In the over 10 years that I have been practicing as a psychologist in London, Ontario one of the most common concerns that clients come to me with is anxiety. Clients have lots of different ways of describing this experience. Stressed out. Burnt out. Overwhelmed. Can’t stop worrying. Agitated. Most clients have tried very hard to manage their anxiety on their own, many for years. Lots of clients are taking anxiety medication. But it's just not working…anxiety and worry keep coming back. Chronic worry and fear are still ever-present.
Anxiety is a completely normal and helpful emotion. It is activated when we are faced with possible problems or threats to our sense of security. It helps us plan, problem solve, manage risk, and reduce harm that may otherwise affect us negatively. But sometimes anxiety can be excessive. It can take over our minds and bodies in a way that, over time, becomes exhausting and debilitating. This is problematic anxiety.
Anxiety affects our bodies by increasing arousal. Normal anxiety increases arousal but then our bodies return to a more relaxed state. Problematic anxiety results in chronic arousal. You are physically tense all the time. Some clients feel anxiety in their upper body – stiff neck and shoulders and headaches. Some clients experience chronic stomach aches, nausea, and diarrhea. Panic attacks are a severe form of anxiety and can feel like your body is going haywire – heart pounding, sweating, dizziness, difficulty breathing, and chest pain are some common symptoms. Panic attacks can be triggered by stress or can come up completely out of the blue. These unexpected attacks can be a terrifying experience. Panic symptoms can come on so quickly and intensely that some people believe they are having a heart attack and rush to the ER. Physical anxiety symptoms are taxing to our system and when they hang around too long, they result in exhaustion.
Anxiety also takes over our thinking. Racing thoughts. Constant “what ifs”. The barrage of worries is unrelenting and can affect our ability to focus on daily tasks. Problematic worry often results in a sense of urgency – a feeling that we must attend to the worry right away. We get into a situation where we are constantly jumping from one concern or problem to another. This makes us feel like there is not enough time to get anything done. This cognitive state is not only draining but results in feelings of being out of control. Chronic, intense worry can result in major disruptions to our sleep, which can deplete our coping resources and make it even harder to cope with anxiety.
When I work with clients in counselling, I operate from a core belief that we are all just doing the best we can in each moment and situation. We do things for a good reason, even if perhaps the things we are doing may not be the best strategies in the long-term. When we are trying to cope with excessive anxiety, we often resort to several predictable strategies that may help us cope in the moment but actually make our anxiety worse over time. This is why it is so hard to stop worrying and stressing out. My next post will be about these specific unhelpful strategies.
When I work with clients in therapy on managing anxiety, we work together to first understand what anxiety looks like for them. How is anxiety expressed and affecting them? Then we uncover the strategies that the client is using to cope. We take a look at how these strategies may actually be making their anxiety worse over time. Then we work to shift from these unhelpful strategies to strategies that are effective in managing and decreasing the intensity of anxiety. We address both the physical and cognitive symptoms of anxiety.
It is incredibly rewarding to work with clients on conquering anxiety. Anxiety is actually highly treatable! You do not necessarily need to be taking anxiety medication to manage problematic anxiety. Anxiety does not have to rule your life and suck the joy out of your day-to-day experiences. My model for helping clients with anxiety is primarily based on Cognitive Behavioural Therapy (CBT). It is an evidence-based problem-focused therapy that can really work to decrease the intensity of anxiety symptoms.
If you are struggling with problematic anxiety, I’d be happy to help.