anxiety

Managing Anxiety Through Biofeedback

Managing Anxiety Through Biofeedback

Everyone has anxiety from time to time, but chronic anxiety can interfere with your quality of life. While perhaps most recognized for behavioral changes, anxiety can also have serious consequences on your mental and physical health. Biofeedback focuses on often hidden indicators of prolonged or inordinate stress an anxiety by regulating Autonomic Nervous System and treating anxiety and stress caused by the ongoing activation of the Sympathetic Nervous System .

What is Generalized Anxiety Disorder? Emotional and Physical Manifestations

It’s the thinking, thinking, thinking, dwelling, dwelling, ruminating, ruminating, and inability to shut the mind off.

“Anxiety’s like a rocking chair. It gives you something to do, but it doesn’t get you very far.” ~Jodi Picoult

“Anxiety’s like a rocking chair. It gives you something to do, but it doesn’t get you very far.” ~Jodi Picoult

Generalized anxiety disorder is a relatively common anxiety problem, affecting 3-4% of the population that turns daily life into a state of worry, anxiety, and fear. Excessive thinking and dwelling on the "what ifs" characterizes this anxiety disorder. As a result, the person feels there’s no way out of the vicious cycle of anxiety and worry, and becomes depressed about life and the chronic state of anxiety they find themselves in.  Generalized anxiety usually does not cause people to avoid situations, and there isn’t an element of a "panic attack" involved in the prognosis, either.

Emotional Manifestations

Feelings of worry, dread, lack of energy, and a loss of interest in life are common in general anxiety. Many times there is no "trigger" or "cause" for these feelings and the person realizes these feelings are irrational. Nevertheless, the feelings are very real. At this point, there is no "energy" or "zest" in life and no desire to want to do much.

“Anxiety is love’s greatest killer. It makes others feel as you might when a drowning man holds on to you. You want to save him, but you know he will strangle you with his panic.” ~Anais Nin

“Anxiety is love’s greatest killer. It makes others feel as you might when a drowning man holds on to you. You want to save him, but you know he will strangle you with his panic.” ~Anais Nin

This emotional fear and worry can be quite strong. If a loved one is ten minutes late, the person with generalized anxiety fears the very worst -- something’s dreadfully wrong (after all, they’re ten minutes late!), there’s been an accident, the paramedics are taking the person to the hospital and his injuries are just too critical to resuscitate him....."Oh, my God!.....WHAT AM I GOING TO DO?" Feelings of fear and anxiety rush in from these thoughts, and the vicious cycle of anxiety and depression runs wild.

Some people with generalized anxiety have fluctuations in mood from hour to hour, whereas others have "good days" and "bad days". Others do better in the morning, and others find it easier at the end of the day. These anxiety feelings and moods feed on themselves, leading the person to continue in the pattern of worry and anxiety -- unless something powerful breaks it up.

“If you trade your authenticity for safety, you may experience the following: anxiety, depression,addiction, rage, blame, resentment, and inexplicable grief.” ~Brene Brown

“If you trade your authenticity for safety, you may experience the following: anxiety, depression,addiction, rage, blame, resentment, and inexplicable grief.” ~Brene Brown

Physical manifestations 

The physical manifestations of generalized anxiety may include headaches, trembling, twitching, irritability, frustration, and inability to concentrate. Sleep disturbances may also occur. Elements of social anxiety and/or panic may sometimes be present, such as high levels of self-consciousness in some situations, and fear of not being able to escape from enclosed spaces.

It is also common, but not universal, for people with generalized anxiety to experience other problems, such as a quick startle response, a lack of ability to fully relax, and the propensity to be in a state of constant motion. It is difficult for some people with generalized anxiety to settle down enough to have a quiet, reflective time where they can calm down, relax, and feel some peace and tranquility. Strategies to peacefully calm down and relax are one part in overcoming this problem.

“People have a hard time letting go of their suffering. Out of a fearof the unknown, they prefer suffering that is familiar.” ~Thich Nhat Hanh

“People have a hard time letting go of their suffering. Out of a fearof the unknown, they prefer suffering that is familiar.” ~Thich Nhat Hanh

What Causes General Anxiety?

Normal life stresses aggravate generalized anxiety. The person who typically performs well at work and receives a sense of accomplishment from it, all of a sudden finds that work has become drudgery. If work is perceived as a negative environment, and the person no longer feels fulfilled, then considerable worry takes place over these situations. As a result, the anticipatory anxiety about going to work can become quite strong.

“Nothing can bring you peace but yourself.” ~Ralph Waldo Emerson

“Nothing can bring you peace but yourself.” ~Ralph Waldo Emerson

How It is Treated ?

Generalized anxiety has been shown to respond best to cognitive-behavioral therapy, an active therapy that involves more than just talking to a therapist. In CBT, the person gradually learns to see situations and problems in a different perspective and learns the methods and techniques to use to alleviate and reduce anxiety. Sometimes medication is a helpful adjunct to therapy, but for many people it is not necessary. Research indicates that generalized anxiety is fully treatable and can be successfully overcome over the course of about three to four months if the person is motivated and works toward recovery.

Generalized anxiety must be chipped away from all sides and that is what CBT is designed to do. No one has to live with generalized anxiety disorder.  Treatment for GAD has been shown to be both effective and successful.

Please seek a therapist who understands anxiety and the anxiety disorders. Remember, that just because a person has a degree behind their name, does not mean they understand and can treat an anxiety disorder. Feel free to ask questions of any professional and make sure your therapist understands and knows how to treat generalized anxiety. It is usually a good idea to see a specialist in this area because they have a practice that is geared toward the anxiety disorders.

I Am Anxious and Can’t Get Out of It! What’s Wrong with Me?

Anxiety is a solvable problem, yet you might find it harder to overcome. The reason is that, while you have the ability to overcome it, anxiety “tricks” you into maintaining it rather than removing your fears and symptoms. Most people try to resist anxiety, however most of the anxiety problems come from efforts to resist or remove anxiety.

Most people mean well when they suggest to someone feeling anxious to “calm down!” or advice to “stop worrying about it!” Yet, nothing good comes out of it. If it were that simple people would “calm down” or “stop thinking” about it.

The more you fight your anxiety, the more it grows. It’s like throwing gasoline to the fire. People who struggle with persistent anxiety have tried some type of relief and when it has not worked they might think it is their fault or that there is something wrong with them for not being able to get out of it.  But if it’s really true that the harder you try the worse it gets, you probably need to look at the other strategies. Here are some successful methods I use in session with clients struggling from anxiety noticing results:

1. Psycho-Education: To reduce and overcome anxiety, you must understand the symptoms. If you know that adrenaline is a result of the flight or fight system, you won't be as worried and unsure as to what's happening to your body. If you recognize your symptoms you might find it comforting to know it is anxiety that’s causing you to feel or behave a certain way. Learning how your anxiety works is the first step to healing.

2. Diaphragmatic Breathing – All of us breathe (I’d hope) yet most anxious individuals do not use their lungs in a way that is beneficial for them. Diaphragmatic breathing technique is a technique I use in session to help clients come back to a normal state, slightly reducing anxiety and its physical symptoms. 

3. Biofeedback – Practicing biofeedback can be not only helpful for anxiety but also measurable for the “skeptical”client. Heart Rate Variability is very important for the entire regulation of the complete system. The autonomic Nervous System is the balance between the sympathetic and parasympathetic and enables humans to adapt very rapidly to the vast potential for changes that occur in their environment. As you can imagine this does wonder for he anxious body and mind.

4. Guided meditation – I work mostly with high functioning anxious individuals that suffer in silence. Most of them are accomplished in life, attended college, have great jobs, yet they deal with lingering anxiety day in and day out. My work includes guided meditations to increase self-compassion. Meditation itself is used in the sessions to create space and bring to surface negative self-talk, feelings of guilt, shame, not worthy etc…and then counteract these feelings with kindness. This approach is challenging for most yet has helped many clients to be easy on themselves, recognize thought patterns of self-destruction and see themselves in a different light.

Overall, it’s important to learn to identify your triggers and responses and find strategies that work for you. If you have difficulty managing anxiety and it impedes your ability to carry out your day to day activities therapy can help.

What is Depression and How can I Treat It?

Millions of Americans suffer from some form of depression every year, making it one of the most common mental disorders in the country. Being depressed often feels like carrying a very heavy burden, but you are not alone in this struggle.

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Depression is more than just feeling sad. Everyone feels upset or unmotivated from time to time. Prolonged feelings of sadness and loss of interest in daily activities, trouble sleeping, decreased or increased of appetited are all symptoms of a more mood disorder. If these symptoms persist for a period of at least two weeks, it is considered a depressive

According to a 2010 World Health Organization (WHO) report, depression accounted for 3.7% of all U.S. disability-adjusted life years and 8.3% of all U.S. years lived with disability.

Causes of Depression

There is no one cause for depression, as it depends on a unique combination of an individual’s genetic makeup and environmental conditions. There are many factors to take into account:

·         The brain’s physical structure or chemistry

·         History of depression in family

·         History of other disorder (SAD, Anxiety, Complex Trauma etc.)

·         Stressful, traumatic events (abuse, financial issues, death of a loved one)

·         Hormone changes (menstrual cycles, pregnancy, taking hormones)

·         Certain medications (sleeping aids, blood pressure medication)

Types of Depression

Depression types can take many forms. The fifth edition of the Diagnostic and Statistical Manual of Mental Health Disorders lists nine distinct types:

1.      Major Depression, is the most common type of depression. Often, people with major depression experience recurrent episodes throughout their lives.

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2.      Dysthymia is a persistent low mood over a long period of time, even a year or more. It could be described as feeling like you’re living on autopilot.

3.      Some people are more sensitive to the lower amount of light in the wintertime. Seasonal Affective Disorder is a type of depression brought on from a lack of natural sunlight.

4.      Those with Atypical Depression often report feeling a heaviness in their limbs. They may suffer from irritability and relationship problems, as well as be prone to overeating and oversleeping.

5.      Bipolar Disorder is also called Manic Depressive Disorder because it involves alternating between mania and depressive episodes.

6.      Sometimes depressive episodes can get so severe that hallucinations or delusions are present, the person becomes catatonic, or they feel stuck in bed. This is known as Psychotic Depression.

7.      Postpartum Depression occurs after giving birth. Mothers may feel disconnected from their new baby or fear that they will hurt their child.

8.      Severe depression that shows up during the second half of the menstrual cycle is called Premenstrual Dysphoric Disorder. It affects the individual’s ability to function normally.

9.      Situational Depression is triggered by a life-changing event. It could be anything, from losing your job to the death of an immediate family member.

Signs and Symptoms of Depression

Though there are multiple types of depression, many of them have similar recognizable symptoms. This list provides a general idea of what comprises depression:

·         Persistent feelings of sadness, hopelessness, worthlessness, or emptiness

·         Irritability, frustration, or restlessness

·         Loss of interest in activities or hobbies that used to be enjoyable

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·         Difficulty sleeping, sleep disturbances, or sleeping too much

·         Fatigue and lack of energy

·         Difficulty thinking clearly, remembering, concentrating, or making decisions

·         Appetite or weight changes

·         Recurrent thoughts of death or suicide

·         Physical symptoms such as headaches, stomachaches, or back pain

Experiencing some combination of these symptoms for a period of at least two weeks likely signifies that you are in the midst of a depressive episode.

Treatment

Any treatment for depression should coincide with a healthy diet and regular sleep schedule. It may sound simplistic, but the importance of taking care of your body cannot be overstated.

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There are various methods you could use to sooth the symptoms of depression. Physical activity is especially helpful for the depressed mind. It enables you to better handle stress, helps you sleep better at night, and the endorphins released give you a mental boost.

Yoga is a more accessible form of exercise, because it doesn’t require equipment and because many of the moves and poses do not require much effort.

Meditation is a highly effective way of clearing your head and calming your body. It’s also easy to do, with guided meditations available through phone apps, online in text and videos, and in books.

If you enjoy keeping a journal, you may find that it helps to express your thoughts on paper instead of bottling them inside. It’s helpful to have close friends and family who you can confide in, but they’re not always available or may be dealing with stress of their own.

For a more hands-on approach, try a mental health experts to dive into learning healthy coping skills to help with the current mood and prevent relapse.

Sonila Sejdaras Psy.D, LCSW, CADC

What do I have Anxiety or Depression & How to Tell the Difference?

Depression and Anxiety are two different medical conditions, yet their symptoms, causes, and treatments can often overlap. People struggle sometimes to determine the difference between these two conditions. This is because many people with anxiety also develop depression and vice versa. Approximately 50% of people diagnosed with depression with also be diagnosed with an anxiety disorder. However, it’s important to get an accurate diagnosis in order to treat the correct conditions.

Many people with depression may experience what is known as “anxious distress” in addition to their low mood causing them to feel tense, restless, and have trouble concentrating because they worry so much. They are afraid that something bad is going to happen or that they might lose control of themselves. Below is a list of symptoms of depression:

 

Symptoms of Major Depression

·         depressed mood

·         lack of interest in enjoyable activities

·         increase or decrease in appetite

·         insomnia or hypersomnia

·         slowing of movement

·         lack of energy

·         feelings of guilt or worthlessness

·         trouble concentrating

·         suicidal thoughts or behaviors.

For a diagnosis of major depressive disorder, a person needs to have experienced five or more of these symptoms for at least two weeks. People experiencing some of these symptoms might also be diagnosed with persistent depressive disorder (dysthymia), premenstrual dysphoric disorder, or a depressive disorder due to another condition. They may also meet the criteria for bipolar disorder if they also experience symptoms of mania.

Symptoms of Generalized Anxiety Disorder

·         excessive worry

·         restlessness

·         being easily fatigued

·         trouble concentrating

·         irritability

·         sleep disturbance

·         muscle tension.

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If you’ve experienced these symptoms most days for more than six months, and they cause distress in your daily life, then you may receive a diagnosis of generalized anxiety disorder. Other types of anxiety disorders include separation anxiety, panic disorder, or phobias, among others.

If you compare the two lists of symptoms, you can see that there is some overlap. Sleep problems, trouble concentrating, and fatigue are all symptoms of both anxiety and depression. Irritability may also manifest in forms of anxiety or depression (in place of low mood).

There are however, some distinguishing features. People with depression move slowly, and their reactions can seem flattened or dulled. People with anxiety tend to be more keyed up, as they struggle to manage their racing thoughts. Another distinguishing feature is the presence of fear about the future in people with anxiety. Depressed people who do not have anxiety are less likely to be fraught with worry about future events, as they are often resigned to believing that things will continue to be bad. In other words, they may predict the future based on how they feel in the moment.

It is important to remember to let a doctor or mental health professional evaluate you to see if your symptoms meet the criteria for a depressive disorder or an anxiety disorder.

 

How Does Social Anxiety Affect Your Life ?

Social anxiety disorder affects approximately 15 million American adults and is the second most commonly diagnosed anxiety disorder following specific phobia. The average age of onset for social anxiety disorder is during the teenage years. Although individuals diagnosed with social anxiety disorder commonly report extreme shyness in childhood, it is important to note that this disorder is not simply shyness that has been inappropriately medicated.

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Social anxiety disorder can cause tremendous suffering on the lives of individuals who deal with it. Symptoms may be so extreme that they disrupt daily life and
 can interfere significantly with daily routines, occupational performance, or social life, making it difficult to complete school, interview and get a job, and have friendships and romantic relationships. People with social anxiety disorder are also at an increased risk for developing major depressive disorder and alcohol use disorders. 

Despite the availability of effective treatments, fewer than 5% of people of with social anxiety disorder seek treatment in the year following initial onset and more than a third of people report symptoms for 10 or more years before seeking help. The defining feature of social anxiety is intense anxiety or fear of being judged, negatively evaluated, or rejected in a social or performance situation. People with social anxiety disorder may worry about acting or appearing visibly anxious (e.g., blushing, stumbling over words), or being viewed as stupid, awkward, or boring. As a result, they often avoid social or performance situations, and when a situation cannot be avoided, they experience significant anxiety and distress. Many people with social anxiety disorder also experience strong physical symptoms, such as a rapid heart rate, nausea, and sweating, and may experience full-blown attacks when confronting a feared situation. Although they recognize that their fear is excessive and unreasonable, people with social anxiety disorder often feel powerless against their anxiety.

Social anxiety disorder can be overcome, although it takes both consistency and persistence.  A successful therapy program for social anxiety disorder must address the dozens of cognitive methods, strategies, and concepts that will allow people's brains (i.e., their brain associations or neural pathways) to literally change.  The brain is continually learning, and irrational thoughts and beliefs can change as a result of this cognitive process.  

A good therapy program will supply the necessary and specific strategies as well as indicate to people how and why they need to practice, work on, and begin to accept rational thoughts, beliefs, emotions, and perceptions.

Social Anxiety & Eating Disorders

Social Anxiety & Eating Disorders

Many individuals with eating disorders experience significant anxiety. There is a strong correlation between individuals who have pre-existing anxiety and/or depression to develop eating disorders. 

Individuals with eating disorders often report that their anxiety generally centers on fear of humiliation when in public or social situations.  They fear being judged in both body shape and size and for how and what they eat. Often, shame and self-criticism that eating disorder sufferers typically feel with respect to their own body, is projected on to other people who they infuse with the power to hurt them or make them not feel safe or valued.

Patients also feel the need to accommodate other people’s feelings at the expense of their own, not feeling that they fit in, not being able to assert their point of view, essentially not feeling comfortable in their own skin when in the company of other people.  Some patients report that these feelings and interpersonal issues are significantly reduced or disappear in the safe world and solitude with food. 

Exploring how anxiety can be focused around interpersonal and relational issues in addition to a general state of free floating (likely, biologically driven) anxiety can be extremely useful in understanding a person and assessing outcomes.

It is important for health care practitioners to help patients distinguish from where their anxiety originates and then how to treat it – what is driving the anxiety bus – free floating, indiscriminate anxiety or specifically targeted to interpersonal or psychological forces. 

If you’re someone who has some concerns regarding anxiety and eating disorders, discuss them with your provider to evaluate your symptoms and/or to get the help you need.

How to Deal with Anxiety and Relationship Problems

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There is a wealth of information about anxiety and how it impacts emotional, psychological, and physical health. Anxiety can cause the person to feel overwhelmed, panicked, and a general sense of unease. These symptoms can affect not only your well-being but it can take over many other areas of your life such as work, family members, friends, and your intimate relationship. Are you feeling stressed on your relationship or contemplating ending it? If so, anxiety may be playing a role on putting your relationship at risk.

 

1.     Anxiety destroys trust and connection

If you’re feeling overwhelmed, worried about your recent argument, or trying to “fix” things as soon as possible you might not have time to notice on what is happening in the now. The fear and worries can cause you to be less attuned to your needs and your partner’s needs. The inability to be present in the moment can muddle your insight and awareness on how to take care of yourself and the relationship. When we ruminate about problems in a state of chaos we feed the anxiety.

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Shift your focus on being instead of doing. It is difficult to listen to your thoughts & physical signs when you are not slowed down. Pause, think, and feel, instead of assuming and letting your anxious thoughts take over. Help yourself find the evidence before you jump into conclusions. Once you’re in a calmer place, you can start to share openly with your partner on what happens to you when you’re feeling worried. Be intentional about building trust and connection by reaching out to your partner: be vulnerable, help your partner understand what anxiety feels and looks like. Instead of attacking or withdrawing strive to deepen your connection with your partner.

 

2.     Anxiety fogs your brain

Asking someone to share what they are feeling in a state panic, is easier said than done. Anxious people find it extremely difficult to give themselves or partner attention or space that is needed. In the heightened state of anxiety, some might try to avoid it while others believe “fixing the problem” immediately.

Taking a short break can be beneficial for you and your relationship. Resisting your feelings can feed and intensify anxiety, therefore acknowledging them can ease some of the tension you might experience. Approach a conversation with partner with kindness, and discuss some of the thoughts or fears that drain your energy.

3. Anxiety is the enemy of self-compassion

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Because anxiety brings an overactive fear response, ruminating about it may leave you with very little time to practice self-care. Some anxiety is healthy for everyone. However, if your anxiety causes you to reject/avoid things that are beneficial for you, it can create more suffering for you and your relationship. Could it be that the anxiety is real but not true?

Quite your mind to hear your own wisdom. Anxiety rubs people of joy. Practicing being with your uncomfortable thoughts, pausing, and listening to your anxiety might be just what you need to remove those invisible chains your anxiety creates. The deepest gift we can give ourselves is the quality of non-doing presence. So…. notice your anxiety, and come back to it with a lot of kindness. Intentionally turn your attention to whatever opens your heart by looking for what you love and practice. Practice being present for yourself and your partner and then practice some more and remember- where attention goes energy flows.

How to Screen for Social Anxiety?

How to Screen for Social Anxiety?

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If you have noticed some anxiety or think you might suffer from social anxiety, but are on the fence contacting a health care professional you can use the questions below as a guidance to share the results with your provider when you're ready to get some help.

Are you bothered by the following?

An intense and persistent fear of a social situation in which people might judge you

Yes    No

Fear that you will be humiliated by your actions

Yes    No

Fear that people will notice that you are blushing, sweating, trembling, or showing other signs of anxiety

Yes    No

Knowing that your fear is excessive or unreasonable

Does a dreaded situation cause you to...?

Always feel anxious?

Yes    No

Experience a panic attack, during which you suddenly are overcome by intense fear or discomfort, including any of these symptoms:

Yes    No

Pounding heart

Yes    No

Sweating

Yes    No

Trembling or shaking

Yes    No

Chest pain

Yes    No

Nausea or abdominal discomfort

Yes    No

Feelings of unreality or being detached from yourself

Yes    No

Fear of losing control or “going crazy”

Yes    No

Fear of dying

Yes    No

Numbness or tingling sensations

Yes    No

Chills or hot flushes

Yes    No

Go to great lengths to avoid participating?

Yes    No

Social anxiety may also be connected to other diagnoses such as depression. In addition, substance abuse, in particular alcohol is used most of the time as a way to cope with social anxiety. The questions below can help distinguish between social anxiety, depression, and/or substance abuse.

Have you experienced changes in sleeping or eating habits?

Yes    No

More days than not do you feel sad or depressed?

Yes    No

Are you not interested in life?

Yes    No

Do you feel worthless or guilty?

Yes    No

During the last year, have the use of alcohol or drugs been helpful to cope with?

Yes    No

Has your use placed you in a dangerous situation, such as driving a car under the influence?

Yes    No

Have you gotten arrested?

Yes    No

Do you continue despite problems you might have because of the use? 

If you answer yest to most of these questions, it is highly recommended you reach out to a health care provider to get treatment for a more fulfilling life. 

 

Anxiety & Sleep Problems

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Is Anxiety Interfering With Your Sleep?

 

Over 18% of nation’s population experience anxiety disorders, and the majority of them have sleep –related problems. The lack of sleep can increase not only anxiety but other mood related issues such as depression, anger, irritability, and/or muscle pain. If anxiety or disrupted sleep crops up occasionally, these simple strategies may help you relax your body and mind so you can get the sleep that you need.

Sleep Hygiene

A healthy bedtime routine allows your body and mind to slow down. Take at least half an hour before bed to play quiet music, take a bath, or read a book. Deem the lights one hour before you go to sleep; Avoid electronics an hour or more before your sleep; Spend a few minutes before bed using diaphragmatic breathing to help relax.

Exercise

Regular exercisers fall asleep faster and sleep more soundly. In fact, even a single moderate-intensity workout can improve sleep among people with chronic anxiety. Here are some recommendations for the ones who don’t enjoy going to the gym: Stretch often, simple yoga exercises throughout the day will do the trick; Go for a walk; Be active at home by using an indoor trampoline

Steer clear of stressful activities before bed.

Leave the bill paying for earlier in the day, stay away from heated social media exchanges, and skip the evening news.

Put your to-dos on paper.

Instead of letting your brain swirl with all the things that you don’t want to forget to take care of, write them down so your brain can relax and let go.

It’s not always easy to tell if your symptoms are an indication of an anxiety disorder or just the normal amount of worry. Certain situations, especially the ones we don’t like, can cause our anxiety symptoms to spike. Moving, changes in relationships, financial troubles, and speaking in public can all trigger these spikes. If your anxiety has spiked out of control, or has become debilitating to you by interfering with your daily life, it might be time to seek professional help.

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