Whenever your everyday worries have crossed over into generalized anxiety disorder (GAD) and the consistent level of anxiety is disrupting your life, the first step should be self-help. It’s a bit like taking the decision to quit smoking. No one else can do it for you. There will be withdrawal symptoms to deal with. There will be a craving for nicotine. Habits will trigger the desire for a cigarette. You have to meet all this and come out smiling without a cigarette in your hand. It’s all about will power. So, when GAD seems to be taking over your life, you should look at your fears and teach yourself how to cope. If you can learn how to do it, the decision to quit worrying will hold up. You will own that decision. You can make it work. But if you cannot manage the trick on your own, there’s help available. Although the US is slower to pick up this particular ball than other parts of the world, there are more people now offering Cognitive Behavioral Therapy (CBT). Because of the demand on a small number of therapists there will be some delay in getting an appointment and it may be more expensive. If you have one, check your health plan to see what is covered. All the research shows this form of therapy is very cost-effective.

So what is it about GAD that makes it difficult to deal with? The real problem comes because GAD changes the way in which you see the world. Most people manage to stay reasonably positive about themselves and what they are doing. But when the negative starts to color your outlook, it even makes the idea of self-help seem unlikely to succeed. You will be beaten before you begin. Indeed, because you are so used to expecting the very worst outcome from everything you do, you will expect nothing less than a catastrophe if you start trying to change your own mind. If this is your view of the world through GAD’s less than rosy spectacles, you need the help of a CBT therapist.

What then is CBT? It’s a practical way of coping. You start by learning about GAD. You cannot beat something you do not understand. Seeing anxiety for what it is helps you beat it. So start by monitoring your anxiety level. See what triggers it and how long each attack lasts. Then learn breathing and relaxation exercises. You have to control the physical symptoms to calm the mind. Now challenge yourself. No more avoidance. You have to confront your fears. Go into the situations which usually trigger anxiety and learn how to cope. Once you see you can survive the trigger situations, it helps to change your mindset from negative to positive.

This is not to say you will not need to take Xanax for a short period of time. It can give you a period of calm and give you a better chance of learning coping strategies. But the aim should always be to conquer anxiety without having to depend on Xanax. No matter how good a drug, you should not have to depend on it.