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Anxiety is commonplace and something we all feel to some measure throughout the week. Facing important events, sensing a threat or danger, can all produce mild and brief anxiety tension. However anxiety experienced by someone with an anxiety disorder is frequent, intense, and can be enduring, lasting several hours, or perhaps even days. Unfortunately many people live with anxiety before seeking help and it’s important to know the spectrum of anxiety disorders is effectively treatable.
Therapy is a collaborative process, where we work with you to identify specific concerns and develop concrete skills and techniques for coping with anxiety. You can expect to practice their new skills outside of sessions to manage anxiety in situations that might make them uncomfortable. Anxiety disorders are very treatable with most patients who suffer from anxiety able to reduce or eliminate symptoms after several (or fewer) months of therapy, and many noticing improvement after just a few sessions.
An unpleasant, intense and disturbing reaction that surfaces soon after witnessing or experiencing a traumatic distressing event such as a horrific event or natural disaster. Acute Stress Disorder usually occurs within a month of the triggering event, lasting at least 3 days and can persisting for up to one month.
While each of these anxiety disorders has unique characteristics, they all share the common foundation of:
Danger, either real or imagined, can activate our fight or flight response and lead to changing 3 systems of our functioning.
How does it work altogether? If you’re spending a great deal of time worrying about money (cognitive), you’re prone to feel on edge or nervous (physical), and might find yourself consumed with excessively checking your household budget and even daily or hourly monitoring investments (behavior).
Anxiety can be a tremendous burden with many sufferers finding themselves struggling at work, school or even just at home from anxious, sometimes obsessive and negative thoughts that haunt for unpredictable lengths of time. Some of the more common feelings that are caused by anxiety are feelings of nervousness, dread, panic, confusion and general worry. Even temporarily co-existing with these feelings can be tormenting – and it doesn’t have to be as anxiety disorders are both the most common and most treatable mental illness.
For most of us, experiencing symptoms of anxiety are occasional, brief, and non disruptive to our lives. But when any of the symptoms of anxiety are persistent and intense, disrupting your ability to manage daily tasks, study, work or socialize it’s likely at the level of being a disorder.
It may not always be easy to tell if your everyday anxiety has become an anxiety disorder as it can manifest in many forms. However, feeling anxious persistently or for brief but intense episodes, which strike for no apparent reason are common signs of anxiety being at the disorder level. Examples of specific symptoms are as follows:
Regardless if anxiety manifests in psychological (worrying) or physical (racing heart) symptoms, it’s problematic when it is unexpectedly severe or lasts longer than anticipated after a stressful situation has ended.
There are no clear-cut reasons as to why some people develop anxiety disorders while others don’t, however research has indicated that several factors may be involved. Similar to most mental health issues, anxiety disorders appear to result from a combination of psychological and biological factors, along with challenging life experiences, including:
In sum, the precise causes of anxiety disorders in each case are not completely understood but likely emerge from a combination of factors including psychological and developmental, genetic, and environmental.
“Cognitive behavioral therapy (CBT) is considered the gold standard in the therapeutic treatment of anxiety disorders “ – Cognitive Behavioral Therapy in Anxiety Disorders: Current State of the Evidence
Most experts agree that the most effective treatment for anxiety is cognitive-behavioral therapy. Cognitive-behavioral therapy is a problem-focused approach to treatment based on the cognitive and behavioral aspects of anxiety disorders.
Through weekly sessions your symptoms of anxiety are assessed within a cognitive-behavioral framework, and the goals and tasks of therapy are established. As the therapy progresses, behavioral and cognitive tasks are assigned to help you with the anxiety disorder learn skills to reduce anxiety symptoms. As the symptoms improve, we’ll focus on underlying issues that may pose a risk for “relapse,” (the return of symptoms).
A standard component of cognitive-behavioral treatment is exposure therapy, which involves gradually exposing you, either directly or through your imagination, to the feared situation that triggers anxiety. For example, the person who has a fear of dogs will be asked to spend some time with dogs.
The rationale behind exposure therapy is that by practicing exposure to their fears, people have the opportunity to learn that their fears are excessive and irrational, and that the anxiety decreases with more and more practice. This process is called habituation. Because facing fears is hard for a great many people, exposure therapy generally starts by exposing the person gradually and to situations creating mild symptoms of anxiety, and ‘ladders up’ to exposing the person to moderate situations of anxiety and eventually onto severe situations of anxiety.
With cognitive-behavioral therapy, coping skills are incrementally developed and strengthened. In the case of someone who fears dogs, therapy may begin with the person discussing dogs, then progress to the person looking at photos of dogs, watching movies that showcase dogs and watching dogs from a distance, until eventually he or she can approach and pat different types of dogs. These situations start to elicit less and less fear with repeated exposure and as the new coping tools are learned and adopted, the disorder subsides.
The time it takes to experience progression in therapy depends on the severity of the fear, the circumstances around its origin, and your ability to tolerate incremental levels of discomfort associated with arousing your anxiety.
An essential part of cognitive-behavioral therapy in treating anxiety disorders is helping you identify, probe and ‘course correct’ any tendency to overestimate perceived threats along with any sense that you are unable to cope with the situation.
Cognitive strategies are formed coupled with exposure therapy to help you recognize thoughts, beliefs, attitudes, and appraisals can produce and sustain anxious states. For instance, people fearing dogs may have the mistaken belief all dogs are dangerous, based on an earlier experience with a single dog bite.
Over the course of treatment you’ll develop skills that enable you to identify anxiety-related thoughts, any common distortions in your thinking, examine the evidence validating or invalidating your fear, and apply less-threatening alternative reactions to the object or situation of your fear.
Building a bond of trust and a healthy therapeutic relationship are essential in treating anxiety disorders because we know you can feel vulnerable talking about what makes you anxious. For this reason we get to know you as an individual rather than through the lens of your anxiety. We want to hear your story, find your strengths and give you a voice in the process of deriving an effective treatment plan as we recognize you as an individual.
While an anxiety disorder can be challenging to overcome, the good news is we can help you work through it. In a nutshell, cognitive-behavioral therapy can shift negative thought patterns in order to positively affect how your response to all you’re going through and that’s top of mind. Our practice offers online counseling (telehealth) services to help you identify and understand your anxieties.
We enable you to receive confidential guidance from experienced, licensed, master’s-level counselors using HIPAA-compliant software, online right from the privacy of your own home or office.
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