Therapy for Anxiety in DC
• Written by Dr. Collin Vernay •
“Worrying is carrying tomorrow's load with today's strength— carrying two days at once. It is moving into tomorrow ahead of time. Worrying doesn't empty tomorrow of its sorrow; it empties today of its strength.”
—Corrie Ten Boom
What is anxiety?
Anxiety is the body’s natural response to stress. It is anticipatory in nature and may be described as a feeling of fear or apprehension about the future (even if that future is only moments ahead).
Anxiety is a normal and expected feeling to have as a human being. In fact, anxiety can be quite adaptive, both by alerting us to immediate threats to our well-being and by signaling our attention. Some amount of anxiety can even be motivational, as when an upcoming deadline focuses our energy into completing an assignment or when we feel an adrenaline rush during an important sports game. However, excessive, persistent, or prolonged exposure to anxiety can be harmful to our bodies and may get in the way of us accomplishing our goals or meeting important day-to-day tasks.
Anxiety disorders are the most prevalent mental health concern and affect around 30% of the adult population in the United States at some point in their lives, though not all experiences of anxiety meet criteria for diagnosis. It is often most helpful to consider anxiety as existing on a spectrum, with lower rates of anxiety serving to motivate us to action and higher rates becoming distressing and running the risk of interfering with our lives. Whatever the case may be, anxiety is highly treatable and responsive to mental healthcare, and most individuals struggling with anxiety can learn to more effectively manage their concerns and thus live more satisfying and fulfilling lives.
Common symptoms of anxiety
The symptoms of anxiety can be understood in four broad categories, including 1) cognitive, 2) emotional, 3) behavioral, and 4) physiological symptoms. These symptoms are interrelated, and experiencing one set of symptoms is likely to provoke others. For example, a person may have the thought, “I think my marriage is failing.” This cognition may provoke feelings of shame, fear, sadness, or guilt. It’s likely that such feelings would produce physiological reactions, like an accelerated heart rate or rapid, shallowing breathing. In order to cope with these difficult feelings, one might engage in particular behaviors. In the case of anxiety, these behaviors often take the form of avoidance, such as choosing not to discuss these fears with your spouse.
The symptoms of anxiety can be highly individualized and often reinforce one another. Understanding your particular experience of anxiety may provide opportunities for disrupting this pattern (e.g., choosing to discuss the aforementioned fears with your spouse, using cognitive strategies to challenge your fears, etc.). Click through the symptom categories below to review a few examples for each, and check out my article on cognitive distortions to learn more about some of the patterns of thinking most associated with anxiety:
Physiological symptoms are especially heavily weighted in our experience of anxiety, as anxiety activates the body’s fight-flight-or-freeze response. This response is a physiological “gearing up” of the body to respond to danger that has ensured our survival when confronted with urgent threats to our safety (e.g., physical attacks). However, the “threats” in our lives today are rarely physical and tend instead to be more abstract (e.g., a failed test, going to a party, dating). The brain fails to differentiate these threats in its fear response, resulting in the same bodily experience of anxiety as if confronted by a bear. You may feel tense, experience rapid and shallow breathing, or notice an accelerated heart rate when confronted with anxiety-provoking triggers, for example. When our experience of anxiety is persistent or non-specific (i.e., generalized), this response can be especially distressing, distracting, and negatively affect the quality of our lives.
Causes of anxiety
Some amount of anxiety in our lives is normal, healthy, and adaptive. However, when this anxiety becomes either disproportionate to a given situation, inappropriate to an individual’s age, or begins to hinder one’s ability to function day-to-day, it may meet criteria for an anxiety disorder diagnosis. Anxiety is best understood as existing on a spectrum, and even levels of anxiety that do not qualify for a diagnosis may still be distressing or distracting and benefit from treatment.
According to the American Psychiatric Association, the cause of anxiety disorders is not fully understood, but as with most mental health concerns, it is believed to be attributable to a combination of genetic, environmental, psychological, and developmental factors. Anxiety disorders can run in families, suggesting that those who develop anxiety disorders may have a genetic disposition to them that is activated when combined with environmental stressors.
Anxiety disorders
It is important to use caution when exploring diagnoses for anxiety disorders, especially without the guidance of a mental health professional. In general, I see diagnosis as a useful tool for understanding a client’s concerns and for guiding treatment, though many clients who benefit from therapy may not meet criteria for a particular diagnosis. Most who do can find relief in treatment by more effectively managing their concerns and thus live more satisfying lives. That said, here are a few examples of anxiety disorders, as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-V):
Generalized anxiety disorder
Panic disorder
Specific phobias
Agoraphobia
Social anxiety disorder
Separation anxiety disorder
Selective mutism
It is not uncommon for an individual diagnosed with an anxiety disorder to additionally suffer from depression, with an estimated 60% of individuals also qualifying for a diagnosis of major depressive disorder. While the reason for this remains unclear, theorists believe this may be attributable to underlying neurobiological mechanisms shared by both anxiety and depression. Additionally, it may be that the effects of either experience on one’s quality of life contributes to the development of the other or that they may be provoked by the same environmental stressors. For example, a person who is socially anxious may find it difficult to develop and maintain relationships, which may lead to the persistent feelings of sadness characteristic of depression. Lastly, this commonality may simply be attributable to the criteria professionals have established for both disorders, which share similar symptomological profiles.
Treatment options
Anxiety disorders are highly treatable and responsive to care. However, according to the Anxiety and Depression Association of America, as little as 37% of those struggling with anxiety disorders receive treatment. This may be due to a combination of factors, including poor public awareness of anxiety and treatment options, financial and institutional challenges, mental health stigma, and psychological or emotional barriers to getting started.
Generally, treatment for anxiety involves some combination of talk therapy, medication management, and/or other complementary health practices (e.g., stress and relaxation techniques, mindfulness and meditation). Finding a qualified therapist in DC with whom to explore treatment options can be an important first step to getting started.
I often work with individuals struggling with anxiety in my own practice and have seen how therapy can help you to live a more balanced life. If you’re interested in working together, simply click the “Find Relief” button below to contact me.