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How does anxiety affect you?


Natalie
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Anxiety disorders affect about 40 million American adults, so chances are that we have a significant number of readers dealing with these sorts of issues. Even though the disorders that are lumped together in this category may seem dissimilar at first glance (e.g., a person with obsessive compulsive disorder may seem nothing like a person with social phobia), at a basic level they are quite similar. Simply put, people with Anxiety Disorders are trying to cope with out of control physical and mental anxiety symptoms that make it difficult to live their lives and get things done. Another characteristic that is quite common across people with Anxiety Disorders is the sense of shame or embarrassment that they feel for not being able to control their symptoms.

One of the unique things about a Internet community is that individuals who have problems that make it difficult for them to leave their homes, or uncomfortable interacting with others face to face, can seek support and advice in a safe way. We encourage you to share your stories with others.

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Guest ASchwartz

Thank you for sharing experiences living with an anxiety disorder. I realize how very limiting and awful these anxiety disorders can be. I am also aware of how it can keep a person imprisoned in their home because of the fear of going and coping with others.

There are some mental health clinics that specialize in anxiety disorders and even send a psychiatist to the patient's home to do an evaluation and provide medication. This is followed up by visits from a paraprofessional who helps get patients out of the house, but gradually and with kindness and sensitivity. These paraprofessionals are themselves recovered anxiety disorderred patients who have been through the same program and know how to help people recover. I have seen it succeed.

Also, it's a good thing that you have joined our community where you can get a lot of support.

Allan Schwartz

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What sort of group treatment are you waitlisted for? I'm curious. Did they tell you the name of the treatment they intend to offer you?

I can certainly see how the different aspects of your anxiety interfere with your treatment seeking. People think that the OCD stuff is the worst and it is when it is really bad, but when you are really struggling with the basics of just dealing with people and being able to just engage a treatment, the social fears can be where the true action is at.

I can tell you that psychotherapy treatments for anxiety are pretty good these days, as are medication treatments. if/when you are finally able to engage a treatment program I think you are likely to feel some relief.

Please listen to these two podcasts as they are with leaders of modern day anxiety research. It may be enlightening for you.

Richard Heimberg, Ph.D.

David Barlow, Ph.D.

Mark

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You have asked a great question that many people wonder about. What do I work on first? Although I cannot answer that question directly for you, I can give you some insight into what a therapist might consider if you asked him or her that question.

Clinicians often have to prioritize what to work on with clients, because many (if not most) people do not show up with 1 circumscribed problem. One strategy is to choose an issue that is a bit more amenable to change than the others (not that it is more or less important, just more "changeable") and start there. Starting therapy with a success experience can provide the client with positive energy and the impetus to tackle other issues.

Other times, the strategy might be to teach the client initial skills that will become important as the therapy progresses. So, I might teach a person (such as yourself) with chronically high levels of anxiety some relaxation strategies that can be used as he or she starts to tackle underlying core beliefs that are driving the anxiety feelings (this is from a Cognitive Behavioral Approach, where both thoughts and behaviors are addressed).

Another method with clients who seem to have a behavioral style or pattern of interpersonal interactions that drive most of their problems is to address this first. For instance, if a person's problems with being assertive in social situations are fueling anxiety and depression feelings, the therapist might start by teaching assertiveness skills.

Problem focus is also driven by lots of other considerations. There are times when a client refuses to focus on particular problems, and forcing someone to work on specific issues may not work. Still other clients may need to use medication therapy (e.g., anti-anxiety medications or antidepressants) to get to a place where they can focus on psychotherapy work. Make no mistake, psychotherapy is indeed hard work. Unfortunately, clinicians cannot wave a magic wand and make people better.

There are also practical considerations that drive problem focus. Therapists may change their strategy depending on how much time they have to work with a particular client (e.g., because of insurance or money restrictions, transportation issues, etc.); the client's particular strengths (e.g., someone who isn't very good at monitoring their thoughts probably isn't going to start with focusing on core beliefs); level of motivation; degree of trust in the therapist. etc. etc.

So, back to you. It sounds like you think that your diagnosis/diagnoses may not be accurate. For you, the best place to start would not be focusing on what to work on first, but to focus on getting a handle on what exactly is going on. I think that consulting a mental health clinician that has experience in assessing anxiety disorders would be a great place to start.

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  • 2 weeks later...

Good for you for making an appointment! A couple of things that may help you in preparing for the appointment- take some notes with you of things that you want to bring up. There is nothing wrong with having a memory reminder. Also, if this is the first time that you are seeing the person (I am assuming you are referring to going to a mental health clinician), he/she will be asking you lots of different questions. These are assessment questions that allow him or her to get a better handle on what is going on and figure out a diagnosis. In other words- he or she isn't going to invite you into the office and then stare blankly at you until you come up with something profound to say. Take several deep breaths and do the best that you can. It's okay to feel nervous.

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Guest ASchwartz

Hi Forgeting,

Congratulations on your first appointment. You are very hard on your self, though. It takes time to become comfortable with a new therapist. Have you looked for a therapist who uses Cognitive Behavioral Therapy? I mention it because they make the sessions much more structured with strategies to help reduce anxiety. You might do better with something like that.

What do others think?

Allan

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Hi-

I also think that finding someone who specializes in treating anxiety disorders would be a good idea. They will understand what is going on with you, and may have more appropriate questions for someone who seems to be struggling with fear in an interview/therapy session.

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Guest ASchwartz

Hi Forgeting,

Don't you kind of think that your fear of other people judging you is really you judging yourself?

The job of the therapist is never to be judgmental. Also, many of us feel ashamed of talking about our anxieties. We mistakenly think we should never feel afraid. Well, people feels afraid, anxious and terrified, especially in this unstable world of ours.

Don't you think you are your own worst judge? What feels worse than harsh self criticism??

What do you think?

Allan

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Guest ASchwartz

Hi Forgeting,

I get the idea, from what you have written, that you were shamed when you were a child and maybe when you were a teenager. Is that so and can you tell us about it?

Shame and anxiety are deeply connected and some parents use shaming to a terrible degree in raising children. In fact, shame is just awful. It causes people to want to run and hide, just like you feel, Forgeting.

What was there in your background to make you feel shamed?

Allan

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Guest ASchwartz

Hi Forgeting,

Oh, yes, Eating Disorders are usually accompanied by feelings of shame and by depression. You sound as though depression is all too common for you.

Of course, I always recommend psychotherapy (you may be in therapy but I do not remember) and there is always medication.

However, in addition to that and exercise I want to suggest something:

It appears to me that you reject the hurt young child in your psyche. How about embracing that child, loving her, being patient with her, all the things that probably did not happen during your childhood.?

Allan

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Guest ASchwartz

Hi,

What I mean is to work at being less judgmental towards your self.

All of us may want to forget some troubling things from the past but its all stored in our brain and can come back to haunt us during times of stress.

Despite your efforts to compartmentalize your issues: anxiety, ED, etc, it all comes together because its all part of you. I agree with Natalie that someone trained in treating anxiety would be excellent for you.

Allan

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