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7860 Mission Center Ct, Suite 209
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At The Center for Stress and Anxiety Management, our psychologists have years of experience. Unlike many other providers, our clinicians truly specialize in the diagnosis and treatment of anxiety and related problems. Our mission is to apply only the most effective short-term psychological treatments supported by extensive scientific research. We are located in Rancho Bernardo, Carlsbad, and Mission Valley.

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Read our award-winning blogs for useful information and tips about anxiety, stress, and related disorders.

 

Filtering by Tag: GAD

How Do I Know If I Need Therapy?

Jill Stoddard

By Annabelle Parr

Each May we celebrate Mental Health Awareness Month to draw attention to and reduce stigma around mental health issues. According to the National Alliance on Mental Illness, or NAMI, 1 in 5 people will be affected by mental illness in their lifetime. And as we discussed last May during #CureStigma, “while 1 in 5 Americans are affected by a mental health condition, 5 in 5 Americans know what it is to feel pain. The frequency, intensity, and duration can vary, but pain itself is a function of being human. When culture stigmatizes the 1 in 5 and simultaneously dichotomizes illness and wellness, the resulting message is that it is shameful to struggle and to feel pain. In essence, stigma says that it is shameful to admit our own humanity.”

Do I need therapy?

Given that all of us will at some point encounter painful experiences and emotions, this year we are discussing how to know when it might be helpful to seek therapy. Though it may be clear that those affected by a previously diagnosed mental health condition could benefit from therapy, for those who are either undiagnosed or are struggling with anxiety, stress, grief, sadness, etc. but do not meet diagnostic criteria for a mental health disorder, it may be harder to discern whether therapy is warranted.

How am I functioning in the important areas of my life?

For nearly every condition in the Diagnostic and Statistical Manual (DSM-V; APA, 2013), clinically significant impairment in an important area of functioning is a required criterion to receive a diagnosis. In other words, the presenting symptoms must be making it very difficult to function at work or school, in relationships, or in another important life domain (e.g., a person is feeling so anxious that she is not able to make important presentations at work, or so stressed that he is finding it difficult to connect with his loved ones).  When life has begun to feel unmanageable in some capacity, or if something that was once easy or mildly distressing has become so distressing it feels impossible, it may be worth considering therapy.

Could things be better?

It’s also important to note that you do not have to feel as though things are falling apart before you seek professional counseling. Therapy can be helpful in a wide range of situations. It can help you not only navigate major challenges or emotionally painful periods, but also can enhance your overall wellbeing by helping you to identify your values and lean into them. Maybe things are going fine, but could be better. A therapist can help you identify what could be going better and can help you learn to fine tune the necessary skills.

I want to try therapy, but where do I start?

Whether things feel totally unmanageable or it just feels like they could be better, it’s important to find a therapist with expertise relevant to what you would like assistance with. Working with children requires different expertise to working with adults, just as working with couples and families requires additional expertise to working with individuals. Different conditions also correspond with particular evidence based practices. For stress and anxiety disorders – including social anxiety, generalized anxiety, panic disorder or panic attacks, and phobias – evidence based practices include Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT). The gold standard of treatment for obsessive compulsive disorder (OCD) is Exposure and Response Prevention (ERP), and evidence based treatments for PTSD include Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT) (all of these—ERP, PE, and CPT --fall under the CBT umbrella). So no matter what you are seeking treatment for, ensuring that the therapist you choose has expertise that aligns with the types of concerns you are struggling with is critical. For some more tips on finding and choosing a therapist, click here and here. For more information on the different kinds of licenses a therapist may have, click here.  

Though there is no right or wrong answer as to whether or not you need therapy, if you are unable to behave in ways that make life manageable and/or fulfilling because of difficult thoughts or feelings, you may find therapy beneficial.

CSAM IS HERE TO HELP

If you or someone you love might benefit from cognitive behavioral therapy (CBT) or acceptance and commitment therapy (ACT) for anxiety, panic, phobias, stress, PTSD, OCD, or insomnia, or if you would like more information about our therapy services, please contact us at (858) 354-4077 or at info@csamsandiego.com

Hey Siri, I’m Feeling Anxious: Apps for Anxiety

Jill Stoddard

by Annabelle Parr

There seems to be an app for everything these days. Smartphones have become like little pocket genies – your wish is its command. Whether you want a date, a ride, or help with a physical or mental health concern, your smartphone claims to have you covered. 

Recently, there has been a surge in apps claiming to help calm anxiety. Some offer mood tracking, others offer guided breathing and meditation, still others allow you to track your thoughts, claiming to utilize CBT methods to help you reframe unhelpful ideas. While technology can be a powerful tool, it’s important to think critically about how we use it and the effect it can have before we rely on it too heavily.

What does the data say about anxiety apps?

Depression and Anxiety: The official journal of the ADAA recently published a study conducted to assess commercially available anxiety apps. Researchers analyzed 52 anxiety/worry relief apps that purportedly use psychological techniques. They discovered that 67.3% of the apps were developed without any input from a healthcare professional, and only 3.8% of them had been rigorously tested.

So the people developing anxiety apps may not actually know much about anxiety, and they almost certainly don’t know if their app will really help you.

Authors of the study concluded that while apps have the potential to broaden access to mental health resources, there is currently a major lack of data regarding the efficacy and effectiveness of the available options. As such, the application space has yet to reach its full potential in helping people with anxiety.

What if an anxiety app is helping me?

Of course, the issue here is a lack of data. You may have found an anxiety app that does help you to manage your worry throughout the day. Guided meditations, breathing exercises, and journaling our thoughts and feelings can certainly be useful.

Should I ask Siri or a professional?

However, an app does not replace professional treatment. If you are dealing with anxiety that is impairing your ability to function in your day to day life, it’s important to seek professional guidance.

Human connection is important for our mental health.

Furthermore, while apps may one day prove to be a useful anxiety management tool, they will never replace the human connection that takes place in the context of therapy. In fact, it is actually the therapeutic relationship itself that is the most important aspect of therapy – it accounts for around 30% of the variance in treatment outcome, which is significantly more than any other factor, including the specific techniques used by the therapist (like CBT or mindfulness). This means that who your therapist is, how you relate to them, and the relationship you share is the most helpful part of therapy. An app will never be able to offer this relationship.

Technology may help us manage anxiety, but it may also be a source of anxiety.

Finally, when considering anxiety apps, it is important to note that according to the APA, smartphone use has been linked to higher stress levels, particularly in those who check their phones constantly.

Given the rapid development of technology and its ever broadening influence in our lives, it is important that we stay curious and aware of the potential it has to both help and hinder us, particularly when it comes to something as important as our mental health.

CSAM IS HERE TO HELP

If you or someone you love might benefit from cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), or biofeedback for anxiety, depression, stress, or PTSD, or if you would like more information about our therapy services, please contact us at (858) 354-4077 or at csamsandiego@gmail.com.

References:

American Psychological Association (2017). Stress in America: Coping with Change. Stress in America™ Survey.

Sucala, M., Cuijpers, P., Muench, F., Cardos, R., Soflau, R., Dobrean, A., Achimas-Cadariu, P., & David, D. (2017). Anxiety: There is an app for that. A systematic review of anxiety apps. Depression and Anxiety: The official journal of ADAA, 34(6). 518-525. 

 

5 Myths About Anxiety

Jill Stoddard

By Trevor McDonald
edited by Annabelle Parr

People are talking about mental illnesses, like anxiety disorders, more often and more openly. Social media and access to digital content has helped facilitate the conversation. However, there is still a stigma surrounding mental illness, and while easy access to content can help reduce shame, stigma and misunderstandings about mental illness, it can also spread mistruths and foster outdated myths. This hurts those who suffer from mental illnesses as well as those trying to understand and support them. So let’s clarify some things about anxiety.

According to the National Institute of Mental Health (NIMH), anxiety disorders are the most common American mental illness, affecting 40 million adults – 18% of the population. Despite this substantial figure, the Anxiety and Depression Association of America (ADAA) estimates that only 33 percent of those suffering will receive treatment.

Anxiety is a blanket term. We all know what it feels like to feel anxious. But when we talk about anxiety as a mental illness, we may be referring to any number of disorders, from generalized anxiety disorder to social anxiety disorder to panic disorder to a specific phobia. Though all of these things fall under “anxiety,” each manifestation looks and feels a bit different.

Fortunately, anxiety disorders can be treated. Having a supportive network that includes mental health professionals and ideally, understanding loved ones, is critical. The first step toward encouraging and facilitating treatment is dispelling myths and providing education for both those struggling with anxiety and the people around them. Here are five of the biggest myths about anxiety disorders:

1. “You don’t really have anxiety. Everyone gets anxious/nervous!” Of course, everyone feels anxious or stressed sometimes. But according to the DSM V, when someone has an anxiety disorder, they feel excessively anxious about a number of things more often than not, and it significantly impairs their ability to function in a major area of their life. We must understand that there is a big difference between feeling anxious about a particular event or challenge, and feeling the chronic anxiety that comes with an anxiety disorder. Furthermore, it’s important not to toss around statements such as “I’m so OCD” when all we mean is that we like our desk organized. Minimizing an anxiety disorder in these ways undermines the challenge that something like generalized anxiety disorder or OCD can pose to people who are struggling with them.

2.  “You can get over anxiety with yoga, taking a walk, or meditation.” While taking a holistic approach to wellness is smart, and such activities can help with the symptoms of anxiety, taking a yoga class won’t “cure” an anxiety disorder any more than it will spina bifida. Though it can be tempting to offer advice to try to help those struggling with anxiety, it’s important not to minimize their experience or assume that you have a solution to offer them. Only a mental health professional should be offering any kind of “prescription” or suggestion for treatment.

3. “Anxiety means a person is weak, or they must have had a really bad childhood.” The former is never true; the latter could be part of the foundation for an anxiety disorder, though this is certainly not always the case. Trauma can kick start an anxiety disorder, but it’s not the only source. A big reason people with mental illnesses don’t talk about their condition is because they don’t want to be seen as weak or feeble, even though they’re not. It takes tremendous strength to live with any disorder. Invisible disabilities can be especially trying because people can’t “see” the disorder a person is battling.

4. “Anxiety isn’t that big of a deal.” Everything is relative. Anxiety disorders exist on a spectrum. If you know someone with anxiety, you can’t gauge how severe their disorder is. But unless you are a therapist, psychiatrist, or doctor, it’s not your job to gauge the severity of someone else’s anxiety. What you need to know is that anxiety is a big deal to the person suffering from it, no matter where they fall on the spectrum. Further, unlike a broken leg, anxiety can’t be seen on the outside.  So someone may appear perfectly put together on the outside, but is suffering in silence on the inside.

5. “I won’t be able to relate to someone with anxiety.” This myth is usually based on a person’s fear that they won’t know what to say when someone is struggling with anxiety. It’s human nature to want to “fix” things, but anxiety can’t be fixed that easily, especially by a non-professional. Remember that it’s not your job to “fix” someone’s anxiety or make it go away. All they really need from you is empathy. And listening well is far more important than knowing what to say. So when talking to someone with anxiety, let them lead the conversation, don’t judge them, and don’t try to fix it. Let them know that you want to understand and that you hear that they are struggling.  You might also offer to help them connect with professional help.

We’ve come a long way in our understanding of anxiety disorders. Psychological research has given us a solid understanding of anxiety and how to treat it effectively. Of course, there is always more to learn, but now the bulk of our work lies in sharing our understanding with the community and eliminating the damaging and unnecessary stigma that still surrounds mental illness. Working to un-learn false claims and myths of the past is a big step in the right direction. Doing your part to educate yourself and others will make a big difference in the lives of everyone with an anxiety disorder.

CSAM IS HERE TO HELP

If you or someone you love might benefit from acceptance and commitment therapy (ACT), cognitive behavioral therapy (CBT), or biofeedback for anxiety, depression, stress, or PTSD, or if you would like more information about our therapy services, please contact us at (858) 354-4077 or at csamsandiego@gmail.com.

Let’s Talk About Anxiety

Jill Stoddard

by Annabelle Parr

Anxiety is a hot topic these days. It’s all over the news, and apparently it is on the rise. In the age of information and technology, we are constantly bombarded with doom and gloom news alerts, including reminders that on top of everything else, we are plagued with increasing anxiety. Eventually, these reminders can get exhausting and may even contribute to the anxiety that is apparently so prevalent in the first place.

Image source: https://www.theodysseyonline.com/poems-read-anxiety

Image source: https://www.theodysseyonline.com/poems-read-anxiety

Of course, there are benefits to all this conversation around anxiety: we have a better understanding of what anxiety is and as a result we may be able to understand and empathize with those who are struggling better. But it’s important to be careful that we don’t pathologize all anxiety, and that we don’t lose sight of the strength that exists in those who truly do have anxiety disorders.

Anxiety: Natural Response to Stress or Disorder?

The way we talk about anxiety today, it is easy to believe that all anxiety is inherently bad and forget that it’s our natural response to threat or danger. We actually need anxiety to survive; it prepares our body to respond appropriately in the face of danger. However, our physiological experience of anxiety developed back when the regular dangers humans faced included running from large, sharp toothed predators. So when we are experiencing the fight-or-flight response before a big exam or presentation, it may not feel particularly adaptive. But despite the discomfort that comes with anxiety, it is natural when it is experienced as the result of a particular situation or problem, when it is proportional to the stressor, and when it only lasts until the situation is resolved (ULifeline, 2016). Anxiety, though often painful, is an important and adaptive part of the human experience.

Image source: aconsciouslifenow.com

Image source: aconsciouslifenow.com

Though originally an adaptive response, anxiety does have the potential to be harmful when it manifests as “constant, chronic and unsubstantiated worry that causes significant distress, disturbs your social life and interferes with classes and work” (Active Minds, 2016). In other words, anxiety is no longer helpful when it begins to appear when there is no actual threat present. When a person experiences anxiety but has no threat to respond to, what happens? They begin avoiding situations that are actually safe. Their mind and body are telling them that safe situations are threatening, which can have a debilitating effect. When anxiety becomes disordered, it arises unexpectedly, is overwhelming, and, rather than catalyzing adaptive behavior in the face of a threat, often fosters avoidance of everyday situations (Here to Help, 2016).

Image source: http://www.huffingtonpost.com/2015/05/18/anxiety-photos-katie-crawford_n_7292548.html

Image source: http://www.huffingtonpost.com/2015/05/18/anxiety-photos-katie-crawford_n_7292548.html

So what is the takeaway? Anxiety is uncomfortable, but it helps us respond to threat, uncertainty, trouble, or feelings of unpreparedness (Active Minds, 2016). Anxiety becomes a problem (and possibly a disorder) when it comes seemingly out of nowhere and in the absence of a stressor proportional to the response, and it interferes with functioning in some way.

Recognizing Strengths as well as Struggles

There is no denying that feeling anxious is not pleasant. It can range from uncomfortable to unbearable. For those with anxiety disorders, anxiety is unpleasant on a whole new level; it can be completely overwhelming and paralyzing. It is hard to describe how out of control one can feel in the middle of a panic attack, or how draining it is to go through the day (week, month, or year) flooded with anxiety.

But in the midst of this struggle, it’s important to remember that anxiety doesn’t own you. It may be a part of you, and it may influence your life in various and profound ways. But anxiety does not determine who you are. A diagnosis does not define you. You are not a disorder. You are not weak, powerless, or alone.

Image source: http://quotesgram.com/from-brene-brown-quotes/

Image source: http://quotesgram.com/from-brene-brown-quotes/

Acknowledging the pain anxiety can bring is so important, but it can also be helpful to recognize that struggling with anxiety may also foster certain strengths. According to Dr. Tracy Foose (2013), trait anxiety is associated with being “highly conscientious, honest, detail oriented, performance driven, socially responsible, [and] self-controlled.” Furthermore, learning to cope with anxiety can push us towards an increased self-awareness and knowledge of ourselves. Because it is so uncomfortable, it can motivate us to grow and change parts of ourselves or our lives that may not be serving us. And once we learn that we can move through the discomfort of anxiety, we often feel stronger and more confident in ourselves knowing that we have the fortitude to move through something so profoundly difficult (Sutherland, 2011).

Finally, if you do feel like anxiety is controlling your life, you don’t have to stay stuck in this space. Not only can anxiety teach you to embrace vulnerability and reach out for support from loved ones, but therapy offers very effective treatment. Cognitive Behavioral Therapy and Acceptance and Commitment Therapy can teach valuable coping skills, and can help to change your relationship to anxiety. Nothing will ever take anxiety away completely, but we wouldn’t want that because without anxiety, we wouldn’t survive. But therapy can help us learn that even in the worst throws of anxiety, we will survive, and even thrive.

CSAM IS HERE TO HELP

If you or someone you love might benefit from acceptance and commitment therapy (ACT), cognitive behavioral therapy (CBT), or biofeedback for anxiety, depression, stress, or PTSD, or if you would like more information about our therapy services, please contact us at (858) 354-4077 or at csamsandiego@gmail.com.

References:

Active Minds. (2016). NSOD: Difference between normal anxiety and an anxiety disorder.  Retrieved from: http://www.activeminds.org/component/content/article/512-nsod-difference-between-normal-anxiety-and-an-anxiety-disorder

Foose, T. (2013, Feb. 19). Positive traits seen in anxiety disorders. SF Gate. Retrieved from: http://www.sfgate.com/health/article/Positive-traits-seen-in-anxiety-disorders-4291474.php

Here to Help. (2016). What’s the difference between anxiety and an anxiety disorder?  Retrieved from: http://www.heretohelp.bc.ca/ask-us/whats-the-difference-between-anxiety-and-an-anxiety-disorder

Sutherland, M. (2011). The Benefits of Anxiety. Retrieved from: https://willowtreecounselling.ca/articles/the-benefits-of-anxiety/

ULifeline. (2016). Anxiety vs. anxiety disorders. Retrieved from: http://www.ulifeline.org/articles/439-anxiety-vs-anxiety-disorders

The Importance of Boundaries

Jill Stoddard

by Annabelle Parr

Do you ever feel like you can’t say no?  Do you believe that you are responsible for the emotions of others?  Do you take others’ opinions and needs into account before your own?  Do you find yourself unsure of what you want or need (Eddins, 2015)?  If so, you are certainly not alone.  However, your feelings, thoughts, and needs matter.  By setting some boundaries in your life, you can begin to treat your needs as important.

Boundaries and Anxiety

Image source: https://blogs.goarch.org/blog/-/blogs/boundaries-healthy-limits-or-barriers-to-relationships-

Image source: https://blogs.goarch.org/blog/-/blogs/boundaries-healthy-limits-or-barriers-to-relationships-

For people who struggle with anxiety, learning how to create healthy boundaries can be a helpful tool.  Though sometimes people cope with anxiety by creating unnecessary boundaries or avoiding situations that serve as triggers, other times anxiety is experienced as a result of unclear lines between self and other.  When you don’t protect your sense of self, it is easy to feel overwhelmed and take on responsibility for everything and everyone (Eddins, 2015).  This can lead to feelings of guilt and anxiety.  It is not hard for a vicious cycle to ensue, where a lack of boundaries leads to anxiety, and where anxiety leads to a feeling that you cannot set clear and effective limits.

What Are Boundaries

So what exactly are boundaries?  Boundaries help us to define who we are.  They orient us in our relationships, and signify to us and to others where “I end and you begin” (Eddins, 2015).  Boundaries can apply to any area of our lives, and can range from material boundaries to physical, mental, or emotional boundaries to sexual or spiritual boundaries (Lancer, 2015).  Boundaries are very personal, and there is not a right or wrong answer regarding to how to set ones that work for you.  They are based on your beliefs, values, opinions, and needs (“12 Signs,” 2015).

Boundaries as an Act of Love

A common misconception for people who struggle in this area is that setting boundaries is selfish.  However, self-care is not selfish.  Have you ever flown on an airplane, and heard the stewardess tell the passengers in case of an emergency to put their own oxygen mask on before helping others with theirs?  This “oxygen-mask” rule is a profound metaphor for the idea that we cannot take care of others if we have neglected to take care of ourselves first. 

Image source:  http://www.thedynamicturnaround.com/healthyboundaries.htm

Image source:  http://www.thedynamicturnaround.com/healthyboundaries.htm

Setting boundaries for ourselves and giving ourselves permission to articulate our needs is an act of self-love (Strgar, 2010).  And in the wise words of Brené Brown, “we can only love others as much as we love ourselves” (2010).  Furthermore, when we set clear limits in our lives, we are better able to be compassionate towards others.  Brown (2010) states that “the heart of compassion is really acceptance,” and when we lack boundaries, we are not accepting our own needs and we may have a difficult time accepting others if we feel they are taking advantage of us. 

So contrary to this idea that boundaries are selfish, they actually help us love ourselves and others better.

How Therapy Can Help

You are the only one who has the ability to set boundaries in your life.  However, therapy can be helpful in navigating this challenging task.  Therapy offers a place where you can explore your values, your feelings, and your relationships.  Your therapist can help support you in the process of determining where you need to establish stronger boundaries or areas in which you might benefit from more flexibility.

Therapy can also be a good place to experience a relationship with very clear boundaries.  Dr. Irvin D. Yalom (2002) describes “therapy as a dress rehearsal for life,” meaning that it is a safe place to encounter challenging aspects of life and relationships before you face them outside of the therapy room.  An important goal of therapy is to take what you have learned and apply it to the rest of your life, but it can be helpful to practice new skills in a safe space first.

Don’t Forget to Be Kind To Yourself

One final thing to note is that boundaries are learned (Lancer, 2015).  If you are not used to setting clear limits in your life, know that it is a skill that takes practice.  The best way to start learning this skill is to cultivate self-awareness and practice asserting yourself (Lancer, 2015).  Remember, it is important to give yourself grace and to seek support throughout this process.  If you feel like you could benefit from some professional support in developing boundaries in your life…

CSAM IS HERE TO HELP

If you or someone you love might benefit from acceptance and commitment therapy (ACT), cognitive behavioral therapy (CBT), or biofeedback for anxiety, depression, stress, or PTSD, or if you would like more information about our therapy services, please contact us at (858) 354-4077 or at csamsandiego@gmail.com.

References:

12 Signs you lack healthy boundaries (and why you need them). (2015).  Harley Therapy Counselling Blog. Retrieved from http://www.harleytherapy.co.uk/counselling/healthy-boundaries.htm

Brown, B. (2010). The gifts of imperfection: Let go of who you think you’re supposed to be and embrace who you are.  Center City, MN: Hazelden Publishing.

Eddins, R. (2015). Keeping Good Boundaries & Getting Your Needs Met. Psych Central. Retrieved from http://psychcentral.com/lib/keeping-good-boundaries-getting-your-needs-met/

Lancer, D. (2015). What are personal boundaries? How do I get some?. Psych Central. Retrieved from http://psychcentral.com/lib/what-are-personal-boundaries-how-do-i-get-some/

Stgar, W. (2010). The importance of boundaries. The Huffington Post. Retrieved from http://www.huffingtonpost.com/wendy-strgar/working-boundaries_b_717339.html

Yalom, I. D. (2002).  The gift of therapy: An open letter to a new generation of therapists and their patients. New York, NY: HarperCollins Publishers.