Counseling for Anxiety Disorders

Everyone feels anxious from time to time. Occasional anxiety is a normal part of life. Constant or chronic feelings or anxiety or anxiety that lasts longer than just being in the midst of dealing with a problem at work or school, before taking a test or a big event you want to go well, or before making an important decision, however, can become disabling. In that case, it is important to seek help so that anxiety does not control your life and lead to more serious health conditions later on. If you are looking for counseling to help with your anxiety disorder in Yucaipa, Redlands, or anywhere in the Inland Empire, anxiety disorder therapist Dr. Pam Perez can help. We can also provide phone and video sessions if needed. Contact us today to schedule your free consultation.

Common signs and symptoms of anxiety include:

  • Feeling nervous, restless, or tense and on edge
  • Having a sense of impending danger, panic or doom
  • Irritability; feeling agitated
  • Having an increased heart rate
  • Breathing rapidly (hyperventilation)
  • Sweating
  • Trembling
  • Muscle tension
  • Feeling weak or easily fatigued
  • Trouble concentrating or thinking about anything other than the present problem or worry; feeling mentally numb
  • Having trouble sleeping (falling or staying asleep, restless sleep)
  • Experiencing gastrointestinal (GI) problems  (including appetite loss)
  • Having difficulty concentrating or controlling feelings of worry
  • Having the urge to avoid things that trigger anxiety

What are Anxiety Disorders?

For a person suffering with an anxiety disorder, anxiety tends to worsen over time rather than let up after a problem has been resolved. Anxiety symptoms can be so distressing that they can interfere with normal daily activities and affect both mental and physical health to the extent that work, home, and social life are negatively impacted. Anxiety disorders not only the person suffering from anxiety but friends and family members as well. Needless to say, excessive anxiety requires swift treatment as symptoms tend to worsen over time in most cases if left unchecked.

Anxiety Disorder Causes and Risk Factors

Sometimes anxiety disorders result from medical conditions such as heart disease, diabetes, or thyroid problems. Some respiratory disorders can also cause significant anxiety. Other causes include significant life events such as trauma, war, or early childhood experiences. Certain genetic or environmental factors may also play a role in anxiety; brain chemistry is certainly an area of study when it comes to the role neurochemicals play in anxiety.

Contributors to anxiety and anxiety disorders include:

Stressful life events: Being involved in a highly stressful or life threatening event can certainly contribute to anxiety

Gender: Women tend to be diagnosed twice as often as men with these disorders, though both certainly suffer from anxiety

Family history: Anxiety disorders do tend to run in families, so how you grew up (early life experiences) and what you learned about coping with stress can definitely contribute to your anxiety

Medical conditions: Illness, chronic health conditions, traumatic health events can all play a role in anxiety

Substance abuse: Alcohol, drug use, and nicotine from smoking can also increase the risk of an anxiety disorder

Risk Factors for Anxiety Disorder 

Long term anxiety and panic teaches the brain to release higher levels of cortisol (a stress hormone). This often results in a heightened state of alert or feeling stressed and anxious. Headaches and depression are common, as are weight gain, difficulty concentrating, and sleep disturbances.

There are certain risk factors that can increase the risk of developing an anxiety disorder, including:

  • Trauma: Children or adults who endure abuse or trauma or witness traumatic events are at higher risk of developing an anxiety disorder at some point in life
  • Stress due to illness: Having a chronic or severe health condition or serious illness can result in significant stress and worry
  • Long-term or chronic stress: A major life event or chronic long-term stressful life situations can certainly trigger excessive anxiety — work stress, relational stress, a death in the family, or ongoing worry about finances
  • Personality: Certain personality types are more prone to anxiety disorders than others
  • Other mental health disorders: People with other mental health conditions (depression, ADHD, etc.) often also have an anxiety disorder
  • Genetic/environmental conditions: Anxiety disorders can run in families
  • Drugs or alcohol: Drug or alcohol use or misuse or withdrawal can cause or worsen anxiety

Some of the more common risk factors related to chronic anxiety can include the following mental and physical health conditions:

Cardiovascular system issues: Anxiety disorders can wreak havoc on your heart, leading to chest pain, increased risk of high blood pressure, and heart disease. Heart disease, in turn, can raise the risk of heart attack and stroke. Being in a constant state of fight/flight can also send adrenaline into your system, increasing your pulse and breathing rate, and making you feel on high alert constantly. This can weaken your immune system, leaving you vulnerable to colds, infection, and frequent illness. Your endocrine system suffers as well, resulting in a host of issues, including dizziness, fatigue, and other health conditions.

Irritable Bowel Syndrome: Anxiety definitely affects our excretory and digestive systems. Stomach pain, nausea, appetite loss (or overeating/stress eating) are common. A medical history that includes irritable bowel syndrome (IBS) is not at all uncommon in those with anxiety disorder. IBS can cause extreme abdominal distress, vomiting, constipation, diarrhea, and bloating.

Depression: While they are different conditions, anxiety and depression very commonly co-occur. Sometimes depression is triggered by anxiety, especially in the case of GAD (see below).

Other Co-occurring Disorders: Many who wrestle with anxiety also have other co-occurring disorders or physical illnesses that can make symptoms worse and dealing with their stress disorder more difficult. As with any illness or disorder, whether mental illnesses or a physical illness, it is important to seek appropriate treatment and find some relief. Common co-occurring disorders might include:

Anxiety Disorder Types

Not all anxiety disorders are created alike; there are actually several types of anxiety disorders (and anxiety disorder symptoms that go with them), including Generalized Anxiety Disorder (GAD), panic disorder, social anxiety disorder, and various phobia-related disorders. Whatever category you or your loved one falls into, mental disorders in this area can be extremely disabling and need to be taken seriously. Living with constant feelings of anxiety, excessive fear,

Listed below are only a few of the anxiety related mental health disorders. Anxiety disorders can also include obsessive compulsive disorder (OCD), post traumatic disorder (PTSD), selective mutism, separation anxiety disorder, substance induced anxiety disorder, and disorders related to specific conditions.

General Anxiety Disorder (GAD)

GAD is characterized by persistent, ongoing, excessive fear or worry about just about anything. Those suffering with GAD tend to have a sense of impending disaster much of the time; they feel overly concerned about finances, family, work, friendships and other relationships, their health, and other issues in their lives. These worries may be about actual or only about anticipated, possible events. In any case, the distress is very real.

This type of anxiety affects 6.8 million adults, or 3.1% of the U.S. population, in any given year, with women being the most impacted. It often begins in childhood and increases across the lifecycle. Research shows that there are biological and environmental factors related to GAD, particularly when and where stress levels are high.

When anxiety includes three or more of the above symptoms and is difficult to control on more days than not for at least six months, generalized anxiety disorder (GAD) is diagnosed.

Anxiety disorders like GAD do not go away on their own and require treatment from a professional who can treat and help you manage your anxiety. Medication management is often merited until symptoms are under control.

Panic Disorder

Those suffering with panic disorder have actual panic attacks. These anxiety attacks are sudden and intense “attacks” of intense feelings of anxiety, fear and danger, even when no danger is actually present. They are sometimes related to a specific phobia or intense fear of a person, place, or thing, but the person suffering from the panic attack may not know at the time of the anxiety attack what is causing it. The sensations experienced during a panic attack can last several minutes or longer and can be extremely distressing. Many people often believe they are having a heart attack because the symptoms are so distressing and often do mimic a heart attack. While a panic attack is not life threatening, it feels anything but! Panic attacks can include the following:

  • Hyperventilation – rapid, shallow breathing, dry mouth, as if the person cannot get enough oxygen
  • Dizziness – light-headedness, spinning (often due to hyperventilation)
  • Racing heart, chest pain – again, the rapid heartbeat in panic disorder is often caused by hyperventilation and stress (this is the fear of having a heart attack, which adds to the panic and increases the hyperventilation)
  • Sweating – coupled with the exertion of hyperventilation, the body releases stress hormones during a panic attack
  • Tingling (pins and needles) sensation – again due to hyperventilation
  • Fight/flight response – people feel agitated, irritable due to stress hormones being release during a panic attack

The best way to prevent panic attacks is to get treatment for what causes them in the first place. Your therapist can also teach you breathing and grounding exercises to help minimize or prevent them altogether. For very severe panic disorders, medication may be indicated.

Social Anxiety

Social anxiety is yet another stress disorder that can make daily life a major challenge for some people. Just the thought of being in social situations is enough to trigger anxiety, severe muscle tension, heart palpitations and/or chest pain, or other physical sensations related to feeling anxiety for sufferers. Those who struggle with social phobia (social anxiety disorder) have an intense fear of being in social situations, especially when there is a performance aspect involved. The fear of being negatively evaluated or judged by others is so overwhelming that they tend to avoid these situations when and if at all possible. Social anxiety can make a person’s life miserable as it can manifest in just about any situation, including the workplace, school, or any other environment when people gather.

Phobias

A phobia is an intense, persistent fear of something that poses little or not actual danger. Some common phobias include fear of spiders or snakes, flying in an airplane, being trapped in an elevator, or public speaking. Specific phobias depend upon the person and situation that produced it. Phobias tend to produce certain reactions in relation to the source of the object of your fear or the traumatic event related to the fear, such as:

  • Worsening anxiety when thinking about the object of fear as it gets closer to you in time or physical proximity
  • An immediate feeling of intense fear, anxiety, and panic when exposed to or even thinking about the source of your phobia
  • Awareness that the fear may be extreme or exaggerated but still feeling powerless to control it
  • Doing everything possible to avoid the object of your fear
  • Physical reactions/sensations due to the object of your fear (sweating, rapid heartbeat, tight chest, difficulty breathing)
  • Nausea, dizziness
  • In children, tantrums, clinginess, crying, or refusing to leave a parent’s side or approach object of fear
  • Difficulty functioning normally because of your fear

Agoraphobia

Agoraphobia is a type of anxiety disorder related to panic disorder. People with agoraphobia often struggle feeling safe in any public place, especially where there are crowds of people. Most people who have this condition develop it after having one or more panic attacks. Those with agoraphobia fear leaving their homes and so avoid places or situations that might cause them to feel panic, trapped, or helpless and bring on another attack in public. Many avoid using public transportation, being in open or enclosed spaces, standing in line, or being in a crowd, worries that it may be too overwhelming to handle, or so remain trapped in the confines of their home.

Anxiety Disorder Treatments

There are a variety of ways to treat anxiety. Exposure therapy is a common method for anxiety, as is talk therapy using CBT. I always start with working to get to the source of the anxiety and going from there. Lifestyle changes are certainly a great start. Taking stock of the things in your life that may be contributing to your anxiety is the first place to begin and taking a look of what needs changing will help your gain some control over it.

Lifestyle changes

Most of us live a pretty sedentary lifestyle. Regular exercise is not only good for your physical body, though; exercise helps your mental health by increasing oxygen to your body and brain so you can think more clearly and rest more comfortably – all leading to lower anxiety.

Insomnia is a common symptom of anxiety. Practice good sleep hygiene and make sleep a priority by:

  • Keep a consistent routine: try going to sleep at the same time each night
  • Avoid caffeine, heavy meals, and nicotine before bedtime
  • Keep your room dark and cool
  • Take time for winding down before bed by not using your phone, tablet, or computer in bed
  • Dim the lights before bed: don’t read or watch television in bed just before going to sleep
  • Avoid tossing and turning in your bed if you can’t sleep; it’s better to get up and go to another room until you feel sleepy
  • Write down your worries and tomorrow’s to-do list before going to bed

Diet and anxiety

Reducing your caffeine and alcohol intake is essential if you suffer from anxiety. Caffeine is definitely not your friend if you already suffer from the jitters of anxiety. Caffeine can actually increase feelings of panic and anxiety in those with panic disorder. While many use alcohol to calm down and relax, doing that instead of getting to the root of the problem will only lead to another one. Smoking is another problem: while smokers often reach for a cigarette when they are stressed, research shows that, not only does smoking contribute to heart and lung disease,  it only may actually worsen anxiety over time. Nicotine and other chemicals in cigarette smoke alter pathways in the brain that are linked to anxiety.

Psychotherapy

Of course I support this one! Talking through the issues related to your anxiety and getting the root cause that bring more than temporary relief: it can heal it. Cognitive behavioral therapy (CBT) is a method of psychotherapy often used to treat anxiety disorders. CBT focuses on the relationship between thoughts and behavior. It can equip you to change how you react to the things that cause you to feel anxious in the first place and choose healthier responses to those things.

Medication

There are several medications used to treat anxiety disorders that can be extremely helpful until your symptoms are under control. These may include anti-anxiety meds or certain antidepressants. Since some of these tend to work better for specific types of anxiety disorders, you will need to work closely with your health care provider to identify which one is best for you. I taught psychopharmacology for many years at the university level and can help you understand how these work so you can have a more informed discussion with your medical doctor if you would find that helpful. Some medications clearly have side effects that others do not. It is certainly worth exploring which one may work best for you as, in conjunction with talk therapy (psychotherapy), they can very definitely offer you the help and relief you need in many cases.

Pros and Cons of Anxiety Meds

You will need to allow your medical or a mental health professional to diagnose anxiety for you so that, in conjunction with talk therapy, you can get the medication you need to help alleviate it. Below are some of the more common meds used to treat anxiety disorders:

Antidepressants: While these are most often used to treat depression, a good number of them work quite well on treating anxiety. These work by helping improve the way your brain uses the chemicals that then improve your mood (thereby helping you better cope with stress/anxiety). Most prescribed are selective serotonin reuptake inhibitors (SSRIs) such as Lexapro, Zoloft, and others in this drug class. Pros: These meds can help improve mood, appetite, sleep, and energy level as they work on the neurotransmitter that most impacts these areas (serotonin). Cons: They can take several weeks to work. Need to wean off them gradually when ready to discontinue.

Benzodiazepines: These are drugs that are used only when absolutely needed and in the short term because they can be addicting; the body quickly builds tolerance to this class of medication. Benzodiazepines most prescribed are Ativan (lorazepam) or Xanax (alprazolam), or Klonopin (clonazepam). Pro: They work immediately. Con: High addiction potential.

Other anxiolytics: Buspar (buspirone) is in a class of medications called anti-anxiety medications. Buspirone is not related to other anti-anxiety medications, such as benzodiazepines, barbiturates, or other sedative/ anxiolytic drugs. Pros: It has less dependence potential and can be used to treat both short term anxiety or anxiety disorders. Cons: Not very effective for quick relief when it comes to anxiety attacks. It can take several weeks to be most effective. While it can be taken as needed, it is not as effective unless taken regularly.

Beta Blockers: While these are actually used to treat high blood pressure, they can also be used to treat some of the physical symptoms of anxiety such as palpitations. Common drugs in this class might include Inderal (propranolol) or Lopressor (metoprolol). Pro: They can be taken on an as needed basis to reduce acute anxiety. Cons: If you do take these regularly, you cannot stop taking them without weaning off gradually.

Stress Management Techniques

How we manage stress is a key element in dealing with anxiety. There are a variety of stress management techniques that can be helpful in lowering your anxiety. Some find prayer and meditation to be helpful; meditation is just one form used to calm the mind and body and may enhance the effects of therapy. Aerobic exercise has also been shown to help in managing anxiety. When anxiety levels are very high, however, these methods should accompany but not take the place of standard care for its treatment.