Are you often overwhelmed with too much to do? Is constant worrying interfering with your ability to enjoy life? Do you have trouble sleeping or staying asleep? Do you find yourself reaching for food to soothe yourself when you are trying to calm down? Or the opposite, a loss or reduction in appetite? Are you having trouble concentrating, or physically tense?

These are some common symptoms of stress and anxiety, and can wreak havoc on your health, relationships, creativity and overall happiness. Although many of the symptoms are the same physiologically, there are some important differences between the stress and anxiety. Knowing one from the other can help when it comes to treatment. For the most part, stress is caused by external events or conditions, such as a job change, increased work pressures, or family demands. Anxiety is caused by internal demands or fears. When anxiety gets out of control, it’s usually because our fears that are out of proportion to the actual situation. An example might be feeling sick with worry that you might be fired from your job, even when there is no real cause for alarm.

It is normal to have a certain amount of stress and anxiety in our lives. Some kinds of stress (called “eustress”) are optimal levels of stress that boost our brain power and immune system, leading to greater levels of creativity, productivity, and a sense of well being. We feel eustress when we are playing games, watching suspenseful movies or mastering a challenge at work. Normal anxiety is like an internal alarm, alerting us when there are signs of danger or risk. We need some of that! Unfortunately, most of us have too much of both. Anxiety disorders are the most common on the list of mental disorders in the U.S. Fortunately, stress and anxiety are both manageable and treatable. Through therapy and the development of healthy habits and coping skills, symptoms can be greatly relieved.

If stress is the primary problem, it can be managed by doing whatever you can to reduce the causes of stress. This may involve making some hard choices in terms of lifestyle or career. If reducing the cause is not possible or realistic, learning to healthier ways cope with stress can help. Therapy can provide tools for that.

There are several different types of anxiety, all of which are treatable! (In other words, symptoms can be greatly reduced, sometimes to a healthy, normal level)

My approach to treating generalized anxiety is uniquely tailored to each individual, but usually involves some combination of Cognitive Behavioral Therapy, Systematic Desensitization, Dialectical Behavior Therapy, and Sensory Awareness Meditation. Cognitive Behavioral Therapy, or CBT, is the based on the interrelationships between thoughts and beliefs, feelings, and behavior. For example, we may have developed a belief in childhood that we had to be “the best at…” or we are not worthy of love or esteem. That belief might not be fully conscious, but it triggers anxious thoughts, feelings and behaviors, especially when we are under pressure to perform. Part of treatment involves changing or modifying these beliefs so that they are more realistic and self-compassionate. Dialectical Behavior Therapy involves identifying and managing dialectical dilemmas, which come about when a need is competing with a demand; for example, the need to take care of yourself amid demands (including the belief that you should) take care of others. Sometimes simply identifying the catch 22 dilemma and talking about it can be a relief in itself! Dialectical Behavior therapy also involves the development of self-soothing skills and soothing self-talk, which in my opinion, are very important in managing and relieving anxiety. Sensory Awareness (a type of mindfulness) is a deeply relaxing type of meditation which will give you a much needed break from thoughts altogether by focusing completely on one of the 5 senses.

Phobias are specific fears, such as fear of heights, driving, public speaking (the most common), etc… If you have a phobia, you may find that you retreat into a comfort zone to calm yourself, but over time the comfort zone gets smaller and smaller. This can have a tragic effect on your quality of life and relationships. Sadly also, many well-meaning friends or relatives may encourage you to “face your fears” by jumping in the deep end of the pool, so to speak, but this sink or swim approach rarely helps, and more often makes the phobias worse. But it is possible, with the right treatment and specific homework in between sessions, to enjoy a freer, more expansive life. Exposure Response Prevention (ERP) which involves systematic desensitization, is a self-paced, often extremely gradual process of expanding your tolerance to the thing you are most deeply afraid of. Self-soothing skills and support from others can be extremely helpful also. In my experience, motivation is also key to the success of phobia treatment. If you are motivated to do something that requires overcoming a fear, such as a desire to go on a vacation, develop a career, or hobby, it makes a big difference in how often you do your homework. I personally have phobic responses when it comes to technology, but I’m using these anxiety reducing tools myself to help me build this website. My motivation here is to save money! It is possible to live with an untreated phobia, lots of people do it, but when it gets in the way of your enjoyment of life or functioning, it’s worth the effort to treat it.

Obsessive Compulsive Disorder involves repetitive, often ritualized behaviors, such as handwashing or checking locks, etc. For OCD, I use an approach that utilizes Exposure and Response Prevention (ERP), which is the gold standard in evidence based treatments for OCD, phobias and Panic attacks. Many people with other types of anxiety have a few symptoms of OCD as well. It is very common and something I’ve treated successfully. For some people, a combination of therapy and medication can be the most helpful.

Panic attacks are experiences of extreme anxiety that seem to come out the blue. Many of my clients say they feel like they are dying during an episode, due to constricted breathing, racing heartbeat, and other extreme physical and mental symptoms. Many emergency visits are due to panic attacks. The symptoms are so terrifying and exhausting that people will do almost anything to avoid getting another one. Over the years I have worked with lots of people with panic attacks, using a combination of treatments described above and systematic desensitization. I have found that these treatments are highly effective towards reducing the severity and frequency of panic attacks, in some cases eliminating them altogether.

Procrastination and overeating are typical coping mechanisms for anxiety. If you have tendency to binge or graze on food through the day, leading to weight gain or obesity, anxiety could be highly related. Creativity blocks are also usually related to anxiety. I have a strong background in these areas and may be able to help.

Anger management issues and irritability can also be related to anxiety. This is yet another area where hidden anxiety can manifest in our feelings and behaviors.

Do you feel nervous in social situations? Social Anxiety is another extremely common type of anxiety. Sweating, feeling tongue tied, forgetting names, and other kinds of “blanking out” can create a vicious cycle of more and more anxiety, often leading to an avoidance of social situations. Practicing systematic desensitization, which is a gradual and soft type of exposure therapy, starting with the easiest situations first, is a relatively painless process that can yield impressive results.

Imposter syndrome is a type of anxiety where you feel undeserving of your position (usually at a job) and that there is something about it that feels illegitimate. This may also include fears that people will figure you out to be a fraud. Cognitive behavioral therapy can help you identify and address underlying thoughts and beliefs that give rise to these anxious feelings. Sometimes it’s helpful to understand where the beliefs came from, such as having unrelenting standards or other adverse experiences in childhood.

What if you’ve tried one or more of these approaches and are still struggling with anxiety? There can be many reasons for this, of course, but one possibility is that your symptoms are related to unresolved wounds or trauma from the past. Many people have symptoms of Post Traumatic Stress without ever knowing it. You may have been hurt in the past, but never thought of it as a trauma or thought that it could have lasting effects. One example of this is the relationship between being teased or bullied in school and having social anxiety later in life. To learn more about PTSD and my approach to that problem, see my page on PTSD. I use EMDR as well as other approaches to help with PTSD.

An unfortunate reality is that some people are more biologically prone to anxiety than others. Perhaps you are also a highly sensitive person, which is a blessing in many ways but also makes you more prone to anxiety. Other reasons for having a harder time with it include living in a stressful environment, having a chronic physical illness (particularly chronic pain) or additional mental disorders. Difficult life transitions can also trigger more anxiety. The good news is that learning how to manage anxiety better can go a long way towards helping you achieve a happier, more fulfilling life. I have worked with many people who have had several complicating factors, including chronic pain, but over time had a reduction in anxiety, and their increased ability to manage symptoms improved their quality of life and relationships immensely.

You deserve to feel better, and you can feel better. As a Certified Anxiety Disorders Specialist, I have helped many people over the years to reduce anxiety symptoms and enjoy a freer, more expansive life.

Please contact me to schedule your free 15 minute consultation. I look forward to talking with you!

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