For example, according to the National Comorbidity Survey, 4 58% of those with lifetime depression were also observed to have at least one anxiety disorder. Their diagnosis and management are complicated by the considerable overlap of symptomatology. 1, 3 Despite the availability of proven treatments, both disorders remain underrecognized and undertreated. 1, 2 In addition, these disorders are associated with significant decreases in patient well-being and social functioning and can cause considerable pain and suffering, not only for affected individuals but for their family and friends as well. Characteristics such as robust efficacy, speed of onset of activity, the potential for drug-drug interactions, dose response, and tolerability are important considerations in optimizing treatment.Īnxiety and depression are significant public health problems, affecting a wide segment of the general population and accounting for multibillion-dollar expenditures directly related to health care and hospitalizations and indirectly related to morbidity and mortality. The specific profiles of individual agents may assist the clinician in individualizing treatment. Of the newer agents, the selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors have been studied quite extensively in these patient populations. These new choices enable our goal of treatment to encompass not only improvement but also sustained complete remission. The newer antidepressants, in particular, are playing an increasingly important role in the treatment of both anxiety disorders alone and comorbid anxiety and depression. Fortunately, many new therapies are available to assist the clinician in managing these patients. Comorbid anxiety and depression is often more resistant to pharmacologic treatment, and patients with coexisting disorders have a poorer medical prognosis than do patients with either disorder alone. In addition, there is significant overlap between anxiety and depression in this patient population. Patients often present with somatic complaints rather than classic psychiatric symptoms. delivering a speech to people you don’t know.Properly diagnosing and treating patients with anxiety, depression, or both is a challenging aspect of practicing medicine in the primary care setting.preparing to speak in front of a work colleague.actually speaking in front of your family.imagining speaking in front of your family.actually making the speech without an audience.imagining yourself delivering the speech without an audience.Once you feel more relaxed thinking about writing the speech, you’ll try facing more challenging situations. Taking small steps towards being able to speak in public might start with thinking about writing a speech. Example: Fear of public speaking exposure therapy Your therapist will use evidence-based techniques to help you gradually face your fears in a safe environment. If you avoid situations that make you anxious you don’t get a chance to face your fear and prove to yourself you can manage it. Exposure therapy for anxietyīehaviour therapy for anxiety relies mainly on a treatment called 'graded exposure'. This helps to reverse the patterns of avoidance and worry that make anxiety worse. It focuses on encouraging activities that are rewarding, pleasant or give a sense of satisfaction. CBT is often combined with behaviour therapy.īehaviour therapy is used in CBT.
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