Il est basé sur les principes d’autogestion des soins et de la santé. A phobia can also be conveyed by other people (e.g. Elle est un état de complet bien-être physique, psychologique et social. Cet atelier représente une démarche d’intervention de groupe s’échelonnant sur 10 semaines, à raison d’une rencontre de 2 h 30 par semaine. Dans le cadre du programme J’avance !, en collaboration avec Revivre, le Carrefour le Moutier offre, dès le 5 octobre, une session de 10 semaines, les mercredis de … Articles scientifiques, livres et chapitres, actes de colloques, rapports de recherche, etc., publiés par les membres de l'équipe du laboratoire Vitalité. La capacité à se mettre en action est déterminante dans l’autogestion de la santé. Revivre ferme la porte à 2020. When anxiety becomes a source of distress and suffering and harms your ability to function, we may be dealing with an anxiety disorder. An emphasis is placed on active listening and mutual support. Children may also try to recreate the specific situation. In more complex cases, the primary care doctor can refer children and their families to the various pediatric psychiatric services in Québec for more specialized care. • Présentation de Revivre et de son approche : l’autogestion • Description des outils privilégiés pour l’autogestion de l’anxiété • Exercices d’application de l’autogestion à la gestion de l’anxiété et à la présence d’idées suicidaires Objectifs: Développer une meilleure compréhension du rôle de Revivre et de Il reste encore quelques places si vous souhaitez vous inscrire. The period immediately following a traumatic event is crucial. or that they will lose control permanently and go insane. Some findings show that children can develop symptoms of PTSD after seeing images of disasters, even if they were far away from the event). Grâce à l’autogestion, il est possible d’apprendre à vivre avec ce trouble et retrouver la santé. Pour en savoir en plus et s'inscrire ⤵️ The disorder often appears in adolescence or early adulthood, but many people say that they have lived with anxiety their whole lives, or can’t remember when it started. Specific phobia, or simple phobia, is an intense, unreasonable, and persistent fear caused by the presence or anticipation of a specific object or situation. L’autogestion de la santé consiste à développer, par la connaissance et la maîtrise de certaines habiletés de base, du pouvoir sur celle-ci. Pour préserver sa santé, il est important de choisir, au quotidien, des comportements qui contribuent à rehausser nos défenses naturelles et à être en pleine possession de nos moyens physiques et psychologiques. Another process that is often used in this type of therapy is cognitive restructuring, which involves identifying and changing problematic thoughts pertaining to the event, such as those that cause feelings of guilt or responsibility. In order for a diagnosis of generalized anxiety disorder to be made, excessive anxiety must be accompanied by at least three of the following symptoms (only one for children): There are two forms of treatment that are generally recognized as being effective for generalized anxiety disorder: medication and psychotherapy. Panic disorder without agoraphobia is twice as frequent among women as men. Research supports the value of the cognitive-behavioural approach in particular for treatment of this disorder. Malgré ces comportements préventifs, il peut arriver que, dans certaines circonstances, des signaux d’alerte nous indiquent la présence d’une menace à notre état de santé. Sophie Meunier, professeure département de psychologie, UQAM Bruno Collard, directeur clinique, Revivre Plan de la présentation: -Courte bio des présentateurs … Obsessions are intrusive, irrational, and uncontrollable. Panic attacks can occur with other anxiety disorders, such as social phobia or specific phobia. Their worries are hard to control and out of proportion, and often focus on minor events. Depression is often linked with OCD. Pour réussir à bien gérer sa santé, il faut tout d’abord apprendre à bien se connaître. Une opportunité de retrouver l’équilibre et de s’outiller pour le préserver. Initial requests for services should go through the primary care network – pediatrician, general practitioner, psychologist, social worker, or psychoeducator – often via the CLSC. People who suffer from social phobia often have other disorders as well (e.g. Il les aide à adopter des stratégies pour parvenir à mieux vivre au quotidien. If obsessions or compulsions take over a person’s life to the extent that they occupy more than an hour of time during the day or interfere with professional and family life and cause serious distress, then that person may have obsessive-compulsive disorder. 50% to 60% of people who suffer from panic disorder also suffer from depression, and one-third of these people suffered from depression before they developed panic disorder. regroupent de l’information théorique, des exercices, des discussions ainsi que diverses ressources. Nos choix resteront sans effet sur notre santé si nous ne passons pas de la parole aux gestes. People who suffer from social phobia oftenfeel a great deal of distress and have trouble functioning normally in their daily, professional, and social lives. Participez aux ateliers d’autogestion de l’estime de soi et de l’anxiété, au Carrefour le Moutier, à Longueuil. These obsessions sometimes conflict with the person’s personal values, and may be accompanied by disgust and fear. It is frequently associated with the feeling that a disaster is about to happen, and the person often feels an urgent need to flee. Participants are not … There are several types of therapy that are potentially beneficial. # Javance *Autogestion de l’anxiété L’ArrimAge, Dolbeau : 418-276-6498 L'Escale, Jonquière : 418-547-3644 Le Phare, La Baie : 418-544-9301 Some people have several per day, while others may only experience them once per month. Autogestion de l'anxiété, de l'estime de soi et de la dépression Le programme J’avance de Revivre s’adresse aux personnes atteintes de troubles anxieux, dépressifs ou bipolaires. Talking doesn't work for everyone, and in some cases, it can actually help symptoms to take hold by forcing the person to relive the event. People can also learn to modify their behaviour in order to face situations rather than run away from them. Finally, sexual assault does not have to be violent in order to be traumatizing. For psychotherapy, you can consult a mental health specialist who is recognized by a professional association, such as a psychologist or social worker, for support and help in dealing with this disorder. Une nouvelle porte s’ouvre, celle de 2021. Pour en savoir en plus et s'inscrire ⤵️ They may play games that involve the themes of the event over and over, or have nightmares with no recognizable content pertaining to the trauma. Le soutien à l’autogestion et les interventions de faible intensité pour les personnes souffrant de troubles dépressifs et anxieux Janie Houle, Ph.D., psychologue communautaire; professeure au département de psy hologie, UQÀM; her heure régulière au entre de reher he de l’Institut L’AUTOGESTION POUR APPRENDRE À VIVRE AVEC UN TROUBLE ANXIEUX. Recherche. Revivre is a non-profit organization whose mission is to help those living with anxiety, depressive or bipolar disorders, and their loved ones. : generalized anxiety, specific phobia, panic disorder, avoidant personality, and certain mood disorders, including depression). The disorder usually appears in childhood or adolescence, and tends to run in families. Connaître ses forces et ses faiblesses, connaître ses signaux d’alerte indiquant la présence d’un stress trop élevé ou d’une détresse sous-jacente qui peut dégénérer en maladie si elle n’est pas apaisée. -Autogestion de l’anxiété -Autogestion de la dépression -Autogestion pour le trouble bipolaire -Autogestion de l’anxiété en milieu de travail -Autogestion de l’estime de soi Ce sont les cinq ateliers que Revivre donne et qui sont en train d’essaimer à travers le Québec. Self-help groups – such as those at Revivre – can help to break the isolation by bringing people who are going through similar situations together. Brian Bexton, M.D., Psychiatrist and Psychoanalyst, Vice-President of Revivre. Une démarche proactive vers une meilleure santé mentale : ses choix de vie, ses priorités d’action. Sometimes though, anxiety can exert too much influence over certain individuals, or its presence can be excessive or repeated in certain situations that negatively impact your ability to function in your daily life. People often have other anxiety disorders as well. Il faut agir au quotidien pour préserver sa santé, mais également agir dans les moments plus difficiles pour la retrouver. Participants are not required to pay anything or to register in advance. -Autogestion de l’anxiété -Autogestion de la dépression -Autogestion pour le trouble bipolaire -Autogestion de l’anxiété en milieu de travail -Autogestion de l’estime de soi Ce sont les cinq ateliers que Revivre donne et qui sont en train d’essaimer à travers le Québec. A better understanding of the disorder and knowing how it affects you is an important first step. Anxiety is also known to exacerbate physical problems. Get together with other people who have been through something similar. The symptoms of panic disorder can manifest as anxieties concerning the possible consequences or implications of a panic attack. If you think you have social phobia and you want to learn more about the available treatments, one of the first steps may be to talk to a doctor. est constitué de cinq types d’ateliers qui visent le soutien à l’autogestion de la santé pour les personnes touchées par l’anxiété, la dépression ou la bipolarité. Sur Résistance 71 le Blog : Résistance et changement politique… L’Autogestion un antidote au parlementarisme par Daniel Vidal Si le mot “autogestion” n’est arrivé que tardivement dans notre vocabulaire, il recouvre pourtant une histoire riche et ancienne et représente un ensemble de pratiques populaires actuelles et d’horizons culturels bien différents. An ounce of prevention! It is universal and adaptive: everyone experiences anxiety at some point or another. However, it is better not to insist or pressure someone in order to get them to talk. Avoidance of anxietyproducing situations (like school) starts to take over. However, if the fear does not cause any serious problems (e.g. For many people, getting support quickly – within 24 to 72 hours after the event – can help to prevent the development of PTSD at a later date. 30% to 80% of people who suffer from PTSD also suffer from depression. If you think you have generalized anxiety disorder and you want to know for sure, a doctor can help you evaluate the situation and prescribe appropriate treatment, if necessary. Pay attention to your reactions, if you are able to. However, it takes several weeks for them to reach their full effect. The rates are higher in areas of the world where there is armed conflict. par Amarilys Boudreault Afin de débuter cette nouvelle décennie du bon pied, j’ai décidé de rassembler tout plein de trucs et astuces reliés à la gestion du stress et de l’anxiété. In terms of medication, antidepressants that act on serotonin are often recommended for panic disorder. REVIVRE - ASSOCIATION QUÉBÉCOISE DE SOUTIEN AUX PERSONNES SOUFFRANT DE TROUBLES ANXIEUX, DÉPRESSIFS OU BIPOLAIRES : Soutien téléphonique et par courriel.Forum électronique.Groupes d'entraide ouverts.Ateliers de soutien à l'autogestion: dépression, anxiété People who suffer from obsessive-compulsive disorder (OCD) are overcome by excessive worries (obsessions), usually accompanied by ritual routines or gestures (compulsions) aimed at reducing the anxiety caused by these obsessions. Revivre | 1,393 followers on LinkedIn. La présentation décrira les résultats d’évaluation des effets de l’atelier de soutien à l’autogestion de l’anxiété. Some people also have a fear of exhibiting signs of anxiety (e.g. 1-866-REVIVRE Among the various psychotherapeutic Et on a bien hâte de vous dévoiler ce … This includes the use of not only mental health resources (including medication and psychotherapy) but also the adoption of healthy lifestyle habits, the maintenance The most common symptoms include palpitations, blushing, trembling, sweating, digestive problems, nausea, inability to speak, mumbling, dry mouth, confusion, and panic attacks. A panic attack is a sudden episode of very intense fear, accompanied by at least four of the following symptoms: A panic attack reaches its peak quickly – usually in less than 10 minutes – and is limited in duration. Cette session, j'ai décidé de reprendre le pouvoir sur ma santé en participant à un atelier d'autogestion virtuel. They provide a place where people can share their feelings without fear of being judged. Finally, phobias are often caused by traumatic events or direct unpleasant experiences. It can also be helpful to hear the stories of other people who have learned to live with the disorder. Psychotherapy helps to alter certain beliefs and thoughts that can intensify the symptoms of panic attacks. It provokes an immediate anxiety response that can sometimes take the form of a panic attack. Just be available. It can also be helpful to hear the stories of other people who have learned to live with the disorder. Certain medications, such as antidepressants, may be prescribed during medical follow-up in order to reduce the symptoms. The first signs of social anxiety are often discomfort and unpleasant feelings in social situations like the ones mentioned above. Toute personne peut, par ses choix et ses comportements, contribuer à préserver sa santé et à la retrouver lorsqu’elle traverse des épisodes de maladie. Je suis plu L’atelier d’autogestion en milieu de travail s’adresse à toute personne vivant de l’anxiété ou une irrégularité au niveau de l’humeur (dépression ou bipolarité) et qui souhaite améliorer sa relation avec le milieu de travail. Phobias are classified into different subtypes. In complex cases, the primary care doctor can refer children and their families to the various paediatric psychiatric services in Québec for more specialized care. Ateliers d'autogestion du programme J'avance! However, they should be used with caution and sparingly, because they can cause tolerance and addiction problems. Monday and Wednesday afternoons: 1:30 p.m. to 3:00 p.m. Les lundis et mercredis en après-midi, de 13 h 30 à 15 h 00, Les lundis en soirée, de 19 h 00 à 20 h 30, Les vendredis en matinée de 9 h 30 à 11 h 00. There is also a higher incidence of OCD among people who are affected by Tourette’s syndrome. Generalized anxiety disorder affects approximately 5% of the population. Les ateliers psychoéducatifs du programme J’avance! It is not uncommon for several members of the same family to have the same phobia. If you think you have this disorder, one of the first steps may be to talk to your doctor. Panic Disorder - with or without Agoraphobia, Anxiety Disorders among Children and Adolescents. Il faut alors choisir, parmi différentes options possible et en fonction de ce qui nous convient, la conduite à adopter pour éviter une aggravation de son état. est constitué de cinq types d’ateliers qui visent le soutien à l’autogestion de la santé pour les personnes touchées par l’anxiété, la dépression ou la bipolarité.. Ces ateliers ont été conçus par Revivre, en collaboration avec une équipe de recherche et de nombreux experts. The first symptoms often appear during adolescence or early adulthood, but may begin in childhood. Benzodiazepines can provide temporary relief, and can be used as needed when an anxiety-causing situation arises, but antidepressants are often prescribed as a more long-term treatment, because they cause fewer dependency and addiction problems than benzodiazepines. : parents warning their children about certain dangers). In certain cases, medications such as benzodiazepines can be helpful in reducing the intensity of the reaction in the presence of the object of the phobia. Pour remplir sa mission, Revivre s’appuie sur le principe directeur suivant: la construction d’alliances, de collaborations et de partenariats stratégiques avec le réseau institutionnel et communautaire en santé mentale, ainsi qu’avec le secteur privé. In the event of a mass catastrophe, avoid watching the news over and over (this is even more important for children. Ces ateliers ont été conçus par Revivre, en collaboration avec une équipe de … Don’t stay by yourself (this is when you should take advantage of friends and family). program provide support for health self-management.This strategy the efficiency of which has been proven is increasingly recognized as an indispensable component in the treatment of those suffering from anxiety or mood disorders. Étude sur l’autogestion et le rétalissement en santé mentale Janie Houle, professeure, Département de psychologie ,UQAM et chercheuse au CRISE Sophie Meunier, agente de recherche et de planification, Laboratoire Vitalité Benjamin Villaggi, étudiant au doctorat et agent de recherche, Laboratoire Vitalité Jounée d’ativités du RISE Le soutien à l'autogestion disponible pour tous. They also vary in severity. The self-management support tool Getting Better My Way was developed by the Laboratoire Vitalité of the Université du Québec à Montréal, the organization Revivre – Association québécoise de soutien aux personnes souffrant de troubles anxieux, dépressifs ou bipolaires, and the Centre intégré universitaire de santé et de services sociaux de l’Est-de-l’Île-de-Montréal. • Présentation de Revivre et de son approche : l’autogestion • Description des outils privilégiés pour l’autogestion de l’anxiété • Exercices d’application de l’autogestion à la gestion de l’anxiété et à la présence d’idées suicidaires Objectifs: Développer une meilleure compréhension du rôle de Revivre et de Cette stratégie, dont l’efficacité a été démontrée, est de plus en plus reconnue comme une composante indispensable dans le traitement des personnes souffrant de troubles de l’humeur ou anxieux. In addition, when a family adapts to a child’s avoidance behaviour and lets the child avoid the object of the fear, the family may be playing a role in perpetuating the phobia. Ateliers de 10 à 12 semaines visant à limiter leurs incidences au quotidien, améliorer la qualité de vie et prévenir l At that point, we call it an “anxiety disorder.”. Aller mieux… à ma façon est un outil de soutien à l’autogestion qui peut vous être utile pour retrouver l’équilibre et vous sentir bien à nouveau.. Offert gratuitement, cet outil vous permet d’identifier des moyens pour aller mieux et prendre soin de votre santé. 1 866 REVIVRE (738-4873) For psychological help, you can consult a psychotherapist who is recognized by a professional association, such as a psychologist or a social worker. For media interview requests, please contact Jean-Rémy Provost, Executive Director: It is interesting to note that the objects of phobias vary from culture to culture. Psychotherapy is the treatment of choice for specific phobias. : following the therapist’s fingers) until the distress associated with the image fades. revivre@revivre.org, Discussion forum (French only) Social phobia sometimes develops as the result of a trauma. One technique that is often used is to gradually expose the person to various elements associated with the event, beginning with having them imagine scenes related to the trauma, until the anxiety recedes. The individual realizes that these thoughts absurd and all in the mind, and that they have no basis in reality, but he cannot avoid them. Nos services virtuels seront basés sur ce concept unique développé par Revivre. Ces ateliers ont été conçus par Revivre, en collaboration avec une équipe de … We do not yet know a great deal about the causes, but certain psychological factors are often present: low self-esteem, lack of selfconfidence, high standards for success, extreme self-criticism, and placing a lot ofimportance on the opinions of others. Signs that panic disorder may be developing include the following: an individual has experienced more than two unexpected panic attacks and the fear of having a panic attack has lasted for a month or more; the individual experiences significant distress and has problems performing daily activities and getting work done; the individual does not take advantage of interesting opportunities because of a fear of having a panic attack. For further information regarding our mission and services, please visit www.revivre.org. Tous ensemble, passons maintenant à l’action. Loin de moi la prétention d’avoir une solution miracle ou encore de prétendre que l’anxiété se guérit. Dizziness, light-headedness, or feeling faint; A sensation of suffocating or shortness of breath; Feeling detached from oneself or a feeling of unreality. For psychotherapy, you can consult a mental health specialist who is recognized by a professional association, including some psychiatrists or a psychologist or social worker, who can provide you with support on a regular basis, develop a treatment plan with you, and help you to improve your quality of life. The parents are usually part of the treatment process. It is possible to regain control of your health and learn to cope better with your disorder if you take one step at a time. PTSD is characterized by very intense fear combined with a feeling of despair or horror (disorganization or agitation among children).A person who suffers from PTSD continually relives the traumatic event, and avoids situations that remind him of it. The theory behind this technique is that eye movements help to incorporate the information into the memory. One of the common responses to a phobia is to run away from or avoid the situation. Children who have an inhibited temperament may be more likely to develop an anxiety disorder later in life. The obsessions can focus on several themes, but often involve the following: On the other hand, compulsions are excessive behaviours or mental acts (e.g. They provide a place where you can share your feelings without fear of being judged. For some people, panic disorder begins or intensifies when there’s a break in or loss of a significant relationship. Découvrez nos 5 ateliers thématiques d'autogestion et mettez-vous en action dans une démarche concrète, tout en bénéficiant d’un soutien de la part d’un groupe et d’intervenants qualifiés. It can also be helpful to hear the stories of other people who have learned to live with the disorder. These problems tend to run in families. Cette solution, c’est J’avance !, une série d’ateliers en groupe sur l’autogestion de l’anxiété, de la dépression, de la bipolarité et de l’estime de soi.« L’autogestion, ce sont tous les gestes qu’une personne peut faire au quotidien pour aller mieux », résume la directrice du programme, Stéphanie Fontaine, qui souffre elle-même de bipolarité. maintiennent l’anxiété; Encourager l’intégration harmonieuse à un réseau social positif; Développer des habiletés qui permettent de reprendre le contrôle sur sa vie. Self-management of health Self-management includes all the actions that a person takes to take power over their health, by adopting behaviors that: decrease symptoms; help prevent relapse; improve daily well-being. L’AUTOGESTION : MYTHES ET REALITES. Le rôle de Revivre est de soutenir les personnes vivant avec l’anxiété, la dépression ou un trouble bipolaire afin de les accompagner vers une meilleure autogestion de leur santé mentale. PTSD can also develop after witnessing someone else going through such a traumatic event, or even learning that it happened to a family member or a friend. La santé ne se résume pas à l’absence de maladie. Revivre est un OBNL qui, depuis près de 30 ans, offre des services aux personnes vivant avec un trouble anxieux, dépressif ou bipolaire et leurs proches. Children may exhibit specific symptoms; they may have more trouble expressing their emotions, which manifests as disorganized or agitated behaviour. People who suffer from agoraphobia may become more and more isolated, to the point where they significantly limit their activities and social life. Self-help groups – such as those at Revivre – can help to break the isolation by bringing people who are going through similar situations together. Par ailleurs, les groupes d’entraide, notamment ceux offerts à Revivre, peuvent permettre de briser l’isolement en réunissant des gens qui vivent des situations similaires. Among children who have experienced severe trauma, you may also see post-traumatic stress disorder (reliving the traumatic event through intrusive memories or flashbacks, avoiding situations that recall the event, or being hypervigilant). Participants are given the opportunity to share their experiences and offer mutual support in a welcoming and respectful environment. Se familiariser avec différentes approches d’intervention, incluant les ateliers de soutien à l’autogestion du programme J’avance! Forum (French only). Among children and adolescents, anxiety is a normal part of certain developmental stages, and manifests itself as fears that are specific to these stages, such as the fear of strangers (6-18 months), the fear of monsters, the fear of being separated from parents (2-3 years), fear of the dark, fear of sleeping alone (3-6 years), fear of physical danger, fear of school (6-10 years), and anxieties concerning friendship and rejection (10-12 years), identity, fitting in, and the future (adolescence). 514 973-3040 Avoidance of any reminder of the trauma, and efforts to avoid the thoughts, feelings, conversations, activities, places, and people associated with the event; Inability to remember an important aspect of the event; Marked loss of interest or decreased participation in activities that were important to the person before the trauma; The feeling of being in a fog; Feeling detached from others; Losing hope for plans that used to be very important. Starting Monday, November 23rd, 2020. Le programme J’avance! For example, a child who is so afraid of physical danger that he won’t go out of the house may have a phobia. Vous vivez avec l'anxiété, la dépression ou la bipolarité ? For psychological help, you can consult a psychotherapist who is recognized by a professional association, such as a psychologist or a social worker. There are several different therapeutic approaches for learning how to manage anxiety: relaxation techniques, social skills training, and exercises aimed at working on anxiety-related thoughts and beliefs. There are two kinds of treatment for obsessive-compulsive disorder: medication and psychotherapy. Recherche. Depuis sa création en 1991, Revivre axe son travail sur l’autogestion de la santé. On y retrouve les ateliers suivants : Autogestion de l’estime de soi; Autogestion de l’anxiété; Autogestion des troubles anxieux et de l’humeur en milieu de travail; Autogestion de la bipolarité. Some people start by avoiding activities that they are interested in, and end up isolating themselves from others completely, which can leave them feeling extremely lonely. When the fear of an object interferes with someone’s daily habits, ability to function at work, or social life, or if the fear causes the person great distress, this might be a sign of a phobic disorder, and treatment may be necessary in order to regain a sense of wellbeing. If the symptoms persist or are more than you can handle, get help. Simply anticipating contact with the object of the phobia can be enough to trigger these symptoms. If you think you might have obsessive-compulsive disorder and you want to know for sure, a doctor can help you evaluate the situation, and can prescribe appropriate medication, if necessary. These are generally temporary, and should not be considered to be phobias unless they cause significant problems in terms of normal functioning. Découvrez nos 5 ateliers thématiques d'autogestion et mettez-vous en action dans une démarche concrète, tout en bénéficiant d’un soutien de la part d’un groupe et d’intervenants qualifiés. The severity and duration of the disorder may vary from one person to another, and you don’t have to exhibit all of the symptoms in each of the categories in order to be diagnosed with PTSD. The numbers vary from study to study, but the disorder affects somewhere between 2% and 13% of the population. C’est un lieu où l’on peut parler de ses émotions et de son expérience de l’anxiété sans craindre d’être jugé. Les choix que nous faisons et les comportements que nous adoptons dans notre vie quotidienne ont une influence sur notre santé. If you think you have panic disorder and you want to learn more about the available treatments, one of the first steps may be to talk to a doctor. Le programme J’avance! Some phobias may be innate, and may have contributed to our survival as a species by helping us to better adapt to our environment thousands of years ago, but they are no longer useful in the modern world. L'autogestion des soins : connaître, évaluer, choisir, agir. You may see separation anxiety (an intense fear of being away from the parent) or selective mutism (an inability to talk outside of the family). En cherchant de nouvelles idées, j’ai trouvé un atelier d'autogestion de l'anxiété offert par Revivre. It can also help to change certain behaviours in order to promote better anxiety management. Revivre Pour du soutien à l'autogestion de l'anxiété, de la dépression et du trouble bipolaire. Job posting: Anxiety Self-Management Workshop Co-Facilitator. It can happen anywhere at anytime. For example, people who suffer from panic disorder may be afraid that their symptoms are caused by a serious illness (heart problems, etc.)