Washington DC Anxiety Counseling

What is anxiety?

Anxiety is the subjective experience of worry, fear, nervousness, and apprehension, often about things that we cannot control. Although anxiety is a normal human emotion that we all feel from time to time, there are instances where anxiety can begin to take a life of its own and become a debilitating force in one’s life and relationships. Many emotional disorders are anxiety related, such as Post-Traumatic Stress Disorder (PTSD), Social Phobia, Obsessive-Compulsive Disorder, Panic Disorder, and the various Phobias. The prevalence of anxiety is high, with anxiety disorders affecting over 40 million adults in the US each year. Anxiety is often associated with medically unexplained medical symptoms/pain, such as migraines, fibromyalgia, chest pains, tension headaches, asthma, and gastrointestinal upset. 

 

Common Symptoms of Anxiety:

  • Excessive worry or apprehension that interferes with your life
  • Restlessness or feeling keyed up or on edge
  • Difficulty concentrating or mind going blank
  • Irritability
  • Muscle tension
  • Difficulty falling or staying asleep, or restless sleep.
  • Panic attacks
  • Fearful of certain situations or places (flying, heights, elevators, etc.)

In addition to the psychological experience of anxiety, anxiety is characterized by distinct physical experiences. These include:

  • Tension throughout the body
  • Tension headaches
  • Stomach upset, nausea
  • Heart palpitations or increased heat rate
  • Sweaty hands and palms
  • Trouble concentrating, mind going blank
  • Shortness of breath
  • Chest pain

Physiological Pathways of anxiety

Anxiety is manifested in the body. It is a bodily experience based on the activation of the either the somatic, sympathetic, and/or parasympathetic nervous systems. There are three systems of anxiety discharge in the body that I commonly see in therapy with my clients, and you might experience one or more of these, depending on how severe your anxiety is.

  1. Striated muscle: When we experience anxiety in this system, we feel tense. Our muscles are tight. We clench our jaws, or bite our nails. Our back and neck is tight. We have trouble sleeping. When anxiety is predominate in this system, we look “keyed up” and often experience physical symptoms, such as chest pain, back and neck aches, or tension headaches. We wake up sore in the morning. Our muscles feel tight around the face and eyes. If you go to your doctor about his, you might walk out of the office with a prescription for an anti-anxiety medication, such as Xanax.
  2. Smooth muscle: When we experience anxiety in the smooth muscles, we often suffer from stomach upset, nausea, and feeling like we are going to throw up when something “stresses” us out. When anxious, instead of feeling tight and tense, our muscle feel weak or lose. We feel like we have little energy and that our strength is being drained from us. Many do not realize this is the effect of anxiety, as we most often associate anxiety as being “tense”.
  3. Cognitive Perceptual Disruption: When anxiety is channeled into the Cognitive-Perceptual field, our minds go “offline”. We get confused, have trouble putting our thoughts together, feel dizzy or woozy, and have trouble thinking straight. We get forgetful, or become “spacey”. This is the person who faints when they see a bear charging them! To continue this analogy, if a bear charges, a person with smooth muscle anxiety might throw-up, whereas a person with striated anxiety might turn and run, or pick up a branch to fight off the bear.

Anxiety vs. Fear

I am often asked the difference between anxiety and fear. Although they often feel same, fear is the reaction to an actual object or event that involves threat to one’s safety or life. A mugger with a gun or a bear charging you are good examples of something that would (and should!) cause fear. Anxiety, on the other hand, often does not have an object—one will just experience a sense of worry and dread, but not really be sure why.

Treatment

Often our mind tries to makes sense of why we feel anxious and we will try to find meaning or reasons for our anxiety. “I am just nervous about my test next week” or “I just have a lot on my plate right now” are some examples of this.  In therapy, however, my experience has been it can be misleading to overly focus on these external reasons, as I have found this can lead to superficial results, because once the fearful “event” has passed or been resolved, then the mind will find something else to be anxious about. This can go on for years, and is one of the reasons why client’s often feel like their life is never stable or in control.  That is why I feel it is important to get to the root of your anxiety and resolve what is really driving it. In other words, to help you make sound and solid internal changes within yourself, which allows you to be more emotionally calm and secure when life (which it always does!), throws difficult situations our way. In therapy, we examine the internal emotions, feelings, and urges that the anxiety is covering up and blocking. We examine the thoughts that might be exacerbating your anxiety. We examine the behaviors that might be exacerbating your anxiety, and look to how we can make lasting changes in each of these areas.