Anxiety — Inside Out Counseling LLC

Anxiety Explained.

First, without anxiety, we would not be here as a human race. It is essential to our survival and day-to-day lives. It is the brain and body’s way of communicating that we need to take action or that there is a potential threat. This is helpful in certain situations like a house fire, we need to study for an exam, or meet a work deadline. Second, anxiety becomes a problem when it interferes with our daily lives and functioning, which can manifest in various ways (irritability, fatigue, difficulty concentrating, eating, or sleeping, etc.). Below are some common anxiety disorders, effective treatment interventions, and helpful resources.

Inside Out Counseling LLC specializes in treating anxiety disorders in adolescents 10+ and adults.

Specific Phobias

A heightened fear of certain places, objects, or events such as flying, elevators/closed-in places, animals, seeing blood/receiving an injection, vomiting, etc. that cause significant distress and the threat is out of proportion to the actual danger. People with phobias often engage in avoidance. For example: turning down a promotion or not going on vacation because they will have to fly. The problem with avoidance is that it actually feeds into the fear, which is why exposure therapy is the go-to treatment for phobias. People with phobias may have other anxiety disorders. Therapy strategically targets all of them.

Panic Disorder/Agoraphobia.

The majority of us will have a panic attack at some point in our lives yet most of us will not develop panic disorder. So, what’s the difference? A panic attack is a sudden and intense feeling of fear, without a real threat present, accompanied by physical sensations like rapid heartbeat, difficulty breathing, sweating, etc., and often includes thoughts that one is dying or having a heart attack. Panic disorder is when we fear having a panic attack not merely having panic attacks. We fear our own body sensations/thoughts.

Agoraphobia is when one avoids certain places or endures them with great distress. The fear is that they will not be able to get out of the place or get help if they have a panic attack. Common places include driving in cars, shopping malls, crowded places like restaurants, and standing in line. The fear can also occur when one is in open spaces like parking lots, bridges, or outside of one’s home.

Cognitive behavioral therapy (CBT) is effective in treating panic disorder and agoraphobia and combines cognitive (thinking) restructuring, behavioral (tailored exposures), and psychoeducation.

Generalized Anxiety Disorder (GAD)

Excessive worry and anxiety over a variety of events/activities such as school/job performance. One will find themselves worrying about everything and anything and find it time-consuming and exhausting. As a result of this constant anxiety, people may experience fatigue, difficulty concentrating, irritability, muscle tension, or difficulty sleeping. When this affects one’s day-to-day life, it is a good idea to seek therapy. Cognitive behavioral therapy (CBT) including exposure and response prevention (ERP) therapy are effective in treating GAD.

Social Anxiety Disorder

Difficulty and increased anxiety when in social settings including one-on-one or groups. The underlying fear is being judged negatively (consciously or unconsciously) by others and showing symptoms of anxiety (shakey voice/hands, sweating, face turning red). Common settings that involve discomfort are being observed eating, giving a speech, talking in a work/school environment, meeting unfamiliar people, or being in a grocery store. Social settings almost always provoke fear or anxiety. As with other anxiety disorders, cognitive behavioral therapy (CBT) including exposure and response prevention (ERP) therapy are effective in treating social anxiety.

Trauma / Post-traumatic Stress Disorders

Can occur if someone was exposed to a traumatic event directly (threatened death, sexual assault, serious injury), witnessing one, or learning one occurred to someone close to them. The event can be one time or repeatedly. Not all people who have exposure to a traumatic event will develop a trauma and stress disorder such as post-traumatic stress disorder (PTSD).

Intrusive symptoms include (you do not have to have all of these to have a trauma disorder): distressing memories of a traumatic event, recurrent dreams related to a traumatic event, flashbacks that feel like the event is recurring in real time, being triggered by external things that resemble the event, avoidance or efforts to avoid distressing memories, thoughts, or feelings related to a traumatic event or avoiding people, places, objects, conversations that bring up traumatic memories.

Additional symptoms may include (not necessarily all of them): hypervigilance, being easily startled, irritability, difficulty concentrating and/or sleeping, feelings of guilt, fear, anger, or shame, diminished interest in doing activities of interest, inability to feel happy, satisfied, or loving feelings, or negative beliefs.

Symptoms may begin within the first 3 months or there can be a delay of months or even years.

Therapeutic treatment is tailored to the individual and their needs/symptoms and may include learning coping skills, psychoeducation, talk therapy, narrative exposure therapy, cognitive behavioral therapy, including exposures and cognitive (thought) restructuring, and/or Eye Movement Desensitization and Reprocessing (EMDR) therapy. Depending on the severity, medication may be recommended in addition to therapy.

Carrie Torres, MS, LPC-IT at Inside Out Counseling is trauma-informed certified and has experience working with trauma and PTSD with the above therapies except for EMDR.

Resources

The Anxiety Coach

A great resource for everything anxiety including psychoeducation, podcasts, books, and other helpful resources.

Anxieties.com

Free anxiety self-help site.

Your Anxiety Toolkit Podcast/Blog.

“Your Anxiety Toolkit Podcast delivers effective, compassionate, & science-based tools for anyone with Anxiety, OCD, Panic, and Depression”.

Noises in your head Youtube video series.

“When anxiety generates unhelpful worries and obsessions – we’ll call them “noise” – then anxiety becomes a cunning and persuasive challenger. To take him on, you’ll need an outcome picture, grit, trust, and courage.”

How to become more confident: Ted Talk

Till Gross shares "how he overcame his own fears and how everyone can step out of their comfort zone.” An interesting take on facing our social anxieties.

A Better Way to Worry -Hidden Brain Podcast

“Anxiety is an uncomfortable emotion, which is why most of us try to avoid it. But psychologist Tracy Dennis-Tiwary says our anxiety is also trying to tell us something. We explore how we can interpret those messages and manage the intense discomfort these feelings can generate.”

Changing the Culture of Rape Secrecy That Empowers Perpetrators - Ted Talk

“Do you know what to do when someone you care about tells you they’ve been raped? Effectively supporting sex assault survivors not only helps them heal, but also helps change the culture of secrecy that empowers perpetrators. The stories and tips in this talk show how to support survivors well, and make less space for sexual violence in our world.”

988 Suicide & Crisis Lifeline

“The Lifeline provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals in the United States.” Dial 988.