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Q. Is anxiety an indicator of underlying problems?
A. Maybe, it could be. How do you know? You listen to yourself. You ask yourself,
“What is making me anxious?” You try to listen really hard to what the answer is.
Sometimes anxiety, if it’s working properly, is a nudge in the ribs. It means: tune in.
Maybe there’s a social relationship or work responsibility that needs your attention.
Healthy anxiety can be seen as conscientiousness. The anxiety felt in the face of a
looming deadline is normal and healthy. This type of anxiety helps us get things done
that we don’t want to do, such as sorting a pile of papers on our desk or cleaning out an
Dysfunctional anxiety is when the anxiety is so high that it makes your life
unmanageable. When people stop listening to themselves and shut down or distract
themselves with screens or substance abuse to avoid thinking about the thing making
them anxious, their anxiety has become a problem.
Q. When do you know it has moved from healthy anxiety to it being a problem?
A. When whatever is making you anxious is preoccupying you and making your life
unmanageable and interfering with your ability to fully function, anxiety has crossed over
the line into problematic territory. It’s no longer serving a purpose as a nudge in the ribs.
If your body is giving you signals – such as persistent headaches, GI problems,
sleeping difficulties or distractibility – it could be a sign of unhealthy anxiety. If more than
one person in your life is sending you messages that this may be a problem, that’s
important information to pay attention to.
Q. Is anxiety often accompanied by other co-existing conditions?
A. Yes, often, but not always. Many people with anxiety may have other mental health
challenges, including depression, ADHD, Autism Spectrum Disorder and OCD. There
can be other co-existing situations, such as life events and circumstances, that create
anxiety as well.
Q. Do people tend to diminish the legitimacy of their anxiety?
A. People who struggle with anxiety do not listen to appropriate, healthy levels of
anxiety, and then when they get overwhelmed, they tend to push it away. This only
makes the situations causing the anxiety worse. When the anxiety gets to this level,
negative self-talk sometimes strikes, setting sufferers on a downward spiral. Students
stop going to class or doing their homework. Instead of meeting with a teacher or
professor to create a plan to get caught up, they avoid the class and the instructor and
the problem just gets worse. To cope with anxiety, people need to face their fears. Feelings are not facts. But when people’s anxiety gets them into a bad place, they start to have distorted thinking.
Q. Can receiving therapy help anxiety sufferers overcome the things that make
A. Yes. The first thing I’m going to do is to help them face the hard thing. I’ll help them
understand why it’s important and then focus on what needs to be attended to that
they’ve been avoiding.
Q. Is anxiety best treated with medication, or can therapy help?
A. There isn’t one right answer. Some people are wired for anxiety and have a genetic
predisposition for being anxious. They benefit from both therapy and medication. Even
after they’ve been medicated, it doesn’t mean they know how to function. Therapy helps
those with anxiety identify what’s going on inside them before it becomes dysfunctional.
Therapy helps people understand the nature of their anxiety. Specifically, is it an issue
that they don’t have control over that they just need to manage, or is it something they
can do something about? Distinguishing between which it is can help address that
Q. What are the benefits of being treated for anxiety as a young adult versus a
middle-aged or older adult?
A. Therapy can build resilience by helping young people attend to their healthy anxiety
before it becomes dysfunctional. The sooner you learn that the better. Those who have
therapy early haven’t developed all the unhealthy defense mechanisms that build up
when people avoid treatment. It’s like removing wallpaper before painting a wall. It’s a
lot harder to remove the wallpaper if it’s been painted over. If a therapist works with
someone early in their life, that person can develop a healthy understanding about
themselves and learn good habits for relating to others, self-care, and school/work.
By receiving therapy early in life, people develop a good roadmap. By knowing and
understanding themselves, they’re better positioned to attend to their internal cues.
They learn to pay attention and know what to do when it’s time to attend to something.
Q. When do people seek treatment for anxiety?
A. People usually seek treatment when their lives are feeling unmanageable in some
Q. What is your strategy for treating anxiety as a mental health condition?
A. If you’re too anxious, you can’t think clearly and calm yourself. I help patients work on
calming and centering themselves. This helps people think clearly so they can function. There are four areas of coping – mindfulness, emotional regulation, distress tolerance
and interpersonal skills. Some people need to understand what coping skill to use and
to be taught these skills. Some people cope and some people have holes in their
capacity to cope. When people function in a healthy manner, they can identify what’s a
big deal, what’s a middle deal and what’s a small deal and act accordingly.
Q. What causes anxiety?
A. We’re living in a time when the world around us is making people more anxious.
Extreme weather conditions causing floods, wildfires, hurricanes and other natural
disasters, violence in our world, and political discord contribute to a lack of feeling safe
and stable. A few examples of the many sources of anxiety include loss of a job,
terminal illness, divorce, loss of a family member, and financial strain. Both our internal
experience and the world around us can contribute to difficulty managing anxiety