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Alternative medicines such as herbal remedies have been growing in popularity especially as treatments for anxiety disorders such as obsessive-compulsive disorder (OCD). When you examine the science behind each treatment, it’s important to take research quality and the consistency of research results in mind. It’s also smart to consider potential side effects and safety concerns.

Natural Treatments for OCD

Nutritional supplements are available for OCD and anxiety. But you should inform yourself about the evidence-based benefits and potential side effects before you decide to take one.

Most herbal remedies are available at drugstores without a prescription. However, it’s important to talk to your doctor before taking any supplement. In addition to having side effects, many of these nutritional supplements can interfere (enhance or decrease) the actions of prescription medications.

St. John’s Wort

St. John’s Wort (Hypericum perforatum) is best know as an herbal anti-depressive, although its effectiveness in treating depression and other forms of mental illness is controversial. St. John’s Wort has been widely used (and in some cases, licensed) in Europe for decades to treat mood and anxiety disorders.

An analysis has found that hypericum—the chemical that’s thought to be the key ingredient in St. John’s Wort—appears to affect the serotonin system. Disruptions in the serotonin system are thought to be important in the development of symptoms of OCD.

A case study (one patient) suggested that St. John’s Wort was effective in reducing symptoms. A second study (12 people with OCD) found that it produced a significant reduction in symptoms that were similar to what would be expected with treatment with a selective serotonin reuptake inhibitor (SSRI) antidepressant medication. Neither study properly accounted for the placebo effect.

In both cases, the people participating in the research studies were told upfront that they were going to be receiving St. John’s Wort in the hopes of reducing their OCD symptoms. Simply knowing that they were receiving a potentially beneficial treatment could have been enough to cause people to feel better.

At least one randomized-controlled trial looked at whether St. John’s Wort was effective in reducing OCD symptoms. In the study, 60 people randomly received either St. John’s Wort or placebo.

Milk Thistle

Milk thistle (Silybum marianum) is an herbal remedy that has long been used in Iran. In 2010, a double-blind, placebo-controlled study compared the effects of milk thistle to the antidepressant Prozac (fluoxetine) in treating OCD (600 milligrams of milk thistle vs 30 milligrams of Prozac daily).

It was found that there was no significant difference between milk thistle and Prozac for OCD symptoms.

N-Acetylcysteine

N-Acetylcysteine is an amino acid that moderates glutamine in the brain. N-acetylcysteine helps produce glutathione, an important antioxidant. A single study of a single person found that N-acetylcysteine improved the actions of the SSRI Luvox (fluvoxamine), resulting in a significant decrease in OCD symptoms.

5-HTP and Inositol

Since the dysregulation of serotonergic and glutamatergic pathways in the brain appears to occur with OCD, other herbs that work in this pathway have also been considered for their possible benefits. Some of these include 5-hydroxytryptophan (5-HTP) and ​inositol.

Kava (Piper Methysticum)

Kava is an herbal medication found in clinical trials to reduce anxiety, nervous tension, restlessness, and mild depression. It has been used for hundreds of years in Polynesia, the Micronesia Islands, and Hawaii.

The key constituent in Kava is kavalactone, which stimulates production of both serotonin and gamma amino butyric acid (GABA) in the body which produce a calming effect to the body. It’s best to take Kava from a water-based extract at less than 250 mgs per day. Kava is not recommended during lactation or pregnancy.

Herbal Remedy Research Standards

There are special considerations to take into account when looking at scientific studies that investigate the effectiveness of herbal remedies for OCD, anxiety disorders, or any other mental health condition. Sometimes, study results sound impressive because basic research standards were compromised.

Lack of Standardization

First, studies using herbs that are not in a standardized form may have varying activity levels of chemical components. Studies must consider the plant’s accurate identity and whether the active constituents come from the plant’s leaf, root, seed, or stem.

Lack of Placebo Comparisons

Studies evaluating the effectiveness of medications should also include a placebo treatment group that receives a “sugar pill” that is inactive and could not possibly account for any reduction in symptoms. By using a placebo treatment, it is possible to tell if the actual drug had an effect or not.

Potential for Bias

Lastly, it is important that neither the researchers nor the study participants know who is receiving what treatment until the study is over to avoid bias.

Natural Treatments for OCD Can Have Side Effects

Although many consumers believe that herbals are safer and have fewer adverse effects than prescription medications, treatments like St. John’s Wort are not regulated as closely as conventional medications are and they may cause unpleasant or even dangerous side effects in some people.

For example, if you are currently taking an SSRI to treat OCD, it is essential that you consult your treating physician before taking St. John’s wort, as it could affect your body’s ability to metabolize it. This could lead to a problem known as serotonin syndrome.

Because kava may harm the liver, taking this herbal remedy with alcohol may increase this risk.

Other Complementary Therapies

Don’t forget that there are other alternatives for treating the symtoms of OCD. Beyond supplements, lifestyle interventions such as mindfulness meditation, acupuncture, and yoga may be effective as well.

Unfortunately, there have been few clinical trials looking at these interventions for people with OCD and those that have been done are of fairly poor quality. Yet, unlike prescription drugs and herbal medications, lifestyle interventions rarely have significant side effects and may also help reduce stress.

Keep in Mind

Complementary treatments are often most effective when they are used to augment other evidence-based interventions. Treatments for OCD typically include medication and therapy.

Medicines that may be prescribed include selective serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants (TCAs). Therapies that may be helpful include cognitive-behavioral therapy (CBT) or acceptance and commitment therapy (ACT). 

If you do decide to try a natural treatment for OCD in addition to your regular treatment, always talk to your doctor first. You will need to tell them about any medications, supplements, or substances you are also taking to prevent potential drug interactions.

Propaganda is a type of communication that often involves sharing biased or misleading information to promote a particular agenda or point of view. Propaganda is used to influence people’s opinions or control their behavior through various tactics such as name-calling, bandwagoning, or inciting fear.

Here we explore the goals of a propagandist and in what types of situations it is typically used. We also discuss the potential effects of propaganda, along with some steps we can take to keep from being influenced by skewed or false information.

What Are the Goals of a Propagandist?

People use propaganda to promote a particular agenda or point of view. The goals of propaganda can vary, but commonly include:

• Shaping people’s opinions so they think a particular way
• Convincing people to support a specific cause or political candidate
• Encouraging people to behave in a certain way

How Propaganda Is Used

Propaganda can be used in a variety of ways. Among the settings it is typically seen include the media, advertising, war, and politics.

Propaganda In Media

Mass media is often used by propagandists to sway societies or large groups of people to think a certain way. One example of propaganda in media is the film “Triumph of the Will.”

This 1935 film was made to promote the Nazi regime and to encourage people to support Adolf Hitler using fragments of truth combined with certain images chosen to influence social memory. It is considered to be one of the most effective propaganda films ever made.

Propaganda In Advertising

Advertisers use persuasive techniques to try to convince people to buy their products. One example of propaganda in advertising is the use of fear tactics. Advertisers may try to convince people that they need a certain product to avoid a negative outcome.

Another common technique is the use of bandwagoning. The bandwagon effect involves advertisers trying to convince consumers that everyone is using a certain product and that they should too.

Propaganda In War

Propaganda is often used in war. It can be used to make people support the war effort or to discourage them from supporting the enemy.

War propaganda often relies on misinformation and name-calling or the use of derogatory terms to achieve its goals. For example, in World War II, the Nazis referred to the Jews as “rats” and, during the Islamic Revolution, Ayatolla Hlomeini referred to the United States as the “Great Satan.”

Propaganda In Politics

Propaganda is often used in politics to influence people’s opinions about a particular political candidate or issue. Political propaganda can take many forms, but it often relies on emotional appeals, name-calling, and scare tactics.

One example of political propaganda was the Swift Boat Veterans for Truth ads used to attack John Kerry during the 2004 presidential election. Another occurred in the 2008 presidential campaign when propaganda was used to claim that then-candidate Barack Obama was Muslim.

Effects of Propaganda

Propaganda can be dangerous because it often uses partial truths or biased misinformation to shape people’s opinions and control their behaviors. Presenting only some of the information or skewing it in one direction fails to provide a complete and accurate picture for people to consider when deciding their opinions and behaviors.

Other negative effects of propaganda include:

Propaganda Techniques

People can use a variety of techniques to spread propaganda. Here are some of the most common:

• Name-calling: Name-calling involves using derogatory terms to describe an opponent or enemy.
• Appealing to emotions: Propaganda often relies on emotional appeals to influence people’s opinions. For example, propaganda might incite fear or create anger to get people to support a particular cause.
• Bandwagoning: Bandwagoning is a technique that uses peer pressure to convince people to do something. For example, a political candidate might say, “Everyone is voting for me, so you should too.”
• Scare tactics: Scare tactics are used to frighten people into supporting a particular cause. For example, a campaign might warn people that if they don’t vote, a dangerous criminal will be elected.
• Manipulating Information: Manipulating information involves distorting or misrepresenting the facts to influence people’s opinions. For example, a political campaign might make false claims about an opponent to make them look bad.
• Using false statistics: Using false or misleading statistics is a common propaganda technique. For example, a campaign might claim that most people support their candidate, even if this is not true.
• Making unrealistic promises: Making unrealistic promises is another common technique used in propaganda. For example, a candidate might promise to end poverty, even though this is not possible.
• Using symbols: Symbols are often used in propaganda to represent an idea or concept. For example, in 1920, the Nazi party used the swastika to represent its belief in racial purity.
• Slogans: Slogans are short catchphrases used to summarize an idea or concept. For example, in the 2016 presidential campaign, “Make America Great Again” was one of Donald Trump’s slogans.
• Plain folks: The plain folks’ appeal is a technique that uses average, everyday people to endorse a product or candidate. The idea is that if regular people like something, then it must be good. For example, a political campaign might use ordinary citizens in its commercials to try to appeal to voters.
• Testimonials: Testimonials are endorsements from famous or respected people. For example, a celebrity might endorse a candidate for office, or a doctor might endorse a new medication.
• Transfer: This technique uses positive associations to make an object or person seem more favorable. For example, a political campaign might use the American flag in its ads to make the candidate seem patriotic.
• Card stacking: Card stacking is a technique that only presents information that is favorable to the person or thing being promoted. For example, a company might only show the positive reviews of its product and not the negative ones.
• Glittering generalities: Glittering generalities are words or phrases that have a positive connotation but don’t really mean anything. For example, a candidate might say they are “for change,” even though they don’t specify what kind of change they are for.
• Stereotyping: Stereotyping is a technique that uses oversimplified and often inaccurate ideas or beliefs to describe an opponent or enemy.
• Snob appeal: Snob appeal is a technique that uses the idea of exclusivity to make something seem more desirable. For example, a luxury car company might use the slogan, “Only the best for you.”
• Loaded language: This technique uses language to evoke certain emotions or feelings. For example, the phrase “pro-life” is loaded with emotional and moral weight.
• Weasel words: Weasel words are words designed to mislead or deceive people. For example, the phrase, “I’m not saying that X is a bad person, but…” implies that the person is bad without actually saying it.

Tips to Avoid Being Manipulated by Propaganda

One of the best ways to not fall for propaganda is to educate ourselves about the techniques that are used. By being aware of the ways that information can be distorted, we can more easily see through the manipulation and make our own informed decisions.

It’s also important to critically evaluate the information that we receive. Seek out multiple sources to verify facts before making any decisions, and don’t blindly trust emotional appeals or information presented. Instead, we need to take the initiative to learn if the information provided is accurate before developing our beliefs or changing our behaviors.

Putting yourself in situations that are kind of stressful or just plain awkward can be, well, uncomfortable. So why would you intentionally do things you know will create at least some discomfort? While seeking comfort is a great way to find safety and security, avoiding *everything* that makes you uncomfortable prevents you from growing and exploring new opportunities that can make your life richer and fuller.

We all have a threshold for being uncomfortable. How high that threshold is varies from person to person. The higher your threshold, the more comfortable you are with being uncomfortable. However, there are steps you can take to make stepping outside your comfort zone easier, regardless of your natural comfort level.

The Importance of Getting Comfortable Being Uncomfortable

Being uncomfortable is good for you because we must be uncomfortable in order to grow and learn. For example, if you want to become stronger physically, you must lift weights that are heavy. If you want to improve your writing skills, you should write more often rather than sit at home all day watching Netflix.

If you always stay in your comfort zone and avoid situations where you might fail or be uncomfortable, then there is no way for you to grow as an individual.

Why Some People Are More Comfortable Being Uncomfortable

Some people are naturally more comfortable trying new things in life; this is the opposite of what is known as behavioral inhibition. However, some people are more comfortable being uncomfortable simply because they have chosen to constantly stretch their limits.

These people are already in the habit of pushing themselves to their limits so they know what it is like to be outside of their comfort zone. These same individuals have an increased tolerance for discomfort because they have become desensitized over time. Constantly facing new difficult situations and learning from them has left them stronger than they were before.

Uncomfortable vs. Scared: What’s the Difference?

What is the difference between being scared and being uncomfortable? Being uncomfortable means that you are in a situation where things are unfamiliar, outside the norm, and unpredictable. In contrast, being scared implies fear or anxiety about something dangerous happening to yourself or others.

The key is knowledge and practice; gaining familiarity with any new situation. If, on the other hand, you experience intense fear or anxiety in new situations, this could be a sign of a mental health issue that needs separate attention. If your fear is intense, persistent, and interferes with your ability to function normally, talk to your doctor.

How to Get Comfortable Being Uncomfortable

Embracing discomfort won’t be easy, but it’s necessary if you want to experience personal growth. The first step is recognizing the things that make you uncomfortable and knowing how they make you feel. This will enable you to identify what types of experiences to seek out.

Below are some ways to get over being uncomfortable and embrace this feeling more fully:

Challenge Yourself to Take Risks

Take risks and challenge yourself by doing uncomfortable things. Sometimes, just the experience of trying something new can give you the skills and confidence you need to get more comfortable with discomfort.

Do something you’re uncomfortable doing, even if it doesn’t result in immediate positive feedback or reward. Having the experience of “doing” builds confidence and helps build skills to deal with future problems that may arise outside of your comfort zone.

Try New Things

Try new things like a new food or new activity. Be open-minded and flexible. This broadens your horizons and exposes you to new experiences that can help you grow as a person. Instead of seeing these things as something to avoid or fear, try to open yourself up to trying new things and having new experiences.

Ask Questions and Be Curious

Explore new experiences even if they are different than what you are used to. It’s easy to fall into the same old routines and seek the same ideas and experiences. It’s comfortable, but it doesn’t challenge you to learn and grow. Be a student of the world and ask questions. By doing so, you will learn new things and be exposed to different people and backgrounds. This will make your life more fulfilling, even if it makes it uncomfortable at times.

Build Your Social Distress Tolerance

Get comfortable with discomfort in social settings. Try being more social and accepting the discomfort that comes with it. Over time, you will become a better conversationalist, learn how to interact with people in different settings and make new friends.

Get Comfortable Being Different

Embrace standing out instead of trying to be like everyone else. Doing so helps you realize that it’s okay not to fit in with the crowd and that there are other people who feel the same way as you do.

Get Comfortable With Other Opinions

Get comfortable challenging beliefs, ideas, or opinions of yourself and others. Be curious and ask questions. Doing so helps you realize that there are many different perspectives in the world, and it’s okay to have your own. Talking to people who have different ideas and experiences than you can give you a new perspective on the world.

Make a List of Five Activities

Make a list of five things that you’d really like to do that make you uncomfortable. Make a promise to yourself to slowly go through your list and complete the tasks. The trick is to tackle your list slowly and progressively. Start with the easiest item on the list, and then gradually work your way up to the thing that makes you the most uncomfortable.

How to Feel Less Vulnerable When Outside Your Comfort Zone

It’s easy to start feeling vulnerable when you’re outside your comfort zone. You might feel exposed, unprepared, and unsure of how to respond. How can you feel less vulnerable? In order to feel a little less vulnerable and a lot more comfortable, try to:

Avoid Comparisons

Stop comparing yourself to others and focus on your own personal growth. Everyone’s at a different level, and everyone grows in their own way. How can you focus your energy on yourself instead of comparing yourself to others?

Start Small When Trying Something New

The best way to start is with baby steps, such as taking one step every day towards the direction that interests you. How does this help? It works because it gradually exposes you to a new experience. How can you take baby steps instead of skipping straight ahead?

Remember You’re Not Alone

Tell yourself that other people are also outside their comfort zone, too. Everyone’s in a different situation, so remember not everyone has it easy.

How does this help? If you see someone else struggling you may realize you’re not the only person who gets nervous or uncomfortable.

Find Strategies to Ground Yourself

Practice mindfulness and meditation to stay grounded. Research has found that people who experience anxiety or depression can become better at tolerating distress through mindfulness training.

The next time you’re in an uncomfortable situation, try to remain calm and repeat a mantra that will keep your mind from spiraling out of control. For example, you might choose to say things like “I am safe, I am strong” or imagine your emotions washing away with each wave that crashes onto the shore.

Practice With a Friend

Do activities with a friend or get some practice. How can you make your list of five activities more comfortable? For some, it is as simple as doing them with a friend. Others may need practice beforehand or at least know how they work to feel more comfortable. In other words, get support or do some research.

Getting the right diagnosis is crucial to getting the right treatment, so doctors are careful when diagnosing depression or any other mental disorder. Based on your presenting symptoms, they may make a provisional diagnosis until they are able to get more information about your condition. A provisional diagnosis is essentially their “best guess” based on the information they have.

The provisional diagnosis differs from what is known as a differential diagnosis. The provisional and differential diagnoses are two different steps in the process of diagnosing a mental health condition. They both serve essential, but differing, purposes.

What Is a Provisional Diagnosis?

A provisional diagnosis means that a doctor is not 100% sure of a diagnosis because more information is needed. With a provisional diagnosis, a doctor makes an educated guess about the diagnosis you most likely have.

Under the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a provisional diagnosis is indicated by placing the specifier “provisional” in parentheses next to the name of the diagnosis. For example, it might say something like “309.81 Post-traumatic Stress Disorder (provisional).”

A provisional diagnosis may also be given when a person does not meet the full diagnostic criteria for a specific condition, despite having many symptoms. Researchers suggest that a provisional diagnosis recognizes that each person’s experience is unique. While they may not have all the symptoms necessary to diagnose the condition, they would still benefit from treatment.

Making a Provisional Diagnosis

A provisional diagnosis is a tentative diagnosis that a doctor makes after looking at a person’s presenting symptoms, medical history, examination, and preliminary tests. However, the doctor may realize that they need more information to feel comfortable making a definitive diagnosis.

The purpose of providing a provisional diagnosis is so that a person can begin receiving treatment and to help guide further evaluation. Based on this initial diagnosis, a doctor may order additional tests and assessments to confirm their findings. 

What Is a Differential Diagnosis?

A differential diagnosis means that there is more than one possibility for your diagnosis. A doctor must differentiate between multiple diagnoses to determine the correct one and make an appropriate treatment plan.

For instance, there are currently no lab tests to identify depression. Instead, the diagnosis is based on your history and your symptoms.

According to Dr. Michael B. First, Professor of Clinical Psychiatry at Columbia University and author of the DSM-5 Handbook of Differential Diagnosis, making a good differential diagnosis of depression involves the six steps listed below.

Step 1: Rule Out Malingering and Factitious Disorder

According to Dr. First, a doctor’s initial step should be an attempt to determine whether patients are not fully honest about their symptoms. In general, there are two possible reasons for this: malingering disorder or factitious disorder.

Step 2: Rule Out Drug-Related Causes

Certain drugs—both legal and illegal—can cause the same symptoms as depression when misused or even when used as prescribed. These can include the drugs listed below.

Prescription and Over-the-Counter Drugs

For instance, the following are medications that can cause the symptoms of depression:

• Anticholinergic drugs: Such as Bentyl (dicycloverine)
• Anticonvulsants: Tegretol (carbamazepine), Topamax (topiramate), and Neurontin (gabapentin)
• Benzodiazepines: Xanax (alprazolam), Restoril (temazepam), and Valium (diazepam)
• Beta-blockers: Metoprolol and Inderal (propranolol)
• Corticosteroids: Cortisone, prednisone, methylprednisolone, and triamcinolone
• Drugs that affect hormones: Birth control pills and estrogen replacement therapy
• Opioids: Oxycodone, morphine, and fentanyl
• Statins and other cholesterol-lowering drugs: Such as Lipitor (atorvastatin)

Illicit or Recreational Drugs

Below are illicit drugs that can cause the symptoms of depression:

Clinicians can gain clues about illicit drug use, Dr. First says, by interviewing the patient. Sometimes, the family is interviewed as well. They can also look for signs of intoxication and perform blood or urine tests to screen for the presence of both licit and illicit drugs.

Step 3: Rule Out Other Medical Conditions

There are various general medical conditions that can present with psychiatric symptoms. For this reason, it is very important to rule out any underlying conditions when making a diagnosis because they often require unique treatment.

To rule conditions out, clinicians will ask about previously diagnosed conditions. They are particularly interested in those that may have begun around the same time as depression. Lab tests may be ordered to screen for conditions commonly associated with the symptoms of depression.

Some general medical conditions commonly mistaken for depression include:

• Autoimmune disorders (such as rheumatoid arthritis and lupus)
• Chronic fatigue syndrome
• Diabetes
• Fibromyalgia
• Hypothyroidism
• Lyme disease
• Sleep disorders

Step 4: Determine the Primary Disorder

Once other potential causes have been eliminated, it is necessary to distinguish which specific psychiatric disorder the patient has.

Clinicians must differentiate major depressive disorder from related mood disorders and other disorders which often coexist with depression. This is done by following the criteria established in the DSM-5.

Step 5: Differentiate It From Other Categories

There are times when a person’s symptoms are significant but below the threshold to make a diagnosis or the symptoms are clearly related to stress or a trauma.

Dr. First suggests that the clinician consider a diagnosis of adjustment disorder. This is a condition in which the emotional or behavioral symptoms occur within a few months of an identifiable stressor and are severe enough to cause marked distress or significant impairment in functioning.

If symptoms are present and significant but don’t meet full criteria for an established diagnosis, and they are not related to a clear stressor, the categories of “other specified” or “unspecified” might be applied.

Step 6: Establish Boundary

Finally, clinicians need to make a judgment call. They need to determine whether the patient is experiencing significant enough impairment or distress in everyday life and that this impairment has lasted long enough for it to qualify as a mental disorder.

Provisional vs. Differential Diagnoses: Key Differences

A provisional diagnosis is typically given after the first or second appointment and is based on the doctor’s clinical impressions, findings from history, or clinical examination. It may be an educated guess, but it indicates that the doctor is still not 100% committed to it and may change based on new information.

A differential diagnosis involves the process of differentiating a condition from those that have similar symptoms. The provisional diagnosis often indicates what a doctor thinks the most likely diagnosis is among all of the potential diagnoses. 

The provisional diagnosis is often given at the beginning of the process. It provides a starting point but lacks confirmation. 

The differential diagnosis focuses on listing the conditions that might match a patient’s symptoms. It can help doctors collect the information they need to rule out other causes. As more information is collected, a provisional diagnosis can then become a final diagnosis.

What Comes Next

Properly diagnosing depression or any other mental health condition is the first step in treating the whole person. With a proper diagnosis, you can work with a doctor or mental health professional to come up with an effective treatment plan.

The treatment you need depends on your specific diagnosis as well as other factors. It may involve a combination of medications, psychotherapy, and lifestyle changes to get back in balance and feel like yourself again.

Anxiety is a normal part of life as everyone feels some level of worry or unease from time to time. But if you are experiencing severe anxiety that feels overwhelming or out of control, it could be a sign of a mental health disorder—and anxiety-based mental health issues are highly treatable.

Learn more about what extreme anxiety is, as well as the difference between normal anxiety and an anxiety disorder. We also share things you can do if you feel like your anxiety is negatively impacting your life, including several steps you can take to find relief from severe anxiety.

What Is Extreme Anxiety?

‘Extreme anxiety’ is a phrase that people use to describe feelings of worry, panic, or fear that are intense or out of proportion to an actual threat. It’s important to understand that this term is not a clinical term or mental illness diagnosis.

How people experience anxiety can differ from one person to the next. One person may feel like they have small butterflies in their stomach, while another might have severe anxiety in the form of a panic attack. You can also experience different levels of anxiety at different points in time.

If you are experiencing crippling anxiety that makes it difficult to function in various areas of your life—including work, school, and relationships—you might have an anxiety disorder.

Normal Anxiety vs. Severe Anxiety

Not all anxiety is bad. In fact, normal levels of anxiety can be beneficial by helping you better respond to stresses in your environment. For example, research has found that increased levels of anxiety can help you move faster and with greater accuracy when faced with a stressful task.

The difference between normal anxiety and extreme anxiety is how it affects your ability to function and the level of distress that it creates. When anxiety is extreme or severe, it makes it difficult, if not impossible for you to function normally in certain situations.

With severe anxiety, you may not be able to work or socialize like you normally would. It can also create such extreme distress that you begin to altogether avoid situations that are likely to trigger these feelings.

Signs of Extreme Anxiety

If your anxiety is severe in duration or intensity, negatively impacting your life, or increasing over time, you may have an anxiety disorder. Only a physician or mental health professional can diagnose anxiety disorders, but there are both physical and mental symptoms to watch for.

Physical Symptoms

Extreme anxiety can show up in your body physically, in the form of:

• Rapid heart rate
• Increased breathing rate
• Sweating or trembling
• Shortness of breath
• Gastrointestinal issues (stomachaches or digestive issues)
• Sleep difficulties, such as trouble falling or staying asleep

Mental/Emotional Symptoms

Severe anxiety can also impact you mentally or emotionally, resulting in symptoms such as:

• Intense feelings of fear or worry that are irrational or disproportionate to an actual threat
• Increased feelings of irritability and agitation
• Withdrawal from social situations or only enduring these situations with great anxiety
• Difficulty concentrating or problems completing your typical everyday tasks
• Interpersonal and relationship issues
• Thoughts of suicide

Panic Attacks

Extreme anxiety can also manifest as a panic attack. Panic attacks are characterized by an abrupt surge of intense fear or discomfort accompanied by a variety of physical sensations, including:

• Rapid heart rate
• Choking sensations
• Nausea
• Trembling
• Chills
• A sense of unreality
• Feelings of impending doom
• A feeling of losing control or “going crazy”
• Feeling as if you are dying

Types of Severe Anxiety Disorders

There are many different types of anxiety disorders. If you have one of these disorders, your healthcare provider or therapist can evaluate your symptoms to determine which type you have.

• Generalized anxiety disorder: This condition is characterized by feelings of excessive worry about various events, activities, and situations. These feelings are accompanied by other symptoms, including restlessness, fatigue, trouble concentrating, irritability, muscle tension, and sleep disturbances.
• Obsessive-compulsive disorder: Called OCD for short, this condition involves unwanted recurrent thoughts combined with compulsive, repetitive behaviors. For people with OCD, engaging in repetitive behaviors can help temporarily ease the feelings of anxiety caused by obsessive thoughts. 
• Panic disorder: This anxiety disorder is marked by intense and recurrent panic that occurs unexpectedly. During a panic attack, people experience extreme anxiety, feelings of terror, and physical symptoms of fear, often feeling that they are losing control or dying.
• Post-traumatic stress disorder: People with post-traumatic stress disorder (PTSD) experience extreme anxiety and distress due to being exposed to a traumatic event. Symptoms of PTSD can include hypervigilance, flashbacks, and intrusive memories of the trauma.
• Social anxiety disorder: This disorder is characterized by feelings of extreme anxiety in social situations. People with this condition often try to limit or avoid social settings, which can negatively affect their ability to function in relationships, work, and school. 

Anxiety Disorder Prevalence

Anxiety is one of the most common mental health conditions. The National Institute of Mental Health (NIMH) reports that 19.1% of adults in the United States experience an anxiety disorder each year, and an estimated 31.1% will experience this type of disorder at some point during their lives.

Anxiety disorders also tend to be more prevalent among women. Women are twice as likely as men to be affected by an anxiety disorder, so experts suggest that women and girls aged 13 and older be screened for anxiety during regular health exams.

Getting Help for Extreme Anxiety

If anxiety is making it difficult to function normally or creating significant distress in your life, it’s important to get help. Severe anxiety typically will not go away on its own and often worsens over time. Plus, many of the coping strategies that people use to decrease anxiety—such as avoidance—end up making the issue worse.

Fortunately, anxiety can be treated in a number of psychotherapeutic ways. Medications may also be prescribed to decrease anxiety symptoms or treat co-occurring conditions. 

Cognitive Behavioral Therapy 

Cognitive behavioral therapy (CBT) is an evidence-based treatment approach that works by helping people identify and change the automatic negative thoughts that contribute to feelings of anxiety. During treatment, people also learn to identify the situations that trigger anxiety, work on changing their avoidance behaviors, and practice relaxation techniques to reduce feelings of anxiety.

Exposure Therapy

Exposure therapy is another approach used for treating anxiety, and it often results in positive outcomes. This technique involves being gradually and progressively exposed to what it is the individual fears in a safe, controlled way.

During this exposure, people also learn to practice relaxation techniques. Over time, the thing that triggers the fear elicits less of a response and people are better able to tolerate it without experiencing anxiety or panic.

Medication

Anxiety medications can also be used to help people manage their symptoms. Depending on your situation, your healthcare or mental health provider may prescribe a benzodiazepine or antidepressant such as a selective serotonin reuptake inhibitor (SSRI) or selective norepinephrine reuptake inhibitor (SNRI) to relieve your feelings of anxiousness.

Combination Approach

For many people, the best approach is a combination of anxiety medications and psychotherapy. Most of the time, using both anxiety treatments at the same time can greatly improve your quality of life.

Coping With Extreme Anxiety

Living with severe anxiety can present a number of challenges, but there are a few self-help strategies you can use to help manage your symptoms.

• Find social support: Having people to support you is critical to your psychological well-being, but it is especially important when dealing with extreme anxiety. Talk to a trusted loved one or find an in-person or online anxiety support group. Talking about your feelings with others who have been in your shoes is a great way to find support, care, and encouragement.
• Practice mindfulness: A 2019 study found that mindfulness was associated with lower levels of anxiety. Mindfulness involves focusing on the present moment and not worrying about past or future problems. This can quiet anxious thoughts, calm the body, and supports greater awareness.
• Deep breathing: Anxiety can often lead to short, rapid breathing. Research has found that slow breathing techniques can have a number of health benefits, including decreasing symptoms of anxiety. This can be helpful for easing symptoms during times of stress. 
• Limit avoidance behaviors: While avoiding the things that make you anxious can provide short-term relief, this strategy tends to make anxiety worse in the long run. Instead of avoiding your triggers, focus on dealing with them gradually. Start small and utilize coping strategies to reduce your feelings of anxiety. Use relaxation techniques such as deep breathing and remind yourself that anxious thoughts are just thoughts. 

Obedience is a form of social influence that involves acting on the orders of an authority figure. It often involves actions a person would not have taken unless they were directed to do so by someone of authority or influence.

To understand obedience, it is important to also understand how it differs from compliance and conformity. Compliance involves changing your behavior at the request of another person, while conformity consists in altering your behavior to go along with the rest of the group.

Obedience vs. Conformity: How They Differ

Obedience is an essential concept in psychology. The question of why people obey others, its impact on society, and the factors that impact obedience are essential in understanding social behavior and social influence.  However, obedience must be distinguished from other types of social influence, including conformity.

Obedience differs from conformity in three key ways:

• Obedience involves an order; conformity involves a request.
• Obedience is obeying someone of a higher status; conformity is going along with people of equal status.
• Obedience relies on social power; conformity relies on the need to be socially accepted.

Milgram’s Obedience Experiments

During the 1950s, psychologist Stanley Milgram became intrigued with the conformity experiments performed by Solomon Asch. Asch’s work had demonstrated that people could easily be swayed to conform to group pressure, but Milgram wanted to see just how far people would be willing to go.

The trial of Adolf Eichmann, who had planned and managed the mass deportation of Jews during World War II, helped spark Milgram’s interest in obedience.

Throughout the trial, Eichmann suggested that he was simply following orders. He claimed that he felt no guilt for his role in the mass murders because he had only been doing what his superiors requested and he had played no role in the decision to exterminate the captives.

Milgram’s Question

After the horrors of the Holocaust, some people, such as Eichmann, explained their participation in the atrocities by suggesting they were doing as they were commanded.

Milgram had set out to explore the question, “Are Germans different?” In other words, he wondered if perhaps there were some factors at work that had made German citizens obey orders more than others might. He soon discovered, however, that many people are surprisingly obedient to authority.

Milgram’s Results

Milgram’s studies involved placing participants in a room and directing them to deliver electrical shocks to a “learner” located in another room. Unbeknownst to the participant, the person supposedly receiving the shocks was actually in on the experiment and was merely acting out responses to imaginary shocks.

Surprisingly, Milgram found that 65% of participants were willing to deliver the maximum level of shocks on the experimenter’s orders.

Recent Criticisms Cast Doubt on Milgram’s Findings

Milgram’s experiments have long been criticized as unethical, but more recent findings have further complicated the legacy of his research. After examining experimental archives, researchers found that participants in the famous study were often coerced into delivering shocks, which has significant implications for the study’s final results. 

While 65% of the participants followed orders, it is essential to note that the statistics only apply to one study variation. In other trials, fewer people were willing to go through with the shocks, and in some cases, every participant refused to follow orders.

Modern Replications

Despite the problems with Milgram’s original study, some researchers have been able to replicate his findings. In 2009, researchers partially replicated Milgram’s study, but with a top shock of 150 volts. The study found that obedience rates were only slightly lower than those originally reported by Milgram.

Another 2017 replication conducted by researcher in Poland found that 90% of people were willing to go to the highest voltage level.

Zimbardo’s Prison Experiment

Milgram’s controversial experiments generated a great deal of interest in the psychology of obedience. During the early 1970s, social psychologist Philip Zimbardo staged an exploration into the study of prisoners and prison life.

Zimbardo’s Experiment

He set up a mock prison in the basement of the Stanford University psychology department and assigned his participants to play the roles of either prisoners or guards, with Zimbardo himself acting as the prison warden.

According to the researchers, the study had to be discontinued after a mere six days even though it was initially slated to last two weeks. Why did the researchers end the experiment so early? Because the participants had become so involved in their roles, the guards utilized authoritarian techniques to gain the obedience of the prisoners.

The study’s authors suggested that the guards even subjected the prisoners to psychological abuse, harassment, and physical torture.

Contemporary Criticisms

Like Milgram’s experiments, Zimbardo’s experiment has not fared well under more recent analysis. In addition to the long-noted ethical problems with the study, a more recent analysis of the study’s methods has revealed serious issues with the experiment’s design, methods, procedures, and authenticity.

Participants in the study reportedly faked their responses to leave early. Others reported amplifying their behaviors to help give the experimenters the results they were looking for. Critics suggest that the study lacks scientific merit and credibility due to these notable problems with its procedures.

Factors That Impact Obedience

A variety of individual and social factors can impact the likelihood that a person will obey a leader. Some factors that might play a role include:

• Personality characteristics: Certain personality traits, including conscientiousness and agreeableness, have been linked to greater obedience to authority.
• Psychological distance: You may be more likely to engage in obedience to authority if the effects of your obedience feel distant, abstract, or unconnected to your life.
• Ambiguity or lack of information: In ambiguous situations, a person may be more likely to obey someone who seems to have more information than they do.
• Fear of consequences: Obedience often happens because people fear the consequences of disobedience. Children often obey partners or teachers, for example, because they fear punishment or losing privileges if they disobey.

Understanding the Psychology of Obedience

Recognizing the power of obedience can help shed light on why people sometimes follow the orders of an authority figure, even if it violates their own personal beliefs or morals. Helping leaders understand their power in social situations can also help them use it more effectively and responsibly.

Building this understanding may also help people better recognize abuses of power and find ways to better promote responsible, ethical behavior.