Everyone has experienced anxiety at some point, such as feeling nervous around a first date, taking a high stakes test, or walking into a meeting late. It is normal to feel nervous or worry around these things. Worry and anxiety become problematic when it starts impeding your functioning or interfering with your activities. For example, if you do not enter a meeting because you are late and you’re afraid, when you walk in everyone will stare at you or judge you. Another example might be, not going on a first date because you are feeling so uncomfortable and tense at the thought of meeting this person and possibly being scrutinized as well as feeling fearful about having to talk with this person alone.
You may find yourself avoiding events, activities or social gatherings to soothe the anxiety/nervousness/fear you are experiencing. Avoidance behavior can lead to isolation as well as withdrawing socially. Some people may utilize alcohol and recreational drugs to ease their fears and feelings of anxiety while socializing.
Here are 5 signs you may have Social Anxiety as per the DSM-5:
Social Anxiety Disorder affects approximately 7% of the population in the United States as per the American Psychiatric Association. If you are experiencing some of these symptoms and would like to feel some relief, know that you are not alone! As overwhelming as the thought may be, reaching out to a trusted loved one, family member or friend for support can be a great help. Here are some tips to reduce anxiety: http://www.droshea.com/blog/top-5-ways-to-reduce-anxiety-symptoms. If you feel as though you have tried to reach out to your support system as well as trying other strategies and nothing is helping, it may be time to contact a mental health professional.
Disclaimer: This blog is for informational purposes only and is not a substitute for diagnosis, treatment or therapy.
Feeling anxious or worried is something everyone experiences and feels. It is absolutely okay to feel anxious. Most of us feel symptoms of anxiety when we are about to take a test, interview for our dream job or if we have to perform in some way in front of others. Feeling anxiety is not always negative as everyone has an optimal level of anxiety, which is needed for the ideal learning environment. Anxiety symptoms become problematic when they are impacting our daily lives in a negative way. When we find ourselves using “What If” statements when thinking about a situation, when we have trouble sleeping at night because we cannot turn off our mind or when we feel keyed up or stressed out. During these times, we may need to utilize coping strategies to reduce these excessive anxious symptoms and feelings.
Here are 5 ways to reduce anxiety symptoms:
1. Journal: some people find it useful to write down their worries and concerns. You do not have to write in paragraph form or even sentences. You can simply write a list of your concerns/worries. It also helps to set aside some time to worry, think of it as a time out for worrying. The idea is, if you have a set time to worry, you can write down your concerns and worry about them at a scheduled time and not throughout the day and at night while trying to work and/or fall asleep.
2. Breathing: when some people feel anxiety, their heart rate increases and other people hold their breath. When you realize you are feeling anxiety/stress symptoms such as What If thinking, excessive worry or a change in your breathing, you can utilize deep relaxed diaphragm breathing, which can assist with putting your body into a more relaxed state. Sometimes doing deep breathing for a count of 30 can make a difference. Trying yoga and/or meditation can help with learning how to regulate your breathing and also assists in reducing anxiety and stress symptoms.
3. Exercise: not only is exercise good for your body, it is also great for your mind. Exercising such as running, swimming or yoga assists with reducing anxiety and stress. In addition, regular exercise increases mood, overall wellbeing and assists with sleep. If you are having trouble with beginning an exercise program, find something you love to do such as tennis, biking, whatever it is, find an exercise buddy and start. If you are having trouble finding time to exercise, schedule it. Start by walking once or twice per week, to get your body moving. Please speak with your physician before starting an exercise program.
4. Caffeine: decreasing your caffeine intake can help reduce anxiety. Caffeine can increase anxiety symptoms and feelings of stress. It can also interfere with your sleep. If you are consuming caffeine and find you are experiencing anxiety symptoms, notice the next time you have a caffeinated beverage if you feel calmer or more keyed up and stressed out. Try decreasing the amount of caffeine you consume. You can try decaffeinated products or having less caffeine. In addition, decreasing and/or eliminating caffeine from your diet will also assist with sleep issues such as feeling exhausted and alert at the same time as well as difficulty with falling asleep.
5. Self-care: increasing self-care, things that you do, just for you, will help reduce symptoms of anxiety. When we are anxious and stressed, the first thing we usually cut out are the things we do to feel grounded. We remove these from our routine due to lack of time, a sick loved one or a big meeting, etc. When these things are happening and our anxiety is increasing, this is when we need to do self-care and take care of ourselves the most. If you are not taking care of yourself, you will not be able to do the best job you can when you take of others. I am not saying this is an easy thing to do, but if you take care of yourself, you will have more to give to your family, friends and career.
Anxiety is something everyone feels, what is different is the level of anxiety which is individual to each of us as well as how we cope with these anxious feelings and symptoms. To find out more information regarding symptoms of anxiety, please see my blog on the signs and symptoms of anxiety at http://www.droshea.com/blog/top-5-signs-you-may-have-anxiety. In addition, there are some great apps that you can download for your phone or iPad to help with relaxation and breathing which can decrease the symptoms of anxiety and stress.
Disclaimer: This blog is for informational purposes only and is not a substitute for diagnosis, treatment or therapy. Please consult with your physician before beginning an exercise program.
“Anxiety disorders share features of excessive fear and anxiety and related behavioral disturbances. Fear is the emotional response to real or perceived imminent threat, whereas anxiety is anticipation of a future threat” (DSM-5). Everyone experiences anxiety and that is absolutely normal. We typically feel a little anxious when we have a job interview or a presentation. Feeling a little nervous, concerned or apprehensive around these events is to be expected. Research shows that we learn best when an optimum level of anxiety is reached. The optimum level is different and unique to each of us. However, anxiety becomes problematic when these feelings start to impact our daily living in a negative way.
Here are 5 signs you may have anxiety:
If you are experiencing several of these symptoms and they are causing you significant distress in your life and you do not have a medical condition or another mental health disorder that may have similar indicators, you may be experiencing anxiety. However, there are some things you can do today to begin to feel better. Check out my blog where I discuss 5 ways to reduce stress today: http://www.droshea.com/blog/5-easy-ways-to-reduce-stress-today. If you have tried some of these strategies already and/or feel stuck, frozen, or as though nothing is helping, it may be time to reach out to a mental health professional.
Disclaimer: This blog is for informational purposes only and is not a substitute for diagnosis, treatment or therapy.
Anticipatory anxiety is a symptom of anxiety, it is not a diagnosis or disorder. However, many people who suffer from anxiety or have anxiety traits have these common concerns/worries of “what if” thoughts. Many of us find ourselves predicting the future by trying to foresee every possible negative outcome to a situation that may or may not happen. These concerns or worries can be categorized as anticipatory anxiety. There are different degrees of anticipatory anxiety, as the symptoms range from mild to severe.
What If Syndrome is NOT actually a syndrome but a term I use to explain the symptoms of anticipatory anxiety. It is when people think about an event or situation and think of all the different ways the event could go wrong and try to plan for what they feel will be the most common negative outcomes. Unfortunately, most of us do not have a working crystal ball, so predicting the future is difficult at best. If you find that this resonates with you, ask yourself “Does the outcome change when I What If?” Most of the time, the answer to that question is No. So why do we continue to do something we know does not change the outcome? Many of us feel that if we are prepared for the worst, when it happens we will be ready. One of the issues with this type of thinking is that you cannot possibly come up with contingency plans for every possible negative outcome and it actually has the opposite effect. The process of What If is mentally and emotionally draining and increases stress levels and anxiety instead of decreasing it.
Possible ways to reduce What If Syndrome is to be aware that you are doing it and to learn what is triggering this behavior.
Insight into your behavior is a great first step; here are some concrete things you can do:
1. Utilize thought stopping: A technique where you realize the behavior, put a stop sign up in your head and have a prepared other topic to think about. If you do not have something else to replace the thought with, your mind will continue to return to the thought.
2. Exercise: Exercise is a great way to reduce anxiety symptoms, it is recommended that 30 minutes of Cardio exercise up to 5x’s a week decreases anxiety symptoms.
3. Distractions: Find something else to do, play with your kids, pet, or engage someone in conversation.
4. Reach out to your support system: Sometimes talking about these issues with a friend or loved one, helps people let go of the concern/worry.
On the other end of the spectrum, examples of a severe reaction would be someone with PTSD or a fear or phobia who may become panicked at the anticipation of that fear becoming a reality, such as a fear of flying. Someone with a severe fear of flying may have a panic attack at the thought of being on a plane and may dread an upcoming vacation due to this fear. The anticipatory anxiety feels just as real and threatening as the fear itself. If you suffer from some of these more severe symptoms please contact your healthcare provider as a Psychologist, Psychiatrist or Social Worker who has experience and training in working with fears and phobias can assist you with these issues.
Disclaimer: This blog is not meant to be considered therapy or treatment for these symptoms. This blog is for informational purposes only.
Why Do We Find Change So Daunting?
Why do we find it so difficult to change our behavior and maintain that change in our everyday lives? Many of us find the idea of change to be scary. We have routines, relationships and families and any type of adjustment can tip the homeostasis of our lives. Whether the change we are making is for the better or not, it still can upset the apple cart.
The thought of change and the process of change can cause anxiety, worry and fear. These feelings are not usually welcome feelings in our lives such as joy, relaxation and happiness. Most of us do not embrace feelings that may cause us discomfort, so the idea of making a change that will cause us discomfort may seem counter-intuitive. However, many of us need to make changes for health reasons or to improve our lives and the discomfort may be for a short period of time where the actual change in behavior may bring a positive life outcome. Change is not always easy, can be good and sometimes is necessary as we evolve.
When we decide to change a behavior, such as not smoking, weight loss, or starting an exercise program many of us find it extremely difficult to make a permanent change. Using weight loss as an example, some of us have difficulty losing weight, some can meet a partial weight loss goal and others can attain the goal but have difficulty maintaining the weight loss. Changing our behavior involves moving through several stages. Motivation and emotional well being are an integral part of the process of behavior change.
Two famous researchers, James Prochaska and Carlo DiClemente developed The Transtheoretical Model of Behavior Change (TTM) also known as The Stages of Change, which include five stages of change. This is the process that each of us progress through as we are attempting to make a behavioral change. This process is not simple and at times there is frustration and demoralization when we feel we may not be successful on our journey. This model assists us in offering us a vocabulary and a better understanding of the thoughts and feelings we have while we move toward our goal.
The Stages of Change:
Precontemplation: While in this stage we may not see our behavior as problematic. We are sometimes characterized as unmotivated, in denial or resistant to change. We will not be taking action within the next 6 months.
Contemplation: We are sometimes characterized in this stage as ambivalent. We are struggling with the pros and cons of our particular situation, but moving toward the benefits of change. We will be taking action to change in the next 6 months.
Preparation: We have a plan of how we are going to attain our goal of change. We have taken some small action, for example if weight loss is our goal we have been choosing healthier food options. We are intending to take action in the next month.
Action: We have implemented our action plan and have taken specific actions to change our behavior and attain our goals. We must be diligent in this stage to avoid falling back into previous poor behaviors and patterns of behavior. We have changed our behavior for less than 6 months.
Maintenance: We are continuing our changed behavior and are managing temptations to fall back into our previous behavioral patterns. We are gaining confidence that we will continue our current changes. We have changed our behavior for over 6 months.
These stages are fluid and at any time during the process we can fall back to previous stages or relapse. Many of us jump to the action stage when we are really in one of the previous stages, which may be why we have difficulty attaining our goals. Motivation is a key component to progress with change. A strong support system is also very useful while on the journey of change as emotional well being is important to goal attainment. If we have a strong support system we are more likely to continue when we are feeling stressed or tempted to return to previous behaviors.
Disclaimer: This blog is not meant to be therapy or treatment, it is for informational purposes only.
Have you ever had a terrible, horrible, no good very bad day? Like Alexander in the children's book? Many people experience illness, grief and loss, I am NOT minimizing these issues, these people had a very very bad day. This is for those of us, who have bad days, when it really was not the worst day. When we arrived at the gas station only to realize we left our wallet at home. Then we walked into the office and realized our keys were in another bag and had to wait an hour for security to come and let us in the office. This then made us late for our meeting, because the flash drive with the presentation was locked in the office. The presentation was not the best, because we did not review it and make final changes, because we were sitting in the hallway waiting for the key. It is not even noon yet... and at lunch you burn the roof of your mouth on pizza. It is definitely one of those days. You can see how a day starting off this way could leave you in a stressed and frustrated space.
It is the little things that can make or break a day for most people. One extra small thing going wrong could be the difference between an ordinary day or a bad day. Why do we let this happen? Many times it is because we fall victim to the villain of Stress and his sidekick Frustration. It is usually when we start feeling frustrated that we realize, "I am stressed" and somewhere along the way, today took a turn to the dark side.
It helps if we are aware of what is going on, when it is going on. Early intervention is important and can make the difference between a good day and a bad day. The earlier we realize that we are stressed we can make a conscious effort to change our outlook on the rest of the day and implement stress reduction strategies. Be an active participant in your day, try not to let your day happen to you.
5 steps to turning around your day (if you want too):
1. Embrace your bad day: It is okay to feel your emotions, all of them, both negative and positive. It is okay to be upset, stressed and down, even if you do not know why you are feeling that way. It is also okay to stay in a down or bad mood for the day as long as you are not taking things out on others, as this behavior will hurt your relationships.
2. Me Time: Go for a walk or take a time out. Go somewhere you can relax and think. Listening to music can be soothing and can lift your mood. Try some relaxation breathing, yoga or meditation if you enjoy these things. Do something you enjoy while you are reflecting on your day.
3. Exercise: This can help increase your mood and pull you out of the doldrums. Do something you enjoy such as going to the gym, running or biking. Sometimes it helps to exercise with a friend or workout buddy.
4. Phone a friend: Call a loved one or someone in your support system. Processing your day can do wonders in turning it around. Discussing your day with someone also helps with gaining perspective on the events of the day.
5. Let the Love In: Make a mental list of all of the wonderful things in your life, everything that makes you happy and smile. Thinking about all of the goodness in your life as well as everything you are grateful for, can help you feel better. Try to focus on the positive things in your life. Hugging loved ones, children and pets (trees are optional) can help.
Many times it is the rushing around that has us forgetting important things and making errors that we usually would not make. We can still turn the day/evening around if that is what we choose to do. However, it is okay to be in a bad mood for a few hours or a day. Your self talk should say something like "tomorrow will be a better day." It also helps to realize that if burning the roof of your mouth was the worst part of your day, then you had a pretty good day!
Disclaimer: This blog is for informational purposes only and is not a replacement for therapy or treatment. Please consult with your physician before starting an exercise program.
A boundary is the line in the sand that is drawn between what is and what is not acceptable behavior, toward oneself. We have physical, emotional and mental boundaries which we should be setting in all of our relationships. Boundaries help us feel safe, secure and comfortable and help us define how others treat us. The idea is to have firm but flexible boundaries, you do not feel as though you are a controlling person and you may need to adapt some of your boundaries to different situations.
At times we may feel uncomfortable in relationships and in the moment we can not figure out why we are feeling this way. A question you should ask yourself, "Is there a boundary violation happening?" For example, someone is a close talker and moves into your personal space, you may feel some discomfort. It may take a few minutes or even days to figure out why you feel this way when this person comes over to your desk to speak with you. They are breaching your boundary of personal space. Another example is if you are interacting with a friend, family member or your partner and during the interaction, you start to feel resentment toward this person. You may feel they are taking advantage of you in some way, this may be a boundary breach. The next question to ask yourself is "Did I set this boundary?" It is your responsibility to take care of yourself, and set appropriate boundaries for you. If you did set the boundary and it is being violated, ask yourself "What should I do about this breach?"
Boundary setting can feel daunting at times, especially if you generally have loose boundaries. You may feel a little anxious setting limits and may be concerned about possible conflict, retribution in the workforce, being perceived as mean or feeling guilty. You may have many other feelings regarding boundary setting, they are real feelings but should not necessarily stop your boundary setting. Here are some tips for boundary setting.
5 tips for healthy boundary setting:
1. Be direct: State your boundary in a clear and concise manner, so people know exactly where you stand and what behavior is acceptable to you.
2. Saying no: Give yourself permission to say no. Saying no helps maintain boundaries and sets clear limits for what you are and are not willing to tolerate.
3. Practice self care: Self care is important in setting and maintaining boundaries as you need to start putting yourself first, at times. This will help you set limits as boundary setting is a part of self care.
4. Self awareness: Be tuned into your feelings in situations as they are the key to determining if boundaries need to be set. This will also help with recognizing boundary breaches or if someone is trying to push your boundaries.
5. Be assertive: Be assertive and polite when setting boundaries and when maintaining your boundaries during possible breaches. Assertive is not the same as aggressive and you should not become aggressive when setting or maintaining boundaries.
Many people feel that setting boundaries is selfish and that is not true. They help us define where each of us end and the other person begins. The limits we set help us to separate out who we are, our thoughts and feelings, from others in our lives. They improve our self concept and assist us in moving toward healthier relationships.
Disclaimer: This blog is for informational purposes only and not meant to be a replacement for therapy or treatment.
Dr. Deb is a successful Psychologist who practices in New York City. She is an Anxiety Specialist who works with adolescents and adults providing both individual and couples counseling.
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Debra O'Shea, Psy.D PLLC
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