Q. Aren't most anxiety disorders as well as depression caused by biochemical changes in the brain?

A. We know that biochemical changes in the brain accompany mood changes; however, no one has ever proven whether those changes are the cause -- or the result -- of what and how we think and feel. Studies have shown that changing how we think and what we tell ourselves can also create biochemical changes in the brain.

Q. Is treatment covered by health insurance and Medicare?

A. Today, mental health benefits are provided by most insurance companies and by Medicare. There is, however, a great variance in benefits related to sessions covered and co-payments required depending on the individual insurance company and plan. Always read your policy and clarify benefits with your insurance company and, where applicable, with its managed care company as well.

Q. If my parent has anxiety attacks, will I get them too?

A. This gets back to the old nature/nurture issue. We know that anxiety and depression appear to "run in families". Some researchers believe we are genetically predisposed and others have determined that our perceptions, behaviors, and emotional responses are conditioned or learned. The bottom line is that preventive care is effective in emotional as well as physical well-being. If you have a parent who had a heart attack, you are not predestined to have a heart attack. You may be at greater risk; however, changes in behaviors and stress management can prevent both physical and emotional damage.

Q. What can I do to help myself during an anxiety attack?

A. Learn and practice diaphragmatic (deep) breathing when you are not under stress or extremely anxious, so that you are able to use it effectively when needed during an attack. This practice will also help you become more aware of when you begin to feel "edgy" or your breathing becomes very shallow. These are indicators that your anxiety level is going up and you are at increasing risk of having an attack. It has been reported that sometimes breathing briefly into a paper bag helps to regulate one's breathing. Once you stop hyperventilating (short, shallow breathing), your anxiety level will begin to drop.

Q. How will I know if I am having an anxiety attack or some other illness onset?

A. If the anxiety attack begins to abate (lessen) with use of breath management as described above, it is probably an anxiety or panic attack. However, it is always prudent to check out changes in your physical or emotional well-being with your physician.

Q. How do I explain these attacks to my friends, spouse, boss, so people won't think I am going crazy? Should I try to conceal these attacks, or be open about them?

A. This is a difficult question to answer in a public format, because each person's situation may be different. Explaining your emotional discomfort to others who have not experienced them may not lead to increased or appropriate understanding on their parts. On the other hand, concealing such information frequently leads to self-destructive feelings and perceptions; e.g. shame, depression, etc. Please refer to the section on Resources for publications which might be of assistance to you or consult a mental health professional for help in working through your particular situation

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