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Anxiety

Learn about the types and symptoms of anxiety and how therapy can help. Learn how to recognize and help someone having a panic attack.

If depression often occurs due to looking to the past and dwelling on the negative things that have happened, anxiety can be thought of as looking to the future and ruminating about all of the negative things that could happen.

Common types of Anxiety

According to the world health organization anxiety disorders are the most common mental health issue in the world. There are a variety of types of anxiety disorders, but the most commonly diagnosed types are as follows:

Generalized Anxiety Disorder is long-lasting feelings of nervousness and fear that don’t seem specific to a particular thing or situation.

Panic Disorder involves panic attacks often characterized by fear, trembling, and shortness of breath. Other anxiety disorders can be characterized by panic attacks as well.

Obsessive Compulsive Disorder is characterized by repetitive obsessions and compulsions. Different individuals have different focuses for their obsessions in this disorder and not all cases present the same. While some people do have the stereotypic impulses to wash their hands repeatedly or check the locks on their doors excessively, others may have compulsions to pray certain prayers after having a particular thought or eat foods in a particular way that disrupts their life.

Social Phobia which is intense fear of social situations usually handled by avoidance and isolation.

Specific Phobias are intense fears of specific things or situations. Often these fears are crippling and may cause you to avoid the thing or situations in which you are likely to encounter it. For example, someone who struggles with arachnophobia (fear of spiders) might avoid camping with their family based on a fear of coming into contact with a spider.

Post-Traumatic Stress Disorder is based on anxiety stemming from a serious or life threatening traumatic incident that happened to you or you witnessed. It can include flashbacks and nightmares about the traumatic incident among the other stressful symptoms.

Common Symptoms

There are some common symptoms that may be experienced with all anxiety disorders including:

  • Feelings of fear and uneasiness. These usually go beyond just worrying and may be very debilitating for the individual in their daily life.
  • Insomnia. People may feel like they are unable to “turn their mind off” in order to fall asleep.
  • An inability to sit still. You may feel inclined to fidget or feel like you have to keep your hands busy or stay distracted.
  • Muscle tension, headaches; other aches and pains. Often our bodies will tell us when something is wrong even before our minds process the issue, so if you are carrying the stress of anxiety by unconsciously clenching your shoulders for example, you might experience muscle tension or even headaches.
  • Gastro-Intestinal Symptoms. Similar to muscle tension, gastrological symptoms can be the body’s way of telling you that something is wrong. Untreated anxiety can have negative physical effects on the body such as nausea, heartburn, IBS, and even ulcers.
  • Dissociation. If you’ve ever driven home “on autopilot” and couldn’t remember how you got there, this is dissociation. In an anxiety disorder dissociation could happen when your anxiety is triggered so your mind “checks out” rather than facing the trigger or on the other end of the spectrum, the dissociation could go to the extreme in which the person loses touch with reality and feels they are reliving past trauma.
  • Panic Attacks. Panic attacks are incidents in which the sufferer is overcome by anxiety and terror. Panic attacks may strike without warning. Often, the person cannot explain why they feel so fearful or upset, so it can be challenging to calm down. People may even wake from sleep and have a panic attack. They can be triggered by specific situations and they may happen once or be recurrent. While they are very frightening while you are experiencing them, they are treatable.

Panic Attacks are usually characterized by several of the following:

  • shortness of breath or hyperventilation
  • A racing heart
  • Feeling dizzy, light-headed, or faint
  • Trembling or shaking
  • Feeling unable to breathe
  • Chest pain or discomfort
  • Feeling detached from your surroundings
  • Nausea or upset stomach
  • Sweating
  • Dry mouth
  • Numbness or tingling sensations in hands and feet
  • Feeling cold and clammy or overheating
  • Fear of dying, losing control, or going crazy

What can I do to help a loved one who is having a panic attack?

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Remember yourself that in a panic attack your loved one is not thinking clearly and may be in no immediate danger, but there is also something happening on a physiological level, so it can be very overwhelming and scary for them.

The biggest help for your loved one is for you to be present, calm, and non-judgmental. The panicking person may not be in a very reasonable state of mind, so don’t waste your time telling them reasons they shouldn’t panic. If they know what they are afraid of, they may be unable to emotionally detach from that particular fear; on the other hand, if they aren’t sure what is scaring them it also does no good to try reasoning. Telling the panicking person that there is nothing to be afraid of might feel invalidating in the moment, instead, try reminding them of their coping skills.

Coaching a person in the midst of a panic attack can be helpful such as encouraging them to breathe slowly and even counting with their breaths. You can help the person to have a seat and get comfortable, but follow their lead on physical touch. The person who is panicking may normally appreciate a hug, but when he is struggling to catch his breath it might feel suffocating. Others might feel supported or grounded to have you holding their hand or touching their shoulder in the midst of the storm. If you have a relationship with someone who has recurrent panic attacks, the ideal approach would be to talk with them about their experiences before a panic attack so you know how you can be most helpful to them.


How can therapy help?

In therapy we can help you to identify the triggers for your anxiety and develop your coping skills you can better handle your triggers. Your therapist may teach you relaxation techniques such as deep breathing, mindfulness, and progressive muscle relaxation.

In therapy we may also try to identify the underlying roots of the anxiety by processing the emotions and mistaken core beliefs that contribute to the problem. Most of the time the problem goes deeper than the trigger. We develop certain beliefs about ourselves and our world as we experience things based on how we perceive those experiences.

Each source of anxiety might have several roots or “associated channels” attached to a mistaken core belief. So for each mistaken core belief there are a number of memories that you may not even realize are fueling it. In therapy we can work to uncover the associated channels so you don’t keep getting stuck. See the example figure below.

We also teach skills to challenge your thoughts and beliefs. The first step is getting insight into the problem, but then we can help you with the tools to move forward and change your way of thinking.