What is anxiety?
Anxiety is the experience of fear or discomfort in response to things real or imagined. Life presents all sorts of stressors. Anxiety occurs when it feels difficult to be with or relax with these stressors or worries. Anxiety often manifests as a fear of what’s yet to come. Anxiety often occurs as worry about everyday situations. In the psychological literature, there is a multitude of diagnosable anxiety disorders. For example, Generalized Anxiety Disorder is a diagnosis given to people who worry excessively about everyday things. Panic Disorder occurs when people persistently experience panic attacks. Obsessive-Compulsive Disorder manifests as obsessive thoughts and behaviors. And some people experience specific phobias. Specific diagnoses aside, most people experience some level of anxiety in their lifetime.
Who gets anxiety?
An estimated 18.1% of the U.S. population suffers from some type of anxiety disorder. Whether you have a diagnosable disorder or not, it is common to experience mild anxiety. Most of my clients are Millenial or Generation X aged professionals in San Francisco. Some common forms of anxiety I see people come in with are: 1) social, 2) work-related, and 3) existential.
Social Anxiety
Social anxiety can happen for anyone and can be particularly acute for people who didn’t have stable relationships growing up and/or received negative messages from family and peers. And in the modern era of social media and dating apps, many people are left with a longing to connect mixed with a sense of disconnection. Whether you’re looking to improve friendships, dating/romantic connections, family relationships, or work connections, I can help you get what you want by helping you notice the thoughts that are getting in the way; I can also help you learn the skills you need to connect better.
Work-Related Anxiety
I work with a lot of ambitious professionals who care deeply about having a successful career. The workplace can trigger anxiety for a multitude of reasons. Most people want to feel a sense of financial stability, and they sometimes fear losing that. Many people desire to perform well and to be perceived by coworkers/bosses as competent, but they fear failure. In addition, people’s sense of self-worth is often caught up in their position/title at work.
I understand that you likely want to make good money, feel a sense of accomplishment, and feel a sense of value. Together we can look at the fears and thought-patterns that are getting in the way. And we can help you find a sense of self-value outside of your job title.
Existential Anxiety
The Dalai Lama is known to regularly meditate on his own death. Perhaps he does this as a way to become comfortable with the inevitable. Whatever you believe happens after death, the impermanence of your current unique body and life is inevitable. Many people, as they contemplate this fact, want to make sure they live a life full of purpose; they want to make sure they take advantage of the gift they’ve been given. For many people, it can become hard to see the point of their lives. OR, they might have the sense that they’re wasting their energy/time. Together we can take stock of your life and your beliefs. Perhaps there’s a way to shift your perspective that would be helpful. Perhaps there is an actual shift in your life that you’ll be inspired to make as a result of our work together.
How do I know if I have anxiety?
Here are some signs you might have anxiety:
Excessive worrying about things you have no control over.
Restlessness: People will often describe having a feeling of being on edge or having an “uncomfortable urge to move”.
Physical agitation: Anxiety can present in the form of physical symptoms such as sweaty palms, shaky hands, or a racing pulse.
Difficulty Concentrating: It may feel difficult to keep focused on a task and stay productive.- Sleep Problems: It may be difficult to fall asleep. One may also wake up in the middle of the night and have a difficult time going back to sleep.
Irrational Fears: While some people have specific phobias - heights, spiders, etc., others may begin to feel irrational fears as a result of everyday situations.
Avoiding social situations: This is particularly relevant for those experiencing social anxiety. You might find yourself avoiding social situations altogether to avoid discomfort.
Panic Attacks: An estimated 22% of American adults experience a panic attack at some point in their life. A panic attack can be characterized by being overwhelmed by fear, shortness of breath, an increased heartbeat, shaking, nausea, and an intense fear of dying or losing control.
Irritability: People often report feeling a high level of irritability when their anxiety is at its worst.
Natural Ways to Reduce Anxiety:
A healthy diet: A diet rich in whole grains, healthy meats, fruits, vegetables, and nuts is helpful in achieving a stable mood.
Exercising regularly: Regular exercise, particularly cardiovascular exercise and strength training, can help calm one’s nervous system.
Meditation: A regular meditation practice can help calm the nervous system.
Yoga: Yoga has similar calming effects to meditation.
Limiting caffeine: Caffeine can often worsen feelings of anxiety.
Limiting alcohol consumption: Alcohol abuse is strongly linked with anxiety disorders.
Quitting smoking: Smoking is also associated with higher risks of anxiety disorders.
Being careful with drugs: While some people report that marijuana can help with their anxiety, for others marijuana increases anxiety. Stimulants like cocaine are known to increase anxiety as well.
Treatments for Anxiety:
As mentioned in the previous sections, there is a great deal one can do on one’s own to help with anxiety. But for many people, working with a mental health specialist can be extremely helpful. While medication from psychiatrists is an option, it’s recommended to start with talk therapy (what I offer). Some common types of talk therapy to treat anxiety include Cognitive Behavioral Therapy (CBT), Exposure Therapy, Somatic Therapy, and Mindfulness-Based Cognitive Therapy (MBCT). CBT can help shift people’s irrational or destructive thought-patterns to something more helpful. Exposure therapy is particularly helpful for people with phobias; people will be gradually exposed to things they are afraid of. Somatic Therapy will help focus attention on sensations in the body, allowing for deeper presence and emotional processing. MBCT incorporates guided meditation and combines this with cognitive restructuring work - challenging beliefs and/or thought patterns that aren’t working.
Impact of Untreated Anxiety:
When anxiety gets out of control it can make it difficult to perform regular tasks, be effective at work/school, concentrate, and maintain healthy relationships. Anxiety can also lead to other conditions like depression, insomnia, and various physical illnesses. Moreover, persistent anxiety is simply an uncomfortable state to be in. For those who want to live their most joyous and fulfilling life possible, dealing with one’s anxiety is imperative.
My Approach to Treating Anxiety:
I’m a person-centered psychotherapist with an eclectic approach to working with people. I see every person who comes through my door as a unique individual. The work we do will be uniquely catered to YOU.
Often I start sessions by guiding clients through a somatic meditation. The purpose of this is to rest in calm presence; the therapeutic work is best accomplished in this state of mind. It is a place that one can be trained to always come back to. One we’ve settled in and gotten present, we then start to look at the specific manifestation of the anxiety. Is it a general sense of anxiety? Is it triggered in specific situations? Is there a specific phobia? Are there panic attacks happening?
We’ll use an eclectic mix of CBT, Somatic Therapy, Gestalt Therapy, Parts Work, and MBCT to help you with your anxiety. Your beliefs and habitual thought-patterns may be challenged. You may develop a greater capacity to rest in mindful awareness. You may change your behavioral habits or life direction. The work will be catered towards your unique growth and development.
Treatment of Phobias:
As written before, Exposure Therapy is helpful for those experiencing specific phobias. For example, I once had a client who was afraid of driving alone and driving on highways/freeways. She was given weekly assignments to gradually get her more comfortable driving. It started with driving by herself on her own block. Then she drove with a friend on a road next to the highway. Then she drove with her friend for one exit on a quiet section of a small highway. And so on and so forth. This gradual process helped her gradually alleviate her fears. We can cater Exposure Therapy to whatever your specific fear or phobia is.
Dealing with Panic Attacks:
Many people come to me after having panic attacks and ask for specific advice on how to deal with them. There are a few techniques one can use in this difficult situation.
Breathing slowly and deeply: When you intentionally slow down your breath, it can help you relax and generally relieve the panic symptoms.
Stop and think: Sometimes taking a pause is helpful. Think to yourself what it is you most need in this situation.
Think positively: Focus on what there is to be positive about in this situation. Think about what would be helpful. Think about what you’re grateful for.
Resources For Further Reading/Learning:
Anxiety Disorders, NAMI: National Alliance on Mental Illness: https://www.nami.org/learn-more/mental-health-conditions/anxiety-disorders
Anxiety/Panic: Resources - WebMD: https://www.webmd.com/anxiety-panic/guide/anxiety-panic-resources
Anxiety and Depression Association of America: https://adaa.org/
National Social Anxiety Center: https://nationalsocialanxietycenter.com/mission-and-endorsements/