Unpacking Anxiety: How Therapy Can Help
Quick, shallow breaths. Clammy, shaking palms. Feeling like the world is closing in around you. We all experience anxiety from time to time — but what happens when anxiety becomes more than just a transient feeling?
An astounding number of people suffer from a clinical anxiety disorder every year: 40 million Americans, or approximately 18% of the country’s population. Thankfully, these disorders are highly treatable — but only 37% will receive the care they need to feel better.
If you’re suffering from anxiety, you can help shed this stigma by seeking treatment — and speaking out about your struggles. Here’s how therapy can help a person suffering from anxiety, and what to do when it doesn’t.
Experiencing occasional anxiety is part of what makes us human, but when anxiety becomes a near constant experience, it can be an alarm signal for a clinical anxiety disorder. Here’s how therapists tell the difference between normal anxiety and a clinical anxiety disorder.
Symptoms of Anxiety
Anxiety develops when the body’s fight-or-flight system goes into overdrive. When it gets stuck in overdrive, symptoms of an anxiety disorder can materialize. Some of those symptoms can include:
- Feeling nervous, tense or on edge
- A sense of impending doom
- Rapid breathing and/or heart rate
- Sweating and/or trembling
- Trouble concentrating
- Sleep disruptions
- Difficulty controlling worries
- Avoidance of situations or things that trigger these symptoms
In order to diagnose an anxiety disorder, doctors look for at least three symptoms, experienced more often than not for at least six months. When it comes to excessive worry, these worries must be clearly disproportionate to the scale of the problem at hand — and experienced as difficult or impossible to control.
Types of Anxiety Disorders
However, though we often speak of “anxiety” as one disorder, these symptoms can combine in any number of ways to form a variety of different clinical disorders. In fact, anxiety disorders are part of a broad category including (but not limited to) the following disorders:
- Generalized Anxiety Disorder (GAD) is what most people tend to think of when they imagine anxiety. Someone with GAD experiences worries about a wide number of areas in their life, as well as characteristic symptoms of physical tension or discomfort.
- Specific Phobias occur when a person experiences an intense, overwhelming of a particular situation or thing. A few of the most common phobias include agoraphobia (fear of open spaces), acrophobia (fear of heights), claustrophobia (fear of enclosed spaces) and arachnophobia (fear of spiders).
- Social Anxiety or Phobia refers to clinical anxiety occurring exclusively in social situations. A person with social anxiety may keep to themselves due to an excessive fear of judgment by others, and avoid situations in which they must speak, eat or perform in front of other people.
- Panic Disorder is diagnosed when a person experiences a pattern of panic attacks, followed by avoidance of situations or places that triggered a panic attack. When this pattern becomes severe, the person may present with agoraphobia. In Greek, this literally translates to “fear of the marketplace” — expressing the anxiety that someone with agoraphobia experiences in public places. As a result of their panic attacks, someone experiencing Panic Disorder with agoraphobia may seldom or never leave their home — unless accompanied by a “safe” person, or when headed to a “safe” place.
- Obsessive-Compulsive Disorder (OCD) is sometimes characterized as an anxiety disorder, though it comprises its own unique category in the DSM-V. A person with OCD experiences obsessions (intrusive, unwanted thoughts of a disturbing nature), and performs compulsions (repetitive, uncontrollable actions or mental rituals) in an attempt to ward off the compulsions.
Each anxiety disorder has its own unique criteria in the DSM-V manual, which therapists use to make a formal diagnosis of mental illness. Still, it’s important to note that not all people fit neatly into a category when it comes to anxiety. Some people may experience symptoms of a number of disorders, or even meet the full criteria for multiple types of anxiety. In fact, it’s completely normal to experience multiple disorders, such as depression, alongside an anxiety disorder.
Therapy for Anxiety
The first line of treatment for any anxiety disorder, no matter which you are experiencing, is always therapy with a qualified professional. Therapy can make a difference in your symptoms of anxiety by teaching you skills that help you cope with the various symptoms of your illness. Below, we go into further detail about ways that therapy can help a person with an anxiety disorder.
How Does Therapy Help Anxiety?
If you’ve never been to therapy before, you’ve never experienced the transformative effects a good therapist can have on your mind, body and spirit. Therapy can be helpful for anxiety in a number of ways, including but not limited to:
- Identifying triggers. When a person with anxiety first goes to therapy, it’s not uncommon for that person to be unaware of what’s causing their anxiety. A skillful therapist will guide you through exercises to help you discover what your triggers are, and how to cope with them in a healthier way.
- Developing coping strategies. Anxiety can be both physically and mentally uncomfortable. Therapists teach patients with anxiety distress tolerance skills, such as mindfulness and relaxation, so they can learn to cope with uncomfortable feelings. This prevents your discomfort from fueling further anxiety, breaking the cycle of worry and panic that perpetuates an anxiety disorder.
- Exposure to fears in a safe environment. It’s difficult to face your fears on your own — but with the help of a trained therapist, you can encounter situations and things you fear, knowing that you are in a safe environment with a qualified professional. Typically, these exercises take the form of structured Exposure and Response Prevention therapy, which we discuss in greater detail in the next section of this article.
- Unpacking trauma. Many people develop anxiety in response to trauma or adverse experiences, whether during childhood or adulthood. While anxiety is not a helpful coping strategy, when it’s the only one you know, our bodies tend to repeat the cycle they’re used to. A therapist can help you overcome your trauma to interrupt that cycle, breaking the pattern of near-constant anxiety, and help you to develop healthier ways of coping with that trauma.
- Normalizing your experience. But perhaps most importantly, therapists serve the essential function of reminding you that your experience with anxiety is normal. While not everyone feels anxious to the extent that you do, everyone experiences some anxiety from time to time. A good therapist will remind you that the anxiety you feel is normal — and that experiencing zero anxiety symptoms is never the goal. After all, anxiety is your body’s internal warning system! Without any anxiety whatsoever, you might take needless risks like reaching into the oven without a mitt on, or driving without a seatbelt. It’s difficult to have this kind of perspective when you’re in the middle of an anxiety attack, but a therapist can teach you how to get to the point where it’s possible for you to remember that anxiety can be your friend and ally, and help you make peace with your experience.
Types of Therapy for Anxiety
As we mentioned previously, therapy is the first line of treatment for any anxiety disorder — yet being faced with so many options for therapy can trigger even more anxiety! So, how do you determine which mode of therapy is best for you?
Only you can answer the question of which type of therapy suits your style. However, we can teach you what the different styles mean, helping you to navigate the dozens of options available to you — not to mention making it faster and easier to get the treatment you deserve.
Cognitive-Behavioral Therapy (CBT)
Cognitive-behavioral therapy, or CBT, was first developed by psychologist Aaron T. Beck, when he noticed that his patients were often plagued by their internal dialogues with themselves. As a result, Beck developed this mode of therapy to help patients with anxiety, depression and other disorders switch to a more positive way of thinking. Beck’s theory was that our thoughts influence our behaviors, and our behaviors influence our emotions — so, in order to feel better, we must first address the negative thoughts driving our anxiety. To this day, CBT remains a widely-studied (and extremely effective!) mode of therapy for treating anxiety disorders. Generally speaking, CBT is the first line of treatment for anyone presenting with an anxiety disorder — and especially Generalized Anxiety Disorder.
Exposure and Response Prevention (ERP)
Exposure and response prevention therapy, or ERP, is exactly what it sounds like: in a safe, controlled context, the therapist exposes the patient to their fears and helps them learn coping skills to prevent the negative behaviors they’re using to cope with those fears. Alongside the therapist, the patient develops a “fear ladder” of triggers for their anxiety. Beginning with the lowest-grade fear, the patient-and-therapist duo work together to tolerate the fear-inducing context for longer and longer periods of time, all while resisting negative coping strategies.
ERP has proven especially effective for specific phobias (including social anxiety disorder), and especially obsessive-compulsive disorder. For a patient with OCD in particular, ERP is typically the first line of treatment. In ERP for OCD, the patient will specifically resist engaging in their compulsions while being forced to tolerate situations that worsen their obsessions.
Mindfulness-Based Cognitive Therapy (MBCT)
Mindfulness-based cognitive therapy, or MBCT, reduces stress and anxiety by encouraging patients to take part in mindfulness activities. Mindfulness asks patients to stay grounded in the present moment. During mindfulness sessions, patients learn to take notice of their feelings without reacting to them, helping to reduce anxiety and depression. The therapist can then help the patient apply what they’ve learned during mindfulness and meditation to how they react to real-life situations.
Because it was originally developed for PTSD, MBCT is especially useful in patients with a comorbid mood disorder. For instance, MBCT may help patients with both anxiety and depression prevent a relapse of major depression.
Finding a Therapist for Anxiety
Finding the right therapist can be a bit like the Goldilocks story: it takes time to find the one that’s just right for you! Thankfully, there are many resources available to help you locate a therapist who specializes in the treatment of anxiety disorders – and, conveniently, you’re visiting the site of a solid residential treatment facility!
It’s important to understand the difference between the various types of mental health professionals who treat anxiety. Different kinds of mental health professionals have different types of degrees and experience. While the difference between them may be minimal – such as the difference between a Ph.D and a Psy.D – , there are other cases where you may want a professional with more experience.
Other Treatments for Anxiety
While therapy is the first line of treatment for any anxiety disorder, therapy unfortunately doesn’t work for everyone as a solo method of handling their anxiety. Some people struggle to complete the assignments given to them by their therapist. Others may find that the help they receive in therapy is not enough to combat the anxious thoughts running through their heads.
Here are some additional treatments that can be used in connection with your therapy!
When therapy fails to treat anxiety, the first step for most people will be medication. One family of medication, the selective serotonin reuptake inhibitors (SSRIs), is particularly effective in treating anxiety disorders. Examples of SSRIs used for anxiety include fluoxetine (brand name Prozac), sertraline (Zoloft) and escitalopram (Lexapro). For acute anxiety or panic attacks, a doctor may also prescribe benzodiazepines to take on an as-needed basis, but these medications require caution, since they may become addictive if used too frequently. Benzodiazepines include alprazolam (Xanax), diazepam (Valium) and lorazepam (Ativan).
It’s important to note that medication is most effective when used in combination with therapy. Still, depending on your therapist’s training and degree, they may not be able to prescribe you antidepressant or anti-anxiety medications themselves. Most therapists, however, have baseline knowledge about different types of psychiatric drugs. If they cannot give you prescription for medication themselves (as only psychiatrists, who possess an MD degree, can prescribe drugs), your therapist may at least recommend a drug to ask your doctor about, or even give you a referral to a provider who can help you obtain the medication you need to feel better.
Coping with anxiety is never easy, even with therapy and medication to help you. Sometimes, what you really need is a break from it all — and an inpatient treatment center can help.
Inpatient treatment can give you the space you need from the stresses of everyday life, allowing you to focus solely on recovery at a time when you really need it. There are two types of inpatient treatment for mental illness: hospitalization and residential treatment.
Hospitalization typically occurs when a patient is suicidal or experiencing another acute crisis. A hospital stay may last 4-5 days and is intended to stabilize the patient until they can be referred to a residential treatment facility or outpatient treatment.
In contrast, residential treatment typically lasts 60 days or more, and offers 24/7 staffing to monitor your mental health. During residential treatment, you will take part in group and individualized therapy sessions, therapeutic activities and other treatments designed to help you feel better so you can leave the facility feeling better than ever before.
The vast majority of patients with anxiety disorders who seek residential treatment have OCD or another debilitating phobia. However, any person can seek residential treatment for their anxiety if they feel they need it to recover.
Are you suffering from social anxiety? Is your life impacted by this intense form of an anxiety disorder? If so, you should know that you’re not alone and you don’t have to struggle alone. If your life and livelihood are affected by social anxiety, you can reach out to The Meadowglade in order to learn more about how we can help you!