We use a lot of different words to describe anxiety: worry, nervousness, stress, tension, panic, feeling overwhelmed, traumatized or wound-up. Stress is a part of daily life; everybody has their share of stress no matter how simple their life might seem. In psychotherapy we deal with stress when 1) it has become chronic, 2) it has become too intense for the types of events that people are dealing with, or 3) stress becomes so frequent or intense that personal coping skills are no longer effective. The difference between daily stress and clinical anxiety is one’s level of functioning.

Anxiety disorders are the number one health problem in the United States today. Although 15% of Americans deal with an anxiety disorder yearly, only a fraction of them get help. There is a wide array of anxiety disorders, some more common or better known than others.


A panic disorder occurs when someone has one or more panic attacks and becomes extremely worried about the panic attack for a long time after. Panic attacks are very frightening to most people, even though they tend to be fairly short (about 10 minutes or less). Common signs of a panic attack are:

Feeling smothered or short of breath, heart pounding or racing, dizziness, feeling faint, trembling or shaking, feeling of choking, sweating, hot flashes, nausea or abdominal distress, feeling as if things are not real, numbness or tingling, chest pains, fears of going crazy or losing control or dying.

Most people will describe feeling an immense sense of dread and doom. The first few times panic attacks occur, they seem to come out of the blue. After awhile, many people will find that specific situations and events can trigger an attack. Out of fear of developing a new attack, people who suffer from panic attacks may start to avoid places that trigger anxiety, especially places from which they believe escape will be difficult. If taken to an extreme this can lead to something called agoraphobia (fear of public places). Panic disorder can appear at any age, but it usually first appears between late adolescence and mid 30s.

Generalized Anxiety Disorder (GAD)

GAD is characterized by chronic and pervasive worry. Individuals who suffer from GAD are constantly anxious. They worry about a number of topics (their safety, their family’s safety, bills, the house, dying, health, relationships, the news, etc) and have little control over their anxious thoughts. Their worry is long term, and it tends to generalize itself from one issue to another. People with GAD will also complain of difficulty concentration and focusing, irritability, feeling restless, fatigued, muscle tension and difficulty sleeping. GAD tends to occur in combination with mood disorders. It is very tiring, frustrating and overwhelming to worry constantly, and that can lead to depressed moods over time.


The good news is that anxiety as a whole is very amenable to psychotherapy. A number of interventions can be used both in therapy and in daily life to help reduce and even eliminate anxiety. Steps to improve anxiety include: revising how your mind perceives the world, facing fears (progressively, and therapeutically) and learning how to control your body’s physiologic reaction to anxiety. Deep breathing and relaxation techniques are a wonderful way to immediately address stress and are extremely effective if practiced regularly.

Other steps one can take include the following:

  1. Be aware of the events and people in your life that may be causing tension or worry

  2. Be aware of your body (sleep, tension, headaches, changes in appetite)

  3. Be aware of your general mood and state (fatigued, irritable, easily brought to tears…)

  4. Take action by trying to simplify your life as much as possible, by asking for help and support when necessary, by making sure you take time for yourself (at least 20 minutes a day should be selfish minutes), and by practicing relaxation on a daily basis. If stress and anxiety persist go see a professional.

Psychologists can help you identify the source of your anxiety and teach you how to manage and confront it. In some cases anxiety can significantly affect functioning, and medication might be necessary. Talk about this with your therapist or physician and get an appropriate referral to a qualified psychiatrist.

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