Generalized Anxiety

Individuals struggling with generalized anxiety tend to exhibit excessive and uncontrollable worry about daily life and especially the future. Worries may be focused on minor matters such as worrying about being late for an appointment or worrying they will not enjoy a movie they’ve decided to see. Additionally, worrying may revolve around a specific aspect of their life such as health, relationships, work/school, or performance. People struggling with generalized anxiety may also struggle with perfectionism and accepting inevitable uncertainty in life. They may exhibit some or many of the following:

  • Checking behaviors
  • Excessive reassurance-seeking
  • Inability to make decisions
  • Excessive list making or information seeking
  • Inability to allow others to complete tasks in an effort to make sure it is “done right.”
  • Avoidance/procrastination

Some people may even notice physical symptoms including heart racing, sweating, GI upset, restlessness, irritability, and insomnia.

Panic

Anxiety may or may not be experienced with panic attacks which are defined as abrupt and intense surges of fear or discomfort, typically reaching a peak over the course of 10 minutes, during which time the individual also experiences at least four of the following:

  • Tachycardia, heart palpitations, or chest pain/discomfort
  • Sweating
  • Shaking/trembling
  • Feeling short of breath
  • Feeling of choking
  • Nausea or GI upset
  • Feeling dizzy, lightheaded or faint
  • Numbness or tingling
  • A sense of being detached from oneself (depersonalization) or of things being unreal (derealization)
  • Fear of losing control, “going crazy” or dying.

Panic attacks are fairly common and just because you have a panic attack does not necessarily mean you have Panic disorder. Panic disorder is characterized by recurrent and unexpected panic attacks, in addition to changes in behavior. Behavior changes are intended to avoid panic attack triggers and may include:

  • Needing a companion to accompany you places
  • Avoiding things which may trigger panic-like symptoms such as exercise, caffeine, spicy food
  • Carrying items such as medication as a safety net

Social Anxiety

Individuals struggling with social anxiety tend to feel very nervous or uncomfortable in social situations. They are fearful of humiliating or embarrassing themselves and are overly concerned that others will think badly of them in some way. Examples of common fears seen in social anxiety include:

  • Meeting new people
  • Interacting with co-workers/friends/peers
  • Attending social events
  • Being assertive
  • Talking on the phone
  • Ordering food at a restaurant
  • Public speaking
  • Eating/writing in front of others
  • Performing in public
  • Participating in meetings or classes

People with social anxiety tend to have negative thoughts about themselves and how others will perceive or react to them. Sometimes they are overly concerned about exhibiting visible signs of anxiety such as trembling or blushing. Often times, there are attempts to avoid or escape social situations in an effort to reduce anxiety and prevent negative evaluations from others. Social anxiety can put stress on relationships and impair functioning at work or school.

Treatment for Anxiety

Anxiety is a normal part of life, but if you feel anxiety prevents you from truly engaging with life then it’s time to get help. One of the most common ways we tend to cope with anxiety is through avoidance. If we avoid what makes us anxious then we don’t have to feel and experience the difficult thoughts and physical sensations that often accompany anxiety. This can seem like a good plan on the surface but sometimes avoidance comes at a price.

I work with anxiety by teaching different strategies (mindfulness, meditation, relaxation, breathing, grounding, restorative yoga postures) to aid in coming out of sympathetic nervous system activation (fight/flight). These strategies typically help engage the part of the nervous system which promotes relaxation and calm. I also assist clients in identifying their thoughts and the way they are responding to them. Cognitive strategies are employed to help challenge, re-frame and re-focus unproductive, fear-based thinking. Psychoeducation and homework are often part of the treatment plan. We typically also spend time looking at self-care practices including daily routines, sleep hygiene, diet, and exercise habits.