Professional Anxiety Treatment

Written by: Ashley Gilmour
Clinical Psychologist

High levels of anxiety is very common, and there are many different types of anxiety conditions. The good news is that psychological therapy provides effective treatment for anxiety.Read below to learn more about anxiety including the signs & symptoms and anxiety treatment available with our Gold Coast Psychologist.

What is Anxiety?

WHAT IS ANXIETY?

Anxiety is the most common psychological condition among Australiansaffecting approximately 2 million Australians in any one year. This is about 1 in 4 people (1 in 3 women, and 1 in 5 men) who experience problematic anxiety symptoms. Anxiety does not discriminate; it affects anyone of any age, gender, race, nationality, religion, job status, relationship status. Anxiety tends to also commonly occur with depression. Everyone experiences some level of anxiety from time to time; it is normal to feel nervous in situations such as about to go into an exam or to have a job appraisal from your boss, to become a parent for the first time, for concerns about the health or welfare of a loved one, etc. For many people, this anxiety is short lived and once the temporary situation or stressor passes, the anxiety comes back down to normal levels. Normal levels of anxiety do not have too much impact on day to day functioning for the person.

However, for some people, their anxiety can be frequently high and they are debilitated by anxiety on a frequent basis, meaning that because of their anxiety, they find it really hard to do basic day to day things without having the discomfort of anxiety or worry running through their body. For some people, their anxiety can fall into the range of an Anxiety Disorder, for which there are many different types and include these below which you can read more about in the following sections:

• Obsessive-Compulsive Disorder (OCD)
• Generalised Anxiety Disorder (GAD)
• Social Anxiety Disorder
• Specific Phobia
• Panic Attacks/Panic Disorder
• Agoraphobia

OBSESSIVE-COMPULSIVE DISORDER (OCD)

Obsessive-Compulsive Disorder (OCD) is a condition that tends to quite commonly be confused by lay persons with an obsessive-compulsive personality style which when is severe enough, is diagnosed as a condition called ‘Obsessive-Compulsive Personality Disorder’. OCD is characterised by the experience of ‘obsessions’ which are intrusive thoughts that come into a person’s mind against their will and cause them significant distress, and ‘compulsions’ which are repetitive behaviours that a person will attempt to engage in as they believe that by engaging in this particular repetitive behaviour then what they fear is going to happen (the obsession) will be prevented or less likely to ocur. Obsessions are usually about harm occurring to them or befalling upon another person and may include a household appliance (iron, stove etc) not being turned off and catching fire, germs being on their hands which will contaminate them or someone else, having done something morally wrong such as having accidently hit a pedestrian with their car, the backdoor being unlocked which might result in an intruder coming into the house. Obsessions can also be about objects not being in a particular order. Compulsions do not always have to be a logical behaviour to prevent the feared situation (the obsession), for example a person with an obsession about germ contamination on their hands may not wash their hands to deal with this, but may deal with this by attempting to avoid stepping on cracks in concrete which is logicallyunrelated to the nature of the obsession. The person will spend at least one hour of their day engaging in the compulsive behaviour. For some people they may even spend up to at least 3 hours a day on this. For the person with OCD, the engagement in the repetitive ritual temporarily relieves them from their anxiety as they feel that they have for now prevented the harm from occurring. They need to be able to fully complete their repetitive ritual in order to feel relieved. If their ritual is interrupted by someone or something, then they will need to start the ritual all over again, and this interruption of their ritual typically causes a lot of distress for the OCD sufferer. For a person who requires quite elaborate rituals as a form of anxiety treatment, this OCD behaviour can become quite psychologically draining for them and has significant interference with their daily functioning.
The various sub-types of OCD can include, but is not limited to:

• Checking
• Hoarding
• Order/Symmetry
• Morality
• Sexual/Religious
• Contamination/Washing
• Harming/Aggression
• Illness

GENERALISED ANXIETY DISORDER (GAD)

Generalised Anxiety Disorder is characterised by excessive worry about daily events. The person will find this worry difficult to control, and realise that their worry is unreasonable. Often these individuals will say something like “I know that it’s stupid to be worrying about this, but I just can’t help it” about their worries. They will tend to worry about anything and everything from traffic and parking, whether they will finish a task on time, whether they will be late to an appointment, if the kids are okay, the laundry that needs doing, how a particular up-coming situation is going to turn out, amongst many other worries. People with GAD worry about the same sorts of things that everyone else without GAD worry about, though they worry about these things much more frequently than non-GAD worriers, and find it much more challenging to turn this worry off. Because this worry tends to be there much of the time for the person, the physical body tends to respond with muscle tension, irritable mood, sleep issues, dry mouth, amongst other physical/somatic symptoms. People with GAD present with this level of worry for at least six months or more, however any level of excessive worry is enough to cause most people distress or concern, or interfer with their functioning.

SOCIAL ANXIETY DISORDER

Social Anxiety Disorder is anxiety for social situations where the person fears that other people are going to judge them negatively or that they will embarrass or humiliate themselves in front of others in some way. For some people, this fear of social situations can be so intense that they will attempt to avoid the feared social situations at all costs where possible and dismiss any anxiety treatment. If they have to go into the feared situation, they will tend to experience high levels of anxiety, and will try to exit the situation as soon as possible. These people will often try to have a ‘safety person’ – someone whom they trust and feel comfortable with, to go with them into the social situation. Commonly avoided social situations which cause anxiety can include shopping centres, parties, cinema, sporting events, dinner with friends of friends, amongst many others. Some people even have significant anxiety for non-face to face social interaction such as over the phone. For some people, their anxiety for the situation can get so high that they end up having a panic attack. From my clinical experience, not always, though commonly, people who suffer from Social Anxiety also tend to have low self-esteem and low self-confidence also. For some people, this Social Anxiety can be chronic stating that they were “shy” as a child. However, for some people, I find that they can previously have good self-esteem and self-confidence, and feel comfortable in social situations, however a negative situation then occurs e.g., workplace bullying or some other personal stressor which then results in the person developing a shift in their cognitive thinking leading to Social Anxiety symptomatology. It is also common for Social Anxiety to the associated with depressive symptoms, whether sub-clinical or clinical, and in my opinion this tends to be in part contributed to by the low self-esteem – it can be challenging to feel happy when you frequently do not feel good about yourself or feel other people are judging you in a negative way!

SPECIFIC PHOBIA

Specific phobia is where a person experiences anxiety for a specific situation. Common specific phobia situations can include: confined spaces (claustrophobia), heights (acrophobia), the dark (nyctophobia), spiders (arachnophobia), snakes (ophidiophobia), birds (ornithophobia), blood (homophobia), needles/medical injections (trypanophobia), amongst many others. For some people, it can be enough for them to just see pictures or photos of the object they have a phobia of to feel highly fearful. People with a phobia will attempt to avoid the situation at all costs, otherwise they will endure the situation with a lot of anxiety, and they may even have a panic attack. Specific Phobias can develop from when the person was little, or they can develop when the person is older. It is not always clear to know exactly what the situation was that caused the phobia to develop in the first place as many people find it difficult to report the specific time they developed the phobia as people tend to come for treatment for their phobia after a long amount of time suffering through it, usually after the point they get tired of having to live the phobia. However, psychological anxiety treatment for phobias are still effective without knowing the specific situation that caused the phobia.

PANIC ATTACKS / PANIC DISORDER

A panic attack is an intensely heightened state of anxiety/fear beyond that of heightened anxiety. During a panic attack, a person will feel a range of physiological symptoms in their body including:

• increased breathing rate
• increased heart rate
• pounding chest
• tingling sensations
• sweating
• dizziness or light headedness
• hot or cold flushes
• dilated pupils
• a need to go to the toilet
• Cognitions about that they are ‘going to die’, that they’re ‘losing control’ or ‘going crazy’, or that they feel they are having a ‘heart attack’

For some people, panic attacks can almost always occur when the person experiences a particular situation e.g., confined spaces, heights, etc. For other people, their panic attacks can come on unexpectedly at any time, in any place. Because panic attacks can be quite uncomfortable and ‘scary’ to experience for many people, especially when panic attacks are quite a new experience for the person and they do not really understand what it is they’re experiencing or why, the person can fear having upcoming panic attacks and thus avoid situations where a panic attack is likely to occur at all costs. For these circumstances, the person starts to have anxiety about anxiety, which is also called ‘meta-anxiety’ – or the fear of anxiety. For many people, panic attacks can be a frightening experience because it feels like they are going to have a heart attack or die, or because they do not know when the next panic attack is going to come on, thus lack that sense of control over it. Panic attacks can occur as solely part of a Panic Disorder, or they can be part of another condition such as Post-Traumatic Stress Disorder (PTSD), Social Anxiety, and Specific Phobia.

PANIC DISORDER WITH AGORAPHOBIA

Agoraphobia is where a person avoids situations that cause, or are likely to cause them panic attacks. This relates to the panic attacks being feared by the person as described in the section on Panic Attack/Disorder above. These people will otherwise endure this feared situation with high levels of distress and try to exit it as quickly as possible, or only go into the feared situation with a safety person. People with this fear of having panic attacks tend to have an exit strategy already in mind before they enter the situation in case they need to leave the situation immediately.

Anxiety Treatment

WHAT DOES ANXIETY TREATMENT WITH OUR GOLD COAST PSYCHOLOGIST INVOLVE?

Do you suffer from Anxiety? If your answer is yes, the good news is that there are effective psychological treatments available provided by our Gold Coast Psychologist that help to treat or reduce your symptoms of anxiety! One of the most effective psychological anxiety treatments is Cognitive Behavioural Therapy(CBT) which involves identifying your unhelpful thought patterns and beliefs, in addition to your behaviours that have triggered and maintain your anxiety. What your unhelpful thought patterns and beliefs are is likely to be different from anxiety to anxiety condition, depending on what your particular anxiety issue is. For example, someone who suffers from Social Anxiety is likely to have thoughts along the lines of “People think I’m weird” or “People are going to laugh at me”, where as someone with Generalised Anxiety is likely to have a thoughts along the lines of “What is my car runs out of fuel on the way to the shops, and then I have no money, and how am I going to get home? Who is then going to pick up my kids…….” And around it goes. Whereas someone with Panic attacks may have thoughts such as “What if I have a panic attack in this shop? People will notice and I’ll be humiliated, and I might not be able to escape”.

With all anxiety conditions, one behaviour that all anxiety conditions have in common is avoidance! Avoidance of social settings, avoidance of places where a panic attack could occur, avoidance of the object/situation phobia, avoidance of harm befalling, etc. All of this, the thoughts, the beliefs, the behaviours are unhelpful and maladaptive. They tend to maintain the anxiety issue and even make it worse! However, to the person suffering from anxiety, this is the best way that they know how to cope until they find a more helpful way of dealing with the anxious situations. CBT as an anxiety treatment helps the person to identify the unhelpful thoughts and behaviours, and to change these to those which are more helpful, in order to challenge the underlying beliefs. Part of this behavioural work can also include what we call “Exposure Therapy” which is where the person, in a safe manner, gradually confronts the feared situation in order to challenge the belief that is driving their anxiety and overcome their fears.

For some people, their anxiety is quite strong and challenging to shift with CBT alone, thus incorporating subconscious mind work and Schema Therapy can also be very helpful in order to identify the underlying beliefs that is driving the anxiety. This is particularly helpful when the person cannot subconsciously recall the situation that occurred that triggered the development of their anxiety.

Another effective psychological treatment for anxiety is Mindfulness Therapy which is the opposite to CBT. As you have read, CBT is about changing thoughts/beliefs. Mindfulness is about practicing presence without judgement; this is where you are aware of your thoughts and bodily/physical sensations without judging them or trying to change them in any way. The way this works is that when we put focus on trying to get rid of something we do not want to experience, e.g., “I really hate this anxiety feeling, I want to get rid of it so bad”, the thought or feeling tends to intensify even more. By practicing presence without judgement, the thought/feeling eventually loses its strength/intensity, and with this can come a shift in thought/beliefs as well as we are no longer feeding the negative thought or energy.

CAN ANXIETY HELP ME THOUGH?

Yes, certainly. As with any treatment or change, it is important to understand that for anxiety to improve, practice of strategies that are known to help improve anxiety is really the only way that anxiety issues are to resolve, whether you do this in a self-help way, or seek professional help such as with a Clinical Psychologist. We can try and ignore the anxiety or pretend like it is not there e.g., by drinking excessive alcohol, however the anxiety is unlikely to show improvement in this way. By doing something about your anxiety now, it is much more likely to make it easier for you to get a better manage and improvement of your anxiety as opposed to letting it go and getting worse, and then trying to do something about it later on, if at all.

People who experience anxiety at one point in their lives are also at higher risk of experiencing anxiety at a later point in their life, whether that be in a few months’ time, or a few years’ time. However, by understanding your anxiety, effective strategies for anxiety treatment, and to work through any underlying issues that are driving to your anxiety, you are much more likely to be anxiety-free or have milder anxiety in the future, as you will know how to identify it earlier and have a better idea of how to manage it before it gets any worse.

NOT SURE WHAT IT WOULD BE LIKE TO SEE A PSYCHOLOGIST?

You will likely find that seeing a Clinical Psychologist for the first time is not as scary or daunting as what you might expect it to be. To read about what it is like to see a psychologist for the first time, click here.

ARE YOU READY TO TAKE CHARGE OF YOUR ANXIETY TODAY?

Ashley Gilmour, Clinical Psychologist of Vitality Unleashed Psychology is able to provide psychological anxiety treatment at our Gold Coast Psychology practice for a wide range of anxiety issues from mild anxiety to severe anxiety conditions.

To make an enquiry about how we can help you or to book an appointment over the phone, call us on 07 55743888.

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