psychotherapy for 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.

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.

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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What Are Social Anxiety Symptoms?

Social anxiety disorder affects approximately 15 million American adults and is the second most commonly diagnosed anxiety disorder following specific phobia.

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The average age of onset for social anxiety disorder is during the teenage years. Some might dread meeting new people, dating, being on a job interview, answering a question in class, or having to talk to a cashier in a store, others might avoid only some of the scenarios above.

Most people with social anxiety do not talk about it and might not understand why they feel fine in certain situations but not in others. Some might feel physical symptoms of anxiety in situations such as giving a speech, playing a sports game, or dancing or playing a musical instrument on stage.

Here are some of the symptoms of social anxiety when performing in front of others:

  • Extreme fear of other people judging them

  • Staying away from places where there are other people they might feel judged by

  • Blush, sweat, tremble, or feel a rapid heart rate

  • Show a rigid body posture, make little eye contact, or speak with an overly soft voice

  • Find it scary and difficult to be with other people, especially those they don’t already know, and have a hard time talking to them even though they wish they could

  • Be very self-conscious in front of other people and feel embarrassed and awkward

The defining feature of social anxiety disorder is intense anxiety or fear of being judged, negatively evaluated, or rejected in a social or performance situation. Because people with social anxiety disorder may worry about acting or appearing visibly anxious, they often avoid social or performance situations, and when a situation cannot be avoided, they experience significant anxiety and distress.

Although they recognize that their fear is excessive and unreasonable, they often feel powerless against their anxiety. The first step to effective treatment is to have a diagnosis made, usually by a mental health specialist. Without treatment, social anxiety disorder can prevent a person from reaching their full potential.

Making your first appointment when struggling with Anxiety

You may feel anxious about contacting a psychologist. That anxiety is perfectly normal. But having the courage to make a call is the first step in the process to empower yourself and bring a sense of relief to get the help you need.

Once you connect, they’ll lead a brief conversation to get a better sense of what you need and whether they are able to help and when you can make an appointment. Before you take the first available appointment here are some factors you should consider:

  • Know when you're at your best morning, afternoon, or evening, and schedule your appointment accordingly.
  • Consider work schedule and if you have to take time off from work, you might want to schedule your first appointment later in the day so you don't have to go back to work afterward. If you have an upsetting topic to discuss, you may be tired, emotionally spent, puffy-eyed or distracted after your first session.
  • Unless it is a family session, choose a time when you will have child care available.
  • Try to schedule your session at a time when you won't have to rush to your appointment or to your next commitment after the session. 

Hope this helps alleviate the anxiety of taking the first step. Best of luck!

When should you consider psychotherapy?

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Because of the many misconceptions about psychotherapy, you may be reluctant to seek help. It may be stigma, your own judgment, or you may feel nervous about trying it. Overcoming these blocks may be worth it because any time your quality of life isn’t what you want it to be, psychotherapy can help.

Some people seek psychotherapy because they have felt depressed, anxious, or angry for a long time. Others may want help for a chronic illness that is interfering with their emotional or physical well-being. Still, most people have short-term problems they need help navigating. They may be going through a divorce, having relationship concerns, feeling overwhelmed by a new job or grieving a family member's death.

You could benefit from therapy if you have any of the following concerns:

  • You feel an overwhelming, prolonged sense of helplessness and sadness.

  • Your problems don't seem to get better despite your efforts and help from family and friends.

  • You find it difficult to concentrate on work assignments or to carry out other everyday activities.

  • You worry excessively, expect the worst and are constantly on edge.

  • Your actions, such as drinking too much alcohol, using drugs or being aggressive, are harming you or others.

The treatment you receive will depend on a variety of factors: current psychological research, your psychologist's theoretical orientation and what works best for your situation. 

The most important factor to consider is whether your psychologist has the expertise  in the area you need help with and whether your psychologist feels he or she can help you.