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Anxiety and Stress

The world that we live in can be very fast-paced and often stressful. Although some people seem to be able to work through those types of situations without much difficulty, others have a harder time. Anxiety or the feeling of worry, or unease about something that has an uncertain outcome is entirely normal. Unfortunately, individuals can become so focused on those troublesome things that they are unable to move on. Many of these people may suffer from an anxiety disorder. This is a term used to describe a group of mental illnesses whose distress can prevent someone from living a healthy life. Worry and fear are often constant and can be disabling.

Types of Anxiety Disorders

Types of Anxiety Disorder

There are several different types of anxiety disorders; panic disorder, social anxiety disorder, generalized anxiety disorder, and specific phobias. While each condition may share the same general symptoms, what triggers their reaction can be quite different.

Common anxiety disorder symptoms:

  • Panic, fear, and uneasiness
  • Sleep problems
  • Inability to stay calm
  • Cold, sweaty, numb or tingling hands or feet
  • Shortness of breath
  • Heart palpitations
  • Dry mouth
  • Nausea
  • Tense muscles
  • Dizziness

While researchers don’t exactly know what causes an anxiety disorder, they believe that they are the result of a combination of issues, including genetics or faulty circuits in the brain that controls fear and other emotions. Individuals who have symptoms should consult their doctor to rule out medical illnesses that could be causing the symptoms. Unfortunately, no lab tests can accurately diagnose an anxiety disorder.

Anxiety treatment options

Typically, anxiety disorders are treated with therapy, medication, or a combination of both. While talk therapy can help individuals articulate their anxiety, most practitioners prefer individuals to begin treatment with an appropriate medication designed to lessen the severity of symptoms or to prevent them altogether.  Two of the most common types of medications for anxiety is Cymbalta and Paxil.

Cymbalta Prescription

Cymbalta is a selective serotonin and norepinephrine reuptake inhibitor (SSNRI) antidepressant that affects the chemicals in the brain that may be unbalanced in people who have depression as well as those who have a generalized anxiety disorder. While some medications of this type are not suggested for children, Cymbalta has been approved for anyone over the age of seven but must be used with caution.

Paxil Prescription Medication

Paxil is a selective serotonin reuptake inhibitor (SSRI) that, like Cymbalta, affects specific chemicals in the brain. Paxil can be used to treat depression, anxiety, or other disorders as well as improving mood. Unfortunately, it can have more unwanted side effects than other medications that work as it does.   

Cymbalta vs. Paxil

Cymbalta vs Paxil

While both medications have been proven to be very effective, some people or their physicians may prefer one over the over. The following chart highlights some of the things that should be considered before taking either medication.

Paxil

Cymbalta

Pros Pros
   
Available in generic Available in generic
Taken once a day May help alleviate nerve pain from diabetes and other forms of chronic pain
  Has several uses which may be suitable for individuals with multiple conditions
   
Cons Cons
   
More likely to increase the risk of some sexual dysfunction than other antidepressants Not recommended for heavy drinkers or have liver or kidney problems
May not be appropriate if you are elderly or have dementia Can increase high blood pressure
Can cause a higher risk of suicidal thoughts and behaviors in adolescents and children Can cause a higher risk of suicidal thoughts and behaviors for patients under 24 years old

 

How to get a Cymbalta or Paxil prescription in San Francisco

Cymbalta or Paxil prescription medication in San Francisco

Although occasional anxiety can be a normal part of life, those who find that they are dealing with the effects on a routine basis or that it impairs day to day living should seek the advice of a qualified medical practitioner such as those at EZCare Clinic. During your initial consultation, the experienced staff will work with you to determine the root causes that contribute to your anxiety and will design a treatment regimen that will include medications to ease or prevent symptoms and therapy or counseling. With the addition of counseling, patients can learn effective coping techniques that can help with any future issues. At EZCare Clinic, our goal is to treat the whole patient.

If you live in the San Francisco area, make an appointment with EZCare Clinic today. Our staff of caring and knowledgeable professionals have the experience necessary for all your healthcare needs. From routine medical issues to weight management, or mental health concerns and everything in between, EZCare Clinic is dedicated to providing our patients with a comfortable, non-judgmental environment that promotes whole body healing based on proven methodologies, medications and support services. Although an appointment is preferred, walk-ins are accepted Monday thru Sunday from 11 am to 7 pm.

 


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The use of emotional support animals (ESA) has been a hot button topic in recent years. Thanks to wide-spread abuse, individuals who suffer from debilitating mental or emotional disabilities may find themselves in a situation where they need to know their rights under California and Federal law.  Understanding the basic rules governing service dogs or support animals will allow you to be better prepared should any issue arise.

What is an emotional support animal?

While many people confuse support animals with service animals, it is important to note that they are different. A service dog provides the owners with a particular trained skill such as a visually impaired individual or someone that is blind or needs assistance with physical activities require a service animal. In contrast, animals that provide a therapeutic response would be considered a support animal.  A dog or other common domesticated animal that provides support to a disabled individual through companionship, affection, non-judgmental regard, or as being a distraction from issues can be an emotional support animal. Before an animal is deemed as an ESA, a diagnosis of a mental or emotional disability that significantly limits one or more of the daily major life activities must have been made by a qualified mental health professional. Animals that can be used for support may include other species; however, cats and dogs are the ones that typically come to mind. If the disabled person’s need is exclusively limited to a residential setting, any legal species of any age could qualify as an emotional support animal including cats, dogs, mice, rabbits, birds, hedgehogs, and ferrets. These animals are subject to the community’s species regulations, registration requirements, vaccination rules, and prohibitions. However, neither the federal government, the state of California or the city of San Diego requires any type of specialized training for an emotional support animal including basic obedience.

Types of protections for Emotional support animals

ESA Protections

The federal government enacted several measures designed to protect individuals who use service dogs or support animals. As well as adherence to the federal measures, California and San Diego have supported additional rules to govern ESAs.

 

Travel

Traveling can be an anxiety-producing task for anyone. For those who have severe emotional or mental illnesses, it can be debilitating. The Air Carrier Access Act (ACAA) under the Department of Transportation (DOT) protects the rights of individuals using emotional support animals. Guidelines mandate that the animal is allowed to travel in the cabin along with their disabled handler for free. DOT rules for air travel allow for stricter regulations than compared to other accommodations. “Unusual” animals such as snakes, reptiles, rodents, spiders and ferrets are not allowed due to safety concerns. In addition to these limitations, many air carriers have decided to require additional information before allowing travel with emotional support animals. Widespread abuse and the issues associated with them have necessitated that air carriers require proof from a licensed healthcare professional stating your mental health disability and the need for a service animal. This letter must be dated less than one year prior to traveling and follow a specific format. Contact should be made with the carrier well in advance of travel so that travelers have an adequate amount of time to gather all pertinent information. It is also recommended 48 hours prior to air travel; additional contact is made to ensure that there are no last-minute complications that would hinder your travel plans.

While the DOT has a separate policy for air travel, other forms of transportation (mass transit buses, commuter rails, ferries, etc.) is only required to make accommodations for individuals who use service animals and do not make a distinction between them and ESAs. The local provider is allowed to treat ESAs as pets under the same pricing policy, or they are allowed to ban them entirely. Additionally, neither the ACAA nor Americans with Disabilities Act (ADA) protections cover ESAs in any type of transient lodging. Those wishing to travel with ESAs must be prepared to seek pet-friendly accommodations while traveling. Locations can also legally charge a pet-fee for emotional support animals, limit the types of animals and place additional requirements as they see fit.

Employment

Working With An ESA San Diego

As in all fifty states, employers in California are required to make reasonable accommodations for employees with disabilities. While the federal government has created a gray area when it comes to including those who use emotional support animals, California has decided to include support animals in the workplace an appropriate accommodation. Although the federal government only requires employers to have fifteen or more employees before they are subject to this law, California and San Diego make the law a requirement once the employer has a minimum of five employees.

Employers also have some protections under California law. If the accommodations would cause “undue hardship” exemption from the law might be warranted. Examples of “undue hardships” could be exuberant cost or the nature of the accommodation, the size and number of employees of the facility and the employer, the type of operation or how providing the accommodation would affect the facility and the employer. In addition to protections against undue hardships, employers have a right to expect any support animal to be free from offensive odors, has been housebroken, well behaved and not endanger the health or safety of anyone in the workplace including the handler.

Housing

The Department of Housing and Urban Development under the Fair Housing Act (FHA) has mandated that tenants or potential tenants have rights regarding emotional support animals. Reasonable accommodations designed to ensure that people with disabilities have equal protection to use and enjoy an apartment or house are strictly enforced.

Reasonable accommodations, as in employment laws would be a change or exception to a policy that would prevent a disabled individual from performing one or more functions related to life such as working or living independently. Tenants who live in San Diego and require an emotional support animal cannot be denied the right to live with their ESA unless the animal poses a threat to the safety of others or would cause significant damage to the property of others. While some landlords may believe that speculation or fear of an animal is justification for not adhering to this law, the decision must be based on factual evidence of a specific animal’s conduct.

Because the laws regarding emotional support animals are fairly new, many property owners do not know or understand the guidelines set forth by the federal or state government. If you have received your first ESA letter and are unsure of what to do next, there are few basic rules that you should remember. Additional requirements for individuals with ESAs is prohibited. For example, property owners are only entitled to the ESA letter from a qualified healthcare professional and are not entitled to any additional information or demands. Contact with the professional is limited to verifying that the letter is valid and does not include any specific medical information including but not limited to medications or course of treatment. In fact, directly contacting the healthcare professional is not advised. If a property owner or landlord suspects the information provided is fraudulent, such verification should be handled by legal representation.

ESAs cannot be required to wear identifying tags or garments nor can owners be assessed fees or deposits normally required for individuals with pets no matter what species or breed.

Property owners do have certain protections under the laws just as employers do. Though they cannot demand deposits or fees for emotional support animals, they can legally charge the tenant for repairs if the property has been damaged by the animal.

Unfortunately, public places are not required to admit emotional support animals regardless of the requirement to admit service animals. Many places in San Diego are friendly to emotional support animals however, there are just as many who do not understand their purpose. Being prepared to discuss the benefits of ESAs with misinformed businesses and individuals could help you advocate for yourself and others. Please keep in mind that although emotional support animals have numerous protections, it is imperative that ESA owners respect laws that are designed to protect others as well.

How to obtain an Emotional Support Animal in San Diego

If you feel you would benefit from an emotional support animal and live or work in San Diego, the first step would be to consult your licensed mental health professional. To legally qualify you must be certified as emotionally disabled by a licensed psychologist, therapist, psychiatrist or other properly licensed or certified mental health professional. Once diagnosed and it is determined that you would benefit from an ESA in California, a letter from that provider can be issued that outlines your specific mental or emotional disability and your need for that animal can be issued. It can take some time for this process but once completed you the benefits you will receive from your animal is worth the wait.

Give us a call at EZCare Clinic at (415) 966-0848; we’re open 7 days a week, from 11:00 am to 7:00 pm PST. Or you can click here to schedule an appointment online to get your ESA today.


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Signs of Anxiety

It can be hard to know if you suffer from anxiety. So many things in our lives can prevent us from being properly diagnosed, whether it’s the belief that we’re fine, being used to the symptoms associated or being hesitant to seek any sort of help. EzCare Clinic can help you regain control from your anxiety with a variety of options for recovery. It can be overwhelming living with anxiety, but assistance from others who know how to treat it can be a great help. Having anxiety can be a strange and uncomfortable thing, but knowing the signs and symptoms of anxiety can help you better understand what you have and how to treat it.

What Are the Symptoms of Anxiety?

There are a variety of different anxiety symptoms. Due to possible overlap and similarities among traits, it is not unlikely for someone to have more than a few of these at a time.

1. Restlessness

While common in children and teens who have anxiety, adults can also suffer from restlessness. It’s not a definitive sign of anxiety, but it does count as a common symptom. If you find yourself being restless, it means you do not want to be still much of the time; this can include having feelings of needing to be in constant movement.

2. Irrational Fear

If you find yourself stressed out because of anxiety, it’s possible that you can develop irrational fear, or that the irrational fear is part of what makes you stressed. What makes irrational fear different from, say, traditional fear, is that you can find yourself in fear of things that, usually, do not cause the same level of concern in others. While these fears can be phobia specific, they can also be more general. Some fears might be associated with other symptoms, such as the fear of one’s next panic attack or that someone is out to get them.

3. Fatigue/Tiredness

Being tired may not be as strongly associated with anxiety as other symptoms, but it definitely counts as one. Someone with anxiety can suffer from fatigue regularly; it can be the result of another symptom, as well. Fatigue alone cannot classify someone as having anxiety, and it is doubtful that this fatigue alone would have someone claim they have anxiety.

Anxiety symptoms

4. Insomnia

It should be no surprise that having trouble sleeping is a well-known symptom related to anxiety. Being restless and fearful all the time can keep you up, and you might find yourself developing insomnia. This can get in the way of your daily activities as well, which can cause your work or relationships to suffer. If you had insomnia as a child, your risk for anxiety could be higher.

5. Worry

Being worried is nothing new, and is a very normal part of our lives. That said, if you have anxiety, you might find yourself worrying more extremely than most. Things that you could ignore or would not usually bother you are now causing you to be overly concerned. Excessive worry is a significant sign of anxiety, so consult a medical professional if you feel it is interfering with your daily life.

6. Lack of Concentration

You can have trouble concentrating on things if your mind is all over the place and your body is acting stressed or fidgety. Combined with other possible symptoms, one’s concentration will suffer and result in disruption of their daily lives. This lack of concentration can also result in other symptoms, as well, such as agitation and restlessness.

7. Panic Attacks

Sometimes known as anxiety attacks, this is when your heart starts to race, and your palms start to sweat in an irregular matter. Your body goes into a fight-or-flight state, even if there’s no actual danger present; like having irrational fear, much of the cause for a panic attack is mental. While the length of a panic attack can last for several minutes, it ultimately varies.

8. Agitation

If you have a combination of concern, attacks, fatigue, and restlessness, you are likely to become agitated. This means you can get easily frustrated, overwhelmed, and uneasy, all of which can be the result of anxiety.

9. Paranoia

Anxiety can also lead to you being paranoid, which can lead to irrational fear and panic attacks, as well as paranoia about another attack. Paranoia can also relate to you being excessively worried about others in your life, whether harm will come to them, or that someone is out to get you and your loved ones.

10. Sickness

All of the previously mentioned signs and symptoms of anxiety can also lead to one feeling physically ill. This can mean to you having a headache or an ill stomach, or just feeling generally low on energy.

What Are the Different Types of Anxiety?

Types Of Anxiety

Along with the signs associated with anxiety, there also exist different types of anxiety disorders. Your unique circumstances and situations will determine the disorder type you have; some of these are more common than others.

Generalized Anxiety Disorder

The most common of anxiety disorders, this is what people tend to refer to when they talk about having anxiety. Having generalized anxiety disorder means having the most common of signs, such as paranoia, frustration, worry, and fear.

Panic Disorder

This is when panic/anxiety attacks are your prime source of anxiety; physical symptoms include increased heartbeat, intense sweating, trembling, and shortness of breath. Having a panic disorder means being in fear of the next attack and avoiding places and events that could induce an attack. All of this can make the person more resistant to engagement, and may even prevent them from seeking proper help.

Agoraphobia

One of the most common anxiety disorders and phobias, agoraphobia is also well-known as social anxiety disorder. Agoraphobia is when crowds and public spaces cause anxiety, and it’s something you might try to avoid at all costs. This can include a party full of people or public transportation, where there is a lot of foot traffic. There’s also the fear of embarrassment and entrapment that can contribute to the phobia.

Phobia Specific

This is when a very specific thing causes your anxiety. While agoraphobia relates to social environments, some phobias are even more specific than that, such as a fear of snakes, spiders, flying, and of course, clowns. Unsurprisingly, an anxiety attack can occur from encountering something one has a phobia for.

Separation Anxiety Disorder

The fear of losing someone close to you, not wanting to be apart from someone, and extreme concern for what may happen to someone if you are not with them are all related to separation anxiety disorder. While more common in young children, adults are not immune to having this specific disorder.

Where Can I Get Treatment for Anxiety?

If you suffer from any of the mentioned signs or symptoms for over six months, you should get in touch with a medical professional. EzCare Clinic will be able to help you find the best recovery options suited to your unique needs, with the assistance of our certified and licensed physicians. You can make an appointment by calling us at (415) 966-0848 or visiting our webpage. Rid yourself of anxiety and make your appointment today!

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