What is Anxiety?

Everyone gets nervous sometimes, and some of us are nervous a lot! It’s important to know when the nervousness is at “normal” healthy levels, and when it crosses over into being something that is diagnosable (but therefore treatable).

If you’re nervous about an upcoming presentation, meeting someone new, driving to a place you’ve never been or are experiencing something very important and impactful to your future like a job interview, it can be helpful and healthy to be a little bit nervous. It can push you to prepare more effectively before those big events or to pay more attention and be more focused in the moment.

The Diagnostic and Statistical Manual of Mental Disorders (DSM) now on the 5th edition is our diagnostic “bible” of sorts. All of the current possible diagnoses related to mental health, developmental and substance use disorder are located in this manual that is just under 950 pages long. This manual is always under review and as new research comes out, diagnoses are amended, removed or added over time.

Let’s talk more about the clinical definition of Anxiety and what some signs and symptoms are that can help you know if it’s time to get help from a professional.

The DSM-5 describes anxiety as “…the anticipation of future threat.” It goes on to say that “…anxiety is more often associated with muscle tension and vigilance in preparation for future danger and cautious or avoidant behaviors.” Anxiety can manifest in a variety of ways with a variety of symptoms. Common anxiety disorders include Separation Anxiety Disorder, Generalized Anxiety Disorder, Specific Phobias, Social Anxiety Disorder, Panic Disorder, Agoraphobia, and Substance-Induced Anxiety Disorder.

Let’s dig into Generalized Anxiety Disorder (GAD) as it’s one of the most commonly diagnosed mental health conditions in the United States. Symptoms of GAD are:

• Excessive anxiety or worry occurring more days than not for at least 6 months about a number of events or activities

• Difficulty controlling the worry

• Worry associated with 3 or more of the following: restlessness or being keyed up/on edge, easily fatigued, difficulty concentrating or mind going blank, irritability, muscle tension, sleep disturbance (difficulty falling or staying asleep)

• Anxiety or worry and physical symptoms cause clinically significant distress or impairment in social, occupational or other areas of functioning

• The anxiety is not due to the effects of a substance or medication

  Other facts about anxiety:

• Twice as many females as males experience generalized anxiety disorder

• The median age for diagnosis of GAD is 30, though it can begin earlier or later

• Physical symptoms often accompany GAD including sweating, nausea, diarrhea, exaggerated startle response, muscle aches or soreness, trembling, accelerated heart rate, shortness of breath, dizziness, headaches or irritable bowel syndrome.

If you’ve been experiencing any of these symptoms - there is help. Treatment for GAD is via talk therapy, medication management or a combination of both. The gold standard of treatment for GAD is Cognitive Behavioral Therapy, or CBT. CBT helps you to identify and understand how your thoughts, emotions and behaviors are all linked together. When irrational thoughts are present in your mind, often negative effects come from this. Learning to identify, stop, and change your thoughts that are negative or irrational is a focus of CBT. Many therapists (including me) use CBT. It is also utilized for other diagnoses such as depression or helping people make changes with other behavioral or physical health problems as well.

I want to leave you with one thing that I often teach my clients that helps GAD - a grounding technique. I call it 5-4-3-2-1. In practicing it you’ll either think of, write down or speak out loud 5 things you can see in the room you’re in or an imaginary place that you’d like to be in right now. Then 4 things you can touch, 3 things you can hear, 2 things you can smell and 1 thing you can taste. In doing this, it brings you into the present moment and out of your thoughts which may be rapid, negative, overwhelming or repeating unnecessarily. It also helps to bring you in touch with your body - with physical sensations of touch, taste and smell. This technique can be used anytime you need it - while driving, while in a room full of people, when trying to fall asleep or after awakening from a nightmare.

If you or someone you know may have anxiety - reach out to a professional and encourage them to do the same. Treatment works and you can lessen your symptoms and learn ways to be calmer and more grounded and present in the moment, no matter the circumstances.

How the heck do I blog anyway?

I decided that I wanted to write a blog for my website. This year I’m making conscious choices to do things that are super new to me - quitting my job as a director at a local agency after working there for over 14 years, opening my own business, creating business cards, figuring out referral sources, creating a website all my myself, learning what SEO is (halfway at least) and realizing that people blog and maybe I should too?

---

I created my social media sites for Yellow Tree Counseling, LLC, but just cannot keep up with them if I’m being honest. I suppose being honest is a good thing, though it is sometimes super scary. Same with CHANGE. Something I always used to avoid. I’m at a place in life where I want to try new things, take some calculated risks and find more joy and fulfillment in life as a whole. You know, just what everyone everywhere is searching for since the dawn of time.

No big deal, right?!

---

I want this to be a space where I write about things that are therapy and mental health related. I want to normalize seeking help and talking about mental health. I want to share funny things, contemplative things, ways of coping that may help you in a moment of need - things that are meaningful to me and those that I aim to help through my therapy practice.

---

So, welcome. Welcome to this space and thank you for sharing in it with me.

Things Your Therapist is Thinking…

I’m going to let you in on a little secret - we therapists are human too! I know, it’s shocking, but stick with me here.

It’s true that while we’re sharing wonderful insights, reflecting feelings, validating your experience and overall sounding so professional (on a good day) - we’re just human beings sitting there with you. Here are some things we are thinking before, during or after our sessions.

• You’re my favorite/least favorite client.

• I wasn’t looking forward to/super looked forward to our session today.

• You’re a cool human - I wish we could be friends.

• Did I remember to run the dishwasher/turn off the iron/feed the dog this morning?

• I hope I don’t yawn…don’t yawn…don’t yawn…dang I hope they didn’t just see me yawn.

• I’ve totally felt that way too. Actually, you handled that situation a little better than I did!

• I lost someone I loved too, now I’m missing them and I hope you don’t see my tears coming.

• Oops, I said something pretty stupid there. I hope that didn’t wreck our relationship. I will rehearse how to bring this up next time, or apologize when we meet again.

• I have no idea what to say to you right now in this moment.

• You’re sitting in my chair, but I will act as though there’s no such thing as my chair.

• I wish I could punch your dad/mom/grandfather/grandmother/brother in the face for how they treated you.

• I think about how to help you or what interventions will work best in the most random moments outside of our sessions.

• I love seeing your dog/cat/baby/sibling/family when we’re using telehealth.

• I love the decrease in power differential and increase in connection that telehealth provides. I get to meet you in your space with your own comfort items nearby and it’s such a beautiful thing to see into your space.

• I still think about clients I’ve lost to overdose deaths or other causes randomly all the time - even years later.

• I hope you can’t tell that at times I doubt myself as a therapist.

• When you say, “I never thought of it that way”, I get very excited.

• I want you to see yourself the way I see you - as strong, smart, resilient, capable, insightful, funny, and all the other positive things that you typically deny about yourself.

• Your dad/mom/caregiver was wrong in how they treated you - you deserved better and I’m devastated that you didn’t get what you needed.

• My silence is purposeful - you need to hear yourself and I can actually see your gears turning right now.

• I sometimes have no answers for you - not even half of a quarter of a fraction of an answer.

• I wish I could give you the gift of magical healing - poof - the problem you came here with is solved!

• I’m so often overwhelmed with gratefulness that you’re choosing to share the deepest parts of yourself with me, and that I have even a small part in your healing - this is so endlessly amazing to me.