Overcoming Anxiety

How to deal with fear

Anxiety Relief | Treatment for Anxiety

Panic Attack | Phobia | PTSD Therapy

Anxiety, Panic Attacks, Phobia Treatment | Dallas, Richardson, Plano, DFW

By Steve Reed at the Psychotherapy Center

Anxiety Issues, Symptoms and Effective Treatments

Anxiety Symptoms

Anxiety manifests itself as physical tension, apprehension, uneasiness, fidgeting, fatigue, sleep disturbance, a lack of concentration, negative thinking, perspiration, nausea, elevated heart rate, and muscle tension.  These symptoms can occur even if you logically know that there is no real danger.  Overcoming anxiety and its symptoms are vital for good mental health and the ability to function at a high level.  Anxiety therapy is an important approach to relieving these symptoms.

Signs of Anxiety and Stress

It is useful to view the signs of anxiety and stress in four categories: physical, mental, behavioral, and emotional.  Here is a closer and more detailed look at each category.

  1. Physical symptoms and signs of anxiety -

  • Queasy feeling
  • Lump in throat
  • Choking feeling
  • Tight Jaw
  • Pain in head
  • Dizzy feeling
  • Lightheaded or faint
  • Face flushed
  • Pressure in head
  • Heavy feeling in shoulders
  • Chest tight
  • Pressure in chest
  • Breathing restricted
  • Rapid heart rate
  • Butterflies in stomach
  • Knott in stomach
  • Squeezing/tight in the stomach
  • Pressure in stomach
  • Stomach pain
  • Hollow feeling
  • Burning/indigestion
  • Heavy feeling in the stomach
  • Shaky arms/hands
  • Shaky legs/feet
  • A trembling feeling
  • Hot Feeling
  • A numb or tingling feeling
  • Tense
  • Hot/cold sweats
  • Electric feeling

Although this is not an all-inclusive list, it outlines 33 common sensations of anxiety and stress.  If you would like to have a worksheet that will allow you to score the intensity for each sensation that you experience, you can download my PDF titled “Physical Symptoms of Distress Inventory”.

  1. Mental anxiety signs –

  • Catastrophic thinking
  • Worse case thinking
  • “What if” thinking
  • Obsessive thinking
  • Ruminating
  • Racing thoughts
  • Persistent and excessive worry
  • Lack of concentration and focus
  • Thoughts of impending doom
  1. Behavioral signs of anxiety –

  • Hypervigilance
  • Restlessness
  • Difficulty sleeping
  • Fidgety

Anxiety is an umbrella term for emotions that are in the fear family.  It is characterized by excessive apprehension, worry, and uneasiness about a future that is uncertain or feels threatening.  These emotions can be viewed along a continuum from least to most intense.

  1. Emotional feelings of anxiety from least intense to most intense –

  • Apprehensive
  • Jittery
  • Nervous
  • Worried
  • Dread
  • Anxious
  • Fearful
  • Panicky
  • Terror

Through various forms of counseling, therapy, and anxiety treatment with a good Dallas anxiety therapist, the fear, panic, and worry can be resolved.  Below are the different types of anxiety issues that can be treated when your goal is overcoming anxiety.

Anxiety Disorders

Overcoming Anxiety Disorders

  • Panic Disorder

    Panic Disorder is characterized by recurrent unexpected panic attacks or anxiety attacks, constant worries about having additional panic attacks, and changes in behavior related to the anxiety attacks.  Common panic attack symptoms are heart palpitations and pounding, sweating, trembling, shaking, shortness of breath, feeling of choking, chest pain, nausea, abdominal distress, dizziness, feeling lightheaded, feelings of unreality, fear of losing control, fear of going crazy, fear of dying, numbness, tingling sensations, chills, and hot flushes (American Psychiatric Association, 2004).  Panic attack treatment is a frequent focus of anxiety therapy.

  • Post-Traumatic Stress Disorder (PTSD)

    PTSD is characterized by a persistent re-experiencing of traumatic events involving near-death, serious injury, intense fear, and helplessness in the form of distressing recollections, thoughts, dreams, flashbacks, and strong physical reactions to even remotely associated reminders.  This can lead to difficulty sleeping, irritability, and hyper-vigilance.  Social and occupational functioning can be severely impacted.  You can evaluate a specific traumatic incident to determine whether you may have PTSD by taking the "Impact of Event Scale".

  • Social Anxiety Disorder/Social Phobia

    Social anxiety is characterized by a persistent and unreasonable fear of humiliation or embarrassment when exposed to unfamiliar people.  Therefore, the situation is avoided completely or endured with intense anxiety, which interferes with the person’s normal functioning (Durand & Barlow, 2003).  People who call my office often what to know how to overcome social anxiety.  Cognitive therapy can be a particularly useful anxiety treatment for this issue.  It is one of the therapies that I specialize in.

  • Generalized Anxiety Disorder (GAD)

    Generalized Anxiety Disorder is characterized by constant, intense, and uncontrollable worries about everything.  These worries are accompanied by tenseness, irritability, fatigue, and restlessness.  GAD is not only distressing for the people affected by it, but also for everyone around them.  This is sometimes referred to as the worry disease because of the strong amount of automatic negative thoughts that drive the anxiety.  Cognitive Behavioral Therapy (CBT) is an effective anxiety treatment for this problem.  If you would like to see if you meet the criteria for GAD, you can take the "Generalized Anxiety Disorder-7 Questions" inventory.  It is a quick and easy anxiety test that will let you know your anxiety level for the last two weeks.

  • Obsessive-Compulsive Disorder (OCD)

    OCD is characterized by intrusive and unwanted reoccurring thoughts that provoke anxiety and distress.  Having obsessive thoughts can commonly include a focus on things like the fear of oneself or a loved one becoming ill, hurting a loved one, thoughts that conflict with moral beliefs, violent acts or fear of germs, etc.  Compulsions can include an overwhelming urge to engage in repetitive behaviors such as hand-washing, checking to see if a door is locked, checking to see if the stove is off, or a preoccupation with order and symmetry.  Both obsessions and compulsions involve a feeling that one cannot control undesired thoughts and behaviors.  As a result of OCD, the individual suffers frequent bouts of anxiety and a loss of peace of mind.  (National Institute of Mental Health).

  • Specific Phobias

    Phobias are characterized by an excessive, unreasonable, and persistent fear of a specific object or situation that causes immediate fearful responses, anxiety, and distress when being encountered.  Some of these phobias may have some danger associated with them, however, not to the degree of the anxiety experienced.  Physical responses (sweating, dizziness, and heart palpitations), as well as extreme fear, are symptoms of various types of phobias.  Common specific phobias include:

1. Fear of Heights

While people have to be careful in a high place, a fear of heights causes extreme anxiety responses even when a person is safe, such as when looking out of a window or being secured by a banister.  In the DFW area, I have treated many people who had to work in high rise buildings for this phobia.

2. Fear of Flying

Fear of Flying (aviophobia or flight anxiety) may be a combination of a height phobia and claustrophobia (fear of enclosed spaces) for some people.  However, for others, a traumatic incident or a panic attack while flying is at the heart of their flight phobia.  In addition to the symptoms mentioned above, negative thoughts and images of possible catastrophic outcomes can increase the fear even more.  Fear of flying is an extremely common phobia, affecting 2.5% to 6.5% of the population.

3. Fear of Driving

Fear of Driving may be a result of an auto accident or of a traumatic observation, and the symptoms are intensified by negative thoughts and images. But more frequently, the phobia develops as a result of having panic attacks while driving.  Furthermore, a fear of driving can lead to isolation and impact social and occupational functioning due to avoidance of the feared situation.  I provide therapy for many people in the Richardson, Plano, and Dallas area for this fear.  I am well known locally as a Dallas anxiety therapist.  However, since I am one of the few anxiety therapists in the U.S. that specializes in treating this phobia, I commonly treat many people via telehealth in locations such as Houston, Albuquerque, New York, Chicago, etc.

4. Fear of Public Speaking

Public Speaking Phobia is closely linked to fear of embarrassment and humiliation. It is manifested as performance anxiety and stage fright.  This fear is also intensified by negative thoughts about possible shameful experiences and it is related to social phobias.

Phobias and panic attacks often develop because of a traumatic experience.  However, they can also develop as a result of cumulative stress overwhelm.  In such a case, the person's coping capacity is exceeded by a combination of too many stressful experiences.  In the moment of overwhelm, anxiety can become associated with whatever is present in the environment at the time (driving, flying, public speaking, getting a shot, being in a high place, etc.).

Anxiety Disorder Statistics

Impact of Anxiety

Anxiety can lead to avoidance of certain situations and stimuli, as well as unreasonable worry in everyday situations, and can therefore markedly impact a person’s life and relationships.  It can lead to negative thinking, a defeatist attitude, and health issues (such as hypertension, eating problems, headaches, and digestive problems), all of which can result in social isolation and depression.  This shows the crucial need for true anxiety relief and overcoming anxiety symptoms through effective anxiety treatment options.

Anxiety Treatment Without Medication

Minor tranquilizers have been used to treat anxiety, but with only moderate success.  Their side effects are considerable: impaired cognitive and motor functioning, as well as psychological and physical dependence.  A number of car accidents have been associated with the use of tranquilizers.   Therefore, this type of drug treatment is usually only recommended for short-term use and during extreme, stressful situations.  Antidepressants have also shown some moderate benefits for anxiety disorders, even without a mood disorder present, and they can be used for longer periods of time (Buck, 2008).  However, they also can cause a range of adverse side effects.  No one knows the long-term consequences of using many of these newer drugs.  A safer approach to overcoming anxiety includes the treatments and anxiety therapy listed below all of which are beneficial without medication.

Cognitive Behavioral Therapy (CBT)

CBT is one of the best treatments for anxiety.  CBT focuses on dealing with stressful situations and images by means of cognitive restructuring.  This is about learning how to think differently about anxiety evoking situations.  While its short-term success is moderate, similar to drug treatment, its long-term benefits are better.  Moderate anxiety levels, restlessness, and worries can remain, especially in stressful situations but for many people who have frequent worrisome thoughts, ("what ifs") cognitive behavioral therapy can be very helpful for overcoming anxiety.

Exposure Therapy

Exposure Therapy (i.e. Prolonged Exposure Therapy, Systematic Desensitization) is another approach used in CBT, which can work with anxiety triggering images and memories (i.e. imagining stressful situations in the person’s mind) or actually facing stressful situations in real life (i.e. stepping into the elevator to confront the fear of elevators).  Exposure therapy has been shown to calm the alarm center of the brain. (Goossens, et al., 2007).  This, in turn, soothes the sympathetic nervous system reducing symptoms of anxiety.  All types of exposure treatments result in moderate improvement (Whitney, Jacob, Sparto, Olshansky, Detweiler-Shostak et al., 2005).

Anxiety Management Treatment

Anxiety Management Treatment is a more structured approach that involves education, relaxation training, and exposure treatment, but no cognitive restructuring.  Its effectiveness is comparable to CBT (Buck, 2008).

EMDR

EMDR (Eye Movement Desensitization and Reprocessing) uses patterns of rapid eye movements to access anxiety-provoking thoughts. Secondly, it calms the emotional midbrain and helps turn off the alarm response. Finally, it allows the thinking brain to reprocess negative thoughts.  This can enable the mind to automatically shift perspectives about how one thinks.  EMDR can also help integrate more positive replacement thoughts. When you put these benefits together, EMDR for anxiety is an effective tool in the therapy process.

Quick REMAP

Quick REMAP is an alternative approach that calms the person’s emotional and unreasonable but automatic and uncontrollable responses without relying just on his or her logical “thinking brain”.  That part of the brain cannot be reached during extreme anxiety-provoking situations.  Therefore, the “emotional brain” has to be addressed first when emotional issues are treated.  Quick REMAP does just that.  It is a relatively brief and emotionally less painful treatment that does not require the use of medication.  It uses evidence-based acupressure points researched at Harvard Medical School (Wu, et al., 1999 and Hui, et al., 2000) to calm the emotional midbrain and to ease emotional distress first.  However, a change in the person’s thinking and their perspective on anxiety-provoking situations can often take place automatically as a result of the treatment.  Quick REMAP has provided striking and quick results in overcoming anxiety, unreasonable worries, fears, behaviors, and specific phobias, and they tend to be long-lasting.  It is an excellent treatment choice for anxiety, panic attacks, and phobias.  It is one of the strongest forms of anxiety therapy.  As a Dallas anxiety therapist, this is one of the treatment methods in which I specialize.

Plano Anxiety Therapist Steve B. Reed, LPC

Overcoming Anxiety | Finding Relief

As mentioned above, a number of treatment approaches involve systematic desensitization (one of the most common treatments for anxiety) that encourages the person to focus on stressful situations in order to learn to face the fear, to begin to increase their comfort level, and to desensitize the fear gradually.  Cognitive therapy, for example, works with mental images and scary thoughts in order to change those thoughts to be more rational and calming.  However, a person’s cognitive ability is heavily impaired when experiencing anxiety.  Unfortunately, CBT does not have a tool to reduce the person’s extreme emotional distress during the exercise, which can limit its effectiveness.  On the contrary, Quick REMAP focuses on the person’s emotional distress first before – if at all – applying logical cognitive interventions.  At this time, this appears to be the most promising new approach for truly overcoming anxiety.

Before working through emotionally charged situations with Quick REMAP, the person needs to identify specific stressful events that need to be grouped according to various themes, situations, or objects that cause his or her anxiety.  Then one event at a time can be worked on.  The person creates a hierarchical list of anxiety-provoking situations for each cluster that will be dealt with from the least to the most stressful situation on the list.  However, rather than having the person endure each situation without any emotional help for longer periods of time, activating various acupuncture points dissolves his or her distress rapidly.  Using this process with the clients that I treat in the DFW, Dallas, Plano, and Richardson areas, I find the list can be tackled not only much faster than in traditional CBT alone but also in a much less painful manner.

After dissolving the emotional distress, the list can, if required, be approached cognitively in a much more effective manner because, as mentioned above, the thinking brain does not work effectively as long as the emotional charge is too intense.  However, Quick REMAP has often shown that with the resolution of the emotional charge no further cognitive treatment is in fact needed because the perspective of the person towards the respective situations has already switched from viewing them as anxiety-provoking towards entirely neutral.  However, if more cognitive treatment is needed, CBT can easily be blended with Quick REMAP.  This is true anxiety relief that includes emotional healing and cognitive restructuring, both of which ensure long-term results.  Anxiety therapy using a combination of the counseling methods above is the most effective path for overcoming anxiety and it begins with getting expert help with anxiety.

Schedule anxiety relief therapy with Steve.  Call 972-997-9955 today.   


Steve Reed, a Dallas anxiety therapist, is available for an office appointment for your counseling and psychotherapy needs in the Dallas, Fort Worth, DFW metroplex, including Addison, Allen, Arlington, Bedford, Carrollton, Colleyville, Denton, Euless, Fairview, Flower Mound, Frisco, Garland, Grand Prairie, Grapevine, Highland Park, Hurst, Irving, Keller, Lake Highlands, Lewisville, McKinney, Mesquite, Murphy, Plano, Richardson, Rockwall, Rowlett, and University Park. He provides therapy at his office in Richardson, TX. 

Phone and video appointments are available for people worldwide.

You can also contact Steve through email at stevereed@psychotherapy-center.com.


References

American Psychiatric Association (2004). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Arlington, VA: American Psychiatric Association.

Buck, A. (2008). Dealing with anxiety. Practice Nurse, 35(2), 34-37.

Durand, V. M. & Barlow, D. H. (2003). Essentials of abnormal psychology (3rd ed.). Belmont, CA: Wadsworth-Thomson Learning.

Whitney, S.L., Jacob, R.G., Sparto, P.J., Olshansky, E.F., Detweiler-Shostak, G., Brown, E.L. et al. (2005). Acrophobia and pathological height vertigo: Indications for vestibular physical therapy? Physical Therapy, 85(5), 443-458.

Goossens, L., Sunaert, S., Peeters, R., Griez, E. J., & Schruers, K. R. (2007). Amygdala Hyperfunction in Phobic Fear Normalizes After Exposure. Biological Psychiatry, 62(10), 1119-1125. doi:10.1016/j.biopsych.2007.04.024

Wu MT, Hsieh JC, Xiong J, Yang CF, Pan HB, Chen YC, et al. Central nervous pathway for acupuncture stimulation: localization of processing with functional MR imaging of the brain—preliminary experiences Radiology 1999; 212:133-41.

Hui K, Liu J, Makris N, et al. Acupuncture modulates the limbic system and subcortical gray structures of the human brain: evidence from fMRI studies in normal subjects. Human Brain Mapping. 2000; 9:13-25.

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