Introduction
Depression is more than simply feeling unhappy or fed up for a few days.
We all go through spells of feeling down, but when you're depressed you feel persistently sad for weeks or months, rather than just a few days.
Some people still think that depression is trivial and not a genuine health condition. They're wrong. Depression is a real illness with real symptoms, and it's not a sign of weakness or something you can "snap out of" by "pulling yourself together".
The good news is that with the right treatment and support, most people can make a full recovery.
How to tell if you have depression
Depression affects people in different ways and can cause a wide variety of symptoms.
They range from lasting feelings of sadness and hopelessness, to losing interest in the things you used to enjoy and feeling very tearful. Many people with depression also have symptoms of anxiety.
There can be physical symptoms too, such as feeling constantly tired, sleeping badly, having no appetite or sex drive, and complaining of various aches and pains.
The severity of the symptoms can vary. At its mildest, you may simply feel persistently low in spirit, while at its most severe depression can make you feel suicidal and that life is no longer worth living.
Most people experience feelings of stress, sadness or anxiety during difficult times. A low mood may improve after a short time, rather than being a sign of depression.
When to see Dr. B C Shah
It's important to seek help from Dr. B C Shah if you think you may be depressed.
Many people wait a long time before seeking help for depression, but it's best not to delay. The sooner you see a doctor, the sooner you can be on the way to recovery.
Sometimes there is a trigger for depression. Life-changing events, such as bereavement, losing your job or even having a baby, can bring it on.
People with a family history of depression are also more likely to experience it themselves.
But you can also become depressed for no obvious reason.
Depression is quite common and affects about one in 10 of us at some point. It affects men and women, young and old.
Depression can also strike children.
Treatment
Treatment for depression involves either medication or talking treatments, or usually a combination of the two. The kind of treatment that Dr. B C Shah recommends will be based on the type of depression you have.
Living with depression
Many people with depression benefit by making lifestyle changes such as getting more exercise, cutting down on alcohol and eating more healthily.
Self-help measures such as reading a self-help book or joining a support group are also worthwhile.
Symptoms of clinical depression
The symptoms of depression can be complex and vary widely between people. But as a general rule, if you are depressed, you feel sad, hopeless and lose interest in things you used to enjoy.
The symptoms persist for weeks or months and are bad enough to interfere with your work, social life and family life.
There are many other symptoms of depression and you're unlikely to have every one listed below.
If you experience some of these symptoms for most of the day, every day for more than two weeks, you should seek help from Dr. B C Shah.
Psychological symptoms include:
Continuous low mood or sadness
Feeling hopeless and helpless
Having low self-esteem
Feeling tearful
Feeling guilt-ridden
Feeling irritable and intolerant of others
Having no motivation or interest in things
Finding it difficult to make decisions
Not getting any enjoyment out of life
Feeling anxious or worried
Having suicidal thoughts or thoughts of harming yourself
Physical symptoms include:
Moving or speaking more slowly than usual
Change in appetite or weight (usually decreased, but sometimes increased)
Constipation
Unexplained aches and pains
Lack of energy or lack of interest in sex (loss of libido)
Changes to your menstrual cycle
Disturbed sleep (for example, finding it hard to fall asleep at night or waking up very early in the morning)
Social symptoms include:
Not doing well at work
Taking part in fewer social activities and avoiding contact with friends
Neglecting your hobbies and interests
Having difficulties in your home and family life
Depression can come on gradually, so it can be difficult to notice something is wrong. Many people continue to try to cope with their symptoms without realising they are ill. It can take a friend or family member to suggest something is wrong.
Doctors describe depression by how serious it is:
Mild depression has some impact on your daily life
Moderate depression has a significant impact on your daily life
Severe depression makes it almost impossible to get through daily life � a few people with severe depression may have psychotic symptoms
Grief and depression
It can be hard to distinguish between grief and depression. They share many of the same characteristics, but there are important differences between them.
Grief is an entirely natural response to a loss, while depression is an illness.
People who are grieving find their feelings of loss and sadness come and go, but they're still able to enjoy things and look forward to the future.
In contrast, people who are depressed have a constant feeling of sadness. They don't enjoy anything and find it hard to be positive about the future.
Other types of depression
There are different types of depression, and some conditions where depression may be one of the symptoms. These include:
Postnatal depression. Some women develop depression after having a baby. Postnatal depression is treated in similar ways to other forms of depression, with talking therapies and antidepressant medicines.
Bipolar disorder is also known as "manic depression". It's where there are spells of depression and excessively high mood (mania). The depression symptoms are similar to clinical depression, but the bouts of mania can include harmful behaviour such as gambling, going on spending sprees and having unsafe sex.
Seasonal affective disorder (SAD). Also known as "winter depression", SAD is a type of depression that has a seasonal pattern usually related to winter.
Causes
There is no single cause of depression. You can develop it for different reasons and it has many different triggers.
For some, an upsetting or stressful life event � such as bereavement, divorce, illness, redundancy and job or money worries � can be the cause.
Often, different causes combine to trigger depression. For example, you may feel low after an illness and then experience a traumatic event, such as bereavement, which brings on depression.
People often talk about a "downward spiral" of events that leads to depression. For example, if your relationship with your partner breaks down, you're likely to feel low, so you stop seeing friends and family and you may start drinking more. All of this can make you feel even worse and trigger depression.
Some studies have also suggested you're more likely to get depression as you get older, and that it's more common if you live in difficult social and economic circumstances.
Stressful events
Most people take time to come to terms with stressful events, such as bereavement or a relationship breakdown. When these stressful events happen, you have a higher risk of becoming depressed if you stop seeing your friends and family and you try to deal with your problems on your own.
Illness
You may have a higher risk of depression if you have a longstanding or life-threatening illness, such as coronary heart disease or cancer.
Head injuries are also an often under-recognised cause of depression. A severe head injury can trigger mood swings and emotional problems.
Some people may have an (underactive thyroid (hypothyroidism) due to problems with their immune system. In rarer cases a minor head injury can damage the pituitary gland, a pea-sized gland at the base of your brain that produces thyroid-stimulating hormones.
This can cause a number of symptoms, such as extreme tiredness and a loss of interest in sex (loss of libido), which can in turn lead to depression.
Personality
You may be more vulnerable to depression if you have certain personality traits, such as low self-esteem or being overly self-critical. This may be due to the genes you've inherited from your parents, or because of your personality or early life experiences.
Family history
If someone else in your family has suffered from depression in the past, such as a parent or sister or brother, then it's more likely you will too.
Giving birth
Some women are particularly vulnerable to depression after pregnancy. The hormonal and physical changes, as well as added responsibility of a new life, can lead to postnatal depression.
Loneliness
Becoming cut off from your family and friends can increase your risk of depression.
Alcohol and drugs
Some people try to cope when life is getting them down by drinking too much alcohol or taking drugs. This can result in a spiral of depression.
Cannabis helps you relax, but there is evidence that it can bring on depression, especially in teenagers.
And don't be tempted to drown your sorrows with a drink. Alcohol is categorised as a "strong depressant" and actually makes depression worse.
Diagnosing clinical depression
If you experience symptoms of depression for most of the day, every day for more than two weeks, you should seek help from Dr. B C Shah.
It is especially important to speak to Dr. B C Shah if you experience:
symptoms of depression that are not improving
your mood affects your work, other interests, and relationships with your family and friends
thoughts of suicide or self-harm
Sometimes, when people are depressed they find it hard to imagine that treatment can actually help. But the sooner you seek treatment, the sooner your depression will lift.
There are no physical tests for depression, though Dr. B C Shah may examine you and do some urine or blood tests to rule out other conditions that have similar symptoms, such as an underactive thyroid.
The main way in which Dr. B C Shah will tell if you have depression is by asking you lots of questions about your general health and how the way you are feeling is affecting you mentally and physically.
Try to be as open as you can be with the doctor. Describing your symptoms and how they are affecting you will really help Dr. B C Shah understand if you have depression and how severe it is.
Any discussion you have with Dr. B C Shah will be confidential. He will only ever break this rule if there's a significant risk of harm to either yourself or others, and if informing a family member or carer would reduce that risk.
Treating clinical depression
Treatment for depression usually involves a combination of medicines, talking therapies and self help.
Treatment options
The kind of treatment that your doctor recommends will be based on the type of depression you have. Below is a short description of the types of treatment your doctor may recommend.
Mild depression
Wait and see - If you're diagnosed with mild depression, your depression may improve by itself. In this case, you'll simply be seen again by Dr. B C Shah after two weeks to monitor your progress. This is known as watchful waiting.
Exercise - Exercise has been proven to help depression, and is one of the main treatments if you have mild depression. Dr. B C Shah may refer you to a qualified fitness trainer for an exercise scheme or you can find out more about starting exercisehere.
Self help groups - Talking through your feelings can be helpful. It can be either to a friend or relative, or you can ask Dr. B C Shah to suggest a local self-help group. He may also recommend self-help books and online cognitive behavioural therapy (CBT).
Mild to moderate depression
Talking therapy - If you have mild depression that isn't improving, or you have moderate depression, Dr. B C Shah may recommend a talking treatment (a type of psychotherapy). There are different types of talking therapy for depression including cognitive behavioural therapy (CBT) and counselling. Dr. B C Shah can refer you for talking treatment or, in some parts of the country, you might be able to refer yourself.
Moderate to severe depression
Antidepressants - Antidepressants are tablets that treat the symptoms of depression. There are almost 30 different kinds of antidepressant. They have to be prescribed by a doctor, usually for depression that is moderate or severe.
Combination therapy - Dr. B C Shah may recommend that you take a course of antidepressants plus talking therapy, particularly if your depression is quite severe. A combination of an antidepressant and CBT usually works better than having just one of these treatments.
Mental health teams - If you have severe depression, you may be referred to a mental health team made up of psychologists, psychiatrists, specialist nurses and occupational therapists. These teams often provide intensive specialist talking treatments as well as prescribed medication.
Living with clinical depression
There are some key steps you can take to lift your mood and help your recovery from depression.
Take your medication
It is important to take your medication as prescribed, even if you start to feel better.
If you stop your medication too soon, you could have a relapse of your depression. If you have any questions or concerns about the medication you're taking, talk to your doctor or pharmacist.
It may help to read the information leaflet that comes with your medication to find out about possible interactions with other drugs or supplements. Check with your doctor first if you plan to take any over-the-counter remedies such as painkillers, or any nutritional supplements. These can sometimes interfere with antidepressants.
Exercise and diet
Exercise and a healthy diet can make a tremendous difference to how quickly you recover from depression. And they will both improve your general health, too.
Research suggests that exercise can be as effective as antidepressants at reducing depression symptoms.
Being physically active lifts your mood, reduces stress and anxiety, boosts the release of endorphins (your body's feel-good chemicals) and improves your self-esteem.
It also helps your mood to have a healthy diet. In fact, eating healthily seems to be just as important for maintaining your mental health as it is for preventing physical health problems.

JAP, JAAP, JIKRA, SIMARAN, SUMIRAN, REMEMBRANCE AND SMARAN: DR. SHRINIWAS KASHALIKAR

The great seers see the undercurrents of unity. They live in the plane and the spirit of unity!

However; some of us often knowingly or unknowingly stick to some rigid discipline, which often assumes the form of rituals.

This is useful to preserve the heritage of the seer, by virtue of preempting complacency, lethargy and irresponsibility. It is also useful to some extent; to prevent casual approach and/or vulgarization; and maintain sanctity and due seriousness.

But when this discipline sticks to the semantics and external paraphernalia; and loses the spirit of the visionary; it becomes a hindrance to the revitalizing and rejuvenating globalization of the very spirit, with which the visionary lived.

This is exactly why; even as there are billions of us; practicing NAMASMARAN; as a result of the illuminating lives of the seers, sages, saints and prophets; there are literally; so many disunited or un-united sects and cults; even amongst the practitioners! This is also one of the reasons; why; most of us; the advocates of NAMASMARAN; do not understand and appreciate the same spirit of unity and harmony underlying the JAP, JAAP, JIKRA, SIMARAN, SUMIRAN, REMEMBRANCE and SMARAN!

We do not seem to understand that all such synonyms from different languages and different traditions; most importantly connote the conceptualization of holistic perspective, policy, plans, programs and their implementation; and actual realization of the universal unity, harmony and blossoming; foreseen by the seers!

Due to this; we are dedicated to the external forms of religions, sects, cults, traditions etc! We criticize, backbite, humiliate, abuse, run down, despise, hate and harm; the other religions, sects, cults, traditions etc! This may be a case of giving vent to basal and carnal instincts, ulterior motives, prejudices, hatred, vengeance etc; under the garb of devotion; as it is an easier way to feel righteous, secure, convinced, contented and proud! It is also; a tangible way; to boast ourselves as the true devotees (and the others as blasphemous and/or cowards)!!!

If we appreciate the plane and the spirit of unity or our respective gurus, seers, sages, saints, prophets; then; not only we (the practitioners and advocates of NAMASMARAN of different sects, cults, traditions and religions); but rest all; including even the atheists; would actually practice and propagate NAMASMARAN; and unite and blossom!

Introduction
Anxiety is a feeling of unease, such as worry or fear, that can be mild or severe.
Everyone has feelings of anxiety at some point in their life. For example, you may feel worried and anxious about sitting an exam or having a medical test or job interview.
Feeling anxious is sometimes perfectly normal. However, people with generalised anxiety disorder (GAD) find it hard to control their worries. Their feelings of anxiety are more constant and often affect their daily life.
Anxiety is the main symptom of several conditions, including:
Panic disorder
Phobias
Post-traumatic stress disorder
The information in this section is about generalised anxiety disorder (GAD).
Generalised anxiety disorder (GAD)
GAD is a long-term condition which causes you to feel anxious about a wide range of situations and issues, rather than one specific event.
People with GAD feel anxious most days and often struggle to remember the last time they felt relaxed. GAD can cause both psychological (mental) and physical symptoms. These vary from person to person, but can include feeling irritable or worried and having trouble concentrating or sleeping.
How common is anxiety?
GAD affects about 1 in 20 adults in Britain. Slightly more women are affected than men, and the condition is most common in people in their 20s.
How is anxiety treated?
GAD can significantly affect your daily life, making it difficult to carry out everyday tasks. However, several different treatments are available to ease your psychological and physical symptoms. These include psychological therapy and medication.
There are also many things you can do to ease the symptoms of anxiety yourself.
Symptoms of generalised anxiety disorder
The symptoms of general anxiety disorder (GAD) often develop slowly. How severe they are varies from person to person.
Some people have only one or two symptoms, while others have many more.
Anxiety can affect you physically and mentally.
Psychological symptoms of anxiety
GAD can cause a change in your behaviour and the way you think and feel about things. Psychological symptoms of GAD include:
Restlessness
A sense of dread
Feeling constantly "on edge"
Difficulty concentrating
Irritability
Impatience
Being easily distracted
Your symptoms may cause you to withdraw from social contact (seeing your family and friends) to avoid feelings of worry and dread. You may also find going to work difficult and stressful and may take time off sick. These actions can make you worry even more about yourself and increase your lack of self-esteem.
Physical symptoms of anxiety
The physical symptoms of GAD can include:
Dizziness
Drowsiness and tiredness
Pins and needles
Irregular heartbeat (palpitations)
Muscle aches and tension
Dry mouth
Excessive sweating
Shortness of breath
Stomach ache
Nausea
Darrhoea
Headache
Excessive thirst
Frequent urinating
Painful or missed periods
Difficulty falling or staying asleep (insomnia)
How anxiety can intensify
If you are anxious as a result of a phobia or because of panic disorder, you will usually know what the cause is. For example, if you have claustrophobia (a fear of enclosed spaces), you know that being confined in a small space will trigger your anxiety.
However, if you have GAD, what you are feeling anxious about may not always be clear. Not knowing what triggers your anxiety can intensify your anxiety and you may start to worry that there will be no solution.
Causes of generalised anxiety disorder
As with most conditions that affect mental health, the exact cause of generalised anxiety disorder (GAD) is not fully understood.
Some people develop the condition for no apparent reason. Others may develop GAD after a major stressful incident.
Neurotransmitters and anxiety
Research has suggested that GAD may be caused by an imbalance of certain chemicals that occur naturally in the brain. These chemicals are known as neurotransmitters.
Two neurotransmitters thought to affect anxiety are serotonin and noradrenaline. If the level of these chemicals in your brain becomes unbalanced, it can significantly affect your mood and increase your likelihood of developing anxiety-related conditions such as GAD.
However, GAD is most likely to have a complex combination of causes, rather than being triggered by just an imbalance of brain chemicals.
Combination of causes of anxiety
Researchers believe that GAD is caused by a combination of factors, including:
Your body's biological processes
Genetics (the genes you inherit from your parents)
Your environment
Your life experience
Diagnosing generalised anxiety disorder
See Dr. B C Shah if anxiety is affecting your daily life or is causing you distress.
Generalised anxiety disorder (GAD) can be difficult to diagnose. In some cases, it can also be difficult to distinguish from other mental health conditions, such as depression.
Talking to Dr. B C Shah about anxiety
Dr. B C Shah may ask you questions about your worries, fears and emotions. They may also ask about your personal life. Tell him about all your symptoms � physical and psychological � and explain how long you have had them.
You may find it difficult to talk about your feelings, emotions and personal life. However, it is important that Dr. B C Shah understands your symptoms and circumstances so that the correct diagnosis can be made.
You are most likely to be diagnosed with GAD if you have had the symptoms for six months or more. Finding it difficult to manage your feelings of anxiety is also an indication that you may have developed the condition.
To help with the diagnosis,Dr. B C Shah may carry out a physical examination to rule out any other conditions that may be causing your symptoms.
Treating generalised anxiety disorder
There are two main forms of treatment for generalised anxiety disorder (GAD):
Psychological therapy
Medication
Depending on your circumstances, you may benefit from one of these types of treatment or a combination of the two.
Studies of different treatments for GAD have found that the benefits of psychological treatment last the longest, but no single treatment is best for everyone.
Before you begin any form of treatment, Dr. B C Shah should discuss all your treatment options with you. They should outline the pros and cons of each and make you aware of any possible risks or side effects. With Dr. B C Shah, you can make a decision on the treatment most suited to you, taking into account your personal preferences and circumstances.
Psychological treatment for anxiety
If you have been diagnosed with GAD, you will usually be advised to try psychological treatment before you are prescribed medication. The main type of psychological treatment for GAD is cognitive behavioural therapy (CBT).
Cognitive behavioural therapy
Cognitive behavioural therapy (CBT) is one of the most effective types of treatment for GAD. Research suggests that around half of people who have CBT recover from GAD and many others get some benefit.
CBT works by helping you identify unhelpful and unrealistic beliefs and behavioural patterns. You and your therapist work together to change your behaviour and replace unhelpful beliefs with more realistic and balanced ones.
CBT mainly focuses on the problems you have at the moment, rather than events from the past. It teaches you new skills and helps you understand how to react more positively to situations that would usually cause you anxiety.
Applied relaxation
Applied relaxation is an alternative type of psychological treatment. It was initially used to treat phobias, but it is now also being used to treat conditions such as GAD.
Applied relaxation focuses on relaxing your muscles in a particular way during situations that usually cause anxiety. The technique will need to be taught by a trained therapist, but it involves:
Learning how to relax your muscles
Learning how to relax your muscles quickly and in response to a trigger, such as the word "relax"
Practising relaxing your muscles in situations that make you anxious
You will need 12 to 15 hour-long sessions to learn how to use applied relaxation correctly. It has been found to be as effective as CBT.
Medication for anxiety
Dr. B C Shah can prescribe a variety of different types of medication to treat GAD. Some medication is designed to be taken on a short-term basis, while other medicines are prescribed for longer periods. Depending on your symptoms, you may require medicine to treat your physical symptoms as well as your psychological ones.
If you are considering taking medication for GAD, Dr. B C Shah should discuss the different options with you in detail, including the different types of medication, length of treatment, side effects and possible interactions with other medicines before you start a course of treatment.
Long-term medication includes:
Selective serotonin reuptake inhibitors (SSRIs), such as sertraline, fluoxetine, citalopram or paroxetine
Venlafaxine
Pregabalin
Short-term medication includes:
Antihistamines
Benzodiazepines
Buspirone
Selective serotonin reuptake inhibitors (SSRIs)
Selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressant that increase the level of a chemical called serotonin in your brain. They can be taken on a long-term basis.
As with all antidepressants, SSRIs can take several weeks to start working. You will usually be started on a low dose which will gradually be increased as your body adjusts to the medicine.
You may be offered an SSRI called sertraline. Sertraline is not specifically licensed to treat GAD, which means that the manufacturers of the medicine have not applied for a license for it to be used to treat the condition. However, it is used to treat similar conditions, such as panic disorderand obsessive compulsive disorder (OCD).
Citalopram, fluoxetine and paroxetine are SSRIs that are often prescribed to treat GAD.
Common side effects of SSRIs include:
Nausea (feeling sick)
Low sex drive
Blurred vision
Diarrhoea or constipation
Dizziness
Dry mouth
loss of appetite
Sweating
Feeling agitated
Insomnia (problems sleeping)
When you start taking an SSRI, you should see Dr. B C Shah after two, four, six and 12 weeks to check your progress and to see if you are responding to the medicine. Not everyone responds well to antidepressant medicines, so it is important that your progress is carefully monitored.
If Dr. B C Shah feels it is necessary, you may require regular blood tests or blood pressure checks when taking antidepressant medication. If, after 12 weeks of taking the medication, you do not show any signs of improvement, Dr. B C Shah may prescribe an alternative SSRI to see if that has any effect.
When you and Dr. B C Shah decide that it is appropriate for you to stop taking your SSRI medication, you will gradually be weaned off the medication by slowly reducing your dose. Never stop taking your medication unless he specifically advises you to.
Venlafaxine
If SSRIs do not help ease your anxiety, you may be prescribed a different type of antidepressant known as venlafaxine.
Venlafaxine belongs to a group of medicines known as selective serotonin and noradrenaline reuptake inhibitors (SNRIs). This type of medicine increases the amount of the chemicals serotonin and noradrenaline in your brain, helping restore the chemical imbalance that sometimes causes GAD.
You cannot be prescribed venlafaxine if you:
Have high blood pressure that is not being treated
Have recently had a heart attack
Are at risk of having irregular heartbeats (cardiac arrhythmias)
If you have any of the above conditions, you may be at risk of developing complications if you take venlafaxine.
Common side effects of venlafaxine may include:
Nausea
Headache
Drowsiness
Dizziness
Dry mouth
Constipation
Indigestion
Insomnia
Sweating
If you are prescribed this medicine, your blood pressure will be monitored regularly.
Pregabalin
If SSRIs and SNRIs are not suitable for you, you may be offered pregabalin. This is a medication known as an anticonvulsant, which is used to treat conditions such as epilepsy (a condition that causes repeated seizures). However, it has also been found to be beneficial in treating anxiety.
The most commonly reported side effects of pregabalin include:
Drowsiness
Dizziness
Headaches
Pregabalin is less likely to cause nausea or a low sex drive than SSRIs or SNRIs.
Antihistamines
Antihistamines are usually prescribed to treat allergic reactions. However, some are also used to treat anxiety on a short-term basis.
Antihistamines have a calming effect on the brain, helping you feel less anxious.
Antihistamines are only effective when used for a short period of time and will only be prescribed for a few weeks.
Hydroxyzine is the most commonly prescribed antihistamine for treating anxiety. This antihistamine can make you feel drowsy, so it is best not to drive or operate machinery when taking the medication. Other side effects of hydroxyzine include:
Dizziness
Blurred vision
Headache
Dry mouth
Benzodiazepines
Benzodiazepines are a type of sedative that help ease the symptoms of anxiety within 30 to 90 minutes of taking the medication.
Although benzodiazepines are very effective in treating the symptoms of anxiety, they cannot be used for long periods of time. This is because they can become addictive if used for longer than four weeks. Benzodiazepines also start to lose their effectiveness after this time.
For these reasons, you will usually only be prescribed benzodiazepines to help you cope during a particularly severe period of anxiety. Benzodiazepines can cause side effects, including:
Confusion
Loss of balance
Memory loss
Drowsiness and light-headedness
Due to the above side effects, benzodiazepines can affect your ability to drive or operate machinery. Therefore, avoid these activities when taking the medication.
Speak to Dr. B C Shah if you experience any of the side effects listed above. They may be able to adjust your dose of medication or prescribe an alternative.
Buspirone
Buspirone is a medicine that can help ease the psychological symptoms of anxiety. It belongs to a group of medicines known as anxiolytics.
You will usually have to take buspirone for two weeks before you notice an improvement. It will be up to Dr. B C Shah how long you continue to take the medicine after this.
Buspirone works in a similar way to benzodiazepines, but does not become addictive. However, it is only recommended as a short-term form of medication.
Referral for anxiety
If you have tried any two treatments (out of medication, CBT and self-help with guidance from Dr. B C Shah) and you still have significant symptoms of GAD, you may want to discuss with Dr. B C Shah whether you should be referred to a mental health specialist.
An appropriate mental health specialist from your local team will carry out an overall reassessment of your condition. They will ask you about your previous treatment and how effective you found it. They may also ask about things in your life that may be affecting your condition, or how much support you get from family and friends. Your specialist will then be able to devise a treatment plan for you, which will aim to effectively treat your symptoms. This may include any of the following:
psychological therapies such as CBT
appropriate treatment of other diseases and conditions that may have an effect on your anxiety
other medication
further referral to specialists
Self-help treatments for generalised anxiety disorder
If you have generalised anxiety disorder (GAD), there are many ways that you can ease the symptoms of anxiety yourself.
Exercise for anxiety
Regular exercise, particularly aerobic exercise, will help you combat stress and release tension. It also encourages your brain to release the chemical serotonin, which can improve your mood.
Aim to do a minimum of 150 minutes of moderate exercise a week. Moderate exercise should make you feel slightly out of breath and tired. Going for a brisk walk is a good example.
Relaxation
As well as getting regular exercise, learning how to relax is important. You may find relaxation and breathing exercises helpful, or you may prefer activities such as yoga or pilates to help you unwind.
Diet
Changing your diet may help ease your symptoms. Too much caffeine can make you more anxious than normal. This is because caffeine can disrupt your sleep and also speed up your heartbeat. If you are tired, you are less likely to be able to control your anxious feelings.
Smoking and drinking
Smoking and alcohol have been shown to make feelings of anxiety worse. Drink alcohol in moderation and, if you smoke, try to give up.
The Department of Health recommends that men should not drink more than three to four units of alcohol a day and women no more than two to three units.
Support groups for anxiety
Support groups can give you useful advice about how to effectively manage your anxiety. They are also a good way to meet other people with similar experiences.
Support groups often involve face-to-face meetings where you can talk about your difficulties and problems with other people. Many support groups also provide support and guidance over the phone or in writing.
Understanding your anxiety
Some people find that reading about anxiety can help them deal with their condition. There are many books based on the principles of cognitive behavioural therapy (CBT). These may help you understand your psychological problems better and learn ways to overcome them by changing your behaviour.

PRAPANCH: DR SHRINIWAS KASHALIKAR

God is the field and eternal and super controlling cause; and everything else is a "function" or ""contingent".

What is the meaning of doing PRAPANCH in a proper manner?

The perceptions, feelings and behavior; together; are called PRAPANCH. This is like a river.

Drying of river is like rejection of and/or escapism from these (e.g. through indolence, inertia, frustration etc); and is a product of TAMOGUN.

Deluge (destructive to self and others) is like obsessive and indiscriminate involvement and/or entanglement in mundane matters; and is due to RAJOGUN.

Proper flow of river benevolent to all in the surroundings; is like optimization and/or rectification of lif; in moderation; without losing the focus of individual and global welfare; and is due to SATVAGUN.

Ultimately merging with the ocean; is like living to one's fulfillment and complete satisfaction and merging with the ocean of immortality!

Living in the practice of NAMASMARAN makes this possible. This is the essence of Sadguru's teachings.

Essence in Marathi:
श्री राम समर्थ
"प्रपंच करावा नेटका" म्हणजे काय?
प्रपंच म्हणजे नदी. ती सुकणे म्हणजे प्रपंच नाकारणे. हा तमोगुण.
तिला पूर् येणे म्हणजे प्रपञ्चात गुरफटणे, धुंद होणे, खचणे, हतबल होणे. हा रजोगुण.
प्रपंच नेटका करणे म्हणजे नदीने योग्य प्रकारे भरून वाहात आजू बाजू चा परिसर सम्पन्न करीत जाणे. हा सत्वगुण.
प्रपंच नेटका करीत त्याचे सार्थक करणे म्हणजे नदीने सागराला मिळणे.
नामात प्रपंच केला की हे साध्य होते.
हा सद्गुरू च्या उपदेशाचा भावार्थ आहे.

SPIRITUAL INFRASTRUCTURE: DR. SHRINIWAS KASHALIKAR

Roads, bridges, railway, electricity, telecommunication; etc. constitute economic infrastructure; and play an important role in progress.

But if there are no; at least reasonably; healthy individuals, then this economic infrastructure becomes meaningless and useless.

Hence; the health care facilities, housing, drinking water, schools; etc, which constitute social infrastructure; have to go hand in hand; with the development of economic infrastructure.

But if the members of a social group harbor; a perspective, ideology, thinking, feeling, motivation and behavior; of fanatic sectarian development; then it can be counterproductive and destructive to that social group; as well as to the others.

Hence along with the economic and social infrastructure; it is essential to work; on the spiritual infrastructure; simultaneously. We can appreciate this point; if we carefully observe; the quality of individual and social life; in any part of the world; including the developed countries.

The spiritual infrastructure can be developed if there is a simple and inexpensive program that can be acceptable to different ideologies and religions. One such program is; remembering and reorienting to one�s true self; called JAP, JAAP, JIKRA, SUMIRAN, SIMARAN i.e. NAMASMARAN; and can be introduced in every nook and corner of the world and to everyone irrespective of age, sex, occupation, religion, race, nationality etc.