Anxiety

anxietyA little bit of stress is healthy and normal. In fact, researchers have shown that a touch of anxiety or worry can help boost productivity, such as before a big test, exciting event, important game, or presentation at school/work. The stress helps you really “nail it.” Many people who feel worried or stressed from time-to-time may also find that this can be a healthy way of “checking in” with oneself. Acknowledging stress can be one of the first steps towards reducing stress, by identifying when you have too many things going on and may need to take a breather or re-examine life priorities.

For some people, anxiety has taken on a life of its’ own. Worry may be near-constant, and at times you may be able to tell that your thoughts become irrational or you act out in ways that later seem immature or embarrassing. You may find yourself limiting certain activities and your life may feel constrained. Mental stress can also lead to physical stress, such as grinding teeth at night or tense shoulders and back muscles. Working with a counselor with experience in anxiety therapy can help you reduce your stress.

Anxiety and Depression

Anxiety symptoms can occur by themselves. However, anxiety and depression often coincide, and sometimes get mistaken for one another. The lethargy, trouble feeling good about oneself (self-esteem issues), fatigue, and difficulty motivating that can happen with depression can lead to anxiety. Anxiety may manifest as a sense of unease that things aren’t being taken care of as they should, or mistrust of friends and acquaintances. In turn, anxiety can contribute to perfectionism (a sense that nothing is ever good enough) in a way that can damage self-esteem and relationships, leading to or worsening depression. A good therapist can help you decide what is really going on and how you can best tackle the symptoms of anxiety or depression that you’re experiencing. Break the cycle and feel better.
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Symptoms/Signs of Anxiety

Anxiety can manifest in many ways, including:

Physiological symptoms. Anxiety is a specific feeling, and can include physical symptoms such as stomach complaints, chronic muscle tightness and knots, insomnia, and shortness of breath. Sometimes people with anxiety experience more severe attacks, known as panic attacks. Symptoms of a panic attack can include a rapid or racing heartbeat, tremors, racing thoughts, extreme sensations of fear, and a desire to escape your current surroundings. Your system is literally being flooded with neurochemicals normally triggered in a “fight-or-flight” response, except your system is over-reacting- you aren’t actually in any danger. Perhaps you’ve even asked your doctor or local emergency room to check into whether you have a heart condition, and you have been told that you don’t have anything medically wrong with you, and that you are suffering from anxiety.* Counseling can help you learn to literally relax.

Changes in thought patterns. Anxiety often leads to predictable changes in thought patterns. You might be surprised later just how different your thoughts are when you are feeling calm, and wonder to yourself how you could become so irrational or worked up. You might find yourself “catastrophizing”- creating a crisis or anticipating an emergency with little evidence that things will turn out badly. Thought distortions tend to manifest in predictable patterns, such as over-anticipating that something bad will happen, seeing things in terms of black-and-white, assuming you know what people are saying or thinking about you, or taking things too personally.

When a person is anxious, they might also experience obsessive thinking, where one thought or scenario gets played over and over again, like a broken record.  Obsessional thinking is known as rumination, and can often plague anxiety sufferers. A good therapist can help “train” you to monitor your thoughts, so you can begin to name these predictable cognitive (thought) distortions, and over time use methods that will allow you to interrupt and replace anxious or obsessional thoughts.   Cognitive-behavioral therapy techniques, or CBT for short, can help.

Changes in behavior. One of the most common changes in behavior when a person is experiencing anxiety is avoidance. Because certain people, situations, or scenarios provoke such an unpleasant change in the mind and body, you might find yourself doing certain things less. In extreme cases, an actual phobia might develop, where even thinking about a certain situation or event will fill the mind with terror, and the “trigger” for the fear is avoided at all cost.

Another common change in behavior for people with anxiety is compulsive behaviors. This can include compulsive or addictive behaviors such as over-eating, binge drinking, compulsive masturbation, over-spending while shopping, or using drugs to try to calm down or forget about problems for a while. This is known as “self-medicating,” and can often become a problem by itself. In some cases, addictions may develop as a result. Some people suffer from obsessive-compulsive disorder, and engage in rituals or compulsive behaviors designed to reduce their anxiety, but may seem meaningless to others. These behaviors may become so time-consuming and mentally consuming that other activities and relationships suffer. Therapy for anxiety will help you regain control over your behavior.

* Please note: Vanessa Ford is not a medical doctor, and any physiological complaints should be checked out by a medical doctor to rule out a medical or physical cause.
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Panic Attacks and Anxiety

When suffering from a panic attack, the world suddenly feels like the walls are closing in, and every stimulus from within and without can feel threatening. Much like a cave person facing down a saber tooth tiger, our “fight, flight or freeze” mechanisms engage in a way that is disproportionate to the situation at hand.  Our systems are designed to gear up for a perceived threat by giving us the energy and adrenaline to protect ourselves, but when our perception and reality don’t match up, this mechanism can work against us.  Our brains become flooded with neurochemicals which often lead to a host of somatic symptoms: feeling shaky; rapid heartbeat; shortness of breath; feelings of choking; chest pain; intense feelings of fear or of losing control; racing, disjoined thoughts; feeling numb or tingling in the extremities, etc.  Panic!

Because the nature of symptoms associated with panic attacks are so rooted in the body, many people initially respond to these symptoms by going to their local emergency room for medical attention. Although medical attention may be indicated to rule out underlying medical causes, usually one’s health practitioner will be able to help you identify that the true root of your symptoms are psychological in nature.  Short-acting anti-anxiety medication may be helpful as-needed to curb an attack, or longer-acting daily antidepressant medicines may be prescribed to lessen underlying general anxiety.

Over time, a single panic attack may become panic disorder when multiple attacks occur, and fear of having another attack begins to limit a person’s activities or self-concept (such as a fear of losing control or “going crazy.”)  Initial triggers for panic attacks may be vague and difficult to pin down; over time, panic attacks may be triggered by a fear of having further attacks.  Sometimes a person with panic disorder may have very infrequent attacks, but become so scared of having another attack that the disorder can take on a life of its’ own, causing inhibition in multiple areas of a person’s life.  Related fears can lead to avoidant behaviors, as potential triggers for future attacks lead to avoiding suspected triggers, such as taking public transit, visiting certain places, or engaging in certain activities.  Agoraphobia can sometimes be present as well, where a person may fear leaving certain areas they deem safe, such as their homes, or avoid open spaces that may trigger an attack.

Seeking the help of a therapist specialized in anxiety can help control the disorder and offer relief from future attacks and avoidant behaviors. Your therapist should also help you identify and addressing unhealthy coping mechanisms, such as using drugs or alcohol to feel better.  The use of alcohol is very common in people with anxiety disorders, as it provides short-term relaxation and relief from anxiety symptoms.  Over time, however, these symptoms often worsen as the “rebound anxiety” the day after a heavy drinking episode may lead to worsened symptoms, and a vicious cycle of self-medicating.

Sessions may in part focus on developing insight into general causes of anxiety that may have contributed to or exasperated the development of the disorder, but at least a portion of sessions should also be devoted to developing concrete tools for getting symptoms under control. Cognitive-behavioral therapy has been found to be particularly helpful with this.  This form of therapy will help you identify ways in which your thoughts may distort and exaggerate just before and during an attack, and how to identify and correct these distortions to get your mind back under control.  Body awareness and relaxation techniques such as deep breathing can help curb the somatic symptoms associated with an attack.  “Grounding” techniques can help you orient yourself back into your general surroundings, and help you recognize that your “fight-or-flight” response is disproportionate to the situation at hand.  Using all of these techniques and insights in tandem can help you get your life back, as an anxiety therapist can help you reduce avoidant behaviors and reintroduce those situations and activities you’ve learned to withdraw from over time.  You may want to read an article Vanessa wrote on panic attacks for a national website for more information on treatment approaches.
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Anxiety and “checking out”

Although anxiety is usually associated with an experience of high stress, such as rapid thoughts, overwhelming fears, or agitated/nervous behavior, anxiety can sometimes be experienced in ways that feel like the opposite. People who have chronically high levels of anxiety sometimes have the experience of “zoning out” or “numbing out.” The technical term for this is “dissociation.” All of us “dissociate” at times, this is normal. An example might be if you are driving home with a lot on your mind, and you might find yourself not sure what exit you just passed on the highway. It’s as if you weren’t fully “there,” even though on some level you realize you were conscious and able to drive your car down this familiar path. When this form of zoning out becomes more habitual, however, it can become a problem by inhibiting a person from fully experiencing their feelings or be fully available to connect with others.

Examples of dissociation can vary, but might include:

  • Spacing out or zoning out frequently, perhaps friends or loved ones often tell you to “snap out of it.” Perhaps you get so immersed in work or hobbies that you lose track of time or your surroundings.
  • Having the sensation that the world isn’t real, that you are living in movie. Alternately, looking in the mirror and feeling a sense of disconnection with yourself, or feeling disconnected from your body.
  • Having trouble accessing your feelings or being able to tell what your true feelings really are.
  • Having a sense (or being told) that you react to emotional events in a way that is “too intellectual.”
  • Living more in a fantasy world than in the real world. This could include frequent escapes into books, video games or pornography.
  • Having difficulty feeling physical or emotional pain, or cutting or burning oneself just to feel more “alive.”
  • Losing track of significant periods of time on a regular basis.
  • Engaging in high-risk or highly exciting activities such as aggressive sports, gambling, cocaine use, or sexual activity as a way to feel more fully alive.

Although dissociation can feel very different from what we normally associate with the experience of being anxious, it makes sense that someone who is chronically anxious may begin to check out in this way. This form of numbing or zoning out is really a way for the mind to protect itself from experiences that may be too overwhelming for our brains to process all at once. For example, it is very common for victims of trauma, such as during a car accident or sexual assault, to forget all or a part of that experience, to not be able to recall specific details, or not be sure exactly how much time elapsed. This is because of dissociation. For people suffering from more chronic anxieties, every day becomes mildly traumatizing due to an over-exaggerated sense of worry and fear about everyday life. Checking out becomes a way to cope, to escape from the routine experience of high anxiety levels.

Therapy can help you stay more in a balanced, middle state of living life more fully, while developing the tools and insights necessary not to become too overwhelmed by stress, pain or loss. If you find yourself “checking out” on a regular basis, it is important to share that with your therapist so that you can get the most from your therapy experience. Vanessa Ford is experienced not only in helping clients develop anxiety management tools, but in developing “grounding techniques” that help her clients from “checking out” from life when they get too stressed.
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Origins of Anxiety

Anxiety can grow slowly, over time, or can seem to hit all of a sudden. Often chronic stress or unresolved issues can lead to the development of an anxiety disorder. Examples of situations which might lead to anxiety include an abusive or neglectful childhood, growing up with a mentally ill or alcoholic parent, chronic bullying (at school or work), a dysfunctional or abusive relationship, a major betrayal in a relationship (such as an affair or living with someone with an addiction problem). Surviving sexual abuse, physical abuse, or assault, or combat stress may lead to “hyper-vigilance”- always being on guard for the next attack. This is known as post-traumatic stress, because the trauma has passed but one’s mind and body is still on “high alert.” Sometimes an anxiety disorder develops after recovery from drugs or alcohol. With little practice handling life without being able to self-medicate away stress, you may feel unable to cope effectively in sobriety and know that it is time to get some professional help.

Sometimes it may be difficult to identify an environmental cause for anxiety, but you know that chronic stress and worry runs in your family. This can lead to anxiety in two ways- by leaving a person with a genetic predisposition to an anxiety disorder, and by growing up in a household that may have been characterized by a general sense of worry. You may not have been taught the tools growing up to deal with the natural ups-and-downs of life.

Sometimes anxiety seems to strike with no known cause. Anxiety also has a tendency to worsen over time, and take on a life of its’ own. For instance, a panic attack during or after a period of stress or during a significant life transition may later develop into a pattern of panic attacks with seemingly no trigger at all. Phobias may develop in this way also- an unpleasant experience becomes a trigger for a sense of dread that is disproportionate to the risk or threat that the original trigger poses. You may feel threatened and know that it is irrational, but not be able to get it to stop.
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How Does Therapy Help With Anxiety?

Anxiety is a feeling but it can also influence thinking patterns and consequently behavior. When anxiety becomes more chronic and begins to impact a person’s life more regularly, it is known as an “anxiety disorder” and it’s time to get some help from a professional. Anxiety disorders include OCD (Obsessive-Compulsive Disorder), PTSD (Post-Traumatic Stress Disorder), Generalized Anxiety Disorder, Panic Disorder (when a person has panic attacks frequently, or so fears having another panic attack that they begin worry excessively or avoid certain activities), and phobias.

Therapy can help with anxiety and depression in several ways. A good counselor can help you find relief by developing stress management tools. Counseling can help you better name and identify what really happens in your body and mind when anxiety strikes. Your therapist may have you do “homework,” such as journaling about your worried thoughts, or practicing deep breathing or relaxation exercises that will teach you how to relax your body when tense. These methods are generally known as cognitive-behavioral therapy techniques.

Counseling may include linking you to a psychiatrist who can help prescribe appropriate medications, or you may want to talk to your doctor about your symptoms. Therapy combined with medication can provide a powerfully effective team in addressing anxiety and depression. However, taking a medication is a personal decision, and you may find relief from therapy alone even if you choose not to take a medication. In some cases, a history of addiction may leave you reluctant to taking medications you fear may be habit-forming.

A good therapist should also begin to help you identify the “core issues” underlying your anxiety. In many cases, anxiety is a symptom of unresolved issues that need to be identified and addressed. Insight-oriented psychotherapy is another key feature in getting anxiety under control.  EMDR may also be an option. Vanessa Ford’s practice in Chicago helps many clients who suffer from anxiety. Ms. Ford takes a two-pronged approach to anxiety. She will help you develop tools to use to better manage anxiety, and she will help you identify and solve the root causes of your symptoms. Call her to explore your treatment options, and experience relief from the chronic stress of anxiety.
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