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7860 Mission Center Ct, Suite 209
San Diego, CA, 92108


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: anxiety therapy for older adults

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.


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

Older Adults Afflicted with Depression, Stress and Anxiety

Jill Stoddard

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As the baby boomer generation ages, many more begin to experience the physical and mental challenges that inevitably accompany the aging process. The prevalence of mental illness has been found to increase with age. Research indicates that 20 percent of the American population over 55-years-old is afflicted by at least one mental disorder (APA, 2012). Furthermore, nearly 70 percent of those in long-term care facilities display psychological and behavioral challenges (APA, 2012). However, less than three percent of individuals in late adulthood have reported that they seek psychological treatment. Thus, there are likely many individuals within this population who have never sought treatment who could truly benefit from it.

A high co-occurrence rate has been identified between physical health problems and mental health problems. Unfortunately, many physicians fail to notice their patients’ anxiety and depression (Alexopoulos, 2005). As a result, an appropriate diagnosis may be overlooked and associated symptoms may be left untreated.

 Suicide Risk

 Older adults have the highest risk of suicide when compared to all other age groups (Connell, Chin, Cunningham, & Lawlor, 2004). In fact, they are two times more likely to commit suicide in comparison to the general population. Both social factors, such as isolation, and the prevalence of psychological disorders, highly impact the rate of suicide within this population (Alexopoulos, 2005). Thus, if the symptoms of mental disorders are unnoticed and left untreated, they may lead to fatal consequences. Research has shown that approximately 75 percent of older adults who have committed suicide have met with their doctor within the last month (APA, 2012). Thus, it is necessary for everyone, including physicians, to be aware of this high risk age group, so that proper precautions can be taken to prevent suicide and improve overall mental health care.

Potential Signs of Depression in Older Adults

 Here is a list of possible signs of depression in older adults according to the National Alliance on Mental Illness (NAMI, 2013, para. 3): 

  • Memory problems
  • Confusion
  • Social withdrawal
  • Loss of appetite
  • Weight loss
  • Vague complaints of pain
  • Inability to sleep
  • Irritability
  • Delusions (fixed false beliefs)
  • Hallucinations
  • Persistent and vague complaints
  • Help-seeking
  • Moving in a more slow manner
  • Demanding behavior


 While the prevalence of mental health problems is higher in older adults, the good news is that there are evidence-based treatments that can help. Cognitive behavioral therapy (CBT) has been demonstrated to be effective in relieving the symptoms associated with stress, anxiety, and depressive symptoms. In fact, structured therapies, such as CBT, have been found to be as “effective as antidepressants for moderate depression and may be more effective in reducing recurrence” (Ell, 2006, para. 12).

 If you know anyone who suffers from symptoms of depression, anxiety, or stress, please encourage them to seek professional support. If you are in the San Diego area and would like to speak to a professional at CSAM who specializes in CBT for older adult stress, mood, and anxiety problems, please contact us.



 Alexopoulos, G. S. (2005, June). Depression in the elderly. Lancet, 365(9475), 1961-1970. Retrieved from

 American Psychological Association. (2012). Growing mental and behavioral health concerns facing older Americans. Retrieved from

 Connell, H. O., Chin, A. V., Cunningham, C., & Lawlor, B. A. (2004, October 16). Recent developments: Suicide in older people. BMJ, 329(7471), 895-899. Retrieved from

 Ell, K. (2006, July). Depression care for the elderly: Reducing barriers to evidence based practice. Home Health Care Serve Q, 25(1-2), 115-148.

 NAMI. (2013). National Alliance on Mental Illness. Retrieved from