Anxiety Disorders & OCD
What are the Signs and Symptoms of Anxiety?
Do I have Anxiety?
We ALL have anxiety. I can say with 100% confidence that every human on this earth has it to some kind of extent. Anxiety is what gets us to work everyday, it is what has us look at our food before taking a bite, and looking both ways before crossing the street. If you truly had no anxiety, you probably wouldn’t live for much longer, because you would not care about anything. Anxiety is helpful and necessary for us, our survival, and our well being within its normal limits. It is when anxiety grows outside of these healthy limits and begins impacting your life in ways that you don’t like that it becomes something that needs to be addressed and managed properly.
There is a large spectrum of severity and form when it comes to unhelpful anxiety. A lot of people can undoubtedly confirm that yes, they most definitely have anxiety, and others may really wonder if they have it or not, and some with anxiety may not even realize that their anxiety has gotten to an unhelpful point!
Anxiety is any recurring set of intrusive thoughts and feelings that tend to interfere with your day to day life- whether it is thoughts telling you to smell the milk before drinking it or thoughts telling you that you aren’t good enough. Many of us experience unhelpful anxiety in the form of self doubt, negative thoughts, thinking the worst is going to happen (catastrophic thinking), and/or excessively focusing on our fears. Any kinds of thoughts that are repetitive and distracting can be considered symptoms of anxiety. In addition to thoughts, any sudden feelings of sharp physical discomfort when in an unpleasant situation can also be considered symptoms of anxiety, what many would describe to be an anxiety attack or panic attack. While some may experience these thoughts and feelings and be able to continue on with their day, others may surrender to these thoughts and feelings by not getting out of bed, not going to work or class, not starting that project in time, not going on that trip, not taking that risk, maybe even rejecting someone you love or like, and many more.
Here is a list of common signs and symptoms of anxiety:
Inability to fall and stay asleep
Feeling like you can’t concentrate or focus
Losing track of time
Self blame and self doubt
Skipping meaningful life or social events
Frequent stomach aches
Diarrhea or bloating
Skin problems such as eczema or psoriasis
Sudden changes in heart rate or body temperature
Shortness of breath
Feeling that the throat is closing
Sweating or shaking
Loss of appetite or emotional over eating
If you find that you tend to make decisions that you don’t feel great about due to some critical, uncomfortable thoughts or feelings that seem to follow you around, you are likely struggling with anxiety and starting to give your life up in its favor. Giving therapy a try can be really helpful to prevent these things from getting out of control. Therapy is a great investment for your current and future quality of life.
Continue reading for some specific anxiety disorders and their symptoms.
Anxiety Attacks // Panic Attacks
Many people feel that they don’t need help because they aren’t experiencing anxiety or panic attacks. Those that are experiencing regular anxiety attacks would implore you to get help before it gets to the point of physical attacks. Anxiety attacks and panic attacks start with feelings of fear and a need to escape a certain situation, and follow with extreme physical symptoms that very often lead people to the Emergency Room. Many think that they are having a heart attack when in fact, it is actually an anxiety or panic attack, and this can be even more frustrating for people when the ER cannot do anything to help.
Anxiety and panic attacks usually have the following symptoms:
Sudden changes in heart rate or body temperature
Shortness of breath, feeling that you cannot breathe
Feeling that the throat is closing, feeling that you are being choked
Sweating or shaking
Heart palpitations or high heart rate
Chest pain or discomfort
Numbing or dizziness
Feeling disconnected from the body
Fear of losing control or of dying
If you experience an anxiety or panic attack, it is a good idea to check in with a therapist to learn more about what it is that you are avoiding or trying so hard to control, so that these attacks can be better understood and managed with the help of a professional. Nobody should have to live with constant panic attacks.
Social Anxiety // Social Phobia
Anxiety surrounding contacting and communicating with other people is considered to be social anxiety. Social anxiety can come in many levels, from struggling to speak in front of crowds, to not being able to leave your home at all (agoraphobia). Those with social anxiety really struggle to be themselves and get the most out of their relationships and benefit from social support due to constantly attending to their anxieties around others and questioning everything that they do or say. Symptoms of social anxiety can be a mix of any of the aforementioned symptoms of anxiety and anxiety attacks in scenarios involving other people. Overcoming social anxiety and social phobia can be immensely relieving, as authentically socializing with others is a critical part of a well balanced, happy life.
Eating disorders are centered around anxiety regarding food and its relation to body image. Anorexia Nervosa is an eating disorder where someone restricts their eating to a certain extent or completely. Bulimia is an eating disorder in which someone often purges food from their system after eating, whether after binging or only eating a small amount, by taking laxatives or vomiting. These disorders are often fueled by a desire to lose weight, and/or can come from an underlying condition called Body Dysmorphic Disorder, where individuals have a skewed perspective of what they look like (feeling that you are fat even though you are underweight- this is an example of how anxious thoughts can be very far from reality).
While many of us already know the common diagnoses of Anorexia, Bulimia, and Binge eating disorder, not everyone is aware that you can have an eating disorder that does not fall under those specific diagnoses. In fact, there is a new eating disorder called Orthorexia which involves being so obsessive and rigid over a specific diet, often related to a diet fad or trend, that one cannot eat anything outside of the diet. If left unchecked, Orthorexia can quickly and unintentionally lead to Anorexia.
Here is a list of symptoms that can send you down a slippery slope toward eating disorder if you aren’t careful:
Having rigid rules about what you can and cannot eat
Finding yourself thinking about food constantly
Declining participation in certain events due to a food or eating related activity
Having rigid rules about where or with whom you can eat
Experiencing a medical problem as a result of your eating habits
Experiencing weight gain or loss outside of medical recommendations for your height
Obsessive Compulsive Disorder
Obsessive Compulsive Disorder (OCD) is very often misunderstood. Common forms of OCD can include excessive hand washing due to a fear of contamination or germs, or excessively checking for locked doors and turned off appliances due to a fear of break in or fire that would threaten their home and health. OCD can also be more or less invisible, in the form of obsessive thoughts about a certain subject that you find threatening to your quality of life or well being, like whether or not your partner is good for you, or if your child is healthy or not, if you are healthy or not, if you are going to die or not, etc. Many feel that they must ‘control’ these thoughts by thinking specific thoughts to control them, or going through some kind of ritual (whether in the mind or out loud) to reason with the threatening thoughts. This kind of OCD is problematic, because, just like the other more known forms of OCD, it is highly intrusive in your life and can sabotage your ability to be present with the people that you love, pursuing goals that are meaningful to you, and generally contacting the present moment and enjoying life as we all deserve to do.
A form of OCD that is not often talked about is Sensorimoter Obsession, or OCD about somatic, physical sensations that are usually automatic bodily processes such as blinking, salivating, and breathing. Individuals struggling with this obsession often find themselves hyper aware of their bodily processes and unable to bring their attention elsewhere, and this can significantly get in the way of important life activities and be very distressing. ACT works particularly well with treating this form of OCD.
Performance Anxiety / “Imposter Syndrome”
Performance anxiety and Imposter Syndrome are super common experiences for seasoned and brand new professionals. This comes in the form of doubting your abilities, struggling to charge your full worth for your services, and sabotaging your own success. I can tell you right now that if you are struggling with this kind of anxiety, then you highly value competence and a job well done - otherwise you wouldn’t be so worried about your own competence out there. Working with a therapist or life coach can really help you with overcoming the anxiety that comes with starting your own business or following through with your professional goals and can hold you accountable for doing the uncomfortable. Therapy or coaching for this kind of anxiety can be a highly valuable part of your greater business plan. Any forward thinking professional would be smart to have an effective therapist or coach on hand to help navigate the distracting anxiety that the mind can throw at you as you navigate the big bad world of career and business on your own!
How can ACT help me Manage Anxiety?
Acceptance and Commitment Therapy (ACT) targets anxiety in a very unique and effective way. With many other approaches to therapy (that perhaps you have already tried) there is often a focus to control the thoughts (with techniques such as thought blocking or turning a negative into a positive), and there is a lot of trying to rationalize with and prove your thoughts wrong. You might have already noticed that these techniques often don’t work well, and if you haven’t tried it yet, then consider yourself warned ;) This is where ACT takes a very different approach.
Taking action to control or change your thoughts doesn’t work well because you remain to be acting out of avoidance- strategies that you are using to get rid of your unwanted anxiety. In avoiding your anxiety, you have already damaged a lot in your life and restricted yourself- so you don’t want therapy to help you with finding new ways to avoid it and restrict yourself. It might sound counterintuitive, but ACT has you get a little bit closer to your anxiety. Your ACT therapist will ask you some very specific details about your anxiety - what exact thoughts, verbatim, are you experiencing? What kind of a voice do they come in? What physical feelings do they come with, where do you feel it in your body, how quickly does it show up? You will find that as you get closer to the anxiety and observe it in such a way, the threatening nature of your symptoms subside, and you will find yourself willing to make more room for them to be there with you while you carry on with your life.
This is where I tell my clients that I cannot guarantee that their symptoms will go away with ACT, but I can tell you that you will be more clear and oriented toward what you want in your life and your goals as a result of ACT. I want you to practice the ACT techniques that we work on together between sessions in an effort to make space for your anxiety on a day to day basis. It is when you take action against your anxiety, in order to get rid of the anxiety, that you remain harshly judging your experience and in a state of desperate avoidance. While it may seem that the anxiety is the culprit of your life’s problems, it is actually the extreme avoidance that is sending you far away from the kind of life you want for yourself. Often, your anxiety will subside substantially as a side effect to making peace with it and allowing it to be a part of your experience.
Is Online Therapy Appropriate for Treating Anxiety?
Online therapy has some very unique advantages for treating anxiety. The great thing about working with your therapist online is that you can “attend” your session from anywhere! If you are experiencing a lot of nervousness to start therapy, knowing that you can start from a place that you are most comfortable will be much less scary than having to also go to a new place, and you will be more likely to open up more and therefore be able to benefit more from your session.
If you are someone that is particularly struggling with anxiety at work, you might find it especially helpful to practice therapy techniques with your therapist in your office, the setting of your anxiety. Attending therapy from home can be helpful for you to learn and practice techniques with your therapist in a place that is important for you to be able to learn to destress and manage difficult anxiety. Home is somewhere that you are often, so going to therapy from this setting can help you better remember what you are learning and you will be more likely to practice what you learn between sessions.
The only instances in which online therapy is not appropriate for anxiety is in cases that a person is in active crisis, needs active medical monitoring (like for some levels of eating disorder), or for cases of active suicidal ideation and planning.