constant thinking and analyzing of physical or mental symptoms is actually a ritual. So is your constant need for reassurance. If you find new symptoms and then rigorously search for relief from Dr. Google, then you’re performing a ritual. We often know this ritual won’t help much, but we can’t help it, we just have to know about the disease we fear so much.

When people think of OCD, they usually think of the Hollywood version: a quirky guy or gal who repeatedly locks his door or who obsessively avoids stepping on cracks in the sidewalk. While this image is true for a lot of OCD sufferers, the vast majority of individuals with OCD do not perform rituals of this type. In fact, according to Dr. Jonathan Grayson and Dr. Lee Baer (and others), most people with OCD do not use any form of “obvious” ritualizing. This is sometimes referred to as “Pure-O” OCD, meaning “pure obsession.” Mental rituals are also common in people with GAD. Analyzing oneself in circles to the point of exhaustion is quite obviously a ritual in which the individual hopes to find relief by thinking about the problem, as if it could be somehow solved through rigorous analysis. (You’re not going to prevent death or illness by thinking about it, I promise you.)

In his book Freedom from Obsessive Compulsive Disorder: A Personalized Recovery Program for Living with Uncertainty, Dr. Grayson notes that individuals with anxiety disorders are almost always obsessive about their fears and they perform rituals without ever recognizing that they’re doing so. There’s a thin line between “coping technique” and “ritual.” Unfortunately, doctors are reluctant to make an OCD diagnosis unless the rituals are bizarre. According to some doctors, if you search the internet for comfort, that’s GAD; but if you spin in circles, that’s OCD.

One of the largest problems facing people with anxiety disorders is this concern with diagnosis. Far too much emphasis is placed on diagnosis and too little is placed upon the common factors that unify all anxiety disorders. Many people don’t realize that fear is fear, despite whether it’s called “GAD,” “OCD,” or “happy monkeys.” In most cases, the course of treatment is the same for all anxiety disorders (including simple phobias): exposure, deconditioning, medication, therapy, stress reduction, maintaining a healthy lifestyle.

This isn’t to say that there are no differences between the disorders, but these differences are not clear-cut and relate almost exclusively to the source of the fear. For those with GAD or OCD, the source of fear may be anything that causes unrelenting anxiety, such as health worries, or worries about children or family-members. For Social Anxiety Disorder (SAD), the source of fear is limited to social situations or public speaking, although most people with anxiety disorders fear public places and public speaking. For PD, the fear revolves around panic attacks themselves, although almost everyone with an anxiety disorder experiences panic attacks regularly; and people with PD usually develop obsessive fears of panic attacks that leads to all sorts of behaviors. If you think about all of the “althoughs” that we could place into this paragraph, you’d soon realize that the disorders are more alike than they are different. Their common denominator: extreme, unremitting fear.

Another difference that is of a bit more significance is how one deals with the anxiety. A GADer and OCDer will respond similarly with some sort of ritual behavior that alleviates anxiety. For PDers, SADers, and PTSDers, the primary response is usually one of avoidance. But here again, GADers and OCDers also use a lot of avoidance behaviors to cope. Finally, there is one major difference that must be considered. Biology plays an undetermined role in all anxiety disorders, but research has shown that severe OCD may be more “biological” than was previously thought.

I have long wished that anxiety support groups (including internet groups) would stop separating individuals by diagnosis. This segregation by diagnosis is counterproductive and causes confusion. There are a few exceptions to this, as there always are exceptions, but by-and-large, all people living with chronic anxiety can learn from one another despite the source of the fear. And the most under-recognized and under-diagnosed of the anxiety disorders, OCD, is probably the one that we could learn the most from.

So leave the diagnosing to the doctors, the insurance companies, the FDA, and to academia. You should be focusing on recovery. If that means “crossing over” into the foreign territory of another disorder, do it. You might find that territory to be more familiar than you expected.

I tend to get most anxious when I see myself as the last bastion before impending disaster. This is a handy metaphor because it fits into hundreds of actual situations.
For instance, is my child doing well in school? If not, then it must be up to me to halt that demise and fix the problem (teacher, school, learning disability, whatever!). Is there a pain in my body? If so, then it must be up to my brain alone to come up with the answer (certain death) and derail the disastrous consequence. Sometimes as I drive through my town I offer helpful advice to fellow drivers, notice how the city could be more concise with the wording of this sign or that notice. I often see how a kooky intersection could be designed more efficiently, and I correct the incorrect grammar that has been posted on billboards.

I’m a busy bee.

And it is just this busyness that can signal the onset of a full blown panic attack - because if all these wrongs are dependent on me for getting “righted” then we’re ALL in serious trouble! It can make my heart race just to contemplate this scenario.

Through a spiritual program that I follow I’ve come to believe in a power greater than myself. It’s not so relevant that I articulate and explain the personal ins and outs of this belief system, but what IS relevant is the crucial idea that there IS a higher power, and I’m not it! This seems like a simple phrase, and perhaps to those who don’t suffer from anxiety and panic disorders this is taken for granted.

But for me, it has to be consciously and constantly remembered. I am NOT the world’s safety net. I am not my children’s safety net. I am not even my OWN safety net. I’m just a decent human being, living life to the best of my ability, and I probably have a few talents and ideas to contribute to the world, so maybe I could focus on that, eh? I can let go of monitoring the edge of “the great abyss” to make sure no one falls over, and I can do what it is that I can do.

Like, I can make sure my kids get healthy food, and a good night’s sleep. I encourage them to get organized, and ask for help, but I can leave the rest up to them. They will work it out. If I have a pain in my body I can go to the doctor, or I can chalk it up to one of the side effects of HAVING a body, and go on with my day. Chances are I’m not going to die from three or four life-threatening illnesses today. As for my driving, well, I could probably just pay more attention to my own choices, my own speed, and whether or not I’m using my turn signal. If I’ve got so much time on my hands in the car maybe I can listen to a book on tape.

What this practice of depending on a higher power is teaching me is that I do have a place in this world, I’m just not in charge of it. And not being in charge means I do not have to take on the responsibility for the proper management of every detail. I can do what I can do for myself and those in my tiny circle. And I can trust that the same power that organized planet’s orbits and the creation of a galaxy, can probably put the right person on the right task. Just for today I can go with the flow.

Death is a constant worry for me. It is at the core of my anxiety - that fear of death - and I know now that I have to deal with it. I’ve thought a lot about death over the years (and I really mean A LOT), which is kind of sad, when I think about it, because the time I invest in thinking about death is actually a waste of my… What… Life? Yup.

But still - I’ve thought long and hard. I imagine that a lot of people who read this blog have shared a similar experience. Most of us have probably formulated a number of concepts and ideas about death, the meaning of life and everything (42 anybody?). I’ve wondered about what lies beyond, the why and what for of death. I’ve reached a number of conclusions that all contradict each other, prove nothing and offer no final solution.

But a short while ago something struck me. I saw death not as foe but as friend. So today I believe that death is mans greatest motivator. I know that sounds like a strange thing to say but please bear with me because, in my mind, there is no doubt about the truth of this.

He is whom we race against through life. He is a restless competitor and although some of us are able to luckily cheat death for a while he always catches up eventually. Death breaths down our necks, pushes us on, challenges us to leave something remarkable behind when the race is over.

So death motivates us to try to live better lives, longer lives, even forever. We try to attain immortality through our achievements, our family and our day-to-day actions. We hope to be remembered so we may live on. We hope our blood will be carried by future generations.

And death will give us no clue as to what lies ahead after that great race through life. So we are further motivated to make good decisions. To be good. To act the way we think God wants us to act, in case there is a God and in case there is an afterlife. Better safe than sorry, right?

Although the thought of No Thing after death is, to some extent, quite liberating. If there is No Thing then we are free to look at life from another angle. We are more free in our actions and thought. We are forced to appreciate life more. It becomes more valuable and delicate.

But if, indeed, there is a God then his gift to us is surely the ability to create. Perhaps that is the true meaning of man being created in God’s image? Just think what can be achieved if we all decided o­n something, every single person at the same time - to end all hunger, for instance. It would be done. Tomorrow it would be done. But I digress. Its Saturday. I’m tired. Where was I? Oh, yes! I was focusing o­n death (that’s so out of character for me… NOT).

Death is my personal motivator. I race against it. I need to achieve certain things before I go. I need to see certain places. I need to have more children, to make sure I will be remembered for something. I need to feel that I used life fairly and beautifully. I need to affect and inspire others. I want to make a difference.

Death has done this for me. Maybe I can begin to accept it by looking at what it has given. And acceptance is something a lot of us, people who worry constantly, are finding hard to come by. But accepting death is merely hard while denying it is impossible.

Many texts refer to anxiety (and sometimes depression) as the “illness of our time.” It’s a characterization that appears to be prudent. W.H Auden was a British writer who won the Pulitzer Prize in 1948 for his poem, The Age of Anxiety: A Baroque Eclogue. His work focused on the alienation caused by an increasingly fast-paced and industrialized world. This is where the term “age of anxiety” first entered our lexicon. Unfortunately, this feeling of disconnection and fear has gotten worse since 1948.

The Anxiety Disorders Association of America notes that as many as 40 million Americans suffer from some form of anxiety disorder. The National Institute of Mental Health (NIMH) claims, “Anxiety disorders, as a group, are the most common mental illness in America. More than 19 million American adults are affected by these debilitating illnesses each year.”¹ From the perspective of these two sources, anxiety disorders affect somewhere between 19 and 40 million Americans. With the current United States population clock at 298 million, this means that between 6% and 13% of Americans have an anxiety disorder. As for depression, the NIMH says, “In any given 1-year period, 9.5 percent of the population, or about 18.8 million American adults, suffer from a depressive illness.”² The statistics from other industrialized nations are similar to those of the U.S.

In The Anxiety Book, author Jonathan Davidson, M.D. notes that a recent study “that analyzed pooled data on the severity of anxiety in population samples from the early 1950s to the early 1990s, the lead researcher found that anxiety levels have grown more severe over the past forty years. By the 1980s, otherwise normal children were scoring higher than child psychiatric patients from the 1950s.”³ According to Davidson, more people currently see doctors for anxiety than for colds.

We have to ask ourselves: “What’s going on here?” Why is anxiety becoming an increasing burden among industrialized nations while, at the same time, underdeveloped nations (who often suffer much more) experience anxiety at a much lesser degree? On the surface, it would appear that biology has little to do with it. If anxiety were primarily of biological origin, we would see common statistics world-wide. Yet, even still, biology may play a role in ways we least expect. Diet may be an important factor that is often overlooked, but it seems like a stretch to chalk up increasing anxiety to diet alone.

There are some obvious environmental factors that may help us to understand what’s going on. First and foremost, life in Western countries has become increasingly fast-paced. We typically place a lot of emphasis on speed, efficiency, and the monetary cost of time. In addition, we are spending more time commuting and less time with our families. “Studies show Americans spend more time than ever commuting and for a growing number, getting to work takes more than an hour. In the most recent U.S. Census Bureau study, 2.8 million people have so-called extreme commutes, topping 90 minutes.”⁴ Perhaps our work lives are not the cause of the problem but yet another symptom. The most obvious and most pressing apparent cause of anxiety is a disconnected social structure, something that is virtually unknown in underdeveloped countries. We’re spending much less time with friends, family, and far greater time with electronic media and entertainment. Where we once had a tightly knit family structure to provide emotional support, we now have a loose connection of individuals who just happen to be related. Although there’s no research at this time to support this hypothesis, the correlation seems likely. Yet even this is probably not sufficient enough to explain what’s happening. Anxiety is, at its root, uncertainty. We are becoming less comfortable with uncertainty. We are less willing than ever to accept that some things are simply out of control: illness, old age, and death being the most prominent.

Many Western nations have little or no cultural connection to these natural processes. We don’t see illness, old age, and death in the same way that many people throughout the world see it. We see it in an environment where illness can often be “fixed,” old age can be made to look young again with cosmetic treatments, and death is placed behind closed doors where even corpses are made up to look “alive.” In many cultures, this type of behavior would seem absurd, even neurotic. The more we remove ourselves from these natural processes, the more we become uncomfortable with them. As every psychologist and psychotherapist knows well enough, exposure therapy (whereby the patient is slowly exposed to his or her fears) is perhaps the best treatment for anxiety. Is it possible, then, that anxiety could be prevented with such exposure? If we were to see illness, old age, and death in their natural states on a regular basis, would we develop anxiety at such an enormous rate? It’s difficult to know.

Another important feature of Western societies is the emphasis placed on “achievement” or “success,” and such success is usually defined monetarily. This is obviously enormously stressful. It is not uncommon to find individuals with chronic anxiety who fear severe mental illnesses for the sole purpose that such an illness would label him or her as the ultimate failure. It often isn’t the disease itself that is feared, but the social ramifications of the disease. Worries about work, money, and the social costs of “not making it” can be a terrible burden. This lends itself to a materialistic world-view by which our internal value is determined by the amount of stuff that we own.

A recent study found that Vanuatu, a small undeveloped island in the Pacific, boasted the happiest people on the planet.⁵. Although the study, funded by the New Economics Foundation, was somewhat biased in its calculations due to the inclusion of an environment footprint, the results are still quite shocking. This small agricultural island with a population of 210,000 people are happy even without televisions, BMWs, iPods, and massive homes with all the amenities? Believe it or not, this is something we’ve known for quite some time. “Happiness” indices have been compiled for many years, and the developed countries consistently score quite low. The conclusion that most researchers draw is directly related to social integration. The closer we are with our families, the happier we are. And, consequently, the more we value monetary growth and possessions, the less happy we become.

Given all of this, it’s fairly obvious that the massive increase in anxiety is not due to a single factor but rather to an amalgam of environmental, biological, cultural, and social issues. The following list is a short summary of such issues that should be considered:

• Hypermaterialism: an exaggerated focus on material possessions and monetary wealth.
• Alienation from nature: we’ve become spiritually or emotionally removed from nature.
• Increased pressure to “succeed”: we’re constantly focused on our social status as it relates to our income, our education, and our career.
• Population growth: there’s plenty of room for everyone but, for some reason, we choose to live in highly populated areas where we feel unimportant, unnoticed, or unloved. Research has shown that mental illnesses like anxiety are much less common in rural areas.
• Less job satisfaction: we’re working longer hours, commuting farther, and doing jobs that allow for less creative expression.
• Strained familial ties: as a result of overwork, our social circles get smaller. We’re paying less attention to family and friends and placing pressure on our personal relationships.
• Lack of social importance and integration: most “primitive” societies have specific jobs or tasks set aside for each of the members. From an early age, children are assigned tasks that are essential to the life of the community. In contrast, we tend to work in cubicles under flourescent lighting doing tasks that are disconnected from the welfare of our friends and family.
• The prevalence of “bad news”: we’re obsessed with bad news. Be it disease, famine, or war. We consume hours of continuous news coverage that highlight the worst of humanity. Meanwhile, we rarely see or speak of the wonderful good that is done around the world on a daily basis.
• Technology: it’s wonderful, but it also complicates our lifestyle and reduces face-time with others. Ever use the self-checkout line in the grocery store? Yeah, it’s great for convenience, but it’s yet another symptom of how we value our time over social interaction.
• Taboo of death: we don’t speak about death unless it’s in the context of a tragedy. We shove it behind closed doors and refuse to acknowledge our own mortality. We run through life pretending that we’re going to live forever.
• A failure to appreciate the present moment: I think this speaks for itself. If you’re always putting off happiness as something to be achieved at a later date, when can you be happy? How about right now?
• Increased choice: when the possibilities are endless, we can become dizzy with options.

Chronic anxiety is highly treatable, but we mustn’t remove the cause from the treatment. We mustn’t continue to reduce the symptoms of anxiety without actually removing the underlying causes. We often get so busy running from the symptoms that we completely forget to focus on the potential causes of our anxiety. Symptom-management is critical to recovery, but it is not a long-term solution. To find such a solution, we must look deeper. It is fairly obvious that reducing the incidence of anxiety in Western countries is an uphill battle. Doing so requires questioning long-held cultural and social norms, yet not doing anything will likely lead to even more anxiety and suffering. As Gandhi said, “Be the change you want to see in the world.” It starts with us.

¹National Institutes of Mental Health (NIMH). (2001). “Facts About Anxiety Disorders.”: http://www.nimh.nih.gov/publicat/adfacts.cfm

²NIMH. (2000). “Depression.”: http://www.nimh.nih.gov/publicat/depression.cfm

³Davidson, Jonathan. (2003). The Anxiety Book. Riverhead Books, New York: p.3-4.

⁴Reuters via MSNBC. “Americans commute longer, farther than ever.”: http://www.msnbc.msn.com/id/12409128

⁵BBC. (2006). “Happiness doesn’t cost the Earth.”: http://news.bbc.co.uk/1/hi/sci/tech/5169448.stm

I dance with panic and fear. Not necessarily because I like it, but it’s better than any alternatives I’ve found. At first I didn’t want to dance. I was in denial. I tried to organize it away. Drugs helped. I was, in my mind, a perfectly normal person. Happy, positive, busy. I got along well with life. I didn’t push too hard at life, and life didn’t poke too hard at me. But, panic and fear and anxiety came rushing into my life. Without ever asking permission, or inquiring if I knew how to handle them, they were there.

I began to notice dangers. For instance, what if a person (a person like ME) forgets how to swallow? What then? Or, breathing, how about forgetting to breathe? What would happen? I began to choke on most foods, and couldn’t quite catch my breath. My heart raced alot and I thought maybe this was a heart attack. I remember driving down the street and seeing this big Public Service Billboard listing the five warning signs of Heart Attack - I had them all! I pulled the car over and dialed my HMO. The nurse, using a very condescending tone, told me that if I was having a heart attack I wouldn’t be talking to her on the phone and that I was probably fine. I hoped that when they found me dead they could trace the call to her and make her feel terribly guilty. Over the next year I had three MRIs (to find the brain tumors), two Stress Tests (one after wearing a portable heart monitor for 48 hours), numerous x-rays and too many doctor visits to count.

My family physician is a saint, he is NOT condescending and he has been wonderful in explaining the ins and outs of Panic Disorder and General Anxiety Disorder. He has educated me about stress. He is willing to talk meds and refer me to psychiatrists. He orders tests when I am convinced of imminent death. He still takes my calls. After 18 years he STILL takes my calls, and schedules appointments with me - this man is a saint!!

But my *dance* with panic and fear started about five years in to the disease. I just couldn’t get my mind around the possiblity that I may survive these symptoms. I thought I was really petrified of death. And that it was just around the corner. With three small children, and having just turned 30, I was pretty sure that my Panic and Anxiety arose out of a fear that an untimely death would leave my loved ones alone. I began a Jungian analysis and in doing that I started writing down my dreams. I studied Jung’s approach to healing and imagery. It started to occur to me that perhaps I wasn’t so afraid to die. What I was afraid of was life.

And so began the dance - with panic, with anxiety and with life. I began to risk things like making art, studying mythology, and creative writing. The generalized fears and anxieties, the dangers encroaching on my life made their way into collages, journal and stories. I tore paper and glued it to large canvases, splashed paint around and added the flotsam and jetsam of my life. The creations were huge, colorful and full of movement. I took classes at the University and read books, plays and myths from ancient Greece.

I also took Buspar for a few years, then during one terrible time I suffered from depression and Effexor was a life-saver. I have had an “as needed” script for Xanax that lasts for years, but I always have it filled. I don’t mess around with these symptoms, they’re scary and they can kick my butt.

But I dance with them. There is a rhythm and a beat that I can relate to. Many times I can embrace the symptoms and out of them I can create some dynamic response to life and love and fear and risk and pain. And that is the dance. It is a spiritual dance for me now. I know that I’m alive, that I’m human, that I’m scared a lot of the time, but I’m not alone. I’m dancing.

In comes the feeling, the symptom, the pain and the conviction that I’m about to die. And on the best days we swoop together through my studio, throwing paint, gluing glass, paper, beads, sticks and stones to canvases that express this mood. In that frantic effort to catch my breath or slow my heart I smoosh clay into fantastic shapes and fill it with items that poke, prod, stick and pierce the softness. I write stories about death, grief and terrible loss. I write about healing and crying and unlikely groups of people coming together to solve a problem or withstand a devestation.

I dream, I flow, I get scared. I take care of myself - I eat as well as I can, I exercise, I limit my exposure to triggers. I dance with this disease. And in the process of this dance I am living. With abandon. This is my story, and I’m sticking to it!

I admit it. I am one of those people who feed the animals at the zoo, completely ignoring the horde of “Do NOT feed the animals” signs. I am also one of those people who will try to connect two completely unrelated things together though obscure logic and shady analogies.

So, it shouldn’t come as a surprise, then, that I also “feed the anxiety animal” (see - shady analogy…) even though I know it is a fairly bad idea. Just like trying to getting lions to eat from my hand at the zoo (I just can’t stop myself from referring to the zoo thing because the feeding connection makes me feel so clever).

Every day, almost constantly, I’m feeding anxiety. It is like my brain has some sort of a special process that runs underneath everything else and this process is dedicated to create food for my anxiety. With regular intervals the process interrupts me, during my daily routine, just to let me know that it has found (or created) yet another fantastic deadly disease that could very possibly be tied to that small ache in my chest/arm/leg/head/toe/nose/throat/stomach/behind.

In a single day I’ve been able to convince myself that I am dying from multiple cancers, heart disease, brain tumors and the flu. And, of course, the Law states that as soon as a person becomes aware of having some disease, that person will instantly feel the full force of named disease and die horribly. On the spot. Or, at least, that’s what Hollywood has thought us. But, then again, they only have 90 minutes to cover the entire lifespan of their characters…

But hey! That’s what panic is all about people. As soon as I’ve been able to convince myself that I am currently dying from a particular disease, I feel death approaching - fast. By feeding my anxiety from morning to midnight, I am able to guarantee yet another Panic driven ride towards painful death… Or so I believe… up to a few times a week… And I’m still here… But that’s beside the point (or is it?).

The point I am trying to make (however feebly and in a manner that is completely devoid of logic) is that I (we) somehow have to stop feeding my anxiety. I have to stop selling myself short, as well. My inner dialogue almost always represents me as weak, fragile, sick, unable, etc. I am, thus, totally convinced that I can’t handle trouble, pains, problems and normal life difficulties to the same extent as “normal” people. Even though, through my life, I’ve come to know that this is not the truth. It is the complete opposite of truth. But my mind twists it and then feeds the result to my anxiety.

There are ways to stop feeding the anxiety. Mindfulness is one. Breathing correctly is another. Positive thinking. Slowing down. Learning to say “No”. Meditation and, of course, medication.

I’m trying to use some of these things. Sometimes I’m successful, sometimes I’m not. That is - I suppose - how life goes. I know I’ll never be completely free of anxiety and panic. Sometimes I just can’t help myself - I start feeding my anxiety, unable to control it - but sometimes I can control it. I can starve the anxiety monster. At least for a little while.

Generalized Anxiety Disorder, Panic Attacks, and Stress

• Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness by Jon Kabat-Zinn.

This is perhaps the single best book ever written on how to deal with stress and pain. It offers a section dedicated to anxiety and panic, but the vast majority of the book’s material is life-changing and can be applied to all facets of life. This book can be read a thousand times without fully extracting all of the wisdom contained within it. Highly recommended.

• Calming Your Anxious Mind: How Mindfulness and Compassion Can Free You from Anxiety, Fear, and Panic by Jeffrey Brantley and Jon Kabat-Zinn.

This short but powerful book follows in the footsteps of Full Catastrophe Living to provide a effective approach to conquering anxiety and fear.

• Anxiety, Phobias, & Panic: A Step-by-Step Program for Regaining Control of Your Life by Reneau Z. Peurifoy.

This book is chock full of information on anxiety of all types. The author also includes a well-designed self-recovery program that has helped many people regain control over their lives.

• The Anxiety & Phobia Workbook by Edmund J. Bourne.

The author is the Director of the Anxiety Treatment Center in Santa Rosa California and has years of experience working with anxiety. In The Anxiety & Phobias Workbook Bourne couples a wealth of information along with a workbook-style
approach to recovery. This is a valuable addition to your library.

• Natural Relief for Anxiety: Complementary Strategies for Easing Fear, Panic & Worry by Edmund J. Bourne.

This title provides a wide variety of helpful techniques on coping with anxiety, including breathing, yoga, meditation, and lifestyle changes that promote well-being. Bourne also covers herbal supplements and foods that aid in alleviating anxiety symptoms.

• Beyond Anxiety and Phobia: A Step-by-Step Guide to Lifetime Recovery by Edmund J. Bourne.

Much of anxiety therapy is designed as quick, focused intervention, treating a specific syndrome without looking at the possibility of long-term healing. However, true recovery requires something more: understanding the meaning of anxiety symptoms and going deeper to face their underlying sources in a holistic and life-changing way. Beyond Anxiety and Phobia provides an array of alternative strategies for entering this long-term healing mode; describes alternative therapies such as herbs, yoga, massage, acupuncture, and homeopathy; and addresses the impact of perfectionism and other personality issues.

• The Anxiety Book by Jonathan Davidson and Henry Dreher.

This book covers a wide variety of topics in a well-written and calming tone that is a pleasure to read. Davidson and Dreher bring a lot of information together in a format that addresses that most common concerns of the anxious. This is a great book that deserves your attention.

• Overcoming Anxiety: From Short-Time Fixes to Long-Term Recovery by Reneau Z. Peurifoy.

Through activities and case studies, Peurifoy shows sufferers how to shift their focus from the symptoms of anxiety (pounding heart, feeling of choking, dizziness, fear) to the core problems behind the anxiety (childhood trauma, stress from work, etc.) in order to create longtime freedom from anxiety.

Obsessive Anxiety and OCD

• The Imp of the Mind: Exploring the Silent Epidemic of Obsessive Bad Thoughts by Lee Baer.

This book is the definitive authority on those who experience “bad,” “scary,” or “disturbing” thoughts as a result of obsessions. This is commonly seen in individuals diagnosed with Obsessive-Compulsive Disorder (OCD) although anyone can experience these symptoms of anxiety regardless of diagnosis. This book is small but very powerful. This book is a beacon of hope for the millions of people who suffer from scary obsessions. Dr. Baer provides a vast amount of information and guidance on how to rid yourself of these obsessions once and for all.

• Getting Control by Lee Baer.

This is another great book from Dr. Lee Baer. Although the title is written specifically for those with OCD, anyone who experiences chronic anxiety and obsessive worry will find valuable advice here.

• Freedom from Obsessive Compulsive Disorder: A Personalized Recovery Program for Living with Uncertainty by Jonathan Grayson.

Whether the diagnosis is OCD or not, this book’s great strength lies in its advice for dealing with uncertainty. It is a valuable addition to the body of literature on anxiety.

• Brain Lock: Free Yourself from Obsessive-Compulsive Behavior by Jeffrey M. Schwartz.

In Brain Lock, Jeffrey M. Schwartz presents a simple four-step method for overcoming OCD that is so effective, it’s now used in academic treatment centers throughout the world. Proven by brain-imaging tests to actually alter the brain’s chemistry, this method doesn’t rely on psychopharmaceuticals. Instead, patients use cognitive self-therapy and behavior modification to develop new patterns of response to their obsessions. In essence, they use the mind to fix the brain. Using the real-life stories of actual patients, Brain Lock explains this revolutionary method and provides readers with the inspiration and tools to free themselves from their psychic prisons and regain control of their lives.

Spiritual and Philosophical Approaches to Anxiety and Stress

• When Things Fall Apart: Heart Advice for Difficult Times by Pema Chodron.

Pema Chodron is an American Tibetan Buddhist nun whose advice for living is unparalled. In this book, one of her most popular, Chodron explains how to rid oneself of anxiety and negativity through the cultivation of compassion and inner bravery. This powerful book will permanently change the way you see your problems.

• The Places That Scare You: A Guide to Fearlessness in Difficult Times by Pema Chodron.

This is another great book by Pema Chodron (see above), although this one has a slightly more Buddhist bent to it. I would suggest this one only if you found When Things Fall Apart to be helpful.

• Breath by Breath: The Liberating Practice of Insight Meditation by Larry Rosenberg.

This book outlines the ancient practice of vipassana, or insight meditation, and how it helps us overcome our insecurities, fears, disconnectedness, and all other forms of human suffering. But this book isn’t just about meditation, it also covers a large variety of incredibly potent advice about how to live your life without fear and worry. Highly recommended.

• Mindfulness in Plain English by Bhante Gunaratana.

This is possibly the best book ever written on the nuts-and-bolts of insight meditation. Like other books on meditation, this one also contains gems of advice that apply to every part of your life, whether you’re a meditator or not.

Inspirational Fiction

• Tuesdays with Morrie: An Old Man, a Young Man, and Life’s Greatest Lesson by Mitch Albom

This book is not about anxiety in particular, but Morrie’s wisdom about life and happiness is something that no one should miss out on. This is an inspirational story that will touch your heart and change your life. Pay attention. Morrie’s lessons are subtle but incredibly profound.

We worry.