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Worry vs. Anxiety

What exactly is the difference between worry and anxiety? Have you used phrases like, “That gives me anxiety?” or “I’m a natural born worrier?”

I often hear clients use words like worry or anxiety interchangeably but they represent distinct experiences that vary in intensity, duration, and impact on daily life. While worry is a normal response to life’s challenges, clinical anxiety is a diagnosable mental health condition that can significantly impair an individual’s well-being.

Worry, in its basic form, is a cognitive process characterized by apprehension and unease about potential future events. It is a universal human experience and can even serve a protective function by prompting individuals to plan and problem-solve and act. Worry becomes problematic when it escalates to excessive levels, leading to persistent rumination and an inability to control anxious thoughts.

Clinical anxiety, on the other hand, is a mental health disorder that goes beyond the daily concerns of life. It involves heightened and prolonged periods of worry that are often irrational. Generalized Anxiety Disorder (GAD), Social Anxiety Disorder, and Panic Disorder are examples of clinical anxiety disorders. These conditions are diagnosed based on specific criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

One key distinction is the duration and intensity of the emotional experience. Worry is temporary and often resolves itself as situations change or resolve. In contrast, clinical anxiety persists for at least six months and can significantly impact various aspects of life, including work, relationships, and overall quality of life.

Another differentiating factor is the physical and psychological symptoms associated with clinical anxiety. These may include muscle tension, restlessness, irritability, fatigue, and sleep disturbances. Individuals with clinical anxiety often find it challenging to control their worry, and the anxiety can manifest even in the absence of immediate threats.

Let me illuminate the differences with a personal example.  Recently my dog had to go to the animal ER. She needed 2 staples to close a wound.  My husband was waiting with her in the ER for about 3 hours.  I knew this wasn’t a life-threatening injury, yet, while they were gone, my thoughts were focused on her. “Was she going to be alright?”, “Would there be an infection?”, “How much was this going to cost?”.  During this time, I was still able to complete my normal activities for the evening. But my thoughts were fixed on my dog.  I had no physical symptoms, my thoughts were in proportion to the situation, and the rumination stopped once my dog was back at home and I knew she was going to be OK.

What do you notice about worries I shared above? They were all just thoughts. Thoughts we can control. Thoughts we can notice. Thoughts we don’t have to react to. Not all worry leads to anxiety. People who worry all the time forget that their worries are just thoughts

Recognizing the difference between worry and clinical anxiety is crucial for promoting mental health and seeking appropriate support. While occasional worry is a normal part of the human experience, persistent and overwhelming anxiety may require professional intervention, such as therapy, to help individuals regain control over their lives.

The Power of Positive Self-Talk: Easing Panic Attack Symptoms

 

The Power of Positive Self-Talk: Easing Panic Attack Symptoms

Panic attacks can be overwhelming and distressing, affecting millions of people worldwide. When faced with such intense anxiety, individuals may find solace in the power of effective self-talk. Self-talk is the internal dialogue we have with ourselves, and by learning to harness its potential, individuals can reduce the severity and frequency of panic attack symptoms. In this article, we will explore the importance of positive self-talk and its role in calming the mind during panic attacks.

Understanding Panic Attacks

Panic attacks are sudden surges of intense fear or discomfort, often accompanied by physical symptoms such as rapid heart rate, sweating, trembling, and shortness of breath. These attacks can be triggered by stress, trauma, or specific phobias. Often, individuals facing panic attacks experience negative self-talk, where their inner voice catastrophizes the situation, reinforcing their fear and exacerbating the symptoms.

The Impact of Self-Talk on Panic Attacks

The way we talk to ourselves can significantly influence our emotions and reactions. Negative self-talk can fuel panic attacks, leading to a vicious cycle of heightened anxiety. Conversely, employing positive self-talk can have a calming effect on the mind and body, interrupting the panic cycle and promoting a sense of control and security.

When we start to think about our thinking we can make a choice over the thoughts that we think. This is called metacognition. I like Merriam-Webster’s definition of metacognition: awareness or analysis of one’s own learning or thinking processes.

Techniques for Effective Self-Talk during Panic Attacks:

  • Acknowledge the Panic: Instead of denying or trying to suppress the panic, acknowledge its presence. Recognize that it is a natural response to stress and that it will pass.
  • Challenge Negative Thoughts: When negative thoughts arise, question their validity. Ask yourself if there is evidence to support these thoughts or if you are catastrophizing the situation. An example of such a question is: Is this thought really true? Replace these thoughts with more balanced and realistic affirmations.
  • Use Calming Affirmations: Develop a list of calming affirmations that resonate with you. Repeat them during a panic attack to counteract the negative thoughts. Examples include “I am safe,” “This too shall pass,” and “I can handle this.” “These symptoms will start to fade in 5 minutes”
  • Focus on Breathing: Concentrate on your breathing during a panic attack. Deep, slow breaths can help regulate your heart rate and bring a sense of calmness.
  • Visualize Peaceful Scenes: Practice visualization by picturing yourself in a serene and safe environment. Immerse yourself in the details of this mental scene to divert your attention from the panic.
  • Practice Mindfulness: Ground yourself in the present moment by practicing mindfulness. Observe your thoughts and emotions without judgment, letting them come and go like passing clouds.
  • Be Kind to Yourself: Avoid self-criticism and be compassionate toward yourself. Remember that experiencing panic attacks does not define your worth or strength as an individual.

Effective self-talk can be a powerful tool in managing panic attack symptoms. By challenging negative thoughts, incorporating positive affirmations, and practicing mindfulness, individuals can gain greater control over their panic responses. However, it is essential to remember that overcoming panic attacks may require professional support, and seeking help from a mental health professional is crucial for those experiencing severe or persistent symptoms.

The recovery process from panic attacks often involves a combination of psychotherapy and, in some cases, medication. Cognitive-behavioral therapy (CBT) is one of the most effective forms of therapy for panic disorder, helping individuals identify and change negative thought patterns and behaviors that contribute to panic attacks. Medications such as selective serotonin reuptake inhibitors (SSRIs) or benzodiazepines may be prescribed to alleviate symptoms and facilitate the recovery process.

 With patience, practice, and a nurturing internal dialogue, individuals can gradually reduce the impact of panic attacks and embark on a path towards emotional well-being.

Panic Attacks: Triggers and Their Half-Life

Panic Attacks: Triggers and Their Half-Life

Panic attacks can be debilitating and overwhelming experiences, often characterized by a sudden surge of intense fear and anxiety. These episodes can occur unexpectedly or may be triggered by specific situations, thoughts, or sensations. Understanding the triggers for panic attacks and their half-life (the duration of their effects) is crucial for managing and seeking appropriate support. This essay will explore common triggers for panic attacks and delve into the concept of half-life in relation to panic attacks.

Triggers for Panic Attacks:

  • Environmental Triggers: Certain environments can act as triggers for panic attacks. These may include crowded places, confined spaces, or situations that induce feelings of being trapped or helpless. Loud noises, excessive heat, or poor air quality can also contribute to heightened anxiety levels, potentially leading to a panic attack. I’ve often worked with college students who state being in a classroom setting primes their system for panic attacks.  They often sit closest to the door for a speedy escape if necessary.
  • Phobias and Fears: Phobias and specific fears can instigate panic attacks. Whether it’s fear of heights, spiders, or flying, the anticipation or encounter with the phobic stimulus can trigger a sudden and intense panic response. Anticipatory anxiety usually is the biggest culprit when exposure to a known phobia is imminent.
  • Stressful Life Events: Major life events such as divorce, loss of a loved one, job loss, or financial difficulties can significantly impact an individual’s mental well-being. These stressors can create a heightened sense of vulnerability and uncertainty, increasing the likelihood of panic attacks.
  • Traumatic Experiences: Individuals who have experienced traumatic events such as physical or emotional abuse, accidents, or natural disasters may be more prone to panic attacks. Trauma can create a hypersensitivity to triggers, making it challenging to regulate emotions and avoid panic attacks.The parasympathetic nervous system tends to be underactive because our brains are continuously perceiving threats. We never know when it is safe to give the all clear signal and calm down.
  • Substance Use and Withdrawal: The misuse or withdrawal from certain substances, including drugs, alcohol, or medications, can trigger panic attacks. These substances can disrupt the brain’s chemical balance, leading to heightened anxiety and panic symptoms.

Now that we know some common causes of panic attacks, what happens when we actually experience one? Panic attacks involve emotional and physiological characteristics with rapid onset episodes of intense fear or terror combined with a strong desire to escape, and fear of losing control or dying. This is accompanied by increased heart rate, dizziness, sweating, shortness of breath, and shaking. Sounds pretty intense and terrible.

The good news is, they do not last very long.

Half-Life of Panic Attacks: The half-life of a panic attack refers to the duration it takes for the intensity of symptoms to decrease by half. While panic attacks typically reach their peak within a few minutes, the residual effects can persist for a longer period. The half-life varies for each individual, depending on factors such as overall health, coping strategies, and access to support.

According to the National Institute of Mental Health (NIMH), panic attacks last about 10 minutes, from start to finish.  This means the worst is over after about 5 minutes.  While it can seem like an eternity to the person experiencing such debilitating episodes, knowing this fact can drastically help the person as they learn how to talk themselves through the episode in counseling. 

Clients learn to shift their self-care from, “I’m having a heart attack” to “This is going to end. I’m not dying. I can get through anything for 5 minutes.” (More on this in the second article in this series)

It is important to note that the concept of half-life applies more to the physiological symptoms of panic attacks rather than the emotional and psychological aftermath. The emotional impact and recovery from panic attacks can differ significantly among individuals and may require ongoing therapeutic intervention.

Identifying triggers for panic attacks and understanding their half-life is crucial in managing these episodes effectively. Environmental factors, phobias, stressful life events, trauma, and substance use can act as triggers for panic attacks. While panic attacks themselves may subside within a short period, the emotional and psychological aftermath may persist for longer. Seeking support from mental health professionals, utilizing coping strategies, and implementing self-care practices are essential for managing panic attacks and promoting overall well-being. NIMH cites that between 70-90% of people who seek treatment for panic attacks significantly improve. By increasing awareness and access to appropriate resources, you can overcome panic attacks and control them instead of them controlling you.

Mental Health Sources:

  • National Institute of Mental Health (NIMH): The NIMH is a reliable source for information on mental health disorders, including panic attacks. Their website offers comprehensive resources, research-based articles, and treatment options. It provides valuable insights into panic attack triggers and management techniques. [Source: https://www.nimh.nih.gov/]
  • Anxiety and Depression Association of America (ADAA): The ADAA is a nonprofit organization dedicated to promoting the prevention, treatment, and cure of anxiety disorders, including panic attacks. Their website provides evidence-based information, self-help resources, and access to support groups. It serves as a valuable source for understanding panic attack triggers and coping strategies. [Source: https://adaa.org/]

https://www.healthline.com/health/mental-health/how-long-do-panic-attacks-last#length

Online Counseling and Interstate treatment

Most people are surprised to learn that I transitioned to an online counseling platform long before a worldwide pandemic entered our lives.

Covid forced many therapists into the world of online counseling in order to continue to provide care and support for their current clients. A cross-country move prompted me to research the legalities, effectiveness and logistics of online counseling in order to offer continuity for my clients. 

During my training to receive my certification in TeleMental Health, I learned about how the online disinhibition effect can have a positive effect in building rapport quicker in an online setting versus an in-person setting.

Most people mistakenly believe they can continue counseling sessions while on extended trips or after an out-of-state move. However, that is not the case. The general rule across most states is that the therapist must be licensed in the state that the client is currently located. Notice the  distinction made between location and residence. It does not matter if the client has residency in the state the therapist is licensed in but where the client is physically located at the time of the session.

Unfortunately, most therapists used FaceTime or Zoom to continue counseling sessions. However neither of these platforms provide the appropriate ethical safeguards that ensure confidentiality.Not all online counseling platforms are the same.

While most people are accustomed and expect most therapists to offer online appointments in a post-pandemic world, it is important to make sure your therapist has taken the appropriate legal and ethical steps to safeguard your privacy and health information.

 

5 Ways to Sabotage Your Therapy

     By the time someone seeks out a therapist, a significant amount of struggle and pain has already occurred.  Most people have attempted to do something to make themselves feel better to no avail.  At some point, they realize that they could benefit from an outside person to help with their issue.  

     It is not always easy to pick up the phone and call for help. In fact, most people put it off as their symptoms worsen. They often hope things will just improve on their own without intervention or try and struggle to improve things on their own.

     It is no surprise that when people actually begin counseling that they inadvertently or even intentionally do things to sabotage their own success. After 20 + years experience in mental health counseling, I am covering 5 ways that clients sabotage their own counseling process.

1. No-Show your appointments.

     Yep, make sure not to give your therapist any notice.  Not only are you taking a slot away from someone who could have really used it had you given sufficient notice, but it completely disrupts the therapists schedule as well.

     Later when your therapist addresses it with you, avoid telling him or her the real reason such as therapy is becoming difficult, too vulnerable or hard work but that you had to feed your cat. (yes, I was actually told that once.)

 2. Withhold relevant information.

     Of course it takes time to build trust and rapport. I don’t think any therapist would expect their client to share their darkest and most painful stories on the very first session. However, sometimes clients can play games with their therapist in an effort to avoid doing the hard work by saying things like, “Well you never asked me that so I never told you.” 

     Counseling is a collaborative process between therapist and client. Both must work together.  Contrary to popular belief, therapists really are not mind readers. Counseling has a beginning, a middle and an end.  If you want to have a mutually satisfactory outcome then sharing all the relevant bits of your situation are essential.

3. Ghost your Therapist.

     Therapists are a compassionate bunch. We truly do care what happens to you and we wonder how you’re doing when you suddenly just disappear.  Please if counseling isn’t going as you hoped or if it’s just getting too difficult, please communicate with your therapist and let them know. They can pace the sessions so that you feel more comfortable and engaged in the process. It’s okay to even take a break from counseling for a while.

4. Blame therapist for lack of change.

     This one is a bit two sided. If your counseling experience is one in which you just vent about your week, you will not experience change, at least not lasting change. And you’re definitely not building new skills to solve the problems that you’re having and  symptoms will persist. You might feel better temporarily but you won’t experience results. So if you are not making any progress because of a dump session style of counseling then responsibility for the lack of change truly lies with the therapist.

     If indeed your therapist is giving homework, improving coping skills, and increasing insight and you are not experiencing change, consider if you have not been giving your therapist adequate feedback.  In addition, take full ownership of your contribution to the problems that had you seek out counseling in the first place.

     It is important to shift your mindset of counseling to a “working with” model versus a “doing to” model. I always tell my clients that nothing magical happens within a counseling session but it is the work that is done outside of the appointment, during all the other days of the week, in which true transformation occurs.

5. Don’t do your homework.

     This ties in with the above example.  No one I have worked with has gotten better without doing some type of homework. When the pain of staying the same outweighs the pain of changing, that is when you will be willing to do whatever it takes to get better and stay better.

     So do you recognize any of these behaviors in your own past counseling experience? If so that’s a good thing. Now you can be aware of them and understand the resistance to change that is behind them. Once you are aware then you have the power to make different choices. Transformation does not come without doing the hard work. I wish there was an easy button. I wish there was some kind of fast pass. 

     But we didn’t come about our problems or symptoms overnight so likewise change doesn’t happen overnight. Remain committed. Roll up your sleeves and do the hard work. You’ll look back on your counseling experience and be glad for it. 

 

Are you really ready for counseling?

People have all kinds of misconceptions about what happens in a counseling session and I’ve heard it all. But this ONE concept must be woven into counseling if you want to experience results and end treatment successfully.

I Can’t Handle This!

             Anxiety speaks in its own language. Or rather it screams, “I can’t handle this!” Whenever we feel anxious, the underlying belief is that we are not fully equipped to handle the situation.  The common theme of anxiety-provoking thoughts are, “I can’t handle this!”  The resulting feeling is usually overwhelm.  I’ll address this shortly. When we are flooded by thoughts that we cannot handle our present or future imagined circumstances, anxiety is usually the resulting emotion. 

            Of course there is another way to react to anxiety’s unique language.  But first let’s look at this unique language.  Anxiety speaks in a language that isn’t always conscious to us at first.  From a Cognitive-Behavioral perspective we call these automatic thoughts.  Automatic thoughts are those first thoughts that occur after a trigger, usually a situation or event.  These thoughts fly under the radar. We are not consciously aware of them but we react to them almost instantly.  However, we are aware of the subsequent feelings of anxiety, overwhelm, and panic.  Our reactions are then fueled by these feelings. They trigger our alarm system (read more about that in the post here) and throw us into fight, flight or freeze.  From there physiological symptoms develop like increased heart rate, sweating, shaking, and agitation. 

            Anxiety wants to avoid the situation at all costs.  We want to run and get away as quickly as possible.  That is our natural inclination.  We don’t live in an age where we are in fear of being attacked by a saber-tooth tiger.  Often it is modern-day stress that triggers this response. Instead of fight, flight, or freeze, I would propose we focus; to immerse ourselves in the situation through acceptance of what is. That doesn’t mean we have to like it.  If we get a flat tire in the pouring rain at 2 a.m. that doesn’t mean we are to enjoy the situation but to simply accept it and be mindful of the task of replacing the flat tire or calling roadside assistance in my case .

             Overwhelm is when we believe too much is expected of us or there is too much to do and not enough time or resources to accomplish what needs to be done. A more specific definition of overwhelm is to be completely surrounded in or buried by. We just exist in our surroundings. For example, a fish is completely surrounded by water. It simply exists in its surroundings. The fish doesn’t wish for something different. Whether the water is smooth or rough the fish must exist within it.  So it is with us, our current situation is the water that we swim in.

 

             On the other hand, frustration is the belief that things are not the way they should be. So let’s flip this on its head for a minute and consider that things are always exactly as they should be. Because whatever you are experiencing is your current reality so therefore things are exactly as they should be because it is what it is. It isn’t any different no matter how much you want it like it to be.

 

             Most of our problems or struggles are a result of errors in thinking. And when we start to differentiate our thoughts from the truth we begin to accept our current reality, no matter how unpleasant it might be. A new way of thinking will naturally be met with resistance but over time our brain will generate a new dialogue with ourselves. We experience a release of the resistance to our situation. Our language then begins to change to, “I’m exactly where I should be right now.” “I’m right on schedule”. Telling yourself, “I’m late” only increases anxiety and doesn’t get you to your location any quicker.

 

             When resistance to our current situation decreases and we come into alignment with our current reality we experience more ease with the bumps and bruises of our day. We aren’t so easily rattled and thrown off. We simply accept what is. We remain grounded despite our circumstances. That doesn’t mean we like it but we are in alignment with our current reality.

 

             The next level after that is to then consider what this current situation is there to teach us. One one of the biggest shifts in thinking can be to change a simple preposition. Instead of thinking something is happening TO you consider that something is happening FOR you. What is this situation growing in you? Is it patience? Is it increasing frustration tolerance? Self-control? or confidence in yourself that you can handle difficult situations.