About Us . Finding help when you are depressed or anxious can be confusing and frustrating. We are a specialty center that is dedicated to the treatment of Depressive and Anxiety disorders for ages 13 and up. Treatments often need to be tailored specifically to a patient’s unique needs to navigate the complexities of these illnesses. Our team will provide patient education, assessment, testing, and will offer you a comprehensive plan of care. It is our goal is to help you achieve your optimal outcome and reconnect to a better quality of life. Why do we call ourselves Salience Health? The word salience describes the network of the human brain that regulates how we think, feel and behave. This is likely the network responsible for the symptoms you are experiencing. The name Salience also describes what we are all about: a relentless commitment to delivering the best in personalized, evidence-based care to put you on the path to improved mental and physical health. If you are ready to move from hopelessness to health, Salience Health is here to help you make that change. Visit our website below, or follow us on Social Media to learn more. www.SalienceHealth.comTable of Contents How to Use This Guide 1 What is Anxiety? 2 The Many Faces of Anxiety 4 The Burden of Anxiety: Functional Impairment 7 Anxiety Over the Lifespan 9 What Causes Anxiety? 13 Diagnosing and Treating Anxiety 17 Can you Recover from Anxiety 27 Where do I start? 30I ntro If you or a loved one is facing anxiety, this guide offers a road map to recovery. We created this guide to better educate you, your family, and your friends about anxiety’s possible causes, impacts, and its available treatment options. The more you understand the illness, the better you will be prepared to work with your provider to determine the best path to your recovery. So, what’s the best way to use this guide? A good place to start is to set aside some quiet time to read through it at your own pace. If you’re having trouble getting started or having trouble concentrating, understand that these are normal obstacles in anxiety, and they are not your fault. It may be helpful to sit down with a friend or family member and read through it together. Take your time. Make notes of any ideas that seem important or any questions you might have. Bring your notes with you when you meet with your care team. If you see the Salience Health Flower symbol next to the text, it indicates a good issue to discuss further with your provider at your next appointment. 1What is Anxiety? Anxiety is a feeling of unease or tension associated with the anticipation of a future event. Anxiety is a normal emotional state which is very necessary for our survival. Whenever one is in a situation that may be threatening or dangerous, we need our brain to be aware, alert, and able to evaluate the level of risk. We also need our brain to signal our body and prepare it to respond to the situation. For example, you are walking your dog at night and hear a horn blast when you step off the curb. Your brain goes on alert in response to the loud noise and associates that noise with the threat of a car on the road. Your heart rate increases, your muscles tense, and your breathing becomes shallower and faster. This allows you to respond quickly to the threat and move out of the path of the oncoming vehicle. This is part of your fight/ flight response. Did You Know: 19% of American Adults have suffered from an anxiety disorder in the last year.What is Anxiety? SNS/PSNS: Fight, Flight, and Freeze Our fear response begins in our brain. When the brain signals distress, the sympathetic nervous system is activated. The sympathetic nervous system signals the body to react. The heart rate goes up, muscles become tense, and breathing becomes faster and shallower as the body prepares to flee or to fight. The adrenal gland releases epinephrine. When an individual is overwhelmed with fear, they may freeze. The parasympathetic nervous system signals the body to relax and lowers blood pressure and heart rate. While anxiety is a normal, common emotional state which everyone experiences, for some individuals, anxiety can become impairing. When a person experiences excessive worry, fear, or anticipation of threats even when there is no immediate threat in the environment, anxiety can begin to impair their ability to function. When anxiety symptoms become severe, it becomes difficult for the person to focus on daily tasks because they are overwhelmed. Once an individual finds that their symptoms of anxiety get in the way of social, family, relationships, work, or school, it is time to get help! When is anxiety pathological? 3The “Worry Cycle“ The Many Faces of Anxiety Anxiety Disorders are common medical conditions. The National Institutes of Health reports that 19% of American adults have suffered from an anxiety disorder in the last year. It is estimated that up to one-third of adults have had an anxiety disorder in their lifetimes. Social Anxiety Disorder is present in 7% of the population, phobias are present in up to 9% of people, and Generalized Anxiety Disorder is found in up to 3% of Americans. Panic Disorder is found in 2.7% of the population. Anxiety disorders have many different presentations. But there are common symptoms present across these disorders. • Fear • Worry-the anticipation of a future threat of feared outcome • Avoidance • Conditioned responses • Emotional, cognitive, and behavioral changes Person experiences a negative event or severe anxiety. Preoccupation about the experience and worry that the same thing may happen again. Avoidance of the situation or events that the person associates with the onset of the anxiety. Cognitive distortions: generalization- anticipation of negative outcomes in similar situations. Increases in worry and avoidance; increase in bodily symptoms 4Excessive fear and distress when anticipating or experiencing separation from home or major attachment figures (parents, grandparents, caretakers). Common symptoms include excessive worry about being away from home, fears of losing attachment figures due to illness or accidents, fears of sleeping away from home, and physical complaints that occur when separated from family. A child consistently will not speak in social situations but may speak in other settings. Excessive fear of an object or a situation; avoidance of the object or situation. Common types of phobias can include fear of needles, injections, blood, and heights. When present in children, tantrums or excessive crying and clinging to their caregiver are common if the child is exposed to the feared situation. Anxiety disorders that commonly present in childhood: What are some Common Anxiety Disorders? 5This condition is characterized by excessive fear and worry most days for at least 6 months. The person cannot control the worry and has common symptoms including feeling restless or keyed up, easily fatigued, trouble concentrating or experiencing the mind "going blank"; irritability; muscle tension; sleep difficulties. Anxiety can also be secondary to medications, substance (alcohol or illicit drug use), or other medical conditions. Other Anxiety Disorders may have onset during childhood, adolescence, or early adulthood: Excessive fear or worry (anxiety) about one or more social situations. The individual often fears exposure to scrutiny or judgment in the feared situation and may fear embarrassment or humiliation. Common examples are fear of meeting new people, public speaking, or eating in front of others. This disorder is characterized by recurrent panic attacks. A panic attack is an abrupt onset of intense fear that is usually associated with many very unpleasant physical symptoms. These often include symptoms such as palpitations, chest tightness or pain, sweating, trembling, or shaking, feeling short of breath, sensations of choking or difficulty swallowing, nausea, feeling light-headed or dizzy, or sensations of heat or chills. The individual begins to develop persistent fears about having future attacks. This usually leads to very pronounced behavioral changes including avoidance behaviors. One can have occasional panic attacks that are not frequent and do not meet the full criteria for panic disorder. This disorder is characterized by marked fear or anxiety in one or more situations such as: using public transportation, being in open spaces such as bridges or marketplaces, being in enclosed spaces (theaters, elevators), standing in lines or being in crowds, or being out of home alone. The individual avoids the feared places or situations because when they are exposed to the places, intense fear is provoked. 6Next >

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