anxiety disorder Tag

Social Anxiety Therapy

Social Anxiety or Social Phobia

Social and anxiety or social phobia is a kind of anxiety disorder in which the person experiencing the anxiety is fearful of experiencing embarrassment in social situations. According to epidemiological statistics this disorder has a lifetime prevalence rate of as much as 3-13%. Researchers have also noticed a strong family component to this disorder meaning that social anxiety or social phobia occurs with more frequency in first degree relatives. The onset of this particular kind of anxiety disorder is often in the teen years and can sometimes result after having experienced humiliation an embarrassing social situation.

According to the Diagnostic and Statistical Manual IV, this fear is very marked and when a person thinks about performing, speaking, or interacting in a social situation they may notice the fear response and or anxiety onset immediately in the form of sweating, heightened heart rate, increased respiration as well as cognitive responses such as worry and fearful thoughts. The symptoms of social phobia are marked and the person experiencing them recognize that they are excessive fears. An example of social phobia or anxiety is that person is terrified that if they speak up in class that they may blush and others will then see it and laugh at them. As you can imagine this can cause impairment in academic functioning and in many instances the person will avoid the possibility of enduring such a response and could skip class or even drop out of school. Some individuals with a social anxiety may be able to face the feared situation with distress.

Treatment for Social Phobia often involves therapy with a licensed professional counselor or licensed therapist. Counseling has many clinically verified treatment methods which are scientifically validated to reduce the anxiety related to this disorder and help individuals experiencing social anxiety to live normal healthy lives. Mindfulness based stress and anxiety reduction techniques including integrative medicine, medication therapy, meditation, acupuncture, diet, and exercise may also be helpful in treating this anxiety disorder. Please talk to your medical or licensed mental health professional to see which of these would be the best option for you.

Obsessive Compulsive Disorder OCD, Therapy and Counseling

Obsessive Compulsive Disorder

Obsessive compulsive disorder is a type of anxiety disorder which afflicts .5-2.5% of the population. The disorder greatly effects the quality of life for the sufferer and becomes a consuming pattern of anxieties and rituals which are centered around both obsessional worries and compulsive behaviors. Most of the individuals who have this disorder at one time or another acknowledge or have insight that their worry is excessive or disproportionate to the actual fear or anxiety. An example of someone who may be experiencing Obsessive Compulsive disorder is that “It started when I was in my mid 20’s, I was always worried that I would get something wrong, I made lists so I could try to manage my daily living tasks. Soon lists became my life, I would write a list of everything that I needed to do while I was in the shower, then I would check the list 3 times after writing it, to be sure that I did get everything right. Then I would reread my list again 2 times before entering the shower and read it out loud, If I didn’t perform this task I was simply unable to take my shower for the day because I would lapse into such overwhelming anxiety.”

Some examples of symptoms and behaviors association with this disorder are as follows

according to the Diagnostic and Statistical Manual;

That the individual has either obsessions or compulsions and which the definition of these are;

1. Thoughts which are recurring and persistent including images or impulses, these impulses are distressing and cause impairment including anxiety.
2. These impulses, thoughts and images are not related to a threat or worry about a real life problem.
3. There is an attempt to repress and ignore the distressing images, impulses and thoughts.
4. The person who is suffering from this disorder is in recognition that these fears are in fact a product of his or her own thought process.

Compulsions are defined as

1. Repetitive behaviors (e.g., checking, cleaning, cleaning,) and also cognitive acts such as (ie, ritualized prayer, tracing in the mind, taking count of objects or steps) the person feels compelled to enact the behavior in response to the obsession in a system of self created rules.

Obsessive compulsive disorder is a treatable anxiety disorder, the best form of therapy often involves both pharmacology including SSRI’s delivered in conjunction with long-term psychotherapy. Cognitive behavioral therapy has proven effective in managing the symptoms associated with this diagnosis as well as Behavioral Therapy such as Exposure therapy are all effective treatment or counseling models to progress beyond this disorder and take back control over life.

Panic Attacks and Panic Disorder

Panic Attacks and Panic Disorder

As many as 4.7% of people will experience a panic attack at some point in their lives, panic disorder is a form of anxiety disorder which can be extremely intense, many times individuals who have a panic attack end up going to the emergency room imagining that the rapid heart beat and dizziness are a heart attack. Symptoms and features of anxiety disorder according to the Diagnostic and Statistical Manual IV, laid forth by the American Psychiatric Association are as follows: To have experienced at least 4 of the following 13 symptoms;

Heart Palpitations

Trembling

Shaking

A feeling of smothering

Feeling of Choking

Discomfort or Pain in the chest

Nausea

Abdominal distress including a heightened need to urinate or defecate

Dizziness or Lightheadedness

Derealization or Depersonalization

Fear of losing control or a feeling that you are “going crazy”

Sweating, Chills or Hot Flashes

The symptoms of a panic attack are hallmarked by their sudden onset and intensity, unusually a panic attack has an onset in as little as 10 minutes. In example a person who has experienced a panic attack may say “I was sitting on the bus when all of the sudden I felt like I couldn’t breathe, it was like my throat closed up and I was choking but there was nothing in my mouth. I became dizzy and my heart felt like it was beating out of my chest, I started looking around and was going to cry for help. My fingers and toes felt numb and tingling, in a few minutes my heart slowed down a little bit but my stomach was really tight for hours after.”

As you can imagine someone who is experiencing a panic attack is suffering greatly. There are several different types of Panic disorder according to whether they are caused by a specific cue, such as public speaking or encountering an enclosed space such as the panic that can happen with claustrophobia. In other instances, panic attacks can be un-cued or non-specifically cued, this means that sometimes a person who has a panic attack may not understand what the trigger for their panic is until they seek treatment for the panic and uncover the deeper fears and how to manage the panic with their therapist.  A panic attack is differentiated from having a panic disorder which is to have had recurrent and unexpected panic attacks for a period of one month or more. Treatment for panic disorder are therapy, often most effectively Cognitive Behavioral Therapy, with a licensed professional counselor and also medication is sometimes the best treatment. Usually it is a combination of these two treatments which best helps to manage panic disorder. Untreated panic disorder can greatly reduce quality of life, leading to long standing feelings of guilt and shame and even agoraphobia.

Phobia Therapy & Treatment

Phobia

A phobia is a fear or anxiety response of heighted arousal, ie rapid heart rate, rapid breathing, and thoughts of intense worry and this most likely leads to avoidance of the situation or object. Some examples of typical phobias are fear of public speaking, fear of choking or vomiting, fear of spiders (arachnophobia), fear of enclosed spaces (claustrophobia), fear of bridges, fear of tunnels, fear of large crowds, fear of blushing, fear of water or other natural environments, fear of contamination or germs. Phobia is distinct and much more severe than a natural aversion, for instance in the example of arachnophobia, many people do not like spiders and insects but wouldn’t qualify for a disorder because this doesn’t interfere with their functioning and enjoyment of life. A person who simply doesn’t like spiders may sheik if they encounter one and quickly try to remove it from their environment. A person who has a phobia of spiders may feel anxiety if they think about a spider, they may never go into a forest or stay away from other natural environments, they may start to take precautions like spraying repellant everywhere and have continual intrusive thoughts about the possibility of encountering spiders and even stop leaving home or developing agoraphobia because their wish to avoid the spider is so powerful.

The Diagnostic Criteria for A Specific Phobia are;

1. A continual, persistent, and excessive fear caused by the presence or anticipation of the situation and or object, examples may be choking, bridges, tunnel, flying, insects, fainting, speaking, blushing.
2. When exposed to the object or situation an anxiety or hyperarousal response is invoked. This is also a different response in children.
3. In panic disorder the persona experiencing the disorder does recognize that the fear is unreasonable and the response is excessive.
4. The situation or object may be faced or endured but only with very visible and tangible fear, anxiety and distress.
5. This fear and anxiety interferes with the enjoyment and participation of life, limiting professional, occupational, social, relational, and academic performance and functioning.
6. This can be diagnosed only in individuals who are over the age of 18 and it must be experienced for longer than 6 months.

The best way to treat a phobia disorder is with psychotherapy, your licensed counselor can help you by using a very specific kind of therapy called Exposure Therapy. This is a behavioral therapy which a licensed therapist who specializes in treating anxiety disorders will be able to guide you through. In other instances, medication including anxiolytic medication, anti-anxiety and SSRI’s are best used medication therapy to treat and manage panic disorder. Other forms of therapy which may help to manage specific phobias including meditation, mindfulness, exercise and other integrative options like nutrition counseling and acupuncture.

Anxiety; Pills and Possibilities, A Psychotherapists Musings

Who among us has not suffered from feelings of anxiety at some point in his or her life, it is common enough to be among the more often seen symptoms which bring an individual into a therapist’s office. Even for the most staunchly healthy psyches anxiety is a typical benchmark which exists in a range of degrees within the human emotive process. Depending upon you as the individual and the technical approach of your clinician you may be offered a multitude of conflicting remedies to intervene upon that which is ailing you.

There are the wildly popular pharmacological interventions such as Xanax or Valium, while widely popular these interventions do nothing to examine the “how’s” or “why’s” of an anxious feeling. These interventions assume that an increased cardiovascular response, heightened worry, tense muscles, sleepless nights, feelings of agitation are all in the physical realm yet quite mysterious. Indeed anxiety in its more insidious form is a grave health concern so it is with accolades that I note the vast number of humans seeking treatment to escape its grips. There is something inexplicably disconcerting about the hyper arousal of anxiety which compels one towards a greater risk for many other issues health issues such as addictions, depression, coronary heart disease, even eroding the erectile function of both the male and female, to name but a few.

 Most of us recognize that there are yet other forms of anxiety which are our “bon amie,” the kind which compels our actions for good causes such as self and social betterment. Without a touch of anxiety one may hit the snooze button each and every morning and drop out of society all together. Yet for our purposes we will consider the more sinister form with its wanton undesirability which causes many to seek its avoidance at all costs. There are vastly varied approaches within the medical community in terms of treatment of anxiety, there are folk remedies, homeopathic remedies, new age methods, each with their unique utility. Yet most all of these interventions lavish attention upon the amelioration of physical symptoms but may from sheer neglect, fail to examine the psychological underpinnings of anxiety itself. For those who do experience the necessity of utilizing anti-anxiety medication it is an empirically validated fact that the best therapeutic outcomes exists for individuals who make use of psychotherapeutic settings simultaneously. It is within the psychotherapeutic setting that the focus is cast specifically upon the unique psychology which may be breeding and offering sustenance to an overabundance of anxiety.  Allow the remainder of this small essay to offer a rudimentary overview of some of the more typical sources of psychological anxiety.

Significant Life Changes

This form of anxiety is a reaction to some looming occurrence which has skated its way across your horizon, it may be adaptive and is completely natural. Many of us thrive upon constancy, as much as this tendency is at odds with the nature of the universe, inevitably we experience some anxiety while changing jobs, graduating, marrying, divorcing etc. While it is normal to exhibit some emotional reaction to such transitions be mindful to give extra care to yourself even during those joyous transitions. For any anxious feeling that continues to gnaw at your innards, give yourself some time to thoroughly examine  all of your thoughts surrounding the (fill in blank) transition. This reflection affords the opportunity to hone in on any ways your emotional self may be beckoning you towards a closer look at something that your conscious awareness is not seeing completely.  

Emotional Expression

 The more that we attempt to repress our emotional experience the more that they tend to rupture forth in greatly unmanageable ways. Perhaps you are a product of early learning which valued emotional repression and lack of expressiveness. In some way you may have learned early or later in life that it is dangerous or taboo to talk about feelings or even notice that they exist for you, yet the vast and unstoppable torrent of the feeling state will not be escaped. This form of anxiety or panic urges the person towards understanding and experiencing of inner awareness and emotional expression.

Time

The exactitude and finite nature of time is stated by some to be the source of all anxiety. What is it that you will you do with your precious earthly allowance? By becoming more aware of lapsing time, acknowledging that life proffers beauteous opportunity, love, and abundance still too, how will you cope with mounting defeats, losses, and unrealized potentials? Ones highest hope is to make father time ones friend, utilizing our human energies to compel feats which contribute to human progress. For you that may mean many things, to raise a family, build computer software, tend the forest, love deeply, the myriad meanings for the human riddle.

Control

For some of us it is alarming to consider doing something that risks ones perceived control over ones surroundings. That could mean riding in an airplane, making interpersonal changes like developing new relationships, people are the ultimate unknown variables full of competing needs and possibilities.  Will you be able to extend the risk of letting go of the known order to enjoy the potentials?

While this is in no way an exhaustive exploration of that powerful human indicator named anxiety it is something that may compel one to begin to relate to it in a slightly different manner. Perhaps it is time to consider its possibilities, its latent messages, it may one with greater respect for behoove one to not simply extinguish an anxious feeling with a pill or an exercise but to sit with it, even for just a moment, entering its heart palpating, dizzying sensation, in reverential respect for its utility and possibility as an psychic indicator. There is an understanding that in most cases, under the layers of any symptom are a fortunate beckoning towards the best version of yourself, the unrelinquishable layers of consciousness which insist that ideals will be felt and known.

In good health and energy,

Stephanie McCracken MSPC

412-215-1986

Reviving Minds Therapy

1010 Western Ave

Pittsburgh Pa 15233

*This article does not intend to diagnose, treat, or in any way address an anxiety disorder or supplant psychological or medical advice. This is intended for your consideration only.