The Virtual News, Volume 2(1)


Why Am I So Anxious?

Every human feels anxiety on occasion; it is a part of life. All of us know what it is like to feel worry, nervousness, fear, and concern. We feel nervous when we have to give a speech, go for a job interview, or walk into our boss’s office for the annual performance appraisal. We know it’s normal to feel a surge of fear when we unexpectedly see a photo of a snake or look down from the top of a tall building. Most of us manage these kinds of anxious feelings fairly well and are able to carry on with our lives without much difficulty. These feelings don’t disrupt our lives.

But millions of people (an estimated 15% of the population) suffer from devastating and constant anxiety that severely affects their lives, sometimes resulting in living in highly restricted ways. These people experience panic attacks, phobias, extreme shyness, obsessive thoughts, and compulsive behaviors. The feeling of anxiety is a constant and dominating force that disrupts their lives. Some become prisoners in their own homes, unable to leave to work, drive, or visit the grocery store. For these people, anxiety is much more than just an occasional wave of apprehension.


Types of Anxiety Disorders

An anxiety disorder affects a person’s behavior, thoughts, feelings, and physical sensations. The most common anxiety disorders include the following:

Social anxiety or social phobia is a fear of being around other people. People who suffer from this disorder always feel self-conscious around others. They have the feeling that everyone is watching them and staring at them, being critical in some way. Because the anxiety is so painful, they learn to stay away from social situations and avoid other people. Some eventually need to be alone at all times, in a room with the door closed. The feeling is pervasive and constant and even happens with people they know.

People who have social anxiety know that their thoughts and fears are not rational. They are aware that others are not actually judging or evaluating them at every moment. But this knowledge does not make the feelings disappear.

Panic disorder is a condition where a person has panic attacks without warning. According to the National Institutes of Mental Health, about 5% of the adult American population suffers from panic attacks. Some experts say that this number is actually higher, since many people experience panic attacks but never receive treatment.


Common symptoms of panic include:

    • Racing or pounding heart
    • Trembling
    • Sweaty palms
    • Feelings of terror
    • Chest pains or heaviness in the chest
    • Dizziness and lightheadedness
    • Fear of dying
    • Fear of going crazy
    • Fear of losing control
    • Feeling unable to catch one’s breath
    • Tingling in the hands, feet, legs, or arms

A panic attack typically lasts several minutes and is extremely upsetting and frightening. In some cases, panic attacks last longer than a few minutes or strike several times in a short time period.

A panic attack is often followed by feelings of depression and helplessness. Most people who have experienced panic say that the greatest fear is that the panic attack will happen again.

Many times, the person who has a panic attack doesn’t know what caused it. It seems to have come “out of the blue.” At other times, people report that they were feeling extreme stress or had encountered difficult times and weren’t surprised that they had a panic attack.


Generalized anxiety disorder is quite common, affecting an estimated 3 to 4% of the population. This disorder fills a person’s life with worry, anxiety, and fear. People who have this disorder are always thinking and dwelling on the “what ifs” of every situation. It feels like there is no way out of the vicious cycle of anxiety and worry. The person often becomes depressed about life and their inability to stop worrying.

People who have generalized anxiety usually do not avoid situations, and they don’t generally have panic attacks. They can become incapacitated by an inability to shut the mind off, and are overcome with feelings of worry, dread, fatigue, and a loss of interest in life. The person usually realizes these feelings are irrational, but the feelings are also very real. The person’s mood can change from day to day, or even hour to hour. Feelings of anxiety and mood swings become a pattern that severely disrupts the quality of life.

People with generalized anxiety disorder often have physical symptoms including headaches, irritability, frustration, trembling, inability to concentrate, and sleep disturbances. They may also have symptoms of social phobia and panic disorder.


Other types of anxiety disorders include:

Specific Phobia, fearing a specific object or situation.

Agoraphobia, disabling fear that prevents one from leaving home or another safe place.

Obsessive-compulsive disorder (OCD), a system of ritualized behaviors or obsessions that are driven by anxious thoughts.

Post-traumatic stress disorder (PTSD), severe anxiety that is triggered by memories of a past traumatic experience.


Treatment Options

Most people who suffer from anxiety disorders begin to feel better when they receive the proper treatment. It can be difficult to identify the correct treatment, however, because each person’s anxiety is caused by a unique set of factors. It can be frustrating for the client when treatment is not immediately successful or takes longer than hoped for. Some clients feel better after a few weeks or months of treatment, while others may need a year or more. If a person has an anxiety disorder in combination with another disorder (such as alcoholism and depression), treatment is more complicated and takes longer.

While a treatment plan must be specifically designed for each individual, there are a number of standard approaches. Mental health professionals who specialize in treating anxiety most often use a combination of the following treatments. There is no single correct approach.


Cognitive-Behavioral Therapy

The client learns how to identify and change unproductive thought patterns by observing his or her feelings and learning to separate realistic from unrealistic thoughts. This treatment also helps the client alter and control unwanted behavior. VRMC continues to provide virtual reality (VR) exposure therapy for the treatment of fear of flying, fear of driving, fear of heights, fear of public speaking, social phobia, claustrophobia, agoraphobia, panic, eating disorders, anxiety and stress. The virtual reality treatment is used in conjunction with traditional cognitive-behavioral techniques, including breathing retraining with visual feedback of respiration, heart rate, sweat gland activity, and skin temperature. In addition, we continue to offer therapy for physiological disorders such as migraine headache, tension headache, irritable bowel syndrome, and attention-deficit hyperactivity disorder.


Relaxation Training

Many people with anxiety disorders benefit from self-hypnosis, guided visualization, and biofeedback. Relaxation training is often part of psychotherapy. We currently have a “Controlling Stress and Anxiety” group. The group meets on Saturdays from 9-10 a.m., and includes learning and practicing relaxation techniques, meditation, and self-hypnosis for an overall healthier lifestyle. The group facilitator is psychologist and certified hypnotherapist Dr. Jim Spira, who has over 20 years of experience working with stress and anxiety disorders. If you would like more information about the group please contact our receptionist staff at (858) 642-0267. The next “Controlling Stress and Anxiety” group will begin on Saturday March 2nd. We are taking reservations for these groups now.



Antidepressant and antianxiety medications can help restore chemical imbalances that cause symptoms of anxiety. This is an effective treatment for many people, especially in combination with psychotherapy.

The treatment for an anxiety disorder depends on the severity and length of the problem. The client’s willingness to actively participate in treatment is also an important factor. When a person with panic is motivated to try new behaviors and practice new skills and techniques, he or she can learn to change the way the brain responds to familiar thoughts and feelings that have previously caused anxiety.


Current Events at VRMC

VRMC would like to welcome Norman D. Severe, Psy.D., the Director of our new Child and Family Program. Dr. Severe is now available to see patients for child and family therapy as well as for psychological testing and assessment. He uses interactive technologies as an integral part of many of his treatment programs.

Dr. Mark Wiederhold, VRMC’s Medical Director serves as Editor-in-Chief of CyberPsychology & Behavior Journal, now in its fifth year of publication and currently indexed in both Medline and PsychLit/PsychInfo ( This peer-reviewed journal explores the impact of the Internet, Multimedia, and Virtual Reality on behavior and society, as well as how these advanced technologies are being used in the diagnosis, assessment, and treatment of mental health disorders. This journal allows professionals in the field to keep up with results from the latest controlled studies. We recently published the results of a controlled clinical trial using virtual reality exposure therapy for the treatment of patients with fear of flying. The paper has been published in the Emerging Communication Series Vol. 2, Toward CyberPsychology: Mind, Cognition, and Society in the Internet Age, by IOS Press. (

VRMC therapists recently attended and presented their research at the 10th annual Medicine Meets Virtual Reality conference in Newport Beach, California ( The international conference hosts a two-day mental health and rehabilitation symposium as well as an evening poster reception and hands-on demonstration evening so that the general public can try the newest technologies being used worldwide by clinicians and researchers. The Interactive Media Institute, VRMC’s affiliated non-profit, will host next year’s two day mental health and rehabilitation symposium.

We are opening our 2nd VRMC location in Los Angeles in March 2002. To schedule an appointment please see the contact information below. We look forward to being of service to those who need us in the future, and hope to continue to expand the services we offer to the Southern California community.



Dr. Brenda K. Wiederhold, Ph.D., MBA, BCIA Dr. Mark D. Wiederhold, M.D., Ph.D., FACP Ruth Kogen
Executive Director Medical Director Research Editor


Donations to support research and training opportunities combining technology and psychology may be made to our 501c3 nonprofit organization—the Interactive Media Institute.
Donations are tax deductible, and a letter will be provided for tax purposes.