Mr. Adam Harris Saltz, MSW, LICSW

Collectively, anxiety disorders are the most common mental health issues diagnosed in the United States -- even more common than depression. Women are more likely than men to be diagnosed with anxiety, and it is extremely common for a person with anxiety to have another illness at the same time, such as depression, a physical illness, or substance abuse.

Treatment for anxiety usually involves medication and psychotherapy together. Medications used may include antidepressants (which also work for anxiety), anti-anxiety medications, or beta blockers (which can be used to control the physical symptoms of anxiety). Psychotherapy can be useful to teach patients new ways of thinking and reacting so that they can manage their feelings of worry and fear. Support groups can also be very effective for anxiety, and they can be a form of treatment themselves for social phobias. Stress management, relaxation techniques, and meditation all help reduce feelings of anxiety or of being out of control. Finally, having a strong support network of family and friends is an excellent way to help manage the difficulties of life with anxiety.

• Accidents
• Sexual or physical assault
• Combat
• Childhood abuse
• Domestic abuse
• Natural disasters
• Torture and kidnapping

People who have experienced significant and repeated trauma are more likely to develop PTSD. Those who have disorders like depression or a family history of depression may also be more prone to PTSD. PTSD symptoms typically begin one month to one year following the traumatic event. There are four main categories of PTSD symptoms:

• Intrusive memories: Intrusive memories include unwanted memories, feelings of reliving the traumatic event, distressing nightmares, and emotional disturbances from triggers (signs that serve as reminders of the traumatic event). Intrusive memories can lead to elevated heart rate, anxiety, combativeness (fight), withdrawal (flight), and many other responses.
• Avoidance: Avoidance is an attempt to avoid speaking or thinking about an upsetting event. People with this response might also try to avoid certain people or locations that prompt memories of an event.
• Changes in physical and emotional reactions: These changes may include difficulty sleeping, hypervigilance, self-destructive behavior, and feelings of guilt and irritability.
• Alterations in cognition and mood: Alterations can cause negative self-beliefs, depression, shame, and detachment from others.

The intensity and frequency of these symptoms can vary over time. PTSD symptoms may suddenly return after disappearing for years. Many PTSD patients find treatment helps to gradually reduce their symptoms over time.

The most common treatments for PTSD are psychotherapy and oral medications. Psychotherapy for PTSD can include cognitive therapy (therapy to change thought patterns), exposure therapy (therapy to confront memories of the traumatic incident) and eye movement desensitization and reprocessing therapy (EMDR). EMDR integrates exposure therapy with guided eye movements to help patients confront and process their trauma. Certain oral medications may help with PTSD, such as antidepressants and anti-anxiety medications. Self-care, support groups, and relaxation may also benefit those with PTSD.

The path to overcoming PTSD can be long and challenging and people with PTSD can benefit greatly by seeking professional treatment from a mental health care provider. Treatment can reduce PTSD symptoms, provide essential coping strategies, and improve one's quality of life.

Humans begin to gain self-esteem in childhood from being cared for by adults and reaching natural milestones such as learning how to tie one's shoes. Self-esteem evolves through adolescence and adulthood, and can change drastically based on one's positive and negative experiences. It's important to develop healthy self-esteem to navigate through challenges, make decisions, and gain motivation to pursue interests.

Self-esteem issues can influence one's emotions, behavior, relationships, and world view. Self-esteem issues frequently arise from low self-esteem. Low self-esteem can be caused by factors such as trauma, caregiver neglect, abuse, bullying, and academic, social, or professional difficulties. Stressful life events such as parental divorce, caregiver conflict, and financial problems may also contribute to low self-esteem. In recent years, researchers have highlighted the influence of social media in negatively impacting adolescents' mental health. Common signs of low self-esteem include:

• Focusing on failures instead of accomplishments
• Feeling triggered when making mistakes
• Constantly comparing oneself to others in a negative way
• Lacking confidence

Excessive self-esteem can also be problematic in that it can hinder one's ability to form relationships with others. People with extremely high self-esteem may appear to be conceited or entitled. Some researchers suggest very high self-esteem can lead people to engage in more risk-taking behaviors. Causes of excessive self-esteem are less well-known, but may include upbringing, personality, and cognitive biases.

Fortunately, self-esteem issues can be readily addressed at any time. Positive self-affirmations recognizing one's own accomplishments can raise low self-esteem. Accepting one's own weaknesses and imperfections can benefit those with both low and high self-esteem. People with self-esteem issues often find therapy is an effective means to improve their self-esteem and mental health. Cognitive behavioral therapy (CBT) can help people with self-esteem issues identify and change destructive patterns of thought. Support groups, family counseling, and antidepressant medication may also help with self-esteem issues.

Maintaining a positive outlook and belief in oneself can go a long way towards forming healthy self-esteem. Developing a strong sense of self can be important for well-being and contributes to overall happiness and success in life.