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Anxiety disorders come in many forms.


Sometimes, fears of certain situations are inhibiting your sense of freedom and choice and reducing your quality of life. Other times, anxiety involves worry - thinking a lot about the future, and struggling with the possibility of negative outcomes in an uncertain world. There are also times that anxiety manifests physically, with symptoms such as fast heart rate, stomach distress, and difficulty breathing. 


Regardless of the form your anxiety takes, treatment can help. 


If you have generalized anxiety disorder, you might notice that you just can't stop yourself from worrying about things, no matter how hard you try. ​You experience worry about the same things other people seem to worry about - finances, safety, relationships, possible failure - but you seem to worry a lot more than other people. GAD also manifests in additional physical symptoms, such as trouble sleeping, muscle tension, gastrointestinal problems, and fatigue. 


Social anxiety disorder is more than just introversion or shyness. It's the fear of being scrutinized or judged by others, leading to avoidance of social situations such as public speaking, dating, or social events. Rather than avoiding these situations purely by choice, you know that your fear is stopping you from living the life you want to live. If you have this disorder, you may have the tendency to think of yourself in extremely critical ways, and often assume that others are thinking negative thoughts about you. Social anxiety can sometimes involve intense physical anxiety, such as blushing, heart pounding, and trembling. 


If you tend to worry a lot about having potential health problems, you may be struggling with illness anxiety disorder. People with illness anxiety frequently worry that they may have a serious medical problem, even if they are told by doctors that nothing is wrong. Maybe someone in your family had a serious illness, so you are worried you might have it, too. Maybe you have minor symptoms but are concerned they might develop into a major problem. You might perform frequent internet searches about medical conditions, repeatedly check over your body for signs of illness, repeatedly go to doctors to check on new symptoms, or avoid doctors for fear that something really might be wrong. Sometimes the worry itself creates physical symptoms, such as stomach distress and chest discomfort, leading to a vicious cycle.


Panic attacks are associated with many different anxiety disorders; they involve sudden, intense physiological anxiety including symptoms like heart palpitations, hyperventilation, shaking/trembling, and shortness of breath. Panic attacks are sometimes associated with specific fears or worries. For some people, however, this intense physiological anxiety seems to come out of nowhere. If this has happened to you, and you often worry about having another panic attack, you might have panic disorder. Panic disorder involves repeated, unexpected panic attacks, with accompanying worry that you might have another panic attack. Sometimes, panic disorder escalates into increasing avoidance of situations where you might experience panic, such as exercise, driving, traveling far from home, or being in crowded places. This is called agoraphobia. Without treatment, agoraphobia may escalate into becoming completely home-bound.


Sometimes, anxiety manifests in fears of specific objects or situations, like fears of flying, heights, bodies of water, snakes, dogs, seeing blood or getting a shot, etc. If you experience intense anxiety related to a specific situation and you try to avoid that situation at all cost, you may have a specific phobia. Some people with specific phobias may experience panic attacks when they try to confront the fear-inducing situation(s). 



Anxiety treatment can vary quite a bit depending on your specific symptoms. Your difficulties may fit into one of the disorders above, or you may not be sure what exactly you're anxious about. Regardless of the specific symptoms, anxiety is usually best treated with one of the forms of Cognitive Behavioral Therapy (CBT).


Our clinicians are trained in and utilize traditional CBT approaches and what are termed "third wave" approaches, such as Acceptance and Commitment Therapy (ACT). These treatments are offered depending on the evidence supporting their utility for your specific symptoms and your treatment goals. Traditional CBT involves gaining awareness of your thought processes, re-evaluating your ways of thinking, and working toward thinking in new and more adaptive ways. ACT is an experiential therapy involving mindfulness, exercises in acceptance of difficult thoughts and feelings, values clarification, and intentional commited action toward the things that matter to you.


When anxiety involves specific fears or avoided situations, treatment also involves exposure therapy. Exposure therapy can be a part of CBT or ACT, and is almost always a part of evidence-based treatment for anxiety disorders. Exposure therapy is a cognitive-behavioral technique involving, essentially, facing your fears with the support and guidance of a therapist. It's more complicated than that, however - there are ways to ensure that these exercises result in lasting change, and you will likely need a skilled therapist to help. Exposure therapy is hard to find - most therapists haven't been trained in it and don't offer it. This is unfortunate, as it's one of the most effective treatments across the anxiety disorders.

Exposure therapy looks different than typical talk therapy. Rather than just talking things through in a therapist's office, sessions involve both talking and actually doing things. This may involve exercises outside of the office, out in the community. 

Your clinician will meet you where you're at with these exercises, knowing that it requires great courage to even consider approaching the situations that trigger your anxiety. Most people find that exposure therapy helps them gain a sense of mastery and control, improves quality of life, and reduces life-limiting symptoms.

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