Therapy for Anxiety & Stress

What are Anxiety & Stress?

Anxiety and stress are feelings we have that are difficult to separate, and depending on your level of self-awareness, sometimes difficult to detect. Like all feelings, they are signals of change, and perhaps, signals of a need to make changes in how we’re caring for ourselves. Stress and anxiety are commonly discussed in tandem, as we do here, but to be clear they are different processes that play out in our bodies. We define and discuss each below, and provide you with a brief understanding of the serious effects both can have on your health and daily functioning.

Treatment for Anxiety & Stress

In this section we discuss the critical importance of self-care in managing the accumulating feelings of stress and anxiety. We also discuss specific interventions that you can begin to practice in your daily life that can have a meaningful effect on your ability to deal with anxiety and how they change the structure of your brain. At the bottom of the page, we demonstrate a technique to help you identify how stress may show up for you and we provide an in the moment breathing exercise that you can use at any time throughout your day to find a sense of calm.

What is Stress?

Stress is difficult to define, but understanding what it is and how you can reduce and manage it could be the key difference in having a successful marriage or adding years onto the end of your life. To attempt to put it into the most simple terms, stress is the result of an experience and the body’s subsequent reaction to that experience. The experience can be a lived experience, meaning something that has actually happened, or a psychological experience, meaning something that has only happened in your head. There are negative stressors (difficult co-workers, a traffic-jammed commute, or an inability to understand your emotions) and there are positive stressors (being promoted at work, having a baby, or buying a home). What makes a stressor positive or negative has to do with our perception of the experience and our appraisal of our own abilities and resources to handle the experience.

The most common example you will likely hear for the positive purpose of stress relates to our survival as humans. Imagine you’re camping in the Cascades. Your tent is zipped up and all of your belongings are safe inside with you. Your sleeping bag is finally warm and as you start to drift off to sleep you hear some rustling, breathing, and heavy footsteps coming from outside the tent - the unmistakable sound of a bear, one that’s all too close for comfort. At this point, your central nervous system has activated your fight, flight, or freeze response - your heart is beating faster and you respiratory system has increased your rate of breathing in order to increase the oxygen levels in your body, in the case that you determine that you need to fight or flee. Your mind is also racing at this point, likely going through a safety checklist to ensure you didn’t leave any food laying around outside your tent, essentially making yourself into bear bait, and trying to determine your best course of action.

The stress response is the reaction that happens in our bodies (see above), and it includes a release of hormones such as cortisol and adrenaline, which affect motivation, sleep, digestion, and your body’s ability to respond to fear. Stress can have a damaging effect on every major system in our bodies (reproductive, endocrine, gastrointestinal, respiratory, nervous, etc.). The American Institute of Stress lists 50 different symptoms of stress, both mental and physical, that have serious implications on your ability to function daily and live a long life. The symptoms include a wide range: a change in appetite, exhaustion, difficulty concentrating, chest pain, excess anxiety, depression, and frequent crying spells or suicidal thoughts.

Stress is not something that can be ignored or entirely eliminated in our lives. There are steps you can take to reduce the amount of stressors you face daily, such as, gaining skills in resolving conflict and communicating with the people in your life, putting limits on endless doom scrolling on your phone, and creating routines to complete unavoidable tasks of daily life. Once you’ve examined your life and reduced unnecessary stressors, learning to manage the inescapable stress in your life is essential to healthy living. We talk more about the treatment for stress below, but next we take a look at anxiety and the effects it can have on you.

What is Anxiety?

There is a distinction to be made between anxiety and an anxiety disorder. Like stress, all of us face anxiety from time to time in our lives. Although it isn’t pleasant to feel anxiety in your body, it is useful when we recognize it and respond appropriately. An easy example is you have a project that has to be completed by a specific deadline, and the worrying related to the completion of this task helps to motivate you and stay on schedule. This type of situational anxiety is essential for our survival and dissipates once the event is over.

Anxiety disorders on the other hand are irrational, persistent or chronic, and are marked by behaviors such as avoidance and escape. Around 19% of Americans are impacted by anxiety disorders every year, and left untreated, these disorders can have lasting effects on every aspect of your health (biological, psychological, and social). Below is a brief explanation of the specific types of anxiety disorders.

• Generalized Anxiety Disorder - Marked by inappropriate and excessive worrying that persists more than a few months, and the worry isn’t directly related to any particular event or circumstance.

• Panic Disorder - Commonly referred to as “panic attacks.” Distinguished by sudden bouts of heightened anxiety with common physical and psychological symptoms like sweaty palms, rapid heart beat, and a fear of dying. The episodes can last up to 45 minutes but typically peak within 10 minutes.

• Agoraphobia - The fear of having anxiety or a panic attack in an environment that is perceived as potentially inescapable or where the person may not be able to receive help easily. Approximately two-thirds of people who experience panic attacks develop agoraphobia as well.

• Social Anxiety Disorder - The irrational fear of being negatively evaluated by other people. Sometimes this is felt as a fear of embarrassment.

• Separation Anxiety Disorder - The fear of being separated from an attachment figure.

• Specific Phobia - An irrational and excessive fear of a specific situation or object, such as flying or dogs.

Anxiety disorders commonly occur along with other diagnoses like Post-traumatic Stress Disorder (PTSD) and depression, and can be a cause for substance use and addictions. Because anxiety disorders tend to form together with other disorders, it can make it difficult to tell what you’re feeling and why your feeling it. It doesn’t always appear to be an issue based in fear to the person experiencing the anxiety, or to the people around them. It is often expressed as anger, irritability, being tense or rigid - and it can go undiagnosed for a lifetime. This illusive effect of anxiety makes it essential to work with a professional to receive proper treatment.

Treatment for Anxiety and Stress

There is no cure for stress and anxiety - as stated above, we all have to experience different types and levels of stress and anxiety throughout our lives. However, we can become highly skilled at managing these feelings in order to lessen the impact on our mental and physical health and our daily functioning. We start with reducing stressors and building skills to ensure that you are getting relief from these confusing and unwanted feelings. Some skills provide relief in the moment (see below), when you’re not feeling at your best but you still have to get through your day. Other skills are preventive, which stop the accumulation of stress and the long list of negative symptoms that often follow. The preventive skills are often referred to as self-care.

Learning and implementing daily self-care habits are the key to avoiding the build-up of stress and anxiety. If you delay going on that run or getting into your yoga practice for too long, you start to feel it in your body and you become irritable, short, and reactive with the people around you - often with the most important people in your life. This is not your best self, and it’s not the self anyone has ever dreamed of being. Self-care is a daily practice and much of it can be accomplished by setting realistic goals and forming habits.

Self-care isn’t just exercising and making sure you get enough sleep, though both of those are critical to your health. It can also include taking a hot bath, cleaning your house, hygiene, drinking enough water, practicing mindfulness and other forms of meditation, keeping a journal, and spending time with people who you enjoy. It’s important to find what works for you.

Treatment for anxiety disorders is more specific. The resulting avoidance and escape behaviors end up making problems worse for people because they tend to become isolated from social contacts and disconnected from the world around them in order to gain a sense of safety. Working with a therapist to begin to examine your fears and understand their irrationality is a good first step. Utilizing visualization techniques can help to approach the feared objects or environments in a safe space. Ultimately, therapy aids in taking small steps toward facing your fears until you can function and feel a sense of calm.

Interventions for Anxiety & Stress

A Mindful Neuroscience Approach

Having a basic understanding of how your brain works can give you an added sense of control in your life. The way that our brains grow is through a process called neuroplasticity, which means that when a brain region receives neural firing, brain cells begin to cluster in that region. More firing means more cells clustering, and eventually, with enough repetition you have significant growth and what’s called neural pathways. The term pathways is helpful here if you can picture a path in a forest. The more times that path is traveled the deeper and wider it becomes, and the more connected the pathway will be to other regions of the forest. It’s the same idea with neuroplasticity and your brain.

The prefrontal cortex (PFC) and the limbic system, specifically the amygdala, are the areas of the brain implicated in general anxiety disorder and panic disorder. Brain imaging studies have given us incredible insight into structural issues for people who suffer from these disorders, and what we can do to correct those issues.

The PFC is the part of your brain that separates you from other mammals. It’s involved in critical tasks like impulse control, empathy, and most importantly for our purposes - emotional modulation. The limbic system is described as your brain’s emotional center, and the amygdala, is often referred to as the fear center. It’s the part of your brain that helps you to react to a dangerous situation before you’re consciously aware of the danger. For instance, suddenly halting on a trail if a snake is in your path. If your amygdala is functioning properly you will stop moving slightly before the image of the snake has registered in your field of consciousness. The PFC is located on top of the limbic system and typically they directly communicate. One of the things brain imaging has been able to show us is that in people with general anxiety disorder and panic disorder, these connections are atypical, meaning they aren’t as strong as they could be and impact the PFC’s ability to soothe the amygdala when it isn’t functioning properly and is reacting to a perceived, yet, irrational fear - like a snake you saw on a hike you took several months ago. The other important finding of brain imaging studies in regard to anxiety disorders is what we can do to fix those impaired connections.

Mindfulness meditation techniques activate the PFC specifically, creating what’s called neural firing in that region. Mindfulness is a practice of focusing your attention on a specific sensation, such as the inward and outward flow of breath through your nostrils or the rise and fall of your abdomen with each breath. When we focus our attention, the brain pools resources to those areas and creates new neural pathways, as we discussed above with the example of creating paths in a forest. Over time, with repeated practice of focusing our attention on a specific sensation, the neural pathways grow larger and the brain is thus changed. Scans have shown that focused attention on sensations of sounds grow the auditory regions of the brain, and likewise for the visual regions with focused attention on sights. The growth of these brain regions is important to create linkage between separated regions in order for the brain to function in a more balanced and adaptive manner.

These findings and techniques are exciting in that they mean while we can never rid ourselves of anxiety completely, certain disorders can be overcome. It’s also important to note here that mindfulness techniques must be used appropriately in dealing with specific issues like generalized anxiety disorder and panic disorder, and can be potentially harmful if practiced by someone with a history of trauma who doesn’t have adequate emotional regulation skills. Keep scrolling to learn about a technique you can use to calm yourself from stress and anxiety in the moment.

How to Calm Yourself

As an example of an intervention that is helpful in the moment, take some time now to scan your body for any tension you might be experiencing presently. Because we feel stress and anxiety in our bodies, it’s critical to raise your level of awareness of physical sensation and identify how you experience stress and anxiety in your particular body. Are your feet flat on the floor? Are your shoulders up around your ears or down and relaxed? Is your jaw clenched? Are you holding your breath? Is your mind racing? These are some of the many common indicators that you can use throughout your day to identify when you’re feeling stressed or anxious and begin to use various soothing and relaxing techniques to feel more calm.

As an example of one of those techniques, take in a deep breath while counting to four, pause and hold the inhaled breath and count to four, then exhale while counting to four, and hold again after you exhale for another count to four. Repeat this four to six times, or until you feel calm in your body. This exercise is called squared breathing and it will calm your central nervous system and provide relief from stress and anxiety.

The next step is uncovering what may be causing these feelings. Click the link below to schedule a consultation to ensure you’re a good fit to work with one of our therapists.