All About Anxiety | Types of Anxiety | Treatment for Anxiety
What is Anxiety?
Anxiety is your body and mind's way of responding to stressful events and situations.
Our brain is actually programmed to "worry."
Its job is to help us survive.
This means to always be on alert for dangerous situations. Our brain is constantly looking out for any potential threat to our physical and mental wellbeing. The threat does not actually have to real, we just have to perceive that it is there.
It's natural to experience a certain level of anxiety, especially when we are under more stress and/or engaging in situations that are more unknown and/or challenging. When anxiety raises above a "normal" level and becomes more ongoing, then it can start to cause a lot of distress and difficulties in our lives.
Types of Anxiety Disorders
Anxiety Disorders are the most commonly experienced mental disorder, with women more affected than men. There are several different categories of Anxiety disorders. These include Anxiety Disorders, Obsessive-Compulsive Disorders, and Trauma/Stress related disorders.
Anxiety Disorders
Anxiety disorders, which include Generalized Anxiety Disorder, Phobias, Panic Disorder, Social Anxiety, Agoraphobia, and Separation Anxiety. are characterized by a general feeling of excessive fear and/or worry about situations, future events, and things.
Generalized Anxiety Disorder is characterized by excessive and persistent worry that interferes with daily life. Physical symptoms may include feeling on edge, difficulty concentrating, fatigue, muscle tensions, problems sleeping, etc. Worries often center around daily responsibilities, family/household, health, job/school tasks, etc.
Phobias, Specific Phobia Disorder is excessive and persistent worry/fear around a situation, object or activity. The fear causes great distress and often includes a person going to great lengths to avoid the fear. Some common ones are a fear of heights or spiders.
Panic Disorder involves recurrent Panic Attacks which includes physical and psychological symptoms of distress. This can include rapid hear rate, sweating, trembling, feeling like one is choking and/or can't breath, chest pain, chills, fear of dying, etc. Many times people will believe something is physically wrong with them, such as having a heart attack, and will seek out medical care. Panic Disorder can often co-occur with other mental health disorders such as other Anxiety Disorders and Depressive Disorders.
Agoraphobia is the fear of being in situations where escape may be difficult or embarrassing, often around being in public if a panic attack were to occur. The fear is excessive and interferes with one's ability to engage in daily activities such as going to work/school, to the store, being inside buildings, etc. Agoraphobia may or may not include Panic Attacks.
Separation Anxiety Disorder is an excessive fear of being separated from a person with whom one is attached to. The fear is excessive to their developmental age, is persistent over a period of time and interferes with their daily functioning. Fears usually surrounding something harmful happening to their attached person. This usually first develops in children and can continue through adulthood.
Obsessive Compulsive Disorders
Obsessive Compulsive Disorder (OCD) is characterized by intrusive and obsessive thoughts, sensations, or ideas that make them feel driven to complete a specific routine/ritual around it (compulsion). There is often an excessive fear around dirt and germs which the person is unable to stop thinking/obsessing about. This may lead to them excessively washing their hands and engaging in other activities to avoid exposure to potential germs. The level of this is very intense and cause great distress to the person experiencing this. Many times people will say they are "OCD" as they are very neat or have a high need of having order about certain things. This is typically not OCD, as OCD is characterized by great distress that severely interferes with the person's ability to function in their daily life.
Some other disorders related to OCD include Body Dysmorphic Disorder (preoccupation with their body and believing in excessive flaws/ugliness), Trichotillomania (pulling one's hair out in an anxious and compulsive manner), Excoriation (skin-picking in an anxious and compulsive manner), Hypochondriasis (a preoccupation over health matters), and Hoarding (excessively saving objects that most would deem as "worthless" or trivial that leads to a great interference in their living environment and can interfere with their functioning). With all of these disorders there is an underlying obsessive and compulsive aspect to it where the person feels driven to it and helpless to stop the compulsion.
Trauma and Stress-Related Disorders
When a person experiences or witnesses a traumatic or stressful event or events they may later experience a great amount of psychological distress surrounding the event or what occurred. It is understandable for distress to occur after a traumatic event, when this distress starts to interfere with a person's daily living, then it can become problematic and may need treatment. These disorders include Post-Traumatic Stress Disorder, Acute Stress Disorder, and Adjustment Disorders.
Post-Traumatic Stress Disorder can occur after a person witnesses or experiences a traumatic event such as a terrorist attack, a natural disasters, a serious accident, or a violent personal attack (such as a sexual assault or domestic violence). PTSD is often associated with Veterans that experienced or witnessed combat in war. PTSD can also occur to someone that experienced child abuse or witnessed their parent be abused (domestic violence). A person can also experience PTSD through indirect exposure to trauma such as after a loved one experiences a traumatic event or first responders like Police Officers and Firefighters, that are continually exposed to people that have experienced great trauma.
Symptoms of PTSD include intrusive thoughts and images of the traumatic event. This can include flashbacks where the person feels that they are re-experiencing the event. These flashbacks can be very vivid and make the person believe that they are actually re-living the trauma. There is also often an avoidance of trauma reminders. This may include avoiding certain people, places, and things that may trigger a memory or flashback. PTSD often includes negative thoughts and beliefs around oneself and/or others. This may include feelings of guilt and shame for what happened, feeling that they are "bad" or deserved it, and that one cannot trust people. They may also experience a loss of pleasure or joy in doing things they previously liked and even feel disconnected/detached from others. These symptoms are very common immediately after a traumatic event and can be considered a "normal" response. In order for it to be classified as PTSD they need to continue for more than a month. Symptoms of PTSD can continue for years, especially if left untreated.
Acute Stress Disorder is similar to PTSD in its symptoms however the duration is for one month or less. Once symptoms persist after one month, then it can be diagnosed as PTSD. About half of those that have Acute Stress Disorder will go on to experience PTSD.
Adjustment Disorders occur when a person has difficulty and is experiencing distress after a stressful event. The event can be a single event such as a break-up, or can be chronic or several events, such as a long-term illness or on-going relationship problems. The distress can be marked with a depressed mood, anxiety, impulsive or negative behaviors, that cause difficulties in one’s life. Adjustment disorders occur within 3 months of the stressful event and do not continue more than 6 months once the stressor has ended. Adjustment disorders can lead to other more serious mental health disorders without proper treatment and/or support.
Treatment for Anxiety Disorders
As with most mental health conditions, getting support and treatment is imperative. Anxiety Disorders typically will not get better on their own and usually the opposite will occur. Many typical and common reactions to anxiety (such as avoidance, perfectionism, and compulsive behaviors) end up increasing anxiety. A negative cycle then ends up occurring where the person experiences anxiety, engages in maladaptive behaviors towards it, anxiety increases, then the maladaptive behavior increases, which again leads to more anxiety. Anxiety is also marked with a lot of distressing physical symptoms, which can also lead to additional thoughts and feelings of anxiety which creates another negative cycle.
There are many different ways to treat anxiety and most will respond well to psychotherapy, also called “Talk” therapy, and/or medication. Some Evidenced-Based Treatments include: Cognitive-Behavioral Therapy, Acceptance and Commitment Therapy, Exposures therapies, and Mindfulness-based therapies.
Cognitive-Behavioral Therapy | CBT
Cognitive-Behavioral Therapy (CBT) includes exploring ones thoughts, feelings and behaviors and how these interact and influence one another. CBT will help you identify negative thought patterns and learn how to replace them with more helpful ways of thinking. Therapy will also include exploring healthy coping strategies.
CBT has been demonstrated to be helpful for many mental health disorders including ones that are Depression, Anxiety and Trauma based.
Acceptance and Commitment Therapy | ACT
Acceptance and Commitment Therapy (ACT) centers around helping someone come to acceptance for their internal self (feelings and thoughts), while learning coping strategies to assist with struggles. Increasing psychological flexibility about how one thinks of themselves and their struggles is a core component. Engaging in Mindfulness exercises and meeting oneself with Compassion are also important aspects of ACT.
Exposure Therapies
Exposure therapies are helpful for those that experiencing symptoms from Trauma-Related disorders (such as PTSD), OCD, and Phobias. A common reaction to anxiety is to avoid what makes one anxious. This avoiding, however, ends up increasing anxiety. Exposure therapies work with slowly exposing the individual to the situation(s) that cause anxiety while engaging in calming and coping strategies to assist themselves in the moment. Over time the anxiety that occurs from the exposure to the stressor and/or fear will slowly lessen.
Mindfulness-Based Therapies
Mindfulness-based Therapies will often include components of CBT while also utilizing the practice of Mindfulness. Mindfulness is to focus to the present and become aware of one’s thoughts, feelings and sensation without judgment. Practices of mindfulness can include Meditation, Breathing exercises, body scans and yoga.
MMP Therapy
In my therapy, I utilize a combination of the above therapies while also exploring your past experiences, including how you were raised and how these may have contributed to your current struggles. I believe that we are all worthy of living a meaningful and happy life. There will be struggles and we can grow from them. No one is “broken” and we can overcome our conditioning and negative thought patterns. You are not your thoughts.
If you live in California and would like to work with me, please reach out!
Disclaimer: This is not a replacement for a therapeutic relationship or mental health services. This is for educational purposes only and should be in used only in conjunction in working with a licensed mental health professional. If you are in California and looking for a professional therapist feel free to use the contact me to request an appointment or search Psychology Today for local therapists in your area.
