This web page provides an introduction to anxiety symptoms, anxiety disorders and anxiety treatments. It also describes the results-focused psychotherapy treatment for fears and anxiety I provide as a New York licensed clinical psychologist, counselor and coach. I have been treating Specific Phobia, Panic Disorder, Post-Traumatic Stress Disorder (PSTD), Obsessive-Compulsive Disorder (OCD), Social Phobia, and Generalized Anxiety Disorder (GAD), with a practical, multimodal approach which I have developed over the years for working with these painful psychological conditions.
Anxiety Disorder Symptoms and Psychology
Anxiety is a commonly experienced feeling of "nervousness," tension or a vague sense of dread or fear. We may experience a feeling of anxiety when we are anticipating an upcoming event and imagining that it will be stressful or threatening. An Anxiety Disorder, however, is an extremely unpleasant psychological condition that can interfere with one's peace of mind and ability to function.
Fear is a natural, instinctive tool of human survival. It provides extra energy to run away or fight when we are confronted by an actual physical danger. An Anxiety Disorder is a learned, psychologically based pattern of fearful thoughts, behaviors and emotional-physiological reactions which is evoked in situations which pose little or no actual threat.
Here is a brief example:
A talented, ambitious middle manager felt trapped in a boring but demanding job. He received a somewhat critical performance review. The following morning, he boarded a crowded elevator and experienced an anxiety attack, characterized by fear, sweating, hyperventilation and rapid pulse. He soon started having recurrent anxiety attacks at the office and on the way to work (Panic Disorder). He began avoiding elevators (Specific Phobia). At first he thought that he was having a heart attack or a stroke. When it turned out that he was not medically ill, he began believing that there was "something wrong" with him, that he was losing his mind or his "nerve." He was too ashamed to talk to anyone, and began to isolate himself socially and to self-medicate with alcohol. He did not get professional help until his anxiety and depression became severe and too obvious to conceal at work.
This example illustrates how anxiety disorders can develop when we take our psychologically-based perceptions of threat too literally.
Anxiety Disorders make people vulnerable to depression, stress-related medical problems, alcohol, or substance abuse. Sometimes anxiety disorders go into remission, but they may return and get progressively worse.
Symptoms of anxiety can seem so strange or disturbing that many people are reluctant to share them with friends or family. For example, many men who suffer from anxiety attacks or performance anxiety, or social anxiety are reluctant to discuss their anxiety with anyone. Some people needlessly suffer alone for years.
Please phone me in New York City or White Plains, NY if you have questions about whether you are suffering anxiety disorder symptoms and might benefit from anxiety treatment.
Diagnosis and Treatment of Anxiety Disorders
Each Anxiety Disorder has its own unique features, but symptoms usually overlap. Excessive, irrational fear, tension and worry are core anxiety symptoms. Often there are medical consequences or physiological symptoms such as sleep problems. Sometimes anxiety disorder symptoms affect interpersonal or professional functioning. Here is a list of some of the more common Anxiety Disorder diagnoses.
Anxiety Disorder Diagnoses: Best Anxiety Disorder treatments
A Specific Phobia is the experience of extreme, irrational fear and other phobic symptoms in the presence of something that poses little possibility of actual harm. The diagnosis of specific phobia refers to a number of particular phobias. For example, a phobia may be limited to particular kinds of transportation, spaces, places, situations, activities, animals, or people. A phobia is named for the kind of situation it is limited to, e.g., acrophobia refers to fear of heights. People usually go out of their way to avoid the thing or situation which is identified with the phobia.
Psychologically, phobias often build upon ordinary innate childhood fears that are not completely outgrown. Fear of the dark, high places, or strangers, fear of separating from trusted family members, or mistrust of trying new things or eating new foods. These are common and useful behaviors for very young children until they can learn how to distinguish harmful from harmless circumstances.
A specific phobia can develop through a stimulus-response connection to a stressful or traumatic event or through a symbolic internal mental association. This psychological linkage may or may not be conscious. As time goes on, a specific phobia may be strengthened by a person's avoidance behavior itself, or by external rewards for avoidance or by "support" from others for procrastinating or avoiding of the situation. So, even though a phobia can start simply, the longer it goes on untreated, the more potentially complicated it can become treat. Phobias also become stronger when they are not understood or challenged. Cognitive behavioral therapy is the best treatment for early stage phobias of the first type, I find, and Interpersonal and psychodynamic Psychotherapy is best in treating more complex and later stages phobias.
Panic Disorder begins with an anxiety attack or panic attack that may occur without warning or realistic provocation. Panic or anxiety attacks symptoms can be very unsettling or even terrifying. Two or more closely spaced anxiety attacks are considered a Panic Disorder. Panic Disorders symptoms include chest pain, heart palpitations, hyperventilation, shortness of breath, dizziness, feelings of unreality, and fear of dying.
Chronic Panic Disorder may result in a disabling, progressive pattern of phobic avoidance behaviors called Agoraphobia, in which the individual remains at home. Effective anxiety and panic attack treatment begins early, and may include anxiety medication or medications as part of the psychotherapy treatment plan. I find the best treatment for anxiety panic disorder is a combination of cognitive-behavioral therapy, psychodynamic psychotherapy and stress management counseling.
Post-Traumatic Stress Disorder (PTSD)
Post-Traumatic Stress Disorder (PTSD) symptoms can develop some time after experiencing or viewing traumatic event s like rape, assault, or physical disasters. The physiology and psychology of anxiety, fear and terror create unnerving, disruptive symptoms or troubling psychological conditions like a panic disorder or a phobia. Persistent Post-Traumatic Stress Disorder symptoms like flashbacks, nightmares, emotional numbing, depression, irritability, distractibility, and rage episodes can be disabling.
Like Panic Disorder Counseling, it is best when Post Traumatic stress Disorder treatment begins as soon as possible. For most of my clients, I find cognitive behavioral therapy techniques for PTSD, in combination with a practical stress management counseling approach, to be effective for getting symptoms under control.
Obsessive-Compulsive Disorder (OCD)
Obsessive-Compulsive Disorder (OCD) symptoms consists of repetitious, unwanted thoughts or compulsive actions which one feels incapable of controlling. Procrastination, doubt, ambivalence, regret, and guilt often accompany OCD. As in Generalized Anxiety Disorder, excessive worry is a key symptom which causes a great deal of unhappiness and results in a painful self-involvement at the expense of relationships. Obsessive Compulsive Disorders can be very different, one from another. For example, obsessional jealousy looks very different from compulsive hand washing and germ avoidance. The best obsessive compulsive disorder treatment will depend very much on the individual's personality and what is driving the OCD symptoms
Social Phobia symptoms are based upon fear of being observed and judged by others. Anxiety and fear of embarrassment hold people back from social interaction, from speaking in public, or meeting new people. Social phobia can create disabling obstacles to personal and professional growth. The causes of social phobia include constitutional shyness, a low threshold for excitability in social situations, poor self concept, lack of self confidence, unpreparedness for certain situations, and negative experiences and or ideas about these situations.
The best Social Phobia treatment, I find, combines cognitive behavioral therapy and interpersonal psychotherapy and practical counseling with homework assignments.
Generalized Anxiety Disorder (GAD)
Generalized Anxiety Disorder is characterized by generalized fears, daily tension and unnecessary, extreme worry over everything and nothing in particular. Generalized anxiety disorder robs life of happiness and produces its own stress. People with GAD often anticipate the worst, and they exhaust themselves while waiting for it to happen. GAD symptoms also include exhaustion, headache, and insomnia. It can be mistaken for depression. There is some evidence that cognitive behavioral therapy is the best generalized anxiety disorder treatment.
Treating Anxiety Disorder: a Result-Focused Treatment Approach
Anxiety Disorders respond well to a dynamic, stepwise psychotherapy and counseling approach. I find it best to treat presenting symptoms of an Anxiety Disorder right away and then focus on the situation or psychological issues that drive them. Here is how my approach, as a solutions-focused psychologist, counselor and psychotherapist, works when treating Anxiety Disorders.
We start by quickly addressing and dealing with specific symptoms of an anxiety disorder, usually through cognitive behavioral therapy and stress management counseling. We may then go on to address the fundamental issues which create or drive anxiety by using a combination of relevant, effective treatment methods for Anxiety Disorders, including psychodynamic psychotherapy, interpersonal psychotherapy, positive psychology, and others as needed.
Here are some of the psychotherapy and counseling approaches that I draw upon and tailor to meet the treatment needs of my client's with anxiety disorders.
Stress Management Counseling for Anxiety Disorders
High levels of stress can produce and/or accompany an anxiety disorder. Anxiety and stress can also produce or exacerbate a medical disorder. Stress Management Counseling and treatment provides practical information and stress reduction techniques to control and prevent stress and shorten the length of anxiety disorder treatment.
Cognitive-Behavioral Therapy for Anxiety Disorders
Behavioral therapy uses behavioral techniques to control tension and to overcome anxiety by confronting the feared stimuli. Cognitive therapy teaches people to change nonproductive habits of thinking and to react differently in situations that trigger anxiety. Cognitive behavioral therapy applies cognitive psychology to the process of achieving symptom relief, gaining control of emotional upset and ineffective behavioral reactions.
Psychodynamic and Interpersonal Psychotherapy for Anxiety Disorders
Psychodynamic and interpersonal psychology help people to identify the underlying emotional and relationship issues which create Anxiety Disorders. I find and select the best psychological counseling approaches, like cognitive behavioral therapy, to enhance the effectiveness of insights gleaned from interpersonal and psychodynamic analysis and psychotherapy.
Positive psychology stresses the usefulness of courage, rational optimism and self empowerment in the face of trauma and fear.
Consulting a Psychiatrist About Anxiety Medications
Anxiety Disorder medication may also be considered, as a temporary supplement to behavioral or psychological treatment methods. Anxiety medications may be useful, short-term adjuncts for treating anxiety. Anxiety medications for Panic Disorder and Post traumatic Stress Disorder (PTSD) can be helpful for quickly bringing potentially disabling symptoms under control and preventing them from becoming permanently entrenched. Generalized Anxiety, Phobia, and Obsessive Compulsive Disorder medications, in combination with cognitive behavioral therapy and stress management counseling, can help clients to jump start their recovery from chronic, severe or disabling symptoms of anxiety.
My clients sometimes ask my advice about whether they could benefit from anxiety disorder medications or whether they should consult with a psychiatrist about their symptoms of anxiety. Sometimes I raise the question. The decision belongs to my client. I am open to these discussions and to referring clients for a psychiatric medication consultation. I am confident my grasp of these issues and the professionalism of the psychiatrists I refer to for anxiety medication consultation.
Find Help and Get Therapy for Anxiety Disorders and Phobia in New York City and Westchester, NY
Please feel welcome to contact me if you would like to discuss Anxiety Disorders treatment, or my qualifications as a licensed clinical psychologist, counselor and psychotherapist. I have used therapy, counseling and a variety of psychology methods to help many clients work through stress, anxiety and phobias. I find Anxiety Disorder treatments help most when an experienced mental health professional can choose from a variety of effective psychotherapeutic perspectives and clinical tools.
My anxiety and phobia therapy offices are conveniently located and easy to find in New York City (midtown Manhattan) and Westchester, NY (White Plains), convenient to nearby Greenwich, CT.
I am currently in the process of trying to find a psychotherapy and counseling office in downtown Greenwich, CT.