Generalized Anxiety Therapy

Generalized Anxiety

Generalized anxiety disorder is a mental health concern which brings many people into therapy each year. As many as 1/4^th of people who seek treatment in counseling centers each year do so as a result of wanting to manage symptoms related to Generalized Anxiety Disorder or (GAD). Signs and symptoms of Generalized Anxiety Disorder are free floating thoughts and worries that are not related to a real imminent danger. Those who experience generalized anxiety disorder may find it difficult to distinguish between thoughts and fears which are related to a real possible danger or threat and one that is not. The thoughts, fears, and worries of Generalized Anxiety Disorder co-occur with physical somatic responses such as elevated heart rate, fatigue and restlessness, and or difficulty falling and staying asleep. Individuals who are experiencing this anxiety disorder may also be prone to irritability and may too have a higher incidence rate of other mood and mental health disorders including other anxiety disorders, or depression and substance abuse disorders.

A woman suffering from GAD may say something like “I was always on edge, it was difficult to pin point when the worrying started but it felt like it was one thing after the next. I was worried about getting into college, then how I would manage student and work life after, each test and paper caused me endless worry. It wasn’t just with school either, everything from traffic, to my parent’s health, I wasn’t even able to see the way it was effecting me until things became so bad that I wasn’t sleeping well and started to really feel down. Then I found a therapist and started working on treating my anxiety and along with that I was able to identify how much it had taken over my life.”

Some of the diagnostic criteria for GAD according to the Diagnostic and Statistical Manual, are as follows; Excessive worry for at least 6 months.

The person experiencing the anxiety is not able to control the worries or change the focus of their thoughts. Additionally these worries are accompanied by physical sensations or somatic responses including at least 3 of the following; Restlessness, Fatigue, Concentration difficulties, Irritation of Mood, Tightness in the Muscles, Sleep Cycle Disruptions including Difficulty staying or falling asleep. Remember these symptoms cause significant distress in social, family, or work life and are not caused by another disorder or use of substances. Only a licensed professional counselor, psychologist, or psychiatrist can help you to discern whether you are exhibiting or experiencing the full range or concerns which may mean you qualify for a diagnosis which will then help to guide the treatment for the anxiety disorder.

Treatment for generalized anxiety disorder often involves many therapy and counseling options. Many forms of psychotherapy including, cognitive behavioral therapy, psycho-dynamic therapy, brief solution focused therapy, acceptance therapy, gestalt therapy, rational emotive behavior therapy, are all valid methods to treat anxiety disorders and manage the symptoms associated with it. In other instances, counseling may be used alongside medication therapy, integrative medicine, including mindfulness and meditiation, to achieve a significant and long lasting reduction in the symptoms of anxiety.

Counseling and Wellness Center of Pittsburgh and Monroeville

830 Western Avenue

Pittsburgh Pa 15233

2539 Monroeville Blvd

Monroeville PA 15146

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.

Therapy and Counseling, Treatment For Anxiety

Treatment for Anxiety

Treatment for anxiety takes many forms, there are generally three main agreed upon and clinically verified methods to manage and reduce symptoms of anxiety. Counseling or Therapy with a licensed counselor or therapist is the first treatment route. The treatment route for this form of help can vary from short term, brief solution-focused counseling interventions as well as long term treatment including cognitive behavioral therapy and even existential therapy. Only you and your counselor or therapist can determine which method will be best for you.

Other ways to manage symptoms related to anxiety are to enhance total wellness, this includes  integrative medicine, nutrition counseling, acupuncture, fitness, meditation, and mindfulness. Some people experiencing anxiety find that a holistic approach suites their lifestyle best, in turn they explore clinical herbalism and integrative interventions to learn how this can support positive emotional health and wellness. Holistic therapy is best utilized along with counseling or psychotherapy from a licensed counselor  which is therapy which will focus on finding triggers and changing the cognitive response to anxiety. The final way to treat anxiety is to use medication therapy. Medication has many different options including SSRI’s which must be taken for several weeks before taking effect and then other anxiolytic medication which is more short acting, talk with your psychiatrist or prescribing PCP to explore which form of medication therapy is the best for you to treat your anxiety. Medication often works best to diminish anxiety when it is paired with counseling and therapy which can change the thought patterns, discover underlying causes of anxiety and mange the full way in which it effects quality of life.

Remember that the worst way to manage your anxiety is by doing nothing at all in the hope that your symptoms will disappear. Managing anxiety is done best when we treat it early and completely with solid medical and therapeutic interventions.

Seeking Treatment for an Anxiety Disorder? 3 things to look for in a Therapist to Treat your Anxiety

3 things to look for in a Therapist to Treat your Anxiety.

If you are noticing that there has been a shift in your mood, energy, sleep cycle, appetite, digestion, or overall quality of life, or maybe you have recently been diagnosed with a chronic health condition and have a more recent onset of anxious feelings. You may be wondering if you meet the criteria for the diagnosis of Generalized Anxiety Disorder, Social Anxiety, Panic Disorder, or one of the other major diagnosis which make up this category. Sometimes too, an individual may be suffering from one of these disorders but without realizing it because the patterns of thought associate with the disorder have become so entrenched in the sufferers thinking and way of being that the symptoms which perpetuate the disorder are automatic. A professional assessment and then therapy to treat your anxiety is the next step to healing. In searching for a therapist to help you treat your anxiety you will find a variety of options and treatment styles so many that you may ironically become anxious in the process of choosing. A few things to help you choose the therapist or counselor.

• Check their credentials, choose a licensed therapist who has experience in treating your specific potential anxiety disorder. There are lots of people on line who advertise as life coaches coaches, counseling ministers, or counselors without a license. You owe it to your health and wellbeing to treat your anxiety with a well-trained and licensed therapist.
• Expect to pay for services or use your insurance, if a therapist is offering free counseling or free therapy assessments, this is probably not a good sign. Most qualified and licensed therapists who treat anxiety disorders will expect to be paid for their expertise in helping you to recover from your anxiety disorder. Offering free services is a way new therapists might try to get business if they are very slow or new to the business of therapy.
• In your first appointment and all other appointments, pay attention to how the process feels and what you think about their interventions. Do you feel understood? Does the therapist offer skills and interventions that are relevant to your needs in treating your anxiety? If you can answer yes to these questions, then you are likely well on your way to a solid therapy path and recovering from your anxiety disorder.

Be Well Pittsburgh and Monroeville,

412-322-2129 Call to reach a therapist to help you to treat your anxiety disorder.

The Counseling and Wellness Center of Pittsburgh and Monroeville