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Argentina

Buenos Aires

This experience definitely changed my life for the better. I became more aware of another cultures characteristics and learned to open myself up to people who made my trip something I will cherish for the rest of my life.

Alejandra Limon, California State University- Long Beach

Before I went abroad, I had a lot of trouble deciding which program to choose. I could not be happier that I went abroad with ISA. The connections I have made with my host mom and the friends I met through the program will hopefully last a lifetime. Every day is a new adventure, and every conversation teaches me something new. If you are still having doubts about study abroad, stop! It is the best decision I have ever made!

Kathleen Elliot, University of Massachusetts- Boston

Buenos Aires, an unexpected choice to most people, but the best one you'll ever make. I learned so much about myself and and the world around me in my past five months here. The Argentine people are so welcoming and kind and I feel so fortunate that I was able to experience them and their culture.

Makenzie Pigman, American River College

The ISA in Buenos Aires program provides just the right mixture of immersion, adventure, and security for an unforgettable and truly Argentine experience

Roman Druzdel, University of Pittsburgh

Australia

Adelaide

A short term program is ideal for someone who desires to study abroad, but doesn't want to make a long term commitment. Studying abroad can still be a rich, worthwhile experience--even if it is only four weeks time.

Sarah Roark, University of Utah

Brisbane

My choice to study abroad through ISA was one of the best decisions I have ever made! My time in Australia was lifechanging! The fabulous support I received from the ISA staff was a huge factor. The ISA sponsored trips were exceptional! I would highly recommend ISA to anyone looking for a study abroad opportunity!

Alexandra McDaniel, University of Memphis

Sometimes the best way to grow is to live outside your comfort zone.

Gina Skiris, Elmhurst College

I really loved the location of QUT. It is set in the middle of the city, but being by the botanical gardens gave it an air that one might think they weren't in middle of a city with 1+ million people. The architecture of the campus was beautiful and technology was top-notch. I'd recommend QUT to other engineering students as the courses were comparable in difficulty to those at my home university.

K. Davis, Kansas State University

Brisbane is a perfect city for a student and a tourist. There is so much to see and do, and it is so easy to get around.

L. Hetland, University of Wisconsin-Milwaukee

Cairns

This was an excellent experience overall that I doubt I ever would have had normally. Taking just a few steps outside of what I was used to ended up being an adventure that took me to the other side of the globe where I met some wonderful people and saw beautiful sights. College is a time to have new experiences, and studying abroad is one of the most unique experiences there is.

Daniel Wivell, University of Connecticut

I enjoyed the size of Cairns - it wasn't too big, but it wasn't really small either. The beach was nearby, but the campus was surrounded by hills and mountains, which made for great scenery.

N. Miller, Ohio State University

I never knew I could fall in love with a place. Australia was beautiful and the people were welcoming and friendly. I felt academically challenged at the uni and strove to pass all of my classes the same as I would at home. The hardest part of leaving home was leaving my friends and family. I didn't realize I would have to do it all over again when leaving Cairns. I wish I could stay but I'll settle with coming back to visit. Studying abroad was one of the best decisions I've ever made. My only regret is not staying longer.

Sarah Barry, Grand Valley State University

ISA simplifies the process of studying abroad, whilst also smoothing the transition from one culture to another. Being a part of the ISA program allowed me to make friends before I even arrived at my university, and encouraged me to embrace new experiences with new individuals. Choosing to study abroad was easily the best, and most valuable decision I have made, and I strongly recommend the experience to other students.

Teresa Bennett, Texas A&M University - Corpus Christi

Canberra

This experience helped me learn more about myself, a new culture, and people that I will be friends with for a lifetime. This trip was action packed and filled with a new adventure every day, but there was still time for us to explore on our own. It changed my life for the better and I am so grateful for this experience.

Alexandra Lathos, Cal State University, Long Beach

Don't be scared to go abroad not knowing anyone on the trip. Take chances and meet new people. For me it was breaking out of comfort zone, forcing me to talk to new people and making new friends. I can honestly say that this trip has helped me more than one way with that. I have learned more about myself and other people.

Caryn Eisert, Western Kentucky University

<text style="font-size: 10pt; font-family: 'Microsoft Sans Serif', sans-serif">I had the most amazing experience on this program. I met some amazing friends that I plan to stay close with for the rest of my life and I fell in love with a country and its culture. Australia and ISA were the absolute right choice for me. These will always be some of the most amazing weeks of my life.</text>

Emily Rieck, College of Charleston

I am glad I chose to do my study abroad experience with ISA. The program was very helpful in answering my questions and giving me all of the details I needed. Not only did I get to experience a new country, but I also got to experience athletics in a whole new way. I will forever cherish my experience abroad and I hope to go again some day.

Emma Drackley, South Dakota State University

Gold Coast

Studying abroad is a wonderful reminder that the world is much bigger and much smaller than you think. It's a paradox that makes imperfectly perfect sense and I feel so blessed to have been given the opportunity to begin to understand it.

Jennifer Steel, Furman University

If it terrifies you and excites you then you should definitely do it. I can't believe how much I have been able to do that I didn't think I could do before. Getting out of my comfort zone made me grow into a stronger person and has made me ready to do so much more in life. Choosing to go to Australia was hands down the best decision I ever made in my life!

Katie Vargo, University of Toledo

Studying Abroad was one of the best experiences of my life. ISA answered all my questions and made me feel at ease with living alone in another country. I would highly recommend kids chose ISA to study abroad through.

Lillian Turner, Salisbury University

Melbourne

This place is so amazing, and I have learned so much about myself and photography. I will take back countless memories and a love for the Australian outback. Tomorrow is our exhibition at the Art Vault Gallery and I could not be more thrilled. Finally, a real piece of my artwork will be hanging in a REAL gallery...in AUSTRALIA! I am so excited.

Alexis Petelos, University of Alabama

Being abroad has helped me become more independent and confident in myself. Studying abroad is a life changing decision, for you will gain a whole new perspective of the world and where you live. My advice to you is to make sure you go out to places and explore, do not stay inside all day. Studying abroad may seem expensive but it is an opportunity that is once in a lifetime... Don't be afraid to try new things and have an open mind. If you expect things to be different and accept it before you depart it will make your life abroad 10 times easier. Say yes to adventure and study abroad, for you will receive a chance to gain independence, confidence, friends, and to experience things that are unavailable to you in your home country

Alexis Pettaway, Elizabethtown College

Melbourne takes some getting used to. For the first couple weeks, you will feel totally lost and the public transportation system will be tricky. But after that, everything starts making sense, and it actually gets a lot smaller than you think it is. It ended up feeling like home to me, and I will definitely be coming back here after I graduate. Don't waste time, either. Jump right into everything and take advantage of the opportunities that present themselves. Go on road trips, travel all over, and be open minded about things because it's a totally different way of life in Melbourne. Learn to appreciate the laneways, street performers, and the locals' serious obsession with coffee! This city is amazing and I guarantee you will fall in love with it!

Cara Lee, University of South Carolina

Just an incredible experience, hard to put into words without writing a 20,000 page paper.

David Jeznach, University of Massachusetts, Amherst

To grow as a person and evaluate the different perspectives of others in a new way. Looking not only as myself personally but my culture, understanding and other parts of my life I had not seen the way I see them now.

Kaitlyn Koener, University of Minnesota, Twin Cities

Continue to wander. You never know what incredible experience will become of it.

Madeline Anderson, University of Wisconsin, Milwaukee

There are no words for how perfect my experience was! I fell in love with the Australian lifestyle and made a ton of amazing friends, who still keep in touch with to this day. La Trobe was a perfect Uni to study abroad for many reasons. It was mostly all Australians, so I really got to learn about their culture and get the full "Aussie experience", it's a huge campus and everything you need is right there including stores, a hair salon, restaurants, bars etc. If I had the choice I'd go back today!

Olivia Wicik, Long Island University at Post

I have learned that I can do things on my own and that in the past I have let people talk me out of things, but now I am listening to my own voice because my own voice is what took me to Australia.

Shelby Mulverhill, University of Colorado, Denver

Newcastle

ISA helped me prepare for the adventure of a lifetime. Australia will forever hold a permanent stamp on my heart because I have grown and changed in ways that I will remember forever. The experiences I had are unbelievable and I feel like I created a new life here. I now know that I am ready,confident, and excited for the next journey that this life has waiting for me.

Alexandra Kerlin, Northern Michigan University

Expect the unexpected. That's the best advice I can give anyone who's studying abroad. Sometimes when unplanned things happen and you're forced to adapt to a new environment, just stay positive. From any situation, you'll grow and eventually learn from it. ISA has been a great help throughout my journey abroad and I am so glad to have gone with them. One of my roommates didn't go with an agency and missed out on some great friends and excursions.

Lotus Thai, Chapman University

Studying abroad was the best decision I've made thus far in my life. I had so many amazing experiences and gained so many friends that I will never forget...Even though I only spent 5 months there, I feel like it had an incredible influence on my mindset and view of life. I learned so much about myself. I would highly recommend studying abroad to everyone.

Morgan Schilz, University of Wisconsin, La Crosse

Studying abroad is easily the best decision I've ever made, and I feel very confident in both the country I chose to study in, as well as the program I chose to go with. I am not who I was when I first got here, and I never want to leave.

Olivia Shove, Chapman University

If students have the opportunity to study abroad, they should definitely take advantage of it. Studying abroad was a life changing experience, and I have no regrets. I grew as a person, become more culturally knowledgeable, made incredible relationships with awesome people, and made lifetime memories that I can tell my kid's kids one day.

Taylor Gerstenfield, Bloomsburg University

Sydney

Going abroad is honestly the most worthwhile experience of my life. I've found so many wonderful people and wonderful friends; I really can't imagine my life if I didn't go abroad.

E. Schumacher, University of San Diego

This was a fantastic way to apply the concepts and skills you learn in class, and even further, in a completely new environment. Having global work experience allowed me to grow much more than just being at home. I was forced to assimilate and push myself with my work.

Internship Participant

I am beyond satisfied with my ISA experience. Any student looking to make the most out of their study abroad experience should contact ISA!

Kristen Benkovic, Montclair State University

Studying abroad was beyond travelling to another country for me, I was able to finally accept my flaws and love myself for who I am. Experiencing what life has to offer in Australia helped me grow as a person and appreciate how other cultures live. It was an overall amazing experience. I am sad to see it end but I'm excited to see what my next adventure is.

Kristine Chan Deloso, Portland State University

The most diverse experience you will ever encounter filled with the most fun you will ever have.

Patrick Fullerton, Montclair State University

Townsville

Studying abroad has proved to be one of the most valuable and rewarding experiences I've had. I learned so much about myself not only from being independent in a different country, but also because of the people and opportunities I had a chance to immerse myself in. I would do it all over again a million times if I could!

Austyn Thalmann, University of San Diego

The ISA program was absolutely incredible and made my study abroad experience unforgettable. I felt so prepared to begin my program because of all the help they provided me, up to and through the start of the semester. I always knew I had a helping hand just waiting for me in case anything were to go wrong. I would strongly recommend studying abroad with ISA.

Meghan Dolan, Elizabethtown College

I loved my experience abroad in Australia. The smells, sites, and people I have met really opened my eyes and allowed me to gain many new perspectives. I have really been pushed out of my comfort zone, but that has really benefited me. I am now more confident I can adapt to any situation I am faced. The people I have met and the experiences I have had have been amazing and indescribable. They will forever shape me in the direction I choose to take into the future.

Samantha Poratti, University of Maine, Orono

To anyone who is thinking of possibly studying abroad, do it. Don't hesitate. You will learn more about yourself than any normal university can teach. It is an opportunity to see amazing new places, meet the best friends of your life and if you have time left maybe even learn something in class. I would do it again in a heartbeat.

Zachary Topor, University of Maine

Belgium

Brussels

Belgium is truly the center of Europe. From the food to the people, every single day can be an adventure. This place is not only for career oriented students, it is also a home to relaxed locals and a plethora of party animals. Whether you spend every weekend in a new European country or take the days to explore Brussels, you will not be disappointed. This experience has opened my eyes to new places, cultures, and most importantly new people that I will never forget.

Charlie Schmidt, University of Denver

If you've ever considered studying abroad or if you're even a little bit adventurous, sign up for an ISA program! Studying abroad is such a unique experience. You'll get to know the world around you, meet new people and become more confident and competent while having the time of your life. What's not to love? I am so thankful I chose ISA! I can't imagine studying abroad without their support and guidance.

Sarah Hartley, University of Tulsa

Studying in Brussels through ISA was one of the best decisions of my college career as well as my life. Its central location, international significance, and quirks make Brussels an exciting city to spend four months. The ISA program's staff as well as the college's focus on offering relevant internships to students were also highlights. If you have an interest in experiencing a European city without tons of tourists, but lots of unconventional charm, consider Brussels!

Savannah Lee, Point Loma Nazarene University

My experience abroad changed my entire perspective of our world. I found new passions, friends, goals, adventures, and challenges. I have matured as person and have been to places I never thought imaginable. To future students planning to study abroad, DO IT. There is nothing more rewarding.

Thomas Schorr, University of Tulsa

Brazil

Florianópolis

My time with ISA in Florianopolis was one of the best summers I've ever had. My professors were all really friendly and genuinely want to help you learn, the on-site staff is more than willing to help you if anything goes wrong, and Florianopolis is one of the most amazing places I've ever been. I definitely feel like there's something for everyone here.

Luciane DeAlmeida, Western Washington University

Studying abroad in Brasil rocked my world. I've never fallen so much in love with something in my entire life (the country, the people, everything really). I am going back after graduation for a few months and I am already looking for research positions down there. I talk to my Brazilian friends everyday and miss them incredibly much. I miss our group too, cause our group was awesome. I can't explain it with words. Brasil broke my heart and built it back in the most beautiful way.

Michael Tellman, Creighton University

In two months, what was once a foreign country became my home. Studying abroad has changed my life tremendously. I've learned so much about myself and Brazil's culture. I can say that I have met people from all over the worlds that have a special place in my heart. From the small conversations with strangers on the bus, to the adventurous activities, this has been the best experience I could have asked for.

Vanessa Diaz, University of California- San Diego

Chile

Valparaíso

Studying abroad in Chile has been the single most important experience I have had so far in my life. I have improved my Spanish, met some awesome friends, become more independent, and feel as though I returned to the U.S. a better person.

Jenna Hacker, Northern Illinois University

If I learned anything while abroad, it is that the capacity of human beings for kindness and patience is remarkable. I could ask a complete stranger for help, and he or she would take the time to point out or explain to me what I needed to know. I lost my fear of speaking so fast because I knew that, no matter how funny or confused I sounded, the people I met were more interested in helping than laughing (though there have been some laughs, but laughter is one of the best parts of making mistakes. That's something else I learned.)

Kari Bray, Washington State University

My summer abroad has been a life-changing summer. Being with ISA in Chile I have gotten to experience a different culture first-hand, and also got to experience a part of Chile's history. I don't think I would have ever had these experiences if I had not chosen ISA. I would recommend them to everyone!

Kassandra Baumgardner, University of Alabama, Birmingham

Everything about my experience with the ISA program has been incredible-- more than I could have hoped for. They set me up with an amazing family and a great school which helped me to feel comfortable in this new environment. From there I was able to go off and live my life in Chile, getting to know the culture and its people on a deeper level. My abroad experience has been everything and more than I ever imagined it to be.

Redyn Keller, University of Maine

My time in Chile was like a rollercoaster ride, but wow, was it worth it. I learned so much not only about Spanish and the Latin American culture, but also about myself. I am definitely not the same person I was when I got here. Its true what they say, another culture isn´t necessarily better or worse than your own, its different, learn to appreciate the differences. Thank you ISA Chile for a great semester.

Shaina Gleisner, Messiah College

China

Shanghai

ISA will show you the way and make your stay memorable! Wo ai ISA!

Amanda Ju, Christopher Newport University

Even a one semester study abroad experience will give you a global perspective that can be worth more than a college degree if you use that perspective to change your life.

Christopher Barenz, Western Illinois University

If you can, you should go abroad at least once in your life. If you've never been outside of your own country before, ISA is one of the best ways to go.

Elizabeth Sanford, University of Nebraska, Lincoln

ISA provided me with the opportunity to travel outside of the United States for the first time. I think everyone should have the opportunity to study abroad so that you can learn and live within a new culture. Having studied Mandarin before I went to China really allowed me to enjoy my time and appreciate the opportunity to practice my Chinese with just about everyone I came in contact with. Lastly, ISA Shanghai allowed me to meet so many new people many of which I believe will be friends for a long time.

Joseph Cooke, West Chester University

Five months into my exchange I would still randomly stop while walking with a friend and say "I AM IN CHINA!" Thrilling, enriching and fulfilling experience. I fell in love with the language, the people and the culture; I fell in love with China and ISA is who made this possible.

Leslie Martinez, Texas A&M International University

Studying in Shanghai, China was the best experience of my life. From goose feet to the Forbidden City the culture of China gave me a new perspective on how people live half a world away. At first Mandarin seems like an impossible challenge, but by the end of the trip I believe it is a manageable task. ISA prepared me well for the experience; our director was welcoming and professional throughout the duration of the program and the entire semester was worry free. Studying abroad is an incredible experience that should be considered by everyone.

Philip Wharton, Texas State University - San Marcos

ISA allowed me to have experiences I never would have had at my home university. I never would have thought I would have enjoyed studying abroad as much as I did, but it ended up being one of the greatest experiences I have ever had.

Ryan Schwing, Texas A&M University

It has been a wonderful experience not many get to have. It really challenges you as an individually; socially, mentally, and physically.

Silvana Almonacid, Rider University

Colombia

Barranquilla

Colombia is a wonderful country to choose if you don't want to be sheltered from the realities of the world; it opens your eyes to both the beauty and problems that the individual and countries of this world confront! It is a perfect option for someone seeking an adventure off the beaten path. You will learn so much personally and academically here! I highly recommend it!

Joseph Stanford, Mercer University

My semester in Barranquilla, Colombia, has been the most unforgettable experience throughout my college career. The culture, the people, and the experiences I am taking home have forever impacted my life and my future. I highly suggest incoming students to highly consider the Barranquilla spring semester program because of the Carnavales Barranquilla offers and the continuous support from locals. [Students should] be to be prepared to want to stay for a year because in Colombia they say say "El unico riesgo es que te quieras quedar" (The only risk is wanting to stay)."

Kayla Pollard, Grand Valley State University

Studying aboard in Colombia with ISA has forever changed my life and I am eternally grateful.

Lauren Villanova, Keene State College

Squeezing onto overflowing buses, dancing anywhere and everywhere, eating mountains of rice daily, the welcoming smiles on the faces of locals, sweating so much my clothes are drenched, the sound of vellenato piercing my eardrums, and trying to keep up with the incredibly fast Spanish of the Colombian coast have all become so terrifyingly familiar. I am accustomed to life here and I love it! Barranquilla, Colombia will forever have a special place in my heart!

Rain Johnson, Northern Michigan University

Barranquilla, Colombia was probably the best choice I could have made. They call it "calor humano" here and it can be felt at every corner of the city. The culture is vibrant everywhere you go.

Riti Patel, Loyola University Chicago

Costa Rica

Heredia

My ISA experience in Costa Rica changed my life! I was challenged in so many ways and learned so much about myself. Studying abroad is a must for anyone who wants to expand their horizons, meet amazing people, and see the world with a global perspective.

Callie Muri, Western Washington University

Costa Rica is a country with stunning natural beauty of all genres and one that provides the means to be able to see these places. I'm coming back for sure.

David Boyd, North Carolina State University

Studying abroad not only helps you become submersed in a new culture, but it helps you learn more about yourself and life, broadening your horizons and opening your mind to endless possibilities

Kristin White, California Lutheran University

ISA staff was very helpful and available. It is great that ISA helps students with accommodations, and even better that they give them the option to do certain things by themselves. ISA respects your independence as well as they try to help with everything they can.

Leslie Landin, University of Texas, El Paso

My travel abroad experience was everything I hoped it would be, plus so much more. I practiced and improved my Spanish an extraordinary amount, I met new people, and made friends and connections from all over the world. I also grew close with my host family, experienced the culture, and learned a lot about myself. It was an extremely positive experience.

Teagan Papke, University of Northern Colorado

San José

ISA provided me with an opportunity to learn Spanish in the best environment possible at an affordable cost. Their numerous online resources and friendly staff on-site and off helped to maximize my overall satisfaction with my study-abroad experience as well! By immersing myself in the Costa Rican culture, I not only developed better Spanish-speaking skills, but also gained a better understanding of how to navigate global culture. Pura Vida!

Amie Lemley, University of Alabama Birmingham

ISA is a great program to study abroad with. From beginning to end, there was always someone I could speak to and have any questions I had answered. The staff is friendly and patient. The office abroad was well organized and easy to access. The trip was incredible and I recommend ISA to anyone who wishes to study abroad. Pura Vida!

Andrea Rizkallah, Towson University

My experience abroad in Costa Rica was life changing. There is nothing that could replace the memories made and knowledge obtained. What makes this program so wonderful is being surrounded constantly by positive influences that allow you to create yourself in new ways: a wonderful host family to teach you, ISA to guide you when lost, exploring the beauties of surrounding cities, and the culture as a whole will provide you with an unforgettable experience.

Ashley Westgate, Mercyhurst College

Students should come with an open mind, be ready to integrate with the locals and also be comfortable with some of the changes they could experience coming from another culture. It is an experience you will never forget. Life changing!

Bernard Akem, Northern Illinois University

Great experience and opportunity for personal growth. Thank you!

Karla Ippolito, Arizona State University

Czech Republic

Prague

My time with ISA in Prague has been the best study abroad experience I could have asked for. I had done very little travel before this, so I wanted a program that could offer stucture and assistance when needed, but enough freedom for me to explore and have my own experiences. ISA was perfect for this. They were not overly involved, but I knew the ISA staff was always there to help if I ever needed anything.

Claire Oberman, Denver University

ISA provided me with an exceptional study abroad experience. I could tell that the staff loved their jobs; they were literally always smiling. They were very accommodating, answered all my questions, and offered great suggestions too. They helped me make the most of my time away yet managed to make me feel right at home.

Colby Bjornsen, University of Denver

If you are looking for an experience of a lifetime to grow, learn, travel, and truly immerse yourself, then this program is truly your perfect fit and nothing short of amazing.

Divya Reddy, University of Colorado - Boulder

I learned and experienced things that were only possible once you leave your comfort zone, and I wouldn't change one thing about my time abroad.

Greer Dellinger, University of Oregon

This experience has been amazing! I came here thinking Im just going to be a visitor for a few months and now Prague feels more like home that I ever imagined it could. I wish I was just going back to the States for a visit now and then coming back here to continue to study rather than going back to the States and back to my school there.

Katie Stefano, Virginia Wesleyan College

Studying abroad, especially with ISA, allows students to become more independent and worldly. It gives students the freedom to explore different cultures without enforcing restrictions on experiences that are available. I really feel that I have gotten the most authentic understanding of what life is like, living an Eastern European culture.

Lindsey Peecher, University of Missouri, Columbia

If you're on the fence about doing it: do it. It has changed my life irreparably for the better. I cannot think of what this semester would be like if I had stayed at my home institution. It is an experience that cannot be explained, it just needs to be lived.

Matthew DePue, Texas State University - San Marcos

Prague is one of the most beautiful cities I have ever been to, and I would go again in a heartbeat. There was a special kind of experience that students could have with our professors and ISA advisors that is so different from the US, and I'll never forget it. My advice to future students is to really explore this city. Many people come here because it's in the middle of Europe and therefore easy to travel to other countries, but Prague has its own beauty and history to offer. If you explore and familiarize yourself with the city, you'll fall in love with it too.

Natasha McLain, Arizona State University

If you're going to study abroad (which you most definitely should), ISA is the way to go! They are so helpful throughout the planning process and the on-site staff are so helpful and plan fun excursions and activities to make sure you get the most out of your abroad experience. Other programs don't offer you that!

Rachel Atkinson, University of Kentucky

ISA was the perfect amount of guidance and individualism. I knew no matter what ISA was there for me to guide me when I needed it, without being over my shoulder 24/7 and allowing me to experience this beautiful country on my own. I am so grateful for the opportunity to experience this with ISA and I would recommend it to any student in a heartbeat!

Sabrina Huerta, Washington State University

Prague was the best city in so many ways. Cheap, fun, affordable, and easy on the eyes.

Taylor Craven, University of Colorado - Boulder

ISA made the whole experience easier and more rewarding. Many of the struggles that I saw people in other programs face were dealt with by ISA. Traveling to a new country can be challenging, but ISA works to make the students feel comfortable and feel capable of making the most out of their international experience.

William Atkinson, University of Kentucky

Dominican Republic

Santiago

Everything I've done in Dominican Republic has helped me grow as a person. The ISA staff has done everything to make sure I do well in school, I learn the language to the best of my ability, and, most importantly, I have fun. Honestly, the worst part about it all is leaving.

Ashley Tarr, St. John's University

I came to the Dominican Republic not knowing a thing about it, its history, its culture, or its people. From the moment I stepped off the plane, I fell in love! Yes, it was difficult at times because my Spanish isn't perfect, but that was simply part of the experience and helped me grow as a person. After my time here, I can't imagine never coming back! I'm looking into bringing my pharmaceutical knowledge here for good.

Breann Zerby, Ohio Northern University

I feel like the experience that I received through ISA is something that I could never have done myself. With ISA I was given the opportunity to not only study, but meet all kinds of people from all kinds of backgrounds, meet american friends and go on bucket list excursions.

Melvin Fatimehin, Kansas State University

Best experience of my life. I would study abroad in the Dominican Republic for another year if I could. I met so many new people, made so many new friends and gained a whole other family and just for that I wouldn't trade this experience for the world.

Nea Muller, Western Washington University

My experiences in La Republica Dominicana were challenging, spontaneous, and life changing. I had a wonderful time living with my host family, making friends with locals, and spending time with my ISA fellow students. I have completely fallen in love with this country! The music, the food, and the people are a part of who I am now. I can't imagine going back to the U.S. where I won't hear merengue music on every corner with spanish weaving itself through the streets. I am not ready to go back to the U.S. but I don't know if I ever will be. La Republica Dominicana will always be in my heart and I am already planning on visiting my host family next summer. I am so thankful for this opporuntiy to test my independence, learn about another culture, and dance merengue & bachata every night!

Sarah Potucek, Carroll College

England

London

ISA is a great program provider. I chose them for both a summer in Barcelona and a fall in England. It was one of the best decisions I've made. I am very likely to recommend them to friends, family, and other future abroad. By going through them my study abroad experience was enhanced in more ways than I could have ever imagined. They organized my classes, housing, cultural excursions, and so much more. Additionally the staff members on and off site have always been helpful, kind, and caring. I have always felt comfortable and safe while being away from home, abroad in another foreign country.

Kate Story, University of Tampa

ISA was the right choice for me and my study abroad goals. For those interested in gaining an intimate insight of their place of study, ISA provides the resources and experience necessary for this fulfillment. I have grown and learned so much beyond London. I have learned skills and attitudes that will translate to home in the United States and wherever else I may journey in my lifetime. An incredible journey and experience, I can't imagine going without it.

Paul Faria, Fitchburg State College

I came to England expecting all British classmates, but I soon learned how diverse London is and I have gained a new respect for other cultures. My classes consist of individuals from all over the world and I enjoy getting to know my fellow students and learning about where they come from. There's also always something to do in London, I really think it is the perfect study abroad destination.

Tommie Clark, Iowa State University

Reading

While the journey was filled with its ups and downs, I had an amazing time in Reading. ISA staff did a great job of helping me navigate a brand new country, and I have made friends here who I will always remember. I have learned so much, and I now have a wonderful addition to my resume. Studying abroad is a wonderful choice to make!

Caleb Noel, University of Colorado- Colorado Springs

Studying abroad changed me. It seems scary going some place you wont know anyone, but it was the greatest decision I ever made. Leave any doubt or fear behind and just do it!

Elysa Binger, University of South Dakota

Just go, there will always be things you are going to miss when you leave but the opportunities you gain from studying abroad are a once in a lifetime experience. They say that "traveling is the only thing you buy that makes you richer" and it is true. You gain more knowledge and experience from traveling then from any book you read or any movie you see. Studying abroad makes you see the world in a whole different way. It makes you realize that no mater how big the world is we are all connected in some way.

Marta Faugstad, Bethany Lutheran College

Studying abroad took a lot of courage for me; leaving home behind to see the world can be scary. But seeing other countries, immersing myself in other cultures, and experiencing the sights, sounds, and feelings of the world helped me to mature and become a stronger person, and it was also the most fun I have ever had.

Michael Caulfield, Montclair State University

Studying abroad through ISA was the best choice I've made in my college career. The amount of support and resources ISA gives you during your time abroad really enhances the overall study abroad experience. I know for a fact without the ISA excursions I wouldn't have seen all the wonderful sites England has to offer on my own. Thank you ISA for leading me to create the memories of a lifetime!

Taylor Knudtson, University of Iowa

Fiji

Suva

I came home with so many new, lifelong friends, filled with stories, and a new person. Whatever obstacle I faced while trying to study abroad was completely worth every second. It is an experience not encountered by many, but cherished by those who have the courage to do it.

Estefany Alvarez, Eastern Connecticut State University

Overall, studying abroad in Fiji has been the best experience and decision that I have ever made. I was able to find out who I am and at the same time, figure out what my true passions in life are.

Jaclyn Sena, West Texas A&M University

Of all the international students and the programs they chose, I'm super glad I chose ISA. ISA is like a family and our coordinator was super amazing. We all love her and she's such a sweet heart. ISA is great because they built us up for when we were on our own. It wasn't as scary.

Kansas Glasgow, Middle Tennessee State University

<box>The support provided through ISA was amazing in streamlining my preparations for Fiji. Living in a 'paradise' is far different than visiting one, and nothing can fully prepare you for that. I think everyone needs the experience of living far from familiarity at least once in their lifetime to better understand appreciate their own lives. It's been a beautiful journey.</box>

Nicole MacLean, University of Denver

Be open to new experiences, take in all there is to see and learn, don't let anyone hold you back, and even when you feel like all you want to do is go home, push through it because it's all part of the experience and believe me, if you make it through your time abroad, through all the ups and downs, you're going to be so proud of yourself and you will leave your new favorite country with so much knowledge, confidence, and memories to last a lifetime!

Shelby Leasher, Shippensburg University

France

Lille

ISA Lille was a great overall experience that allowed me to not only step out of my shell and experience a foreign land but to also meet others who wanted to share the experience with me. I think sharing my study abroad time here with others is really what made it worth the trip and I will be forever grateful for them for being here with me.

Elyse Hill, University of Maryland, Baltimore County

If you are wondering whether to invest the time and money enrolling in one of the ISA programs, I strongly suggest you do so. I was simply looking to get a break from my studies in the USA, but what I experienced here (in Lille, France) was beyond my predictions. In addition to developing a greater appreciation toward myself and other people, I feel more complete as an individual and now possess a deeper understanding of my place in the world.

Natalia Kazakova, Western Illinois University

Paris

This experience changed my life. ISA works to show you there is more to study abroad than just going to class and walking by beautiful buildings every day. The program takes you through many different aspects of culture in fun enriching activities.

Alec Miller, Arizona State University

Utilize your resources given to you, take advantage of anything free by ISA. Make sure you understand that study abroad is what you make of it and this is likely the time of your life to be young and carefree. Experience the culture, be smart, and remember above all else that this is meant to be fun and exciting

Helena Craft, St. Edward's University

Through ISA, I have lived in the city that stole my heart!! In two months that I have lived here, I have met students with whom I will be life long friends. I have worked with some of the best professors ever, and I have lived in a host family that truly made Paris feel like home. Merci Beaucoup, ISA!!!!

Kristen Cypret, Missouri State University

ISA had provided me with a once in a lifetime opportunity that I will be forever grateful for. Paris has become a second home to me, and the ISA staff has become family.

Leandra Armstrong, Lasell College

My semester abroad fortified my passion for traveling and learning with an experience that not only educated me in history, language, and culture, but also taught me that strangers can be best friends, and unknown territory can be home.

Zana Karabatak, Ohio State University

Germany

Berlin

It was perhaps one of the most greatest decision I made in regards of studying abroad! Overcoming the initial hositilites and fears of my parents to Berlin provide worthwhile in the end. Far better program than my experience in Austria with ISEP!

Alexander Cline, Georgia College and State University

I loved going through ISA. I have nothing but positive words and experiences with ISA and the people who helped me. I felt so well prepared to go to Berlin because of ISA.

Anonymous

Studying abroad in Germany was a great decision!

Emily Woessner, Florida State University

Taking part in an ISA Study-Abroad experience was integral to my personal and cultural development. Being immersed into a new language and way of life helped me to better understand my own culture, and provide the foundation for cultural exploration in the future.

Ethan Smith, Seattle University

Ireland

Dublin

ISA's staff is extremely friendly and helpful. When I needed advice on anything from a bite to eat in the city, to where to go on weekend excursions, they were always excited to help me find my way, and that has made all the difference in my study abroad experience.

Jeffery Meyer, University of Tulsa

Studying in another country is a huge opportunity and the beginning of finding and creating yourself. Learn from the people you meet and try to meet as many people as you can! Connections with people are what make the experiences in an amazing new place even more enjoyable.

Lindsey Wyffels, West Chester University

ISA gave me the opportunity to experience a study abroad semester while having an on-site support system and fun activities weekly.

Marissa Gamache, Bethel University

ISA was absolutely amazing, they made it so easy and comforting to be away from home. Would recommend!

Matthew Vantslot, Ramapo College of New Jersey

Studying abroad with ISA was hands down the best time of my life. I learned and experienced so much about myself, others, and other cultures. I learned to not let obstacles affect what I want to do, and how to really conquer my goals. I would do it again in a heartbeat- Dublin is my favorite place on earth.

Morgan Bourdreau, University of Massachusetts, Lowell

My time in Ireland was the best 5 months of my entire life. My advice would be to try and find something to do every weekend. Go into the city as much as you can and simply explore. Just walk around with no real purpose. It makes you become much more independent and you'll find loads of cool, local stuff along the way.

Thomas O'Keefe, Widener University

Galway

Studying abroad was definitely one the best decisions I could have made and the experience was absolutely amazing! ISA was there throughout the whole process and made everything flow as smoothly as possible. I couldn't have asked for a better experience in Galway!

Casey Flanigan, Saint Anselm College

Galway was such a lively, friendly little city- it was so easy to navigate and to feel at home!

Emma Anderson, Southern Illinois University Carbondale

ISA provided me with an unforgettable experience and made strong bonds with many new friends. I am so glad I took this opportunity!

Luke O'Brien, Massachusetts College of Liberal Arts

I came to Ireland because of its rich landscapes and culture to learn, study, write, and grow. I was absolutely inspired as an artist and a human being on this trip. It was a dream come true.

Maria Meluso, Missouri State University

Studying abroad with ISA was one of the best decisions I've made. You will grow so much as an individual and meet so many incredible people along the way. I wouldn't trade my experience abroad for anything!

Marisa Tadajewski, University of Michigan - Flint

ISA held my hand throughout the whole scary process that comes with studying abroad. They were there every step of the way from applying, to packing, to enrolling in classes, to even helping with personal issues. The ISA staff is irreplaceable!

Vanessa Esposito, The College of New Jersey

Italy

Florence

Studying abroad was the best decision of my life. ISA really made me feel welcomed and helped me out in so many ways. Without them I wouldn't have had such a great experience like I did. They were so friendly and always helped me out even when I didn't think I needed it. Italy will forever be my second home and I miss it and the people every day.

Adelina Fischer, Grand Valley State University

If I were to study abroad again, I would choose ISA in a heartbeat. The staff is so friendly and fun to go on excursions with, and I felt comfortable asking them for any help I needed.

Alina Harestad, Washington State University

Studying abroad in Florence has been inexplicably life-changing, and my experience would not have been the same without ISA. ISA was always readily available to answer questions or help when I need it. And their excursions throughout Italy helped me to truly appreciate the culture and history of this incredible country.

Emily Russell, Chapman University

My abroad experience is something I will cherish every day for the rest of my life. The memories I made continue to make me the person I am today. Thank you ISA for making me feel right at home 6,000 miles away!

Hannah Zickel, Chapman University

For students who are looking to have a hands-on study abroad experience, ISA is a great program with every opportunity available to become immersed in the culture. My study abroad experience completely changed my perspective on our world and was a learning experience that I will love and value for the rest of my life.

Jacqueline Sherry, Arizona State University

ISA is the perfect home away from home in Italy. The staff is welcoming and want to get to know you. They help make Florence a safe place to live as well as a place you will leave part of yourself.

Katherine Brownlee, Colorado State University

ISA was a great program for me! Studying abroad can be very challenging at times but the overall experience was great.

Marta Mueller, Washington State University

I was really nervous going abroad all by myself for 6 weeks in a country I had never been to before, it took a little bit of getting used to but ISA helped me find activities to do everyday and helped me find friendships that will last for a long time after I leave Italy. Even though it was tough being homesick at times this summer in Florence has been one of the best experiences of my life and I'm so happy I decided to do it.

Natalie Gaines, University of South Carolina

Milan

ISA has easily been one of the best experiences of my life.

Amelia Alameno, University of North Carolina at Charlotte

ISA provided me with 3 wonderful months of personal growth and cultural understanding.

Darlene Graham, Seattle University

The ISA program as a whole is an amazing team! Helpful, supportive, and determined are only a few words I could think of when I think of the ISA team. They made my experience aboard an unforgettable one and one I surely don't regret. My experience aboard has no words because it would be very hard to try and condense it all. It was an experience and a time that helped me grow so much as a person and you get to learn so much about yourself that you never knew. My advice for students that are thinking about studying aboard? DO IT! it is a once in a lifetime chance that should be taken! don't let fear get in the way of you seeing a whole other part of the world! Trust me, it is a decision that you will NOT regret making. Thank you once again ISA for this wonderful opportunity and all the wonderful memories.

Enedine Becerra, California Baptist University

Do everything you ever wanted and prepare yourself to be amazed! You are limitless, and your ISA study abroad opportunity is just the platform from which you can extend beyond what you may have initially imagined for your time abroad. The world is incredible, but the people you meet and the experiences you share with one another are more valuable than any sight that you will see!

Gabriella Serventi, Seattle Pacific University

Luca, my contact here in Milan was amazing. He deserves anything he wants. A great man and a positive influence on my experience while abroad. Luca was a highlight of my trip. I made a genuine connection with him and I felt even more comfortable knowing I could rely on him while in Milan.

Nathan Ellis, Montclair State University

Rome

The ISA Rome program is fantastic. With a great staff and a wonderful academic environment, you'll have an amazing time exploring Rome, Italy, and Europe! This program changed my life. I feel more independent, more accepting, and more in love with the world.

Alexandra Mezza, Notre Dame of Maryland University

I really enjoyed studying abroad through ISA. The ISA staff was very helpful, and the excursions they organized were a lot of fun.

Angela Ciarletta, University of North Carolina – Wilmington

Studying abroad with ISA exceeded my expectations of having an enriching cultural experience. The ISA staff are absolutely amazing, engaged, and passionate about what they do. I will never forget this experience, and hope to continue my studies in Italian culture!

Elizabeth Amini, College of Charleston

ISA was great in preparing me for my trip and my time spent abroad. The staff both online and in my country was so helpful and patient that they really made the transition to a whole new country and culture so easy! Love the ISA staff!

Ella Stwan, Washington State University

The ISA advisors are top of the line, being knowledgeable and more than helpful with any questions you may have. They were a tremendous help in adjusting to my study abroad experience. If I had the choice, I would definitely study abroad with ISA again!

Marc Anthony Sierra, University of Florida

Choosing ISA was one of my best decisions, which you don't realize until you're actually abroad. The Isa staff in the United States as well as in my host city were some of the most kind and generous mentors. I got sick while abroad and they showed so much compassion, by taking me to the doctor and helping me get my medicine, as well as keeping in touch to make sure I was ok, which can be difficult abroad. They made my time in Rome, Italy very worthwhile. When I look back on my time here, they will always be a huge part of why I had such a great time on my trip.

Maris Grantham, University of Alabama

The on-site staff in Rome were the absolute best. So kind and always ready to help at a moment's notice. They will forever be part of my treasured memories of Rome.

Sariah Graves, Arizona State University

Japan

Tokyo

Going to Japan through ISA was by far one of the most life-changing experiences I will ever have. ISA made everything clear to me and provided me with the information I needed before leaving. Despite the fact that this was my first time ever going to Japan, I already felt comfortable knowing that I had a great company to rely on.

Eimanuelle Pendon, University of New Haven

ISA is amazing! They help you every step of the way and help you to feel immersed in the culture through all of the excursions and resources provided. I am glad I chose to go through them.

Kristen Shipley, North Carolina Agricultural and Technical State University

This is a once in a lifetime opportunity, so don't let a fear of the unknown stand in your way; seize the moment!

Megan Jones, Knox College

ISA allowed me to grow as a person and gave me the chance to increase my cultural awareness.

Michelle Rubado, St. John Fisher College

The experience is really great. The culture, the food, the entertainment, everything. Don't discount your fellow ISA students because you'll definitely be lonely without them.

Tyler Ambrose, Becker College

Morocco

Meknes

Morocco is a wonderful place for many different kinds of people and I chose it because I wanted to experience life that was vastly different from the one I grew up in. Not necessarily in the sense of money or food but in culture and lifestyle. What I found here was a culture that I enjoyed and wanted to immerse myself in but also had issues that I fundamentally disagreed with. That was the most valuable part of my study abroad experience: learning that life can exist in many different ways, that there are problems in every society and that its important not to judge a culture from within the confines of your own.

Alexandra Loomis, University of Massachusetts, Amherst

If you are interested in Arabic, Islamic Culture, and Good Food, hands down go to Morocco! This program is so great and I had a blast touring the country, speaking the language, and the overall immersion of the culture! One of the best decisions I have made!

Ben Lutz, Elon University

Studying abroad through ISA gives you the best of both worlds: you have the freedom and independence to move around on your own and explore the country at your leisure, but you also have a friendly, dedicated support system to help you navigate the new culture and get the most out of your time.

Jasmine Green, University of South Florida

I knew I wanted to study abroad, but I'm so thankful I found ISA. Between the directors, my fellow students, the locals, and my homestay family, I could not have asked for a better experience. My five weeks in Meknes flew by, and I hope someday I'll be able to go back!

Logan Tidstrom, University of Michigan

Morocco is the only country where you could be on top of North Africa the same day you got lost in a medina and went swimming at a beach! Morocco really makes you ask, what adventure's next?

Matthew Cassidy, Rollins College

New Zealand

Auckland

Ultimately, you get what you put in. If you want your experience to be worthwhile and memorable, you have to put in the effort as well. Don't go study abroad and only have expectations for the country and the people. Have expectations and goals for yourself. This is the best way to completely immerse in a culture and stretch yourself.

Ashley Park, Chapman University

Living in another country at such a pivotal point in your life has so many advantages. This experience heightened my sense of independence, aided in my own personal growth, and allowed me to have experiences I could have only dreamed about. New Zealand is such a beautiful country and my adventures here reflect that, no pictures will do my memories justice. This country will surely be missed and I hope to return someday soon!

Brenna Thomas, University of San Diego

ISA not only opened the door to my experiences in a new country, but allowed me to grow and experience things I have never had the opportunity to until this past semester. The people and places I was able to visit changed me forever and I'l never forget my semester abroad.

Evelyn Sharkey, University of Colorado, Boulder

Studying abroad through ISA was the single greatest decision I have ever made. You could choose ISA and go anywhere in the world and you will have the greatest experience. ISA in Auckland, New Zealand provided amazing excursions and cultural activities to make the best of my time in this beautiful country. Take advantage of every opportunity ISA gives you and you will have the time of your life. I wish I could stay longer!

Sarah Culver, Christopher Newport University

ISA is going to help your transition to your country abroad so much! The staff are super helpful and care about making sure your experience is really great. Look very carefully at the program you choose and be sure to choose the right one for you.

Shelton Harder, University of North Carolina, Wilmington

ISA staff are extremely helpful during your stay abroad. I would highly recommend ISA as this program not only includes multiple amazing excursions, but creates friendships from day one that will likely last a lifetime!

Simran Sangha, University of North Carolina, Wilmington

Christchurch

Don't be afraid to step a lot outside your comfort zone, because that is when really great experiences happen.

Emily Chatburn, University of Idaho

ISA helped me put together and establish my place abroad. It helped me know what I was getting into and then left me with a support system once I immersed myself in my new life.

Emma Baldwin, DePauw University

Make friends with as many locals as soon as you can! Building friendships right from the beginning was so important to me. Don't be afraid to go somewhere alone if its safe, you can sometimes meet new people easier when you're not surrounded by your usual group. It will be a little sad leaving your new friends behind at the end, but its definitely better than being sad about being alone. Don't feel too much pressure to go out and do everything or make it a competition to see who can do the coolest stuff; do what you're comfortable with, but do make this a memorable experience by doing something fun that you may never have the chance to do again!

Gigi Stephens, Washington State University

<text style="font-size: 10pt; font-family: 'Microsoft Sans Serif', sans-serif">Going with ISA was the best decision I could have made. The transition was fluid, the staff is friendly, and the group I was with really sealed the deal.</text>

Kevin Bagnato, Ramapo University

<box>I'm really glad that I went abroad with ISA because they provided a platform to help me get acquainted with my host country. Upon arriving at my University, I had already met other students from America who were on my same program. It was really helpful to know people in a similar situation; we went to club meetings together and from there were able to meet more locals.</box> <box>
</box>

Liz Arthur, University of Colorado, Boulder

Dunedin

Overall I absolutely loved studying abroad in New Zealand. I truly think that going through ISA enhanced my experience due to the orientation at the beginning where I met my whole program and got to know them so well. Also through planned weekend excursions, or small group meetings. Compared to other programs here, I felt that our ISA group was very close with everyone and the staff truly cared about us as people and wanted to make our experiences the best that they possibly could.

Caroline Garey, University of Colorado, Boulder

Studying in Dunedin affirmed everything I had hoped for in a study abroad experience. Stunning geography, intriguing students and locals, a vibrant university, and great coordinators and programming through ISA. I could not ask for more.

Ellen Smith, DePauw University

ISA has been wonderful! This is my second abroad experience and both times I have loved how ISA has facilitated support and transitions! Take advantage of every opportunity from the beginning to the end! It will fly by and no matter what you do, you'll be wishing you had done 50 other things too! Get to know the ISA program directors! They will be an incredibly valued resource and are always there for you! And getting to know people in your ISA program will also provide friends for life!

Makayla Lorch, CU, Boulder

My semester abroad (in Dunedin) was the best 5 months of my life thus far. I made so many amazing friends (locals and international students) and had incredible adventures that made saying goodbye and leaving (New Zealand) nearly impossible. The ISA program played a big role in my lack of culture shock, or any shock for that matter, upon arriving to the University, and the excursions they offered throughout the semester were well-organized, lots of fun, and kept me close with other students in the program. I would highly recommend studying abroad through this program, for it introduced me to some of my closest friends today, prepared me extremely well for what to expect academically and culturally, and provided me with opportunities to see and do many fun activities throughout New Zealand.

Riley Stutz, University of San Diego

New Zealand is an amazing place with so many great things to do. Dunedin is an extremely diverse and lively city, with tons of beautiful landscape surrounding it. I would recommend to any student coming to NZ that they pack smart: minimal but proper clothing and more gear/equipment that could be used for outdoor activities! I would also recommend that they keep a journal during their stay here. I have seen lots of kids doing it and I regret not keeping one just to write down all of the cool things I've done.

Taylor Burks, University of San Diego

Stress
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Related Terms
  • Adrenal, agoraphobia, angina, antidepressants, arrhythmias, asthma, azapirones, benzodiazepines, beta blockers, bipolar disorder, bruxism, CFS, chronic fatigue syndrome, cortisol, depression, diabetes, DSM-IV-TR, ephedra, epilepsy, epinephrine, fatigue, GABA, GAD, gamma-amino butyric acid, generalized anxiety disorder, hypochondriac, hypoglycemia, IBS, irritable bowel syndrome, migraine headaches, mitral valve prolapse, norepinephrine, obsessive compulsive disorder, OCD, palpitation, panic attacks, panic disorder, phobias, post traumatic stress disorder, PTSD, restless leg syndrome, RLS, SAD, separation anxiety, serotonin, sleep apnea, sleep disorders, social anxiety disorder, tension headaches, thyroid disorders, trauma, trichotillomania, vertigo.

Background
  • Anxiety is an unpleasant complex combination of emotions often accompanied by physical sensations such as heart palpitations (irregular heart beat), nausea, angina (chest pain), shortness of breath, tension headache, and nervousness.
  • The National Institute of Mental Health (NIMH) estimates that anxiety disorders affect about 40 million American adults age 18 years and older (about 18%) in a given year. Only about one-third of those suffering from an anxiety disorder receive treatment. Anxiety disorders are reported to cost the United States more than $42 billion a year.
  • Unlike the relatively mild, brief anxiety that can be caused by a stressful event (such as testing, a job interview, the death of a loved one, or public performance/speaking), anxiety disorders last at least six months and can become worse if not treated.
  • Anxiety disorders can commonly occur along with other mental or physical illnesses, including alcohol or substance abuse, depression, or bipolar illness, which may mask anxiety symptoms or make them worse.
  • According to the Anxiety Disorders Association of America (ADAA), individuals with an anxiety disorder are three to five times more likely to go to the doctor and six times more likely to be hospitalized for psychiatric disorders than non-sufferers.

Signs and symptoms
  • The primary symptoms of anxiety disorders are fear and worry. However, anxiety disorders are also characterized by additional emotional and physical symptoms.
  • Physical: Physical symptoms include heart palpitations (irregular heartbeat), angina (chest pain), hot flashes or chills, cold and clammy hands, stomach upset or queasiness, frequent urination, diarrhea, shortness of breath, sweating, vertigo (dizziness), tremors, muscle tension or aches, fatigue (tiredness), and insomnia (inability to sleep).
  • Emotional/Psychological: Emotional or psychological symptoms can include apprehension, uneasiness, dread, impaired concentration or selective attention, feeling restless or on edge, avoidance, nightmares, irritability, confusion, behavioral problems (especially in children and adolescents), nervousness, jumpiness, self-consciousness, insecurity, fear of dying or going crazy, and a strong desire to escape.
  • Generalized Anxiety Disorder (GAD): Specific symptoms for GAD can include chronic, exaggerated worry, tension, and irritability that appear to have no cause or are more intense than the situation warrants. Physical signs, such as restlessness, trouble falling or staying asleep, headaches, trembling, twitching, muscle tension, or sweating, often accompany these psychological symptoms.
  • Panic disorder: Panic disorder symptoms include heart palpitations (irregular heart beat), angina (chest pain), lightheadedness or dizziness, nausea, shortness of breath, feelings of imminent danger, shaking or trembling, choking, fear of dying, sweating, feelings of unreality, numbness or tingling, hot flashes or chills, and a feeling of going crazy. Since many of the symptoms of panic disorder mimic those found in illnesses like heart disease, thyroid problems and breathing disorders, people with panic disorder often make multiple visits to emergency rooms or doctors' offices, convinced they have a life-threatening illness (hypochondriac).
  • Social anxiety disorder (SAD): Specific symptoms for SAD include blushing, sweating, trembling, nausea, rapid heartbeat, dizziness, and headaches. Some people may have an intense fear of a single social or performance circumstance such as giving a speech, talking to a salesperson or making a phone call, but be perfectly comfortable in other social settings. Others may have a more generalized form of SAD, ranging from such behaviors as becoming anxious in a variety of routines, to clinging behavior, and throwing tantrums.
  • Post traumatic stress disorder (PTSD): People with PTSD typically avoid situations that remind them of the traumatic event, because they provoke intense distress or even panic attacks. PTSD is characterized by three main types of symptoms including: re-experiencing the trauma through intrusive distressing recollections of the event, flashbacks and nightmares; emotional numbness and avoidance of places, people and activities that are reminders of the trauma; and increased arousal including difficulty sleeping and concentrating, feeling jumpy, and becoming easily irritated and angered.
  • Obsessive-compulsive disorder (OCD): Common obsessions include constant, irrational worry about dirt, germs or contamination, nagging feelings that something bad will happen if certain items aren't in an exact place, position or order, fear that one's negative or blasphemous thoughts or images will cause personal harm or harm to a loved one, preoccupation with losing or throwing away objects with little or no value, and rumination about accidentally or purposefully injuring another person. Common compulsions include repeatedly washing one's hands, bathing or cleaning household items, often for hours at a time; checking and re-checking, several to hundreds of times per day, that the doors are locked, stove is turned off, hairdryer is unplugged, etc., unable to stop repeating a name, phrase or tune, an excessive, methodical, and painstakingly slow approach to daily activities, and hording such as saving useless items like old newspapers or magazines, bottle caps or rubber bands.
  • Obsessions and rituals can substantially interfere with a person's normal routine, schoolwork, job, family or social activities. Many hours of each day may be spent focusing on obsessive thoughts and performing rituals, and normal concentration and the performing of daily functions becomes very difficult.
  • Children can also suffer from OCD, but unlike adults, children with OCD do not realize that their obsessions and compulsions are excessive and ritualistic.
  • Phobias: Specific phobias are characterized by strong, irrational, involuntary fear reactions to a particular object, place or situation. The reactions to these fears lead the individual to dread confronting common, everyday situations, or avoid them altogether, even though they logically know there isn't any threat of danger. Symptoms of phobias include heights, flying in airplanes, insects, snakes and other animals, dental procedures, thunder, public transportation, and elevators. The fear doesn't make any sense, but nothing seems to be able to stop it. When confronted with the feared situation, someone with a phobia may even have a panic attack.

Diagnosis
  • Generalized Anxiety Disorder (GAD): GAD diagnosis is when an individual spends at least six months worried excessively about everyday problems. However, incapacitating or troublesome symptoms warranting treatment may exist for shorter periods of time.
  • Panic disorder: Panic disorder (or panic attack) is diagnosed by either four attacks within four weeks or one or more attacks followed by at least a month of persistent fear of having another attack. Also, a minimum of four of the symptoms listed for panic disorders developed during at least one of the attacks. Most panic attacks last only a few minutes and up to an hour in rare cases. They can occur at any time, even during sleep.
  • Phobias: Phobia present with extreme anxiety with exposure to the object or situation. The individual recognizes that his or her fear is excessive or unreasonable, and finds that normal routines, social activities, or relationships are significantly impaired as a result of these fears.
  • Obsessive-compulsive disorder (OCD): A mental health professional will diagnose obsessive-compulsive disorder after a thorough evaluation. Criteria are based upon the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), a clinical book of mental illness diagnoses. OCD diagnosis is based upon recurrent and persistent thoughts, impulses or images that are intrusive and cause distress, thoughts that aren't simply excessive worries about real problems, an attempt to ignore or suppress these thoughts, images or impulses, and the recognition that these thoughts, images and impulses are a product of the mind.
  • Compulsions must meet specific criteria including repetitive behaviors, such as hand washing, or repetitive mental acts, such as counting silently, that the individual feels driven to perform. These behaviors or mental acts are meant to prevent or reduce distress about unrealistic obsessions.
  • Post traumatic stress disorder (PTSD): Although many of the symptoms of PTSD may be an appropriate initial response to a traumatic event, they are considered part of a disorder when they persist beyond three months.

Complications
  • Anxiety can also worsen many pre-existing medical conditions, such as ulcers, hypertension (high blood pressure), asthma, and chronic obstructive pulmonary disease (COPD). Anxiety may also be associated with mitral valve prolapse (condition where the mitral valve does not close properly), chronic fatigue syndrome (CFS), sleep apnea, irritable bowel syndrome (IBS), and chronic (long-term) tension headaches.
  • Depression: Anxiety and depression usually go hand in hand, in both the young and old. The combination of depression and anxiety may increase both substance abuse and suicide.
  • The lifetime risk for depression in people with anxiety disorders may be higher than 70%. Most patients with generalized anxiety disorder (GAD) will experience at least one episode of significant depression and many develop recurrent episodes. In patients with both disorders, GAD usually precedes the onset of depression. Social anxiety during adolescence or young adulthood has been associated with a higher risk for depression, and the presence of both increases the chances for severe depression. People with post traumatic stress disorder (PTSD) are four to seven times as likely to be depressed as are people without PTSD.
  • Bipolar Disorder: Symptoms of panic disorder are very common in people with bipolar disorder (manic-depression). In fact, people with bipolar disorder have 26 times the rate of panic disorder as in the general population. To complicate matters, anxiety can worsen bipolar disorder.
  • Suicide: Anxiety disorders may also contribute to an increased risk for suicide, developing alcoholism and other forms of substance abuse, overeating, may have very negative effects on work, school, and relationships, and decrease the individuals overall health.
  • Physical injury: Individuals with obsessive-compulsive disorder (OCD) may experience physical injury such as skin problems from excessive washing, injuries from repetitive physical acts, and hair loss from repeated hair pulling (trichotillomania). Studies have reported that PTSD may be associated with shrinkage in the brain associated with memory and learning, possibly due to the continued release of the stress hormone cortisol.
  • Physical Effects of Anxiety on Children: Anxiety may be associated with a higher risk for sleep disorders in children, such as frequent nightmares, restless legs syndrome (RLS), and bruxism (grinding and gnashing of the teeth during sleep).

Treatment
  • Psychotherapy techniques:
  • Generally, anxiety disorders are treated with medications, specific types of psychotherapy, or both. Treatment choices depend on the symptoms and the preference of the doctor and patient.
  • Psychotherapy: Psychotherapy involves talking with a trained mental health professional, such as a psychiatrist, psychologist, social worker, or counselor, to discover what causes an anxiety disorder and how to deal with its symptoms.
  • Cognitive-Behavior Therapy (CBT): Many therapists use a combination of cognitive and behavior therapies, this is often referred to as CBT. Cognitive-behavioral therapy is based on the scientific fact that thoughts cause feelings and behaviors, not external things, like people, situations, and events. The benefit of this fact is that an individual can change the way they think to feel and act better even if the situation causing the problem does not change.
  • Relaxation Techniques: Relaxation Techniques help individuals develop the ability to more effectively cope with the stresses that contribute to anxiety, as well as with some of the physical symptoms of anxiety. The techniques taught include breathing re-training and exercise.
  • Anti-anxiety medications:
  • Benzodiazepines: Benzodiazepines are fast-acting sedatives that typically relieve anxiety symptoms within 30 minutes to one hour. The rapid relief when using benzodiazepines makes them very effective when taken during a panic attack or another overwhelming anxiety episode.
  • Unfortunately, benzodiazepines can be addictive. If taken regularly for more than a couple of weeks, physical and psychological addiction is likely to occur. Benzodiazepine may create tolerance, with larger doses needed to achieve the same effect, and serious withdrawal symptoms can occur when going off the medication, including increased anxiety, depression, and insomnia. Some benzodiazepines, including diazepam (Valium®) have a longer half-life in the body, meaning they stay in the body longer. The addictive potential is why benzodiazepines are usually recommended only for short-term. To minimize the withdrawal reaction, it is important to slowly taper off these medications.
  • Some examples of benzodiazepines include alprazolam (Xanax®), chlordiazepoxide (Librium®), clonazepam (Klonopin®), clorazepate (Tranxene®), lorazepam (Ativan®), oxazepam (Serax), diazepam (Valium). Clonazepam (Klonopin®) is commonly used for social phobia and GAD, lorazepam (Ativan®) is used for panic disorder, and alprazolam (Xanax®) is useful for both panic disorder and generalized anxiety disorder (GAD).
  • Most common side effects include drowsiness, impaired coordination, fatigue, confusion and disorientation, dizziness, decreased concentration, short-term memory problems, dry mouth, blurred vision, and irregular heart beat.
  • Azapirones: Azapironeswere developed more recently than benzodiazepines, and are anti-anxiety drugs prescribed for GAD and obsessive compulsive disorder (OCD). Compared to benzodiazepines, the azapirones are slow acting, taking from two to four weeks to provide anxiety symptom relief. Advantages of these drugs over benzodiazepines include less sedation and effects on coordination, and less memory impairment. Withdrawal effects with azapirones are minimal compared to benzodiazepines. Buspirone (Buspar®) is the only azapirone approved for medical use.
  • Side effects may include nausea, headaches, dizziness, drowsiness, upset stomach, constipation, diarrhea, and dry mouth. Azapirones are not to be taken with monoamine oxidase inhibitors (MAOIs, a type of antidepressant) due to the increase risk of life-threatening high blood pressure.
  • Antidepressant medications:
  • Selective serotonin reuptake inhibitors (SSRIs): SSRIs are antidepressants that alter the levels of the neurotransmitter serotonin in the brain. SSRIs have been used to treat panic disorder, obsessive-compulsive disorder (OCD), and generalized anxiety disorder (GAD). They are often prescribed because they have less severe side effects than the older antidepressants.
  • Some SSRIs used in anxiety disorders include fluoxetine (Prozac®), sertraline (Zoloft®), escitalopram (Lexapro®), paroxetine (Paxil®), and citalopram (Celexa®) which are commonly prescribed for panic disorder, OCD, PTSD, and social phobia. SSRIs are also used to treat panic disorder when it occurs in combination with OCD, social phobia, or depression. SSRIs generally are started at low doses and gradually increased until they have a beneficial effect.
  • Tricyclic antidepressants (TCAs): TCAs are older antidepressants that may be prescribed for panic disorder, obsessive-compulsive disorder (OCD), and generalized anxiety disorder (GAD). Tricyclics can also be prescribed for anxiety disorders co-occurring with depression. The tricyclics typically take around two weeks to provide symptom relief.
  • Tricyclics include imipramine (Tofranil®), which is prescribed for panic disorder and GAD, and clomipramine (Anafranil®), which is the only tricyclic antidepressant useful for treating OCD.
  • Monoamine oxidase inhibitors (MAOIs): MAOIs are the oldest class of antidepressant medications.
  • The MAOIs most commonly prescribed for anxiety disorders are phenelzine (Nardil®), followed by tranylcypromine (Parnate®), and isocarboxazid (Marplan®), which are useful in treating panic disorder and social phobia.
  • Atypical antidepressants:
  • There are several newer atypical antidepressants which target other neurotransmitters either alone or in addition to serotonin. Some of the brain chemicals they affect include norepinephine and dopamine.
  • Venlafaxine (Effexor®), an atypical antidepressant, is used to treat GAD.
  • Antidepressants take up to four to six weeks to begin relieving symptoms, so they aren't helpful if first taken during a panic attack.
  • Antidepressants are often prescribed instead of benzodiazepines because the risk for dependency and the abuse is less.
  • Antidepressant can cause loss of sexual desire, nausea, insomnia, sweating, nervousness, dizziness, weight gain or weight loss, dry mouth, constipation, and blurred vision. MAOIs also have severe interactions with certain foods, drinks, and medications. When an individual takes an MAOI, he or she must carefully monitor what is eaten and what drugs are taken. Items that are restricted include many cheeses, chocolate, wine, and beer.
  • Beta-blockers:
  • Beta blockers are type of drug used to treat high blood pressure and heart problems. In anxiety, beta blockers can help control physical symptoms such as nervousness, rapid heart rate, trembling voice, sweating, dizziness, and shaky hands. Beta blockers are prescribed off label for anxiety.
  • Because they don't affect the emotional symptoms of anxiety such as worry, beta blockers are most helpful for phobias, particularly social phobia and performance anxiety (such as a speech or being in front of an audience).
  • Examples of beta blockers include propranolol (Inderal®), metoprolol (Lopressor®) and atenolol (Tenormin®).
  • Side effects include light-headedness, sleepiness, short-term memory loss, unusually slow pulse, fatigue, insomnia, diarrhea, cold hands and feet, and sexual side effects.

Integrative therapies
  • Strong scientific evidence:
  • Kava: Kava kava (Piper methysticum) is a shrub from the South Pacific islands that has been used for centuries to produce calming effects in humans. Studies have found moderate benefit of kava in the treatment of anxiety, and preliminary evidence suggests that kava may be equivalent to benzodiazepine drugs such as diazepam (Valium®). In one human study, kava's effects were reported to be similar to the prescription drug buspirone (Buspar®) used for generalized anxiety disorder (GAD). However, a recent study found no effect in generalized anxiety disorder. The kava supplement should be standardized for best results.
  • There is concern regarding kava's potential toxicity, based on multiple reports of liver damage in Europe and a number of cases in the United States, including hepatitis, cirrhosis, and liver failure. The U.S. Food and Drug Administration (FDA) has issued warnings to consumers and physicians. Kava should not be used in individuals with pre-existing liver conditions or a history of alcohol or drug abuse. Caution is advised when taking kava as numerous adverse effects including sedation and drug interactions are possible. Kava should not be used if pregnant or breastfeeding.
  • Music therapy: Music is an ancient tool of healing. Many different forms of music intervention have been used to reduce anxiety in a variety of medical conditions and medical procedures. The relaxation response is a physiological state that speeds up many of the body's healing responses. Relaxation leads to reduced heart rate, blood pressure, and tension, as well as many other beneficial changes. Music therapy has been shown to promote relaxation and to be of benefit in stress and anxiety.
  • Most studies have shown positive findings, although not all do. There is evidence that music interventions help reduce anxiety related to cataract surgery, sigmoidoscopy, bronchoscopy, breast biopsy, cesarean delivery, colonoscopy, esophagogastroduodenoscopy, cardiac catheterization, hospitalized asthmatic patients, psychotherapy, general medical procedures, radiation therapy, treatment for acute myocardial infarction, preparation for surgery, total knee arthroplasty, ventilator-dependence and transurethral resection of the prostate (TURP). Many of these studies have found reduced blood pressure and heart rate as well. A minority of studies found no benefit including studies related to mammogram, ischemic heart disease, pediatric outpatient surgery, and cardiac catheterization. The choice of music may be a factor in outcomes: listening to music of one's preference has been found to be an important consideration. Overall, the evidence favors use of music interventions for anxiety, although more studies are needed to determine what forms work best. Music therapy is generally known to be safe.
  • Good scientific evidence:
  • Art therapy: Art therapy may enable the expression of inner thoughts or feelings when verbalization is difficult or not possible. Some evidence suggests that creative expression programs in schools involving art therapy may help alleviate problems of self-esteem and can improve social functioning in school age children. Some evidence suggests that a creative expression program involving art therapy may help alleviate these problems, increase self-esteem, and improve social functioning and transitional stress.
  • Art therapy may evoke distressing thoughts or feelings. Use under the guidance of a qualified art therapist or other mental health professional. Some forms of art therapy use potentially harmful materials. Only materials known to be safe should be used. Related clean-up materials (like turpentine or mineral spirits) that release potentially toxic fumes should only be used with good ventilation.
  • Chiropractic, Spinal Manipulative Therapy, Spinal Manipulation: The use of spinal manipulative therapy for the relief of tension headache or migraine headache has been reported in several controlled human trials, systematic reviews, and case reports. Overall, the quality of studies is not high, with incomplete reporting of design, inconsistent use of techniques between studies, and variable results. Despite these methodologic problems, overall the evidence suggests some benefits in the prevention of episodic tension headache. Effects on migraine headache have not been demonstrated. Better quality research is necessary in this area before a firm conclusion can be drawn. Patients should be aware of the safety concerns surrounding cervical/neck manipulation before starting this type of therapy.
  • Use extra caution during cervical adjustments. Use cautiously with acute arthritis, conditions that cause decreased bone mineralization, brittle bone disease, bone softening conditions, bleeding disorders, or migraines. Use cautiously with the risk of tumors or cancers. Avoid with symptoms of vertebrobasilar vascular insufficiency, aneurysms, unstable spondylolisthesis or arthritis. Avoid with agents that increase the risk of bleeding. Avoid in areas of para-spinal tissue after surgery. Avoid if pregnant or breastfeeding due to a lack of scientific data.
  • Hypnosis: Hypnosis is associated with a deep state of relaxation. Several studies support the use of hypnosis to reduce anxiety, particularly prior to dental or medical procedures, or in the management of phobias. Early evidence suggests that these effects may last for up to three years with benefits reported in children and adults. Several promising studies in adults and children report that dental anxiety related to dentist visits can be reduced with the use of hypnotherapy. Benefits may be long-standing (measured at up to three years). However, some research reports that hypnosis may be less effective for this use than group therapy or systematic desensitization therapy. In addition, several studies report improvements in the severity and frequency of tension headaches following several weekly hypnosis sessions. Early research suggests that hypnosis may be equivalent to other relaxation techniques, biofeedback, or autogenic training. Better quality studies are necessary before a conclusion can be made in this area.
  • Use cautiously with mental illnesses like psychosis/schizophrenia, manic depression, multiple personality disorder or dissociative disorders. Use cautiously with seizure disorders.
  • Meditation: Evidence indicates that meditation may help healthy people reduce the effects of stress. More studies are needed to further examine the dynamics of stress and meditation, but meditation may be recommended as a general health-promotion activity.
  • Use cautiously with underlying mental illnesses. People with psychiatric disorders should consult with their primary mental healthcare professional(s) before starting a program of meditation, and should explore how meditation may or may not fit in with their current treatment plan. Avoid with risk of seizures. The practice of meditation should not delay the time to diagnosis or treatment with more proven techniques or therapies, and should not be used as the sole approach to illnesses.
  • Music therapy: Many forms of music intervention have been used to reduce anxiety in a variety of medical conditions and medical procedures. Overall, the evidence favors the use of music interventions for anxiety, although more studies are needed to determine what forms work best.
  • The stress response is a physiological state opposite to that of the relaxation response, with increased blood pressure, heart rate, tension, stress hormones (cortisol), and other potentially adverse changes. In cardiac patients, music has been found to reduce blood pressure, respiratory rate, psychological distress, and cardiac complications. Music therapy may be of benefit in stress by reducing levels of stress hormones in the blood including those released in response to invasive medical procedures. Children receiving immunization may have reduced levels of physiological and behavioral distress with the help of lullabies. Finally, there is evidence that music may reduce the stress response when performing stressful mental tasks. Music therapy is generally known to be safe.
  • Peppermint: Application of diluted peppermint oil to the forehead and temples has been tested in people with headache, specifically tension headache. It is not clear if this is an effective treatment.
  • Allergic/hypersensitivity reactions may occur from using peppermint or menthol by mouth or on the skin, including throat closing (laryngeal spasm), breathing problems (bronchial constriction/asthma symptoms), or skin rash/hives/contact dermatitis. People with known allergy/hypersensitivity to peppermint leaf or oil should avoid peppermint products. Peppermint oil may be safe in small doses, although multiple adverse effects are possible. Very large doses of peppermint oil taken by mouth have resulted in muscle weakness, brain damage, and seizure. Peppermint oil should be used cautiously by people with G6PD deficiency or gallbladder disease. Use in infants or children is not recommended due to potential toxicity.
  • Psychotherapy: Psychotherapy is an interactive process between a person and a qualified mental health professional (psychiatrist, psychologist, clinical social worker, licensed counselor, or other trained practitioner). Psychotherapy, especially cognitive behavioral therapy, may be of benefit in generalized anxiety disorder or panic disorder. Treatment may also include prescription medication in some cases.
  • Psychotherapy is not always sufficient to resolve mental or emotional conditions. Psychiatric medication is sometimes needed. The reluctance to seek and use appropriate medication may contribute to worsening of symptoms or increased risk for poor outcomes. In order to be successful, psychotherapy requires considerable personal motivation and investment in the process. This includes consistent attendance and attention to treatment recommendations provided by the practitioner. Not all therapists are sufficiently qualified to work with all problems. The client or patient should seek referrals from trusted sources and should also inquire of the practitioner's training and background before committing to work with a particular therapist. Some forms of psychotherapy evoke strong emotional feelings and expression. This can be disturbing for people with serious mental illness or some medical conditions. Psychotherapy may help with post-partum depression, but is not a substitute for medication, which may be needed in severe cases.
  • Relaxation therapy: Clinical studies suggest that relaxation techniques may be beneficial in patients with anxiety, although these approaches do not appear to be as effective as psychotherapy. Numerous human studies report that relaxation techniques (for example using audio tapes or group therapy) may moderately reduce anxiety and stress, particularly in individuals without significant mental illness. Relaxation may be beneficial for phobias such as agoraphobia (fear of crowds), panic disorder, work-related stress, and anxiety due to serious illnesses, prior to medical procedures, or during pregnancy. However, there are many types of relaxation techniques used in studies, and many trials do not clearly describe design or results.
  • Avoid with psychiatric disorders like schizophrenia/psychosis. Jacobson relaxation (flexing specific muscles, holding that position, then relaxing the muscles) should be used cautiously with illnesses like heart disease, high blood pressure, or musculoskeletal injury. Relaxation therapy is not recommended as the sole treatment approach for potentially serious medical conditions, and should not delay the time to diagnosis or treatment with more proven techniques.
  • Therapeutic touch: There is some evidence that therapeutic touch may reduce anxiety in chemically dependent pregnant women, reduce stress and anxiety in the work place, and reduce stress in teen-agers with psychiatric disease. Further study is needed to indicate that therapeutic touch is an effective way to reduce stress and promote relaxation. Therapeutic touch is believed to be safe for most people. Therapeutic touch should not be used for potentially serious conditions in place of more proven therapies. Avoid with fever or inflammation, and on body areas with cancer.
  • Yoga: Yoga is an ancient system of relaxation, exercise, and healing with origins in Indian philosophy. Yoga may reduce daily stress and anxiety in healthy people when practiced several times weekly. Several human studies support the use of yoga therapy in the treatment of clinical anxiety disorders, including generalized anxiety and OCD. Available data remains inconclusive, yet thousands of years of effectiveness in India for stress and anxiety must be appreciated.
  • Yoga is generally considered to be safe in healthy individuals when practiced appropriately. Avoid some inverted poses with disc disease of the spine, fragile or atherosclerotic neck arteries, risk for blood clots, extremely high or low blood pressure, glaucoma, detachment of the retina, ear problems, severe osteoporosis, or cervical spondylitis. Certain yoga breathing techniques should be avoided in people with heart or lung disease. Use cautiously with a history of psychotic disorders. Yoga techniques are believed to be safe during pregnancy and breastfeeding when practiced under the guidance of expert instruction (the popular Lamaze techniques are based on yogic breathing). However, poses that put pressure on the uterus, such as abdominal twists, should be avoided in pregnancy.
  • Unclear or conflicting scientific evidence:
  • 5-HTP(5-Hydroxytryptophan, L-5-Hydroxytryptophan): 5-HTP is the precursor of the neurotransmitter serotonin. It is obtained commercially from the seeds of the plant Griffonia simplicifolia. Although 5-HTP has been proposed as a possible treatment for anxiety disorders, there is not enough human evidence to make a firm recommendation.
  • Avoid 5-HTP if allergic or hypersensitive to it; signs of allergy to 5-HTP may include rash, itching or shortness of breath. Avoid with eosinophilia syndromes, Down's syndrome, and mitochondrial encephalomyopathy. Use cautiously if taking antidepressant medications such as TCAs, MAOIs, SSRIs, nefazodone, trazodone, venlafaxine, mirtazapine, bupropion; 5-HTP receptor agonists such as sumatriptan, rizatriptan, naratriptan, zolmitriptan, eletriptan, imotriptan, and frovatriptan; and carbidopa, phenobarbital, pindolol, reserpine, tramadol, or zolpidem. Use cautiously with renal (kidney) insufficiency, HIV/AIDS- particularly HIV-1 infection, epilepsy, and/or with a history of mental disorders. Avoid if pregnant or breastfeeding.
  • Acupressure, shiatsu: Acupressure, or shiatsu, has been used in China for thousands of years for health and healing. Preliminary clinical trials suggest that acupressure may significantly reduce general and pre-operative anxiety. However, these studies have been small and poorly designed, warranting better-quality research. With proper training, acupressure appears to be safe if self-administered or administered by an experienced therapist. No serious long-term complications have been reported, according to scientific data. Hand nerve injury and herpes zoster ("shingles") cases have been reported after shiatsu massage. Forceful acupressure may cause bruising.
  • Acupuncture: Acupuncture, or the use of needles to manipulate the "chi" or body energy, originated in China over 5,000 years ago. Several studies have reported benefits in anxiety disorders, but the studies have been small and poorly designed, leaving the scientific evidence on acupuncture use in anxiety inconclusive.
  • Needles must be sterile in order to avoid disease transmission. Avoid with valvular heart disease, infections, bleeding disorders or with drugs that increase the risk of bleeding (anticoagulants), medical conditions of unknown origin, neurological disorders. Avoid on areas that have received radiation therapy and during pregnancy. Use cautiously with pulmonary disease (like asthma or emphysema). Use cautiously in elderly or medically compromised patients, diabetics or with history of seizures. Avoid electroacupuncture with arrhythmia (irregular heartbeat) or in patients with pacemakers.
  • Aromatherapy: Lavender aromatherapy may be able to reduce anxiety. However, there have been conflicting results, and more study is needed in this area. It is unclear whether lavender aromatherapy reduces anxiety and stress in intensive unit care patients. Essential oils should be administered in a carrier oil to avoid toxicity. Avoid if history of allergic dermatitis. Use cautiously if driving/operating heavy machinery. Avoid consuming essential oils. Avoid direct contact of undiluted oils with mucous membranes. Use cautiously if pregnant.
  • Art therapy: Limited evidence suggests that art therapy, in the context of group psychotherapy, may contribute to the reduction of symptoms of emotional distress in military personnel receiving mental health treatment. Art therapy may evoke distressing thoughts or feelings. Use under the guidance of a qualified art therapist or other mental health professional. Some forms of art therapy use potentially harmful materials. Only materials known to be safe should be used. Related clean-up materials (like turpentine or mineral spirits) that release potentially toxic fumes should only be used with good ventilation.
  • Bach flower remedies
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Courtesy of Calmful Living If you've flown on a plane, chances are you've experienced a delay. When that announcement rings out, the reaction is often annoyance, concern or even anger. Sure, let yourself feel that  ...
Job Stress Tied to Stroke Risk, Study Suggests
Having a high-stress job, particularly one that is demanding but offers little personal control, may raise the risk for a stroke, Chinese researchers  ...
Laughter May Work Like Meditation in the Brain
SUNDAY, April 27, 2014 (HealthDay News) -- Laughter triggers brain waves similar to those associated with meditation, according to a small new study. It also found that other forms of stimulation produce different types  ...
Stressful Jobs With Little Control/Shorter Life Spans?
Posted October 30, 2016 By Randy Dotinga HealthDay Reporter THURSDAY, Oct. 27, 2016 (HealthDay News) -- It can be very frustrating to be in a high-demand job where your boss allows you little control, and a  ...
CALM Connection: Spontaneous Smooches = Spontaneous Stress Relief
Courtesy of Organic Connections Whether it's a surprise kiss over breakfast or a big smooch when you walk through the door at the end of the day, grabbing kisses from your partner here and there can actually  ...

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