Anxiety Answers

I’m antisocial and dealing with emotional and mental health issues

Dear Omo, First of all, I am so glad that you have reached out for help. Coming to BetterHelp for therapy is a brave step and I think you will find that working one on one with a counselor here will really help. It is completely normal to feel anxiety around new people (and people you already know).This can result in shyness *or* sometimes acting overly social and sharing too much to compensate.  Often this stems from a worry about being judged or about being disliked. It seems like social anxiety has increased dramatically since the onset of the COVID 19 Pandemic since many of us have had more limited interaction and spending time with strangers was *literally* unsafe prior to vaccines (and even since then for some). As such, it is important to know that you are not alone in this. When you see people walk into a social situation with a smile and a warm handshake, often they are employing the “fake it ‘til you make it” approach. Further, we live in a society that makes us all feel like we need to be extroverts, whereas it is just fine to be a person who only needs a few close friends instead of a large group. Oftentimes when we are in our 20s we start to recognize whether we are the kind of person who feels recharged after spending time with others (extrovert) or who feels recharged after spending time alone (introverts). There is no one right way. The physical sensations you may be experiencing: increased heart rate, sweating, nausea, feeling overwhelmed and panicked are all signs of your fight or flight response. This is an evolutionary function of our sympathetic nervous system that helps our bodies prepare for dealing with predators (either to fight or flee). In addition, you may feel your muscles tense up and a surge of energy as glucose and adrenaline are released into your bloodstream.  The fight or flight response makes a lot of sense if you are dealing with a physical threat, but it does not help us much when our threat is a work deadline, being late for an appointment, meeting a new person, poor internet connection, or other modern stressors. Indeed, too much of the fight or flight response causes stomach upset, muscle tension, bad mood, trouble sleeping, and eventually even lowered immunity (do you ever notice how college students always get sick right after final exams?).  Back to the fear you may feel in social situations… Social anxiety becomes a serious problem when it starts to inhibit you from doing activities you enjoy, from succeeding at school or work, or from general happiness. What to do about it? - Learn about the links between anxiety, depression, and cognition. From what you wrote, it sounds like social anxiety and other anxieties are not new for you (but is certainly much more problematic right now). A few decades of social science research have helped us understand that our thought patterns and how we consider the world and events lead to specific emotions. Your therapist can teach you more about the cognitive model and describe some practical tools to change the maladaptive thought patterns (in other words, the ways of thinking that keep bringing you down). There are so many practical ways to get started with this work, and it can help strengthen you throughout your life. In the mean time, you can learn more by watching a Groupinar on Better Help about Cognitive Behavioral Therapy to start learning about the links between anxiety and cognition. - Disrupt intense fear or the fight or flight response with deep breathing. Learning deep belly breathing (or “diaphragmatic breathing) is a great tool to add to effective stress management. Taking time to breathe deeply for a few minutes is a free and easy to learn method to take you out of the fight or flight zone and into a zone where you can think more clearly and not experience those side effects. You can Google “deep breathing” or “diaphragmatic breathing” to start learning a technique that really helps most people. You can find mobile apps to help (for example the Breathe2Relax or the Virtual Hope Box app – both are free and evidence-based) or watch videos online that can walk you through it. These are skills that not only help you now, but can assist you throughout your entire life (for example, dealing with road rage, poor customer service, annoying family). You can also disrupt the fight or flight response in the moment with just a minute or two of intense exercise (for example, push-ups, jumping jacks or walking up and down a flight of stairs). This helps use some of the adrenalin and glucose that are released into your blood stream when you have encountered a stressor and leaves you thinking a bit more clearly. - Try to identify triggers. We are creatures of habit, and we tend to be afraid of consistent things. Unfortunately, the more we avoid a fear, the stronger that fear gets (avoidance is like fuel for fear). As such, it is important to start learning about the common themes of what makes you anxious. Is it a fear of being judged? A fear of failure? A fear of not being loved or admired? Everyone is different. The best way to do this is to start keeping a log of the times you experienced the fight or flight response. Jot down in a journal or in an app like Google Keep these times, including: -- What was the triggering event? -- How long did it take to calm down?  Over time, your therapist will likely recommend that you also track “what was the automatic thought,” or the instant thought that just popped in to your mind that might have made you feel even worse (such as “everyone here is going to hate me.” Or “They all think I’m stupid.”) Your therapist can help you identify themes and come up with alternative cognitions or thoughts to battle these automatic thoughts. I see good things in your future. You have already taken a huge first step and I’m confident that you and your therapist here on Better Help will be able to figure out better patterns for you. Best, Julie Note: If you are in crisis and feeling like hurting yourself, please call 911, go to your closest emergency department, or call the suicide hotline (the National Suicide Prevention Lifeline) immediately at 800-273-8255. You could also go to their website to chat at https://suicidepreventionlifeline.org/.    
Answered on 08/09/2022

Is this feeling normal? How can I cope with these thoughts? How do I feel at peace moving forward?

Dear Klaus, First of all, I am impressed that you are reaching out for help. It is a brave first step, and I want to congratulate you on dipping your toe in the water here at BetterHelp to see if meeting with a therapist here will help you. You have raised several different issues here, and it is clear that you have a lot on your mind. Anxiety becomes a serious problem when it starts to inhibit you from doing activities you enjoy, from succeeding at school or work, or from general happiness. What to do about it? - Speak to your medical health care provider about whether anti-anxiety medication may be a good fit for you. Anxiolytics are safe and effective, and they can help increase the effectiveness of one on one talk therapy. - Learn about the links between anxiety and cognition. From what you wrote, it sounds like overwhelming feelings are not new for you (but certainly much more problematic right now). A few decades of social science research have helped us understand that our thought patterns and how we consider the world and events lead to specific emotions. Your therapist can teach you more about the cognitive model and describe some practical tools to change the maladaptive thought patterns (in other words, the ways of thinking that keep bringing you down). There are so many practical ways to get started with this work, and it can help strengthen you throughout your life. In the mean time, you can learn more by watching a Groupinar on BetterHelp about Cognitive Behavioral Therapy to start learning about the links between anxiety and cognition. - Learn more about anxiety in general. Physical sensations like increased heart rate, sweating, feeling overwhelmed and panicked are signs of your fight or flight response. This is an evolutionary function of our sympathetic nervous system that helps our bodies prepare for dealing with predators (either to fight or flee). In addition, you may feel your muscles tense up and a surge of energy as glucose and adrenaline are released into your bloodstream. The fight or flight response makes a lot of sense if you are dealing with a physical threat, but it does not help us much when our threat is a work deadline, being late for an appointment, meeting a new person, poor internet connection, or other modern stressors. Indeed, too much of the fight or flight response causes stomach upset, muscle tension, bad mood, trouble sleeping, and eventually even lowered immunity (do you ever notice how college students always get sick right after final exams?). - Disrupt intense fear or the fight or flight response with deep breathing. Learning deep belly breathing (or “diaphragmatic breathing) is a great tool to add to effective stress management. Taking time to breathe deeply for a few minutes is a free and easy to learn method to take you out of the fight or flight zone and into a zone where you can think more clearly and not experience those side effects. You can Google “deep breathing” or “diaphragmatic breathing” to start learning a technique that really helps most people. You can find mobile apps to help (for example the Breathe2Relax or the Virtual Hope Box app – both are free and evidence-based) or watch videos online that can walk you through it. These are skills that not only help you now, but can assist you throughout your entire life (for example, dealing with road rage, poor customer service, annoying family). You can also disrupt the fight or flight response in the moment with just a minute or two of intense exercise (for example, push-ups, jumping jacks or walking up and down a flight of stairs). This helps use some of the adrenalin and glucose that are released into your blood stream when you have encountered a stressor and leaves you thinking a bit more clearly. - Try to identify triggers. We are creatures of habit, and we tend to be afraid of consistent things. Unfortunately, the more we avoid a fear, the stronger that fear gets (avoidance is like fuel for fear). As such, it is important to start learning about the common themes of what makes you anxious. Is it a fear of being judged? A fear of failure? A fear of not being loved or admired? Everyone is different. The best way to do this is to start keeping a log of the times you experienced the fight or flight response. Jot down in a journal or in an app like Google Keep these times, including: -- What was the triggering event? -- How long did it take to calm down? Over time, your therapist will likely recommend that you also track “what was the automatic thought,” or the instant thought that just popped in to your mind that might have made you feel even worse (such as “everyone here is going to hate me.” Or “They all think I’m stupid.” Or “I need to determine my life’s purpose or else I’m a failure.”) Your therapist can help you identify themes and come up with alternative cognitions or thoughts to battle these automatic thoughts. - Learn more about social anxiety. It is completely normal to feel anxiety around new people or people we already know. Often this stems from a worry about being judged or about being disliked. It seems like social anxiety has increased dramatically since the onset of the COVID 19 Pandemic since many of us have had more limited interaction and spending time with strangers was *literally* unsafe prior to vaccines (and even since then for some). As such, it is important to know that you are not alone in this. When you see people walk into a social situation with a smile and a warm handshake, often they are employing the “fake it ‘til you make it” approach. Further, we live in a society that makes us all feel like we need to be extroverts, whereas it is just fine to be a person who only needs a few close friends instead of a large group. Oftentimes when we are in our 20s we start to recognize whether we are the kind of person who feels recharged after spending time with others (extrovert) or who feels recharged after spending time alone (introverts). There is no one right way. I see good things in your future. Again, I’m so impressed that you have reached out for help and I’m confident that working with your therapist will help you in several areas of your life! Best, Julie Note: If you are in crisis and feeling like hurting yourself, please call 911, go to your closest emergency department, or call the suicide hotline (the National Suicide Prevention Lifeline) immediately at 800-273-8255. You could also go to their website to chat at https://suicidepreventionlifeline.org/.      
Answered on 08/09/2022

What do I do with my life?

Dear T, It's clear you have a lot going on. It can feel so empty to go through life without feeling that you are successful or even comfortable with yourself or the path you are on. I'm so glad you came to BetterHelp; once you are matched with a therapist you will be able to work together to figure out ways you can (1) improve your current progress and (2) make sure that the choices you are making will truly make *you* happy (not just your family). It can be very scary to think that you might be disappointing others, but this is your life and there are many, many potential paths to happiness. Sometimes we need to take a step back and reconsider what is truly most important.  I wanted to set some expectations for you so you know what therapy will be like. Depending on your subscription you will likely have one live session a week with your therapist (by video, phone, or live texting). In addition, you and your therapist can text back and forth through the week, you can attend unlimited free “Groupinars” about behavioral health topics, and you can use the journaling feature. It’s good to shop around for the right therapist based on their specialties. When you are matched with a therapist, make it clear what you are looking for. It will not hurt our feelings for you to try out several of us until you find the correct fit (there are literally 20,000 on this platform, so you have choices!). We just want what’s best for you. Think of it like remodeling a home. You may just want help painting and changing some fixtures or going after walls with a sledge hammer. You would certainly want different kinds of professionals for these tasks, and you would also want to learn their specialties before getting to work. For example, I specialize in anxiety disorders, grief, sleep improvement, and sexual functioning. I also have been successful with many other areas. However, if a client comes to me asking for help understanding their dreams, I would (kindly) suggest they pick another therapist since that is not my area of expertise. Here are considerations as you look into therapy and shop around. 1. CONSIDER WHAT YOU NEED HELP WITH. As I mentioned above, there are lots of styles of therapy, and many different practice specialties. Here are some of the main areas that people usually want help with (but there are many more, of course. You may want to Google, “types of therapy.”) - Empathy (unconditional positive regard). Sometimes we just need someone to listen to us without judging. You may come from a family or friend group where this is hard to find, and a therapist can listen to you kindly and empathically. - Reality testing (helping you separate the logic from emotions). Sometimes we have difficulty understanding whether a situation warrants the kind of reaction we feel. For example, you may become enraged at poor customer service. A therapist can help you understand why you feel this way and how to deal with such situations. - Learning new patterns for thoughts (cognitions). Sometimes we fall into logical fallacies or thought distortions such as-or-nothing thinking and catastrophizing. These lead to increased feelings of depression and anxiety. Your therapist can help you understand these distortions and what to do about them. - Understanding anxiety triggers. We are creatures of habit, and we tend to be afraid of consistent things. Unfortunately, the more we avoid a fear, the stronger that fear gets (avoidance is like fuel for fear). As such, it is important to start learning about the common themes of what makes you anxious. Is it a fear of being judged? A fear of failure? A fear of not being loved or admired? Everyone is different. The best way to do this is to start keeping a log of the times you experienced the fight or flight response. Jot down in a journal or in an app like Google Keep these times, including: -- What was the triggering event? -- How long did it take to calm down?  Over time, your therapist will likely recommend that you also track “what was the automatic thought,” or the instant thought that just popped in to your mind that might have made you feel even worse (such as “everyone here is going to hate me.” Or “They all think I’m stupid.”) Your therapist can help you identify themes and come up with alternative cognitions or thoughts to battle these automatic thoughts. - Disrupt intense fear or the fight or flight response with deep breathing. Learning deep belly breathing (or “diaphragmatic breathing) is a great tool to add to effective stress management. Taking time to breathe deeply for a few minutes is a free and easy to learn method to take you out of the fight or flight zone and into a zone where you can think more clearly and not experience those side effects. You can Google “deep breathing” or “diaphragmatic breathing” to start learning a technique that really helps most people. You can find mobile apps to help (for example the Breathe2Relax or the Virtual Hope Box app – both are free and evidence-based) or watch videos online that can walk you through it. These are skills that not only help you now, but can assist you throughout your entire life (for example, dealing with road rage, poor customer service, annoying family). You can also disrupt the fight or flight response in the moment with just a minute or two of intense exercise (for example, push-ups, jumping jacks or walking up and down a flight of stairs). This helps use some of the adrenalin and glucose that are released into your blood stream when you have encountered a stressor and leaves you thinking a bit more clearly. - Accountability partner. Your therapist can help you set achievable and realistic goals and help keep you accountable for making progress. This can prevent you from making goals that are too large and unrealistic. Your therapist can also congratulate you on the small achievements that you may not want to share with others (for example, “Yay! You were able to go through the day only reading the news twice!”). - Helping you understand how your early life affects you now. In our early childhood we learn many things and have many experiences that lead to our behaviors as adults. Some therapists (especially those with psychodynamic backgrounds) can help you understand these effects. - Coping with grief, mourning and break-ups. Therapists can help you grieve and mourn losses such as deaths, break-ups, and other ways that you have lost people close to you. - Processing and working through trauma. Therapists can help you understand the symptoms of posttraumatic stress and help you learn ways to reduce these symptoms. - Learning ways to improve sleep, chronic pain, sexual functioning, and other quality-of-life factors. There are many evidence-based techniques that therapists can help you learn to improve your daily functioning in these areas. - Improving communication skills with partners, family, children, friends, or co-workers. As the saying goes, “love is never enough.” To help maintain healthy relationships, your therapist can help you learn effective and clear communication skills. 2. CONSIDER YOUR “STAGE OF CHANGE.” Sometimes we may have the need to change but not yet the motivation (like reducing substance use, quitting smoking, or other healthy behavior change). Depending on your stage of change, it may not be the right time for therapy. Here are the major stages of change. Consider where you are: - Precontemplation: This is the stage during which you may not even be aware of the issue. - Contemplation: This is when you are just starting to think about making change. - Preparation: This is when you get ready to change. This is when a therapist is MOST helpful. - Action: This is when we actually start making the change. Therapists are also very helpful here. - Maintenance: Maintaining the change can be difficult, and therapists are very helpful at this stage as well. I’m sending you hopes for quick healing and lifelong growth. Thank you so much for reaching out! Best regards, Julie Note: If you are in crisis and feeling like hurting yourself, please call 911, go to your closest emergency department, or call the suicide hotline (the National Suicide Prevention Lifeline) immediately at 800-273-8255. You could also go to their website to chat at https://suicidepreventionlifeline.org/.
Answered on 08/04/2022

How can I be less triggered by my partner smoking?

Hello Frida,    I am glad you have reached out for some help with how to manage your reactions or your triggers.  I am sure your partner smoking is causing you angst and concern.  I can imagine that you are worried about many things including you partner’s health and wellbeing and how that impacts your future for you both. One thing is for sure, you can support your partner when they are ready, but meanwhile let’s take a look at how you can regulate your emotions so that you do not feel so emotionally triggered and less reactive to the triggers. Here are some strategies you might consider trying: Mediation can help us live more mindful and examined lives. When you meditate, you’re practicing noticing thoughts and feelings without getting caught up in them and telling yourself a story about these emotions.  If you need some help getting to sleep at night, try one of the apps on your phone such as Headspace, Calm or Medito or take a look at some Your Tube Videos for free.  When we are emotionally reactive or triggered, it’s often done compulsively or unconsciously. Meditation helps us be more self-aware and more conscious of our emotions before we react to them. If you feel like you have no control over your emotions or that you can’t help but react, meditation might be a great solution for you. If it’s possible, surround yourself with people who are positive and helpful in the way they think and feel. Who you associate with has an influence on how you perceive things. When a tricky situation arises, and the people you circulate with all give varying suggestions that result in cheerful ones, you are blessed. And you will statistically be less disposed to stress and tension. When the wrong people give you advice that produces more anxiety or results in enemies and animosity, consider running away from them! Sometimes emotionally reacting without thinking is what generally gets us in the most trouble and causes the most emotional pain.  It’s also what makes it harder to stop being emotionally reactive. Get in the practice of thinking before you act on your triggers. It sounds simple but of course it’s not easy – this takes effort and commitment. When you sense intense emotions percolating in you, use that as a reminder to stop, take a breath, and think. You will soon notice the physical response comes on rapid: clenched fists, sweat, hotness on the face, etc. These are clues that should remind you to turn inward first, think about your situation, and then slowly respond. These few seconds of contemplation can offer the clarity you need to respond more productively, positively and calmly. You might be extremely sensitive. You sense disapproval or disappointment from your partner, and you emotionally react by emotionally breaking down. You may feel your value is being underestimated, so you are struggling.  You may even sense projection, manipulation, or offensive, or some sort of accusation, and you do the knee-jerk reaction of reacting to your partner in an offensive manner, too. Tit for tat. A vicious cycle of negativity resulted because you were emotionally reactive. You never did your research to validate your perception of things. Instead, have the decency to give everyone who gives you negative vibes a decent chance to be heard and observed.You will be shocked if, in the end, the other person also thought you were the one initiating the negative vibes yourself.  A previous negative experience may form a prejudice in your mind, even one you may not be fully aware of having. Remind yourself that whenever you are reacting to something in the present, you may be assuming because of an experience in the past. Detaching our previous experiences from our present ones helps us stop being emotionally reactive. We allow past experiences with people, places, and things to inform how we react to similar people, places, and things in the future. It is known that there are 6 basic emotions that are present in all human cultures, they are: surprise, happiness, disgust, fear, sadness, and anger. To add to this emotion list are excitement, shame, pride, satisfaction, amusement, embarrassment, and contempt. Notice that there are both positive and negative emotions here. Wherever possible, be more inclined towards the positive ones to protect your own emotional health because stressors could be significant sources of physiological diseases. But there are also positive emotions in the list that, when used in an overreactive way, which could be reasons for poor health or conflicts with your partner. Let happiness conquer sadness. Look beyond your initial perception of a person who makes you feel anger, disgust, or fear. In the final analysis, trust might overcome all these emotions when you see a positive character in someone you haven’t noticed before. Lower your level of emotional reactivity by immersing yourself in some self-care activities such as a relaxing massage or give yourself a complete spa treat. Go on vacation to a peaceful place.  Hiking in the cool mountains, or to a relaxing beach, consider experiencing the serenity of the woods as recommended locations to recharge and ease your burned nerves and upended emotions. If going to the gym relaxes you, then join one.  It is known that toxins are filtered out of your body and loads of emotional stress by sweating. If sweating is your thing, you can also go on a run or participate in a team sport. Meanwhile, yoga and Tai Chi all have passionate practitioners because of their emotion calming benefits. Tai Chi has health benefits, just like yoga. They both improve movement, your muscles and enhance your flexibility. As a result, your moods and emotions also benefit. Your emotions and your ability to have enough sleep have an intimate relationship. Sleep deprivation makes you more emotionally stimulated easily and more sensitive to stressful stimuli and scenarios (in a negative way). Adequate sleep (6 to 8 hours) is crucial to better handling emotional reactivity in everyday conditions. So when you need to stop working or whatever you’re doing because it’s bedtime, stop. The benefits far outweigh the cons. The regular ingesting of supplements and food that calms your nerves and will help you stop being emotionally reactive is a great habit. Research has taught us that there are dietary supplements that can help lower your emotional anxieties include vitamin D, saffron, magnesium, chamomile, omega 3, vitamin C, L-theanine, CBD, curcumin, and multivitamins. But be well informed from professionals of the proper dosage of these supplements because too much of anything can produce undesired side effects. Calming foods should be naturally rich in magnesium. Spinach, Swiss chard, and other leafy greens are examples. Other sources of magnesium are nuts, legumes, seeds, and whole grains. Zinc is also a natural emotion pacifier. It’s an essential component found in cashews, oysters, beef, liver, and egg yolks. But everything in moderation, as usual. You should also consider what to avoid consuming. For example, there are links between caffeine and anxiety that may make you consider avoiding that extra cup of coffee in the mornings. Absorb and learn all you can about what can help you stop being emotionally reactive. There has never been a time in history when all knowledge is at the tip of your fingers with the availability of internet. Specifically, when you anticipate being part of a stressful situation, narrow down your research to that niche. Like if you’re about to meet the parents of your partner. Research what should be your most appropriate behavior so that less tension will ensue. Laughter and joyfulness should be part and parcel of every effort to reduce being emotionally triggered. Finding something funny in every situation calms your nerves and makes you prepare with excitement, rather than fear or disgust, for the next chapter. A good old laughing spell mashes all emotionally reactive and triggering tendencies. I hope you try a combination of some of these strategies to help you feel less triggered by your partners smoking habits.  It will take work and effort on your part, but the benefits might b well worth it for you.  If you are still struggling t cope with the triggers, consider reaching out to BetterHelp for some support and guidance for a professional therapist.  Someone who can help guide you with further strategies to help you and someone to listen to your concerns and worries. I wish you much luck with your next step. Kind Regards, Gaynor 
(MA, LCSW)
Answered on 08/03/2022

How to deal with extreme anxiety and panic attacks after a sudden breakup?

Thank you very much for sharing your question. It's really hard when we lose a good relationship, I am so sorry about that.    The situation that you describe is really difficult as, of course, it's very tough to move forward when we are still in the same environment. I absolutely understand that. Also, if you are even sharing a bedroom it makes it much harder, as it's more challenging, indeed, to set boundaries and not to get confused with our feelings and emotions and also the others ... I find it completely hard, to be honest.   It's very good, though, that you managed to have this great group of friends that is supporting you, it's a great help and I am very glad that you have it. It's very important to share our feelings and thoughts with others and also to see other points of views for our issues. I understand that you feel like they could be annoyed for listening to you and giving you the same advice, but I am sure that they don't feel that way and they will be there to support you as much as you need it. Furthermore, I always recommend to share this kind of concern to be able to see what they think about it. You will probably see how they are just worried about you and look forward to seeing you better.   I suppose that moving to another place is a possibility that you have been thinking about and I know that sometimes it's just not that easy. However, it's important to have that in mind, as recovering from a break up is much easier and less harmful this way.   About your anxiety and panic attacks, I honestly believe that some sessions of therapy could be helpful for you. Sometimes, just sharing is good enough for us, as we all need to be listened to, but also, some other times, it is interesting to identify which patterns of thought or behavior are not working well for us and, eventually, to introduce some useful changes to start feeling better. Working with emotions and some mindfulness and, maybe, a couple more of approaches could be really useful for this. Also, it's something related to that situation of boundaries that you were describing and the assertiveness required.   Finally, remember that hard experiences are part of life and facing them head-on is something that, even when they are hurting us like now, will make you grow as a person, as long as you keep being authentic and as good a person as I am sure you are.    I hope you choose your best way to achieve your purposes and to feel better. I am sure you will do it.
(Master's, Degree, in, Third, Generation, Psychological, Therapies, Bsc, in, Psychology, Msc, in, Prevention, of, Addictions)
Answered on 08/03/2022

I don't know if I have anxiety or panic attack

ANXIETY: Anxiety is a feeling of fear, dread, and uneasiness. It might cause you to sweat, feel restless and tense, and have a rapid heartbeat. It can be a normal reaction to stress. For example, you might feel anxious when faced with a difficult problem at work, before taking a test, or before making an important decision.   At times Anxiety is a trauma response.    Sorry to hear you struggling. Please email/contact us at contact@betterhelp.com. Call us – 888-688-9296.   There could be many different things going on with you and a therapist could definitely help you figure this out. Perhaps run some Inventories with you (screeners). Its sounds like you may be too hard on yourself to meet your goals and over thinking may be causing some overwhelming feelings thought processes etc...   When individuals are overwhelmed without support, symptoms may arise. Symptoms related to anxiousness, depression, or low self-worth and people tend to start thinking of them-selves negatively. Over time they become stuck in this pattern of self-defeating thinking (negative thought pattern). This is often the case with people struggling with mental illness/ trauma/ addiction/ COVID etc....   There are many treatments/modalities/interventions to use for these symptoms.  The following or an integration of these therapies are a good way to navigate these issues: Cognitive Behavioral Therapy combines several ways to help you change how you think: ·You learn to notice irrational thoughts about yourself. ·         You learn to stop the thoughts. ·         You learn to replace the negative thoughts with accurate thoughts. ·         You can learn to relax your mind and body. ·         You can learn to manage your time better. Humanistic approach: ·      Explore Needs ·      Explore self actualization and self realization ·      Resolve conflicts ·       Reorganize your values and approaches to life ·       Interpret your thoughts and feelings. ·       Change behavior that you believe is interfering with your mental health   The quality of our thoughts changes how we act in and interact with the world around us. Not only does it affect our self-perception but also the relationships we keep with other people. Esteem impacts the jobs we look for, opportunities we take, and what we think we are deserving of. That is why it is necessary that we work on ourselves to get rid of self-defeating thoughts. They are incredibly limiting and can alter the course of the lives that we live. Thankfully there are some ways to help turn around your negative thoughts so that you can fulfill your potential:   Think about the person you would be without the fear and worry. Ask yourself a number of questions. Is your self-doubt keeping you away from the career opportunities that you would like to have? Are you creating problems in your relationships and friendships that would otherwise not be there? Where would you be without all the negativity? It is important to imagine yourself in this position, and know that you are capable of accomplishing all of that. Having the job you want, the relationship you want, living where you want to live. Once you are mentally healthy, you will see that all of this is within grasp and not simply a dream.   Do not assume that everything you feel is a necessary reality. Sometimes honesty is not always the truth, and you should not take it as that. You may feel insecure about your body, which does not necessarily mean there is anything wrong with it. You may feel that someone is critiquing you or does not like you, but that could be entirely false. It is okay to feel insecure and unsure about yourself and situations. But you must take those emotions with a grain of salt as they can be far-fetched. Sometimes the things in your head are just thoughts and nothing more. You may think you are failing in certain aspects of life because you may have not met the goals you personally held. Objectively, however, you probably are flourishing.   Always try to succeed and be better even when you do not feel like it. If you are feeling unwell or incapable, that does not mean you must sit in those emotions and dwell on them. You must push yourself to overcome those self-defeating thoughts and not let your mental health dictate your actions. Negative thoughts make you do what you think you are capable of doing, however, sometimes you can achieve so much more and it is important to be aware of this. Think about what your long-term hopes are and how to go about achieving them without daily setbacks deterring you from that path. Accomplishing something despite everything in your mind working against you provides a great sense of relief. You feel stronger than ever and it is always beneficial to surprise yourself with what you never knew before.   Be realistic about your emotions. If you are feeling unworthy, you might think you cannot do something when in reality you do not want to. “Can’t” and “won’t” are very different things, so recognize the difference. If a task feels particularly difficult, you may think it is impossible to do when in reality it makes you feel uncomfortable and so you make excuses to not do it. And also keep everything in perspective. We take so much for granted in life. Allow yourself to feel grateful for the opportunity to challenge yourself and not have it be something forced onto you. There are many people who must do things every day to survive. They have no options, but knowing that you have a choice makes all the difference in how you approach things.   Being aware of your needs is the first step.   I hope this was helpful and you seek the aid you need. Hang in there you are not alone. You can make it through this.    Read this to your self out loud over and over: 1.     My sadness and my depression do not define me 2.     I don’t have to be productive to see value in myself 3.     I am resilient in the face of any challenge 4.     I am in charge of my life, and my happiness and I feel happy and content 5.     Not everybody will understand my situation, and it is okay 6.     I am much more than what I think I am 7.     Every day is a gift, and I am blessed to see today. I will see tomorrow and the next and bless them too 8.     I have made it this far, and I won’t stop now 9.     I am loved and appreciated even when it seems like I’m not 10. I am a work in progress, and I welcome every positive change. The darkness s in the past, and I open my eyes to new beginnings 11. I am more than what people think I am, and my thoughts do not shape my life 12. I am needed regardless of how worthless I feel 13. Everything will work out perfect for me, and I will watch it unfold 14. I forgive myself, and I don’t blame myself for my current situation 15. It’s in my head. It won’t last forever, and I will come out stronger 16. I deserve love, joy, and happiness. I deserve everything good 17. I don’t have anything to prove to myself or anybody else. I am enough, and that is okay 18. This darkness won’t last forever 19. I am not perfect, and it is okay. I forgive myself, and everyone for not being perfect. We are enough, and that is all that counts 20. I love myself, and I am happy! Also, work on self-care and healthy coping mechanisms  Ways to Relieve Psychological Stress:   1. Large muscle exercise triggers a drop in nervous system activation like fighting or fleeing from physical danger.2. Changing thoughts and perceptions about the stressor. “This project is important to me.”“I really care about this person.”“I’m excited!”3. Relaxation techniques: Train the mind and body to let go of tension and stress   •Deep breathing•Meditation•Progressive muscle relaxation•Visualization•Biofeedback •Autogenics•Self-hypnosis•Body scan•Soothing music   -----5, 4, 3, 2, 1 GROUNDING EXERCISE:   HOW TO DO IT: This technique will take you through your five senses to help remind you of the present. This is a calming technique that can help you get through tough or stressful situations.   Take a deep belly breath to begin.   5 - LOOK: Look around for 5 things that you can see, and say them out loud. For example, you could say, I see the computer, I see the cup, I see the picture frame.   4 - FEEL: Pay attention to your body and think of 4 things that you can feel, and say them out loud. For example, you could say, I feel my feet warm in my socks, I feel the hair on the back of my neck, or I feel the pillow I am sitting on.   3 - LISTEN: Listen for 3 sounds. It could be the sound of traffic outside, the sound of typing or the sound of your tummy rumbling. Say the three things out loud.   2 - SMELL: Say two things you can smell. If you’re allowed to, it’s okay to move to another spot and sniff something. If you can’t smell anything at the moment or you can’t move, then name your 2 favorite smells.   1 - TASTE: Say one thing you can taste. It may be the toothpaste from brushing your teeth, or a mint from after lunch. If you can’t taste anything, then say your favorite thing to taste.   Take another deep belly breath to end.      
Answered on 08/03/2022

What can I do to stop the anxiety or lessen it when I’m not active, that feeling of worry?

Dear Yousef, First of all, I am impressed that you are reaching out for help. It is a brave first step, and I want to congratulate you on dipping your toe in the water here at BetterHelp to see if meeting with a therapist here will help you. You have raised several different issues here, and it is clear that you have a lot on your mind. Anxiety becomes a serious problem when it starts to inhibit you from doing activities you enjoy, from succeeding at school or work, or from general happiness. What to do about it? - Speak to your medical health care provider about whether anti-anxiety medication may be a good fit for you. Anxiolytics are safe and effective, and they can help increase the effectiveness of one on one talk therapy. - Learn about the links between anxiety and cognition. From what you wrote, it sounds like overwhelming feelings are not new for you (but certainly much more problematic right now). A few decades of social science research have helped us understand that our thought patterns and how we consider the world and events lead to specific emotions. Your therapist can teach you more about the cognitive model and describe some practical tools to change the maladaptive thought patterns (in other words, the ways of thinking that keep bringing you down). There are so many practical ways to get started with this work, and it can help strengthen you throughout your life. In the mean time, you can learn more by watching a Groupinar on BetterHelp about Cognitive Behavioral Therapy to start learning about the links between anxiety and cognition. - Learn more about anxiety in general. Physical sensations like increased heart rate, sweating, feeling overwhelmed and panicked are signs of your fight or flight response. This is an evolutionary function of our sympathetic nervous system that helps our bodies prepare for dealing with predators (either to fight or flee). In addition, you may feel your muscles tense up and a surge of energy as glucose and adrenaline are released into your bloodstream. The fight or flight response makes a lot of sense if you are dealing with a physical threat, but it does not help us much when our threat is a work deadline, being late for an appointment, meeting a new person, poor internet connection, or other modern stressors. Indeed, too much of the fight or flight response causes stomach upset, muscle tension, bad mood, trouble sleeping, and eventually even lowered immunity (do you ever notice how college students always get sick right after final exams?). - Disrupt intense fear or the fight or flight response with deep breathing. Learning deep belly breathing (or “diaphragmatic breathing) is a great tool to add to effective stress management. Taking time to breathe deeply for a few minutes is a free and easy to learn method to take you out of the fight or flight zone and into a zone where you can think more clearly and not experience those side effects. You can Google “deep breathing” or “diaphragmatic breathing” to start learning a technique that really helps most people. You can find mobile apps to help (for example the Breathe2Relax or the Virtual Hope Box app – both are free and evidence-based) or watch videos online that can walk you through it. These are skills that not only help you now, but can assist you throughout your entire life (for example, dealing with road rage, poor customer service, annoying family). You can also disrupt the fight or flight response in the moment with just a minute or two of intense exercise (for example, push-ups, jumping jacks or walking up and down a flight of stairs). This helps use some of the adrenalin and glucose that are released into your blood stream when you have encountered a stressor and leaves you thinking a bit more clearly. - Try to identify triggers. We are creatures of habit, and we tend to be afraid of consistent things. Unfortunately, the more we avoid a fear, the stronger that fear gets (avoidance is like fuel for fear). As such, it is important to start learning about the common themes of what makes you anxious. Is it a fear of being judged? A fear of failure? A fear of not being loved or admired? Everyone is different. The best way to do this is to start keeping a log of the times you experienced the fight or flight response. Jot down in a journal or in an app like Google Keep these times, including: -- What was the triggering event? -- How long did it take to calm down? Over time, your therapist will likely recommend that you also track “what was the automatic thought,” or the instant thought that just popped in to your mind that might have made you feel even worse (such as “everyone here is going to hate me.” Or “They all think I’m stupid.” Or “I need to determine my life’s purpose or else I’m a failure.”) Your therapist can help you identify themes and come up with alternative cognitions or thoughts to battle these automatic thoughts. - Learn more about social anxiety. It is completely normal to feel anxiety around new people or people we already know. Often this stems from a worry about being judged or about being disliked. It seems like social anxiety has increased dramatically since the onset of the COVID 19 Pandemic since many of us have had more limited interaction and spending time with strangers was *literally* unsafe prior to vaccines (and even since then for some). As such, it is important to know that you are not alone in this. When you see people walk into a social situation with a smile and a warm handshake, often they are employing the “fake it ‘til you make it” approach. Further, we live in a society that makes us all feel like we need to be extroverts, whereas it is just fine to be a person who only needs a few close friends instead of a large group. Oftentimes when we are in our 20s we start to recognize whether we are the kind of person who feels recharged after spending time with others (extrovert) or who feels recharged after spending time alone (introverts). There is no one right way. I see good things in your future. Again, I’m so impressed that you have reached out for help and I’m confident that working with your therapist will help you in several areas of your life! Best, Julie Note: If you are in crisis and feeling like hurting yourself, please call 911, go to your closest emergency department, or call the suicide hotline (the National Suicide Prevention Lifeline) immediately at 800-273-8255. You could also go to their website to chat at https://suicidepreventionlifeline.org/.    
Answered on 07/21/2022

How do I deal with child trauma that resulted into people pleasing and to set boundaries?

Content/Trigger Warning: Please be advised that the article below might mention trauma-related topics that include types of physical abuse & neglect that could be triggering. Hello Jem, this is an excellent question.  I am often working with clients who experience complex trauma, which is not necessarily overt physical abuse or neglect.  Many of us develop a layer of complex trauma because of a parent or parents were unpredictably supportive or angry with their children when they expressed their needs and tried to exert boundaries.  When you may have initially first tried to find your voice, with your family of origin, to set your boundaries and find your own strong identity which usually starts to happen around the age of 10 and continues throughout your teen years, you might have needed to shut it down to feel safe again.   This is a trauma response called "fawning" which allows a person to maintain engagement in potentially unpredictable and invalidating relationships.  Fawning looks and feels much like you describe.  It is a people pleasing that invalidates the persons individual needs, in favor of maintaining closeness at all costs and preventing potential problems and conflicts that almost always arise in relationships that negotiate and then respect boundaries.  This is harder for you to do because doing so may have a feeling of fear and anxiety connected to it, and, of course, it is usually a learned skill over many years developed in later childhood.  Many of us experience deep connections in our work relationships which then can take on a  similar dynamics to that in our families since we spend so much time together.  These relationships can actually trigger your trauma response since inherent in work is the feeling that it is threatening to your well being if you are not perceived positively. Of course, feeling guilty for staying in your lane at work, and not taking on other's tasks for them, and or, sharing with others your limits around time and energy, is not easy for you when you haven't practiced it!   It can certainly help you to understand how to communicate through this with others using techniques like reflective language.  This is something you can certainly practice at get better at at any age.  It can also help you to seek treatment that specifically addresses your learned trauma response.  This can be achieved in many ways depending on your style as a person and the way you process things in the world. I use psychodynamic principles as well as family systems frame works to help my clients gain a deeper understanding of themselves.  As they do this, much of the charge in their story begins to diminish by being seen, validated and clearly expressed.  Having words to put to your feelings and to be able to talk about it with others in your life, not just in your therapy, but with friends, romantic partners and even your family, is often the key to finding your boundaries and limits in your personal relationships.  This is a form of therapy that requires a commitment of time, and you may indeed want to give your therapy time, especially if you are carrying layers of confusion and family traumas.   A way to reduce your symptoms quickly, and can even be important to do in conjunction with traditional talk therapy, is using a treatment technique called EMDR, that helps clients rework their trauma response.  It is possible to find a therapist who uses EMDR in conjunction with traditional talk therapy.  Some therapists also use a form of CBT that focuses directly on their trauma.  This can also be effective depending on how you may prefer to work through your challenges.   In any of these methods you may expect to find a certain amount of self awareness and relief within a few months of care.  However, a deeper more lasting change in you often happens around 6 months of care and well into a year.   Sometimes you will uncover much inside you in the process of therapy that you will absolutely want to keep working on and you will realize that your personal growth is enhanced, you feel stronger in your life and your relationships and ready for change, and you witness how being validated in treatment effects you.  If you can, consider developing a therapy "relationship" to help you work through your childhood traumas.   I hope that this helps you make some choices for yourself in moving forward and I want to wish you all the best.  Thank you as well for asking such an important clear question. Warmly, Elise B. Jacobson, LICSW Social Worker
Answered on 07/20/2022

How do I know if I NEED therapy for my issues or if I’m just NEEDY and want someone to listen/care?

Dear Atiye, I'm so glad you came to Better Help; Bottom line: if you are experiencing distress, then therapy may be an excellent way for you to help improve your quality of life. I'm a big believer in short term treatment at different stages of life when different stressors are more urgent. I wanted to set some expectations for you so you know what therapy will be like with BetterHelp. Depending on your subscription you will likely have one live session a week with your therapist (by video, phone, or live texting). In addition, you and your therapist can text back and forth through the week, you can attend “Groupinars” about behavioral health topics, and you can use the journaling feature. It’s good to shop around for the right therapist based on their specialties. When you are matched with a therapist, make it clear what you are looking for. It will not hurt our feelings for you to try out several of us until you find the correct fit (there are literally 20,000 on this platform, so you have choices!). We just want what’s best for you. Think of it like remodeling a home. You may just want help painting and changing some fixtures or going after walls with a sledge hammer. You would certainly want different kinds of professionals for these tasks, and you would also want to learn their specialties before getting to work. For example, I specialize in anxiety disorders, grief, sleep improvement, and sexual functioning. I also have been successful with many other areas. However, if a client comes to me asking for help understanding their dreams, I would (kindly) suggest they pick another therapist since that is not my area of expertise. Here are considerations as you look into therapy and shop around. 1. CONSIDER WHAT YOU NEED HELP WITH. As I mentioned above, there are lots of styles of therapy, and many different practice specialties. Here are some of the main areas that people usually want help with (but there are many more, of course. You may want to Google, “types of therapy.”) - Empathy (unconditional positive regard). Sometimes we just need someone to listen to us without judging. You may come from a family or friend group where this is hard to find, and a therapist can listen to you kindly and empathically. - Reality testing (helping you separate the logic from emotions). Sometimes we have difficulty understanding whether a situation warrants the kind of reaction we feel. For example, you may become enraged at poor customer service. A therapist can help you understand why you feel this way and how to deal with such situations. - Learning new patterns for thoughts (cognitions). Sometimes we fall into logical fallacies or thought distortions such as all-or-nothing thinking and catastrophizing. These lead to increased feelings of depression and anxiety. Your therapist can help you understand these distortions and what to do about them. - Understanding anxiety triggers. We are creatures of habit, and we tend to be afraid of consistent things. Unfortunately, the more we avoid a fear, the stronger that fear gets (avoidance is like fuel for fear). As such, it is important to start learning about the common themes of what makes you anxious. Is it a fear of being judged? A fear of failure? A fear of not being loved or admired? Everyone is different. The best way to do this is to start keeping a log of the times you experienced the fight or flight response. Jot down in a journal or in an app like Google Keep these times, including: -- What was the triggering event? -- How long did it take to calm down?  Over time, your therapist will likely recommend that you also track “what was the automatic thought,” or the instant thought that just popped in to your mind that might have made you feel even worse (such as “everyone here is going to hate me.” Or “They all think I’m stupid.”) Your therapist can help you identify themes and come up with alternative cognitions or thoughts to battle these automatic thoughts. - Disrupt intense fear or the fight or flight response with deep breathing. Learning deep belly breathing (or “diaphragmatic breathing) is a great tool to add to effective stress management. Taking time to breathe deeply for a few minutes is a free and easy to learn method to take you out of the fight or flight zone and into a zone where you can think more clearly and not experience those side effects. You can Google “deep breathing” or “diaphragmatic breathing” to start learning a technique that really helps most people. You can find mobile apps to help (for example the Breathe2Relax or the Virtual Hope Box app – both are free and evidence-based) or watch videos online that can walk you through it. These are skills that not only help you now, but can assist you throughout your entire life (for example, dealing with road rage, poor customer service, annoying family). You can also disrupt the fight or flight response in the moment with just a minute or two of intense exercise (for example, push-ups, jumping jacks or walking up and down a flight of stairs). This helps use some of the adrenalin and glucose that are released into your blood stream when you have encountered a stressor and leaves you thinking a bit more clearly. - Accountability partner. Your therapist can help you set achievable and realistic goals and help keep you accountable for making progress. This can prevent you from making goals that are too large and unrealistic. Your therapist can also congratulate you on the small achievements that you may not want to share with others (for example, “Yay! You were able to go through the day only reading the news twice!”). - Helping you understand how your early life affects you now. In our early childhood we learn many things and have many experiences that lead to our behaviors as adults. Some therapists (especially those with psychodynamic backgrounds) can help you understand these effects. - Coping with grief, mourning and break-ups. Therapists can help you grieve and mourn losses such as deaths, break-ups, and other ways that you have lost people close to you. - Processing and working through trauma. Therapists can help you understand the symptoms of posttraumatic stress and help you learn ways to reduce these symptoms. - Learning ways to improve sleep, chronic pain, sexual functioning, and other quality-of-life factors. There are many evidence-based techniques that therapists can help you learn to improve your daily functioning in these areas. - Improving communication skills with partners, family, children, friends, or co-workers. As the saying goes, “love is never enough.” To help maintain healthy relationships, your therapist can help you learn effective and clear communication skills. 2. CONSIDER YOUR “STAGE OF CHANGE.” Sometimes we may have the need to change but not yet the motivation (like reducing substance use, quitting smoking, or other healthy behavior change). Depending on your stage of change, it may not be the right time for therapy. Here are the major stages of change. Consider where you are: - Precontemplation: This is the stage during which you may not even be aware of the issue. - Contemplation: This is when you are just starting to think about making change. - Preparation: This is when you get ready to change. This is when a therapist is MOST helpful. - Action: This is when we actually start making the change. Therapists are also very helpful here. - Maintenance: Maintaining the change can be difficult, and therapists are very helpful at this stage as well. I’m sending you hopes for quick healing and lifelong growth. Thank you so much for reaching out! Best regards, Julie Note: If you are in crisis and feeling like hurting yourself, please call 911, go to your closest emergency department, or call the suicide hotline (the National Suicide Prevention Lifeline) immediately at 800-273-8255. You could also go to their website to chat at https://suicidepreventionlifeline.org/.
Answered on 07/19/2022

How do I stop thinking so much?

Hello Gwaine and thank you for asking a question here on BetterHelp. Having recurring thoughts can be really frustrating, especially when they are thoughts you're trying to avoid or thoughts that cause negative emotions. Our thoughts, emotions and behaviors are all linked, so these negative thoughts that you were having will lead to different emotions which will eventually lead to behavior change. This is why it's so important to understand why you were having the thoughts and what to do about them. I have some ideas that I think could help but I think most importantly we need to talk about therapy first.  As I was stating our thoughts, emotions, and behaviors are all linked. When we have been dealing with negative thoughts for a long time it can lead to that behavioral change. Sometimes we don't even recognize this is happened, and sometimes we need help changing this behavior, controlling the emotions and changing the thoughts. Because of this I would recommend talking to a therapist. It's very easy to get linked with a therapist here on BetterHelp, all you have to do is click on the get started button on the main page and follow the prompts from there. You'll have to answer several questions and then you will be automatically linked with a therapist, if you don't like the therapist you are linked with you're more than welcome to choose one on your own or ask to be automatically linked to somebody else. A therapist could help you recognize behavior in your life that is toxic that you made if that was completely normal, a therapist can help you recognize barriers in your life you didn't even know existed but are stopping you from being the person you want to be, or a therapist can help you understand the root cause of your problems and help you reach solutions faster. Most importantly, they can give you coping mechanisms to help you make it through those really difficult days. I hope you will consider getting linked with somebody soon.  if you were sitting in front of me in a therapy session right now, the first thing I would do is tell you to explain to me what these recurring thoughts are. We have thoughts and emotions because our body is trying to tell us something, trying to ignore these thoughts or push them back would be ignoring what your body is trying to tell you. We want to understand these thoughts and why they are happening, write them down, then write down any emotions you think are attached to them. You mentioned that you're anxious all the time, based off this it sounds like there's some sort of fear wrapped around these thoughts you keep having. I came to this conclusion because fear is the great driver of anxiety, without fear we don't have anxiety . So if you understand what this fear is, make an effort to take away the power the fear has over you, then we will reduce your anxiety and most likely have better control over your thoughts. Write down those thoughts you keep having also write down the fear that may be driving them.One of the best ways you can respond to fear is by putting it in two categories: is it probable or is it possible? Something that is possible is something that we don't need to be concerned with. Let me give you an example: I live close to an international airport and regularly have airplanes flying over my home. It is technically possible that one of these planes could malfunction and crash into my home. If I were to have recurring thoughts about this like, "how would I be able to warn myself this was about to happen, do I need to change my home insurance, how would I get my family out in time, do I need to move to a new area?" The more I do this the more my anxiety will increase, my mind will take something that is merely possible and convince me that it is probable. Our brain has the ability to create a situation that has never happened, convince us that it is going to happen and then cause us to start emotionally reacting to it, it sounds so silly when you think about it and say it out loud but we do it all the time. And for you we want to control this fear, you need to regularly remind yourself that you are focusing on the possible instead of the probable. But what if your fear is something that is probable? If this is the case then you need to get prepared for it. Let me give you another example, when I started driving I was very anxious that I was going to pop a tire on the side of the road and not know how to replace it, looking like a fool trapped on the side of the road. So what I did is I practiced changing a tire in my parents driveway. I was now prepared if this ever happened, the fear was then gone. when we have recurring thoughts like you have been having it is extremely important to dissect them and look into them. You can't try to ignore them and pretend they aren't happening, dig into them, find out why they are happening, find out what emotions are attached to them and then make a plan of action. Throughout this I also want you to practice good self-care. People often confused treating yourself and self-care but they are very different. Good self-care means making smart financial decisions and preparing for the future, it means recognizing toxic behavior in your own life and making an active effort to change it, good self-care means recognizing toxic relationships and choosing to keep those people at a distance and setting boundaries with them, good self-care means taking care of your body by exercising and watching what you put into it. Take all those to heart and practice good self-care. I hope you are able to find something in here that helps and I wish you the best of luck! 
(LPC)
Answered on 07/19/2022

How to overcome anxiety

Hello! First I would like to thank you for having the courage to reach out with your question. It is not always easy to ask for help with the things which we are having intimate struggles. It takes courage and self-awareness to identify that there is something that needs to be addressed and then to take the steps necessary to get that help. You have already taken that first step!Anxiety is a many layered thing and there are so many different types that play off of one another and give fuel to other areas of concern. Social anxiety, and the inability to engage in a functional way can lead to problems in academics, career and interpersonal relationships. Often, when I approach anxiety with the members that I work with, I first try to take a look at what exactly triggers the anxiety. Is there a catalyst? Is it predictable? Is there no obvious trigger and is the anxiety more of a constant? Then, we work on how the anxiety actually manifests. You mentioned in your question that you create distance when the anxiety comes on and you are struggling in general with the ability to stay consistent in a job position. Your anxiety may then manifest in avoidance, isolation and withdrawing from work or other areas of life that cause you stress. It can take time to really tease out these first few steps and process what the cause and effect of the anxiety is. But once we are able to truly understand it, we can begin to work toward coping with it and managing the symptoms so they do not disrupt our day to day.Coping with anxiety looks different for everyone and you may find that works well for 99% of the population seems to do nothing for you. But that’s okay! There are a number of ways to address anxiety and work toward a more functional life. We will discuss various ways of coping, self-care and other protective strategies. There may be need for healthy boundary setting or scheduled time for mindfulness and meditation. By making efforts in these areas and setting small, attainable goals, it is possible to develop a routine that helps you to, over time, overcome the anxiety you are struggling with.
Answered on 11/10/2021

My girlfriend has dealt with anxiety and an eating disorder

Dear User 12,   You are doing the right thing in reaching out for help. When someone you love is dealing with mental health issues, it presents a challenge to both of you, and to your relationship. It can be taxing on your own coping skills to be the primary support person for someone who is struggling and vulnerable. You have likely taken on the role of being “the strong one” as your girlfriend has gone through the recovery process. Having someone like that to depend on often makes a huge difference in a person’s recovery. But you are human too, and cannot always be strong. Your relationship needs to have room for you to have your own ups and downs. The metaphor of "putting on your own oxygen mask first" is very applicable here, because depleting your own resources to meet someone else’s needs is not sustainable and does not serve either of you or help her recovery.   When you say that you are the only person who knows, I wonder if you mean you’re the only one in her personal circle of friends, family, etc. I would hope that she is receiving therapy to assist in her ongoing recovery. This is essential, or at least highly recommended, to help a person manage stress and minimize the risk of relapse. People with eating disorders can also benefit from opportunities to connect with others who are also recovering. Sharing mutual support in groups, online chat rooms, or through a “buddy system” with an accountability partner can be a key component of recovery. The value of this kind of peer support can apply to anxiety as well.   I’m glad to see that you have identified your own need to have someone to talk to. Pursuing individual therapy for yourself is an important proactive step for safeguarding your own mental health and resilience. It can also help you to build stronger communication skills. These can benefit you in every area of your life, of course, and can be a huge advantage for anyone who is a key support person in someone else’s recovery. The need to have periodic honest but difficult conversations will present over time, and the better equipped you are to listen deeply, and find the right words to express your concerns the better it will be for both you and your girlfriend.   Having a lasting relationship with someone who has mental health challenges means going through a lot of ups and downs together. Of course there will be good times, and hopefully they will be increasing as your girlfriend gets stronger in her recovery. But there will also be low points. And you will feel the pain with her because of how much you care. This is natural; of course her happiness is important to you. However, as much as compassion is important, it will also be best for both of you if you can maintain enough emotional distance or autonomy that you can find your own happiness alongside your empathy for her. I find this to be a key component to being a successful long-term partner to someone who has depression, anxiety, or any other mental or physical illness. It might sound selfish to say that you should be happy in spite of her pain, but in reality, becoming anxious or depressed yourself benefits no one and ultimately harms your relationship.   If there is any way to expand your girlfriend’s circle of support, I would strongly encourage her to do that. If she would be willing to share her struggles with additional friends or family members, even one or two, there could be benefits all around. She would have someone besides you to turn to, allowing you bear a smaller portion of the load during difficult times, and others might provide a helpful perspective and appreciate the chance to offer their support.   Now that we have addressed your own self-care, here are some resources to help you be the best support person you can be for your girlfriend.    https://centerfordiscovery.com/blog/eight-ways-help-friend-eating-disorder-recovery/   https://themeadowglade.com/support-someone-recovering-from-eating-disorder/   https://www.verywellmind.com/how-to-help-someone-with-anxiety-5089005   Here is a brief summary of some of the tips in the articles:   Make an effort to talk to her about other things and have normal, everyday conversations even during difficult times. If you are preoccupied with concern about her eating disorder or a possible relapse, be sure to not over-question. Save serious discussions for serious times, and limit the duration of these talks.   Don’t discuss weight, dieting, or label either foods or body size as good or bad as if they were moral issues. If at all possible, redirect the conversation when others get onto these topics around your girlfriend.   Do not police your girlfriend’s food choices, but refrain from participating in behaviors that encourage disordered eating such as late night bingeing and excessive exercising. If you witness her engaging in unhealthy behaviors, avoid blame and instead use “I statements” to express your concerns, such as, “I sense that you’ve been more preoccupied with calorie-counting lately. Do you think that’s something to be concerned about?”   In regard to supporting her efforts to overcome anxiety, learn to recognize the first signs that she is worrying more than usual. Give her gentle, positive messages reminding her that she has handled difficult things in the past and that you are confident that she is also equal to future challenges. If you find her getting caught up in “what-ifs,” such as asking some form of “What if something terrible happens?” and then looking to you for reassurance, offer that reassurance briefly, but refrain from providing it constantly. Instead, remind her that she has the tools to bring herself back to a safe place emotionally, and encourage her to practice these skills.   Thank you for reaching out and I hope my answer has provided some guidance about how to establish and maintain a healthy emotional environment for yourself and be a positive influence on your girlfriend’s recovery.   Best wishes to both of you.   Julie            
(LCSW)
Answered on 10/15/2021

What help should a person with skin picking disorder get?

Hello there,I would, of course, require more information before being able to render a diagnosis however, you are talking about symptoms that sound very similar to OCD - Obsessive Compulsive Disorder.  Generally speaking, when it comes to anxiety, you do NOT want to avoid the things that make you anxious. All this does is strengthen the anxiety. What is most helpful with anxiety management is facing the anxiety head-on, doing the things that make you uncomfortable. Safety is a big priority though, so please do not forget that.    OCD can show up in the form of skin picking, hair pulling, etc. Do you know what your triggers are to picking your skin, what makes you want to do it or what triggers you to engage in that behavior?    Do you think it would be beneficial for you to seek out the support of a therapist to help you? It is hard to provide a clear and direct answer within this forum since I cannot ask you questions and get more information.   Below is the DSM 5 definition of OCD from BeyondOCD.org; Clinical Definition of OCDThe DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) provides clinicians with official definitions of and criteria for diagnosing mental disorders and dysfunctions.  Although not all experts agree on the definitions and criteria outlined in the DSM-5, it is considered the “gold standard” by most mental health professionals in the United States.DSM-5 Diagnostic Criteria for Obsessive-Compulsive Disorder (300.3)A.    Presence of obsessions, compulsions, or both:Obsessions are defined by (1) and (2):1. Recurrent and persistent thoughts, urges, or impulses that are experienced, at some time during the disturbance, as intrusive and unwanted, and that in most individuals cause marked anxiety or distress.2. The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or action (i.e., by performing a compulsion).Compulsions are defined by (1) and (2):1. Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly.2. The behaviors or mental acts are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation; however, these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent, or are excessive.Note: Young children may not be able to articulate the aims of these behaviors or mental acts.B. The obsessions or compulsions are time-consuming (e.g., take more than 1 hour per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.C. The obsessive-compulsive symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.D. The disturbance is not better explained by the symptoms of another mental disorder (e.g., excessive worries, as in generalized anxiety disorder; preoccupation with appearance, as in body dysmorphic disorder; difficulty discarding or parting with possessions, as in hoarding disorder; hair pulling, as in trichotillomania [hair-pulling disorder]; skin picking, as in excoriation [skin-picking] disorder; stereotypies, as in stereotypic movement disorder; ritualized eating behavior, as in eating disorders; preoccupation with substances or gambling, as in substance-related and addictive disorders; preoccupation with having an illness, as in illness anxiety disorder; sexual urges or fantasies, as in paraphilic disorders; impulses, as in disruptive, impulse-control, and conduct disorders; guilty ruminations, as in major depressive disorder; thought insertion or delusional preoccupations, as in schizophrenia spectrum and other psychotic disorders; or repetitive patterns of behavior, as in autism spectrum disorder).Specify if:With good or fair insight: The individual recognizes that obsessive-compulsive disorder beliefs are definitely or probably not true or that they may or may not be true.With poor insight:  The individual thinks obsessive-compulsive disorder beliefs are probably true.With absent insight/delusional beliefs: The individual is completely convinced that obsessive-compulsive disorder beliefs are true.Specify if:Tic-related: The individual has a current or past history of a tic disorder.Reprint permission pending from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, (Copyright 2013). American Psychiatric Association.I am going to define Exposure Response Prevention therapy below. This definition is taken from IOCDF.org. This is the gold standard treatment and care for anxiety disorders. You can also go to this website to see if any therapists near you specialize in OCD.What is Exposure and Response Prevention?You may have heard of Cognitive Behavior Therapy (CBT) before. CBT refers to a group of similar types of therapies used by mental health therapists for treating psychological disorders, with the most important type of CBT for OCD being Exposure and Response Prevention (ERP).Exposure in ERP refers to exposing yourself to the thoughts, images, objects, and situations that make you anxious and/or start your obsessions. While the Response Prevention part of ERP refers to making a choice not to do a compulsive behavior once the anxiety or obsessions have been “triggered.” All of this is done under the guidance of a therapist at the beginning — though you will eventually learn to do your ERP exercises to help manage your symptoms.That said, this strategy of purposefully exposing yourself to things that make you anxious may not sound quite right to you. If you have OCD, you have probably tried to confront your obsessions and anxiety many times only to see your anxiety skyrocket. With ERP, the difference is that when you choose to confront your anxiety and obsessions you must also commit to not give in and engage in the compulsive behavior. When you don’t do the compulsive behaviors, over time you will feel a drop in your anxiety level. This natural drop in anxiety that happens when you stay “exposed” and “prevent” the compulsive “response” is called habituation.Another Way to Think About ERP:Think of your anxiety as an alarm system. If an alarm goes off, what does it mean? The alarm is there to get your attention. If an intruder is trying to break into your house, the alarm goes off, wakes you up, gets you to act. To do something. To protect yourself and your family. But, what if the alarm system went off when a bird landed on the roof instead? Your body would respond to that alarm the same way it would if there were an actual threat such as an intruder.OCD takes over your body’s alarm system, a system that should be there to protect you. But instead of only warning you of real danger, that alarm system begins to respond to any trigger (no matter how small) as an absolute, terrifying, catastrophic threat.When your anxiety “goes off” like an alarm system, it communicates information that you are in danger, rather than “pay attention, you might be in danger.”Unfortunately, with OCD, your brain tells you that you are in danger a lot, even in situations where you “know” that there is a very small likelihood that something bad might happen. This is one of the cruelest parts of this disorder.Now consider that your compulsive behaviors are your attempts to keep yourself safe when that alarm goes off. But, what does that mean you are telling your brain when you engage in these behaviors? You are reinforcing the brain’s idea that you must be in danger. A bird on the roof is the same as a real intruder breaking into your home.In other words, your compulsive behavior fuels that part of your brain that gives out these many unwarranted alarm signals. The bottom line is that to reduce your anxiety and your obsessions, you have to decide to stop the compulsive behaviors.However, starting Exposure and Response Prevention therapy can be a difficult decision to make. It may feel like you are choosing to put yourself in danger. It is important to know that Exposure and Response Prevention changes your OCD and changes your brain. You begin to challenge and bring your alarm system (your anxiety) more in line with what is happening to you.How is ERP different from traditional talk therapy (psychotherapy)?Traditional talk therapy (or psychotherapy) tries to improve a psychological condition by helping the patient gain “insight” into their problems. Talk therapy can be a very valuable treatment for some disorders, but it is not effective at treating the active symptoms of OCD.While talk therapy may be of benefit at some point in an OCD patient’s recovery, it is important to try ERP or medication first, as these are the types of treatment that have been shown through extensive research to be the most effective for treating OCD.
(LPC, NCC, CEDS-S)
Answered on 09/30/2021

How do I stop overthinking?

Dear NG,   Thank you for your message and sharing.   I understand how difficult it is to try stopping your thoughts. I could imagine how hard you have been trying and how frustrating to feel that nothing is working.    We can't stop our thoughts, but the more we practice being mindful of the present, the better we can catch ourselves with our thoughts and develop an alternative response to them, and learn to let go.   During moments like this I remind myself the teachings regarding worries, it is consisted with a 2 part questions:   1. Is this problem within my control? If so, then this problem will be solved given time and the right intervention. 2. Would worrying about it make any difference? If not, then is it worth it to sacrifice our time and mental health worrying over something that (1. can't be solved anyway / 2. will be solved anyway)?   This is definitely easier said than done, therefore as a fellow human being, I am working with you to pay attention to what is good, what is kind rather than our worries.   Obsessive or consuming thoughts can make living miserable when you are plagued by them, but this very situation can become the invitation to transcend mind and be free of suffering forever.   Can you stop obsessive thoughts? - If you could, it would be great, but the truth is that it's slightly more complicated than just suppressing your thoughts which at-most you can do for a few seconds. Plus suppressing thoughts is even worse than enduring thoughts. It builds up a lot of negative energy inside.   So how to stop these stops thoughts? The secret to stopping these thoughts is to detach from the mind because You cannot fight mind with the mind. Let's look at this in more detail.   What Causes Obsessive Thoughts?   If you generated the thoughts, you could've controlled them too.   The truth is that you don't generate thoughts, the mind does. And the mind is on auto-mode most of the time.   You can see this for yourself; can you predict what you will think 30 seconds from now? If you can't how can you assume that you are generating the thoughts?   If you believe that you are your mind, that's a false notion again.   If you are your mind then how can you observe the thoughts? So you must be separate from the mind to see what the mind is doing.   The mind generates thoughts, which are mostly just energy forms. These thoughts pass through like clouds. We identify with some of these thoughts and obsess over them.   So in truth, all thoughts are just neutral energy forms; it's your interest or association with the thoughts that makes them obsessive. If you can understand this truth, you have taken the first step towards getting rid of obsessive thoughts.   How to Stop Obsessive Negative Thoughts?   If you are asking this question, ask yourself another question - "is this question not another thought? It's a thought about killing thoughts".   All your attempts at suppressing and stopping thoughts fail because you are using the mind to stop the mind. The police man and thief are both the mind; so how can the police man catch the thief?   So you cannot kill the mind by force. The mind dies its own death by the poison of disassociation.   What gives power to a thought? - Your interest. If you have no interest in a particular thought then it loses its hold over you.   You can try this out now. Let the thoughts flow through your mind but don't take interest in them. Just stay as a bystander or a watcher and let the thoughts float.   Initially you might have a hard time watching thoughts because of your inherent habit of associating with each thought that arises.   It helps to know that you are not your thoughts, that thoughts are just energy forms created in the mind. Why does the mind create thoughts? No one knows - it's just something it does, why bother. Do you ever ask why does the heart beat?   With a little practice you will get really good at watching thoughts and not involving yourself with them.   You will stop giving power to thoughts by not giving them your interest. Thoughts die immediately when they are deprived of this fuel of interest. If you don't associate with the thought or give power to the thought, it will wither away quickly.   What Are Thoughts?   Past events get stored as memories. Your mind conditioning and beliefs are also stored as memories. All this is unconscious storage; the mind does all this in auto mode.   Perceptions and interpretations are created in the mind based on its past "external" conditioning and also its natural conditioning (genetics). These interpretations, perceptions and judgments come up as thoughts in the mind, and they can be positive or negative depending on the mind's conditioning.   Thoughts are generated based on the past incidents/memories, future projections and interpretations on the present life situation. It's like a computer trying to predict or conjure up projection based on the data it has collected so far.   When thoughts are negative in nature (thoughts of worry, anxiety, stress, lack, resentment, guilt etc.) they produce resistance to the movement of your life, and this resistance is felt as suffering. Negative thoughts will always stand in resistance to the movement of your life, like blocks of stone in the midst of a swift current of water.   Life is a stream of pure positive energy and hence any negative thought will stand in opposition to it, causing friction which is felt as suffering in the body.   The thoughts in your mind gain power from your attention and interest. Your attention is the fuel for your mind. So when you give attention to consuming thoughts in the mind, you are unconsciously fueling it and thus attracting more momentum for these negative thoughts.   The momentum of negative thoughts in your mind will slow down, and ebb away, automatically when you stop feeding your attention to it. Stay as an open space of awareness without focusing your attention on the negative thoughts of the mind, and soon they will lose their momentum.   You can focus on the positive thoughts generated in the mind, and thus develop a positive momentum in your mind. Every time your mind produces some positive thoughts, e.g thoughts of love, joy, excitement, abundance, beauty, appreciation, passion, peace etc, focus on it, milk it, and give attention to it.   This will cause your mind to attract more positive thoughts and thus build a positive momentum.   Whenever the mind thinks negatively, don't give it attention or interest, this will cause the ebbing away of the momentum of negative thinking. It's really that simple. Once you understand the mechanics of how thoughts gain momentum in the mind, you will be in total control of your state of being.   The Practice of Watching the Mind   All you need to do to get rid of obsessive thoughts is to watch the mind without getting involved.   You will get really good at this with just a little practice. This practice, or "sadhana" as called in Hindu scriptures, is the root of awakening from the illusion of mind.   Without trying to understand this practice just implement it. The more you try to understand the more mind gets involved. Just watch the mind and you will soon see that you are not the mind at all.   That the mind is like a machine in your head that generates thoughts based on your attention/interest. Be free of your mind by depriving it of your interest. This is the only direct path of becoming free of the mind.   Please let me know if this is helpful, looking forward to talking with you more :) Jono
(MSW, LICSW, LMHC)
Answered on 09/29/2021

How do I get better at managing guilt and shame?

  Yes, triggering thoughts and feeling emotional can feel very vulnerable! Breathe through it. You are not your emotion, it can be important to observe our emotions and acknowledge they exists. Try to experience your emotions like wave, coming and going. Notice how the water is calm, you begin to see the wave building (that is the emotion/feeling). What happens after the wave passes? (Water is still and calm). Recognize that the emotion will pass, it won’t last forever. You may find it helpful to concentrate on some part of the emotion, like how your body is feeling, or what the emotion looks like. Don't try to push the emotion away - This makes the emotion stronger, and increases our suffering.   Emotions are neither “good or bad”; it’s just there. Remember, we label our experiences as ‘good’ or ‘bad’. Anger, fear, sadness are all painful emotions, but they are not bad.  We all experience these feelings.   Here is a strategy that can help us create distance between our thoughts/feelings and our personalities. Remember - You are not your feeling. Your emotion is part of you, and it does not define you Practice creating distance by saying “I am having the Feeling _____” or “I am having the thought____” versus “I am angry” “I will fail”.               It can be helpful to first learn about what worry/anxiety is, when it comes up, and to be more aware of the 'worry process'.  These thoughts can get in the way of what we want, and can impact our confidence, self-esteem, and overall well-being. Worry is like a rocking chair - it gives us something to do, but does not get us anywhere (fun, but also realistic quote!). Our thoughts, feelings, and behaviors are SO connected. When we experience a particular thought, it can trigger a feeling and lead to a behavior.For example: thought (I can't do this/I'm not good enough) leads to feeling (anxious, sad, depressed) which leads to behavior (isolate, withdraw). The reason I share this, is because when we shift the way we think, it will shift the way we feel and behave. Which gives us more control of our emotions.For example: thought (it is going to be okay) leads to feeling (calm, relaxed) leads to behavior (engaged, motivated).It is important to stay grounded in our thought patterns. Often times, "worry" is about the past or the future, and with that - we completely miss the present moment. And this impacts our emotional control!   - it may be helpful to reflect on what exactly feels triggering in those moments. Is it the core beliefs of 'not being good enough' or irrational thoughts of 'what could happen' (things that actually have not happened, worst case scenario) Some thoughts like predicting or assuming what is going to happen - these are known as 'fortune telling' basically assuming the outcome of the future…without evidence, this is actually not happened AND it takes you away from enjoying the present moment. I'll share some more worksheets on these particular thought patterns (core beliefs and cognitive distortions) which will help you gain more awareness into what is triggering some of the feelings you experience.   Even this thought of "not good enough" is another judgment or opinion we might have of ourselves which adds to feeling upset, bothered, or insecure. We can challenge this thought by reflecting on 'what is good enough'. Make expectations of yourself more realistic, you are Human, you are allowed to make mistakes and there is no such thing as perfect.           Cognitive distortions are irrational thoughts that we can get stuck in. They are common, yet unhelpful    Cognitive distortions are simply ways that our mind convinces us of something that isn’t really true. These inaccurate thoughts are usually used to reinforce negative thinking or emotions — telling ourselves things that sound rational and accurate, but really only serve to keep us feeling bad about ourselves        ALL-OR-NOTHING THINKING ·       You see things in black and white categories. If your performance falls short of perfect, you see yourself as a total failure.   OVERGENERALIZATION ·       You see a single negative event as a never-ending pattern of defeat.   MENTAL FILTER ·       You pick out a single negative detail and dwell on it exclusively so that your vision of all reality becomes darkened, like the drop of ink that discolors the entire beaker of water.   DISQUALIFYING THE POSITIVE ·       You reject positive experiences by insisting they "don't count" for some reason or other. In this way you can maintain a negative belief that is contradicted by your everyday experiences.   JUMPING TO CONCLUSIONS ·       You make a negative interpretation even though there are no definite facts that convincingly support your conclusions.   Mind Reading. You arbitrarily conclude that someone is reacting negatively to you, and you don't bother to check this out.   The Fortune Teller Error. You anticipate that things will turn out badly, and you feel convinced that your prediction is an already established fact.   MAGNIFICATION OR MINIMIZATION ·       You exaggerate the importance of things (such as your goof-up or someone else's achievement). Or you inappropriately shrink things until they appear tiny (your own desirable qualities or the other fellow's imperfections). ·       This is also called the "binocular trick."   EMOTIONAL REASONING ·       You assume that your negative emotions necessarily reflect the way things really are: "I feel it, therefore it must be true."   SHOULD STATEMENTS ·       You try to motivate yourself with shoulds and shouldn'ts, as if you had to be whipped and punished before you could be expected to do anything. "Musts" and "oughts" are also offenders. ·       The emotional consequence is guilt. When you direct should statements toward others, you feel anger, frustration, and resentment.   LABELING AND MISLABELING ·       This is an extreme form of over-generalization. Instead of describing your error, you attach a negative label to yourself: "I'm a loser." When someone else's behavior rubs you the wrong way, you attach a negative label to them: "they are annoying." ·       Mislabeling involves describing an event with language that is highly colored and emotionally loaded.   PERSONALIZATION ·       You see yourself as the cause of some negative event which in fact you were not primarily responsible for.                                          Core beliefs are the very essence of how we see ourselves, other people, the world, and the future. Sometimes, these core beliefs become 'activated' in certain situations. This is where the automatic thoughts/cognitive distortions can stem from         Just because we have thoughts does not mean they are 100% true. We can work towards challenging the self-talk into something more healthier and rational. We can challenge the thoughts by asking ourselves questions…   Some examples: ·       What negative thought about a situation/incident/experience am I having? ·       How is having this thought helping me? ·       How is having this thought hurting me? ·       What evidence/facts support my thought? Is there evidence contrary to or against my thought? ·       Am I interpreting/judging/labeling the situation or experience without examining all of the evidence? ·       How would a friend think about this situation? What would a friend say? ·       How can I think about the situation/incident in a positive way? ·       What else can I tell myself in this moment? ·       Will this situation or experience matter six months from now? How about one year from now? Five years?       Cognitive Therapy Techniques/Skills to Change Your Thoughts Identify Distortions in automatic thoughts. Examine the Evidence - Instead of assuming that your negative thought is true, examine the actual evidence for it.  For example, is it true that I never do anything right? What are some things I do well? What are the things I'm not so good at? The Double-Standard Method - Ask yourself, "Would I say this to a close friend who was very much like me and had a similar problem?" "What would I say to a friend?" Practice saying that to yourself. The Experimental Technique - When you have a negative thought, ask yourself if there is a way you could test it to find out if it is really true. Thinking in Shades of Gray - (useful for all-or-nothing thinking) Remind yourself that things are usually somewhere between 0 and 100 percent.  Instead of insisting "I am perfect and never make a mistake" or "I am a horrible person, I messed up/I'm giving up…."  acknowledge a mistake, forgive yourself, and move forward with your life The Survey Method - Ask yourself "Would other people agree that the thought is valid?"  Or ask people in your life you trust questions to find out if your thoughts and attitudes are realistic. Define terms - (useful if you are labeling yourself). Instead of putting yourself down as "a failure" or "a loser" or "a fool." Ask yourself:  What does failure mean? What is a loser? What is a fool? The Semantic Method - (useful for "should statements"). Substitute a phrase like "it would be nice" or "it would be preferable" in place of "I should."  This may help you look at the thoughts without having expectations, and decrease times of being too self-critical. Re-attribution - (useful for personalization). Ask yourself what other factors may have contributed to this problem.  Focus on solving the problem one step at a time, instead of using up energy towards feeling guilty or blaming yourself. Cost-Benefit analysis. Ask yourself, "How will having this thought/belief help me, and how will it hurt me?"  You can also use this question on negative behavior patterns (i.e. lying in bed, spending too much time on social media) or self-defeating beliefs like "I must always try to be perfect."       Each of us has a set of messages that play over and over in our minds.  This internal dialogue, or personal commentary, frames our reactions to life and its circumstances.  One of the ways to recognize, promote, and sustain optimism, hope, and joy is to intentionally fill our thoughts with positive self-talk.  Too often, the pattern of self-talk we’ve developed is negative.  We remember the negative things we were told as children by our parents, siblings, or teachers.  We remember the negative reactions from other children that diminished how we felt about ourselves.  Throughout the years, these messages have played over and over in our minds, fueling our feelings of anger, fear, guilt, and hopelessness.  That voice inside your head has a huge impact on who you are and how you live your life. You may not think so, but with practice you can change your self-talk. Why wouldn’t anyone want to develop a habit of positive self-talk? It uplifts you; it helps increase your confidence, it enables you to attract what your heart desires, it allows you to adopt a healthier lifestyle and it helps reduce stress. Try the following exercise.  Write down some of the negative messages inside your mind that undermine your ability to be the best version of yourself.  Be specific, whenever possible, and include anyone you remember who contributed to that message.  Now, take a moment to intentionally counteract those negative messages with positive truths in your life.  Don’t give up if you don’t find them quickly.  For every negative message there is a positive truth that will override the weight of despair.  These truths always exist; keep looking until you find them.  You may have a negative message that replays in your head every time you make a mistake.  As a child you have been told, “You’ll never amount to anything” or “You can’t do anything right.”  When you make a mistake—and you will because we all do, and we are allowed to make mistakes, we are Human—you can choose to overwrite that message with a positive one, such as “I choose to accept and grow from my mistake” or “As I learn from my mistakes, I am becoming a better person.”  During this exercise, mistakes become opportunities to replace negative views of who you are with positive options for personal enhancement.  Positive self-talk is not self-deception.  It is not mentally looking at circumstances with eyes that see only what you want to see.  Rather, positive self-talk is about recognizing the truth, in situations and in yourself.  One of the fundamental truths is that you will make mistakes.  To expect perfection in yourself or anyone else is unrealistic.  To expect no difficulties in life, whether through your own actions or sheer circumstances, is also unrealistic.  However, it can easily slip your mind to regularly practice positive self-talk if you don’t make it a habit. And yes, it might sound and feel ridiculous at first, but if you keep going with your positive self-talk it will become natural to you. To help you stay on track, you may like to put some post-it notes wherever you'll see them: on the bathroom mirror, on your computer screen, inside of your wallet, in your car — wherever works for you. It’s important to constantly remind yourself to speak kindly to yourself until it becomes a habit.   Bring your awareness to your self-talk when you wake up, when you’re driving to work, waiting to be served at a restaurant, exercising, or lying down; use it every day, in all situations. When negative events or mistakes happen, positive self-talk seeks to bring the positive out of the negative to help you do better, go further, or just keep moving forward.  The practice of positive self-talk is often the process that allows you to discover the obscured optimism, hope, and joy in any given situation. Your self-talk creates your reality. Some examples of messages you can remind yourself of: ·       I am capable. ·       I know who I am and I am enough. ·       I choose to be present in all that I do. ·       I choose to think thoughts that serve me well. ·       I choose to reach for a better feeling. ·       I share my happiness with those around me. ·       My body is my vehicle in life; I choose to fill it with goodness. ·       I feel energetic and alive. ·       My life is unfolding beautifully. ·       I am confident. ·       I always observe before reacting. ·       I know with time and effort I can achieve. ·       I love challenges and what I learn from overcoming them. ·       Each step is taking me to where I want to be. Notice Your Patterns The first step toward change is to become more aware of the problem. You probably don’t realize how often you say negative things in your head, or how much it affects your experience. The following strategies can help you become more conscious of your internal dialogue and its content. ·       Journal Writing: Whether you carry a journal around with you and jot down negative comments when you think them, write a general summary of your thoughts at the end of the day, or just start writing about your feelings on a certain topic and later go back to analyze it for content, journaling can be an effective tool for examining your inner process. ·       Thought-Stopping: As you notice yourself saying something negative in your mind, you can stop your thought mid-stream my saying to yourself “Stop”. Saying this aloud will be more powerful, and having to say it aloud will make you more aware of how many times you are stopping negative thoughts, and where. ·       Rubber-Band Snap:  Another therapeutic trick is to walk around with a rubber band around your wrist; as you notice negative self-talk, pull the band away from your skin and let it snap back. It’ll hurt a little, and serve as a slightly negative consequence that will both make you more aware of your thoughts and help to stop them! (Or, if you don’t want to subject yourself to walking around with a rubber band on your wrist, you’ll be even more careful to limit the negative thoughts!)     Replace Negative Statements  A good way to stop a bad habit is to replace it with something better. Once you’re aware of your internal dialogue, here are some ways to change it: ·       Milder Wording:  Have you ever been to a hospital and noticed how the nurses talk about ‘discomfort’ instead of ‘pain’? This is generally done because ‘pain’ is a much more powerful word, and discussing your ‘pain’ level can actually make your experience of it more intense than if you’re discussing your ‘discomfort’ level. You can try this strategy in your daily life. In your self-talk, turning more powerful negative words to more neutral ones can actually help neutralize your experience. Instead of using words like ‘hate’ and ‘angry’ (as in, “I hate traffic! It makes me so angry!”), you can use words like ‘don’t like’ and ‘annoyed’ (“I don’t like traffic; it makes me annoyed,” sounds much milder, doesn’t it?) ·       Change Negative to Neutral or Positive:  As you find yourself mentally complaining about something, rethink your assumptions. Are you assuming something is a negative event when it isn’t, necessarily? (For example, having your plans canceled at the last minute can be seen as a negative, but what you do with your newly-freed schedule can be what you make of it.) The next time you find yourself stressing about something or deciding you’re not up to a challenge, stop and rethink, and see if you can come up with a neutral or positive replacement. ·       Change Self-Limiting Statements to Questions:  Self-limiting statements like “I can’t handle this!” or “This is impossible!” are particularly damaging because they increase your stress in a given situation and they stop you from searching for solutions. The next time you find yourself thinking something that limits the possibilities of a given situation, turn it into a question. Doesn’t “How can I handle this?” or “How is this possible?” sound more hopeful and open up your imagination to new possibilities?    
Answered on 09/25/2021

How to manage anxiety?

Hello Fox,   Thank you for sharing some of your story about the anxiety you are currently dealing with in your life on The Betterhelp Platform.  I can see that you might be feeling overwhelmed with your life and your current love situation.    I will answer your question: How to manage anxiety?   I will share some information explaining what anxiety disorders are, the symptoms, possible causes and treatmetns and then offers some tips on how you might manage your symptoms. If you are feeling overwhelmed and unable to cope I would encourage you to reach out to your medical provider or to a professional mental heath therapist for some support.  If you were unable to share all your details on here perhaps you might want to talk your details through with an impartial listener.   What Are Anxiety Disorders?   Anxiety is a normal emotion. It’s your brain’s way of reacting to stress and alerting you of potential danger ahead.    Everyone feels anxious now and then. For example, you may worry when faced with a problem at work, before taking a test, or before making an important decision.   Occasional anxiety is OK. But anxiety disorders are different. They’re a group of mental illnesses that cause constant and overwhelming anxiety and fear.  The excessive anxiety can make you avoid work, school, family get-togethers, and other social situations that might trigger or worsen your symptoms.      With treatment, many people with anxiety disorders can manage their feelings   Types of Anxiety Disorders   There are several types of anxiety disorders:   Generalized anxiety disorder. You feel excessive, unrealistic worry and tension with little or no reason. Panic Disorder. You feel sudden, intense fear that brings on a panic disorder. During a panic attack you may break out in a sweat, have chest pain, and have a pounding heartbeat palpitations. Sometimes you may feel like you’re choking or having a heart attack. Social Anxiety disorder. Also called social phobia, this is when you feel overwhelming worry and self-consciousness about everyday social situations. You obsessively worry about others judging you or being embarrassed or ridiculed. Specific phobias. You feel intense fear of a specific object or situation, such as heights or flying. The fear goes beyond what’s appropriate and may cause you to avoid ordinary situations. Agoraphobia.You have an intense fear of being in a place where it seems hard to escape or get help if an emergency occurs. For example, you may panic or feel anxious when on an airplane, public transportation, or standing in line with a crowd.   Separation anxiety. Little kids aren’t the only ones who feel scared or anxious when a loved one leaves. Anyone can get separation anxiety disorder. If you do, you’ll feel very anxious or fearful when a person you’re close with leaves your sight. You’ll always worry that something bad may happen to your loved one.  Selective mutism. This is a type of social anxiety in which young kids who talk normally with their family don’t speak in public, like at school. Medication-induced anxiety disorder. Use of certain medications or illegal drugs, or withdrawal from certain drugs, can trigger some symptoms of anxiety disorder.     Anxiety Disorder Symptoms The main symptom of anxiety disorders is excessive fear or worry. Anxiety disorders can also make it hard to breathe, sleep, stay still, and concentrate.  Your specific symptoms depend on the type of anxiety disorder you have.    Common symptoms are:  Panic, fear, and uneasiness Feelings of panic, doom, or danger Sleep problems Not being able to stay calm and still Cold, sweaty, numb, or tingling hands or feet Shortness of breath Breathing faster and more quickly than normal (hyperventilation) Heart palpitations Dry Mouth Nausea Tense muscles Dizziness Thinking about a problem over and over again and unable to stop (rumination) Inability to concentrate Intensely or obsessively avoiding feared objects or places   Anxiety Disorder Causes and Risk Factors   Researchers don’t know exactly what brings on anxiety disorders. A complex mix of things play a role in who does and doesn’t get one.    Causes of Anxiety Disorder   Some causes of anxiety disorders are:  Genetics. Anxiety disorders can run in families.  Brain chemistry. Some research suggests anxiety disorders may be linked to faulty circuits in the brain that control fear and emotions.  Environmental stress. This refers to stressful events you have seen or lived through. Life events often linked to anxiety disorders include childhood abuse and neglect, a death of a loved one, or being attacked or seeing violence.   Drug withdrawal or misuse. Certain drugs may be used to hide or decrease certain anxiety symptoms. Anxiety disorder often goes hand in hand with alcohol and substance use. Medical conditions. Some heart, lung, and thyroid conditions can cause symptoms similar to anxiety disorders or make anxiety symptoms worse. It’s important to get a full physical exam to rule out other medical conditions when talking to your doctor about anxiety.    Risk Factors for Anxiety Disorder   Some things also make you more likely to develop an anxiety disorder. These are called risk factors. Some risk factors you can’t change, but others you can.    Risk factors for anxiety disorders include:    History of mental health disorder. Having another mental health disorder, like depression, raises your risk for anxiety disorder.  Childhood sexual abuse. Emotional, physical, and sexual abuse or neglect during childhood is linked to anxiety disorders later in life.  Trauma. Living through a traumatic event increases the risk of post traumatic stress disorder (PTSD), which can cause panic attacks. Negative life events. Stressful or negative life events, like losing a parent in early childhood, increase your risk for anxiety disorder.   Severe illness or chronic health condition. Constant worry about your health or the health of a loved one, or caring for someone who is sick, can cause you to feel overwhelmed and anxious.  Substance abuse. The use of alcohol and illegal drugs makes you more likely to get an anxiety disorder. Some people also use these substances to hide or ease anxiety symptoms. Being shy as a child. Shyness and withdrawal from unfamiliar people and places during childhood is linked to social anxiety in teens and adults.  Low self-esteem. Negative perceptions about yourself may lead to social anxiety disorder.   Anxiety Disorder Diagnosis   If you have symptoms, your doctor will examine you and ask questions about your medical history. They may run tests to rule out other health conditions that might be causing your symptoms. No lab tests can specifically diagnose anxiety disorders.   If your doctor doesn’t find any physical reason for how you’re feeling, they may send you to a psychiatrist, psychologist, or another mental health specialist. Those doctors will ask you questions and use tools and testing to find out if you may have an anxiety disorder.   Your doctors will consider how long you’ve had symptoms and how intense they are  when diagnosing you. It’s important to let your doctors or counselors know if your anxiety makes it hard to enjoy or complete everyday tasks at home, work, or school.    Anxiety Disorder Treatments   There are many treatments to reduce and manage symptoms of anxiety disorder. Usually, people with anxiety disorder take medicine and go to counseling.  Treatments for anxiety disorder include:    Medications Several types of drugs are used to treat anxiety disorders. Talk to your doctor or psychiatrist about the pros and cons of each medicine to decide which one is best for you.    Antidepressants. Modern antidepressants (SSRIs and SNRIs) are typically the first drugs prescribed to someone with an anxiety disorder.  Examples of SSRIs are lexapro and Prozac.   SNRIs include duloxetine Effexor. Bupropion. This is another type of antidepressant commonly used to treat chronic anxiety. It works differently than SSRIs and SNRIs. Other antidepressants. These include tricyclics and monoamine oxidase inhibitors (MAOIs). They are less commonly used because side effects, like drops in blood pressure, dry mouth, blurry vision, and urinary retention, can be unpleasant or unsafe for some people.   Benzodiazepines. Your doctor may prescribe one of these drugs if you’re having persistent panicky feelings or anxiety. They help lower anxiety. Examples are Xanax and Klonopin. They work quickly, but you can become dependent on them. Usually, they’re meant to be an add-on to your anxiety disorder treatment and you shouldn’t take them for a long time.  Beta-blockers. This type of high blood pressure drug can help you feel better if you’re having physical symptoms of anxiety, such as a racing heart, trembling, or shaking.  A beta-blocker may help you relax during an acute anxiety attack. Anticonvulsants. Used to prevent seizures in people with epilepsy, these drugs also can relieve certain anxiety disorder symptoms.  Antipsychotics. Low doses of these drugs can be added to help make other treatments work better.  Buspirone (BuSpar). This anti-anxiety drug is sometimes used to treat chronic anxiety. You’ll need to take it for a few weeks before seeing full symptom relief.    Psychotherapy: This is a type of counseling that helps you learn how your emotions affect your behaviors. It’s sometimes called talk therapy. A trained mental health specialist listens and talks to you about your thoughts and feelings and suggests ways to understand and manage them and your anxiety disorder.   Cognitive behavioral therapy  (CBT): This common type of psychotherapy teaches you how to turn negative, or panic-causing, thoughts and behaviors into positive ones. You’ll learn ways to carefully approach and manage fearful or worrisome situations without anxiety. Some places offer family CBT sessions.   Managing Anxiety Disorder Symptoms   These tips may help you control or lessen your symptoms:   Learn about your disorder. The more you know, the better prepared you will be to manage symptoms and roadblocks along the way. Don’t be afraid to ask your doctor any questions you might have. Remember, you are a key part of your health care team.  Stick to your treatment plan. Suddenly stopping your meds can cause unpleasant side effects and can even trigger anxiety symptoms.  Cut down on foods and drinks that have caffeine such as coffee, tea, cola, energy drinks, and chocolate. Caffeine is a mood-altering drug, and it may make symptoms of anxiety disorders worse. Don’t use alcohol and recreational street drugs. Substance abuse increases your risk of anxiety disorders. Eat right and exercise. Brisk aerobic exercises like jogging and biking help release brain chemicals that cut stress and improve your mood. Get better sleep. Sleep problems and anxiety disorder often go hand in hand. Make getting good rest a priority. Follow a relaxing bedtime routine. Talk to your doctor if you still have trouble sleeping. Learn to relax. Stress management is an important part of your anxiety disorder treatment plan. Things like meditation, or mindfulness, can help you unwind after a stressful day and may make your treatment work better. Keep a journal. Writing down your thoughts before the day is down may help you relax so you’re not tossing and turning with anxious thoughts all night.  Manage your negative thoughts. Thinking positive thoughts instead of worrisome ones can help reduce anxiety. This can be challenging if you have certain types of anxiety, however. Cognitive behavioral therapy can teach you how to redirect your thoughts.  Get together with friends. Whether it’s in person, on the phone, or the computer, social connections help people thrive and stay healthy. People who have a close group of friends that support and chat with them have lower levels of social anxiety.  Seek support. Some people find it helpful and uplifting to talk to others who are experiencing the same symptoms and emotions. Self-help or support groups let you share your concerns and achievements with others who are or who have been there.  Ask your doctor or pharmacist before taking any over-the-counter meds or herbal remedies. Many have chemicals that can make anxiety symptoms worse.   Anxiety Disorder Outlook It can be challenging and frustrating to live with an anxiety disorder. The constant worry and fear can make you feel tired and scared. If you’ve talked to a doctor about your symptoms, then you’ve taken the first step toward letting go of the worry.    It can take some time to find the right treatment that works for you. If you have more than one anxiety disorder, you may need several kinds of treatment. For most people with anxiety disorders, a combination of medicine and counseling is best. With proper care and treatment, you can learn how to manage your symptoms and thrive.     There is hope!   I wish you the best of luck with getting your life back on track.   Kind Regards,   Gaynor           
(MA, LCSW)
Answered on 09/24/2021

Is it avoidant personality disorder?

Paste your content here. Why hello there! There is so much to unpack in your question. My response is going to lead to many more questions so brace yourself! :-) I think in our culture, we have a habit of self-diagnosing ourselves with mental health disorders - and all of our loved ones and hated ones too! Could you 'have' avoidant personality disorder? Certainly - from what you describe. Could you have social anxiety, or be a natural intervert, or 'relearning' how to be in the world after a 10 year pornography/sex addiction? Absolutely! Could it be something else? Of course! For an actual diagnosis, I suggest forming a relationship with a licensed therapist and work with a person who is able to answer all the other questions that are pertinent in this situation. Here are some questions that are coming to mind for me. - How old are you? Did you grow up in the age where of your social interaction was learned online? Could that be contributing to social anxiety in 'real life' situations?   - What are you afraid of in social situations? Are you a person of color or another minority group? Are there complex societal reasons to be a afraid? What triggers your fear?    - Are you a highly sensitive person and have strong reactions and responses to triggers like being rejected?   - What does your avoidance pattern look like? If you were to draw a map or an outline can you pinpoint the same triggers every time? What do they have in common? You are saying that it's the same whether it's a platonic or a romantic relationship - so that does not appear to be a trigger. Are there other triggers?   - What is the benefit of isolating yourself? Why do no not feel fear or anxiety when you are alone but you do with other people?   - Are you in a program of Recovery for your sex/porn addiction? If not, would you benefit from starting one and conversing with other folks who embarked upon the same behavior as you for the same reasons - anxiety and fear?   - What's up with your family estrangment? What is the connection to the abuse and neglect you experienced with the behavior of avoiding relationships?   My suggestion to you is to find a trusted person to begin exploring these questions. If you don't want to 'do therapy' (which I highly recommend - and not just because I'm a therapist), then do you have a spiritual advisor with whom you could talk through these questions? Or a mentor? Or again, a sponsor or support person in a Recovery? You may greatly benefit from Cognitive Behavioral Therapy. Look it up. You'll like it. The fact that you are ready to explore it is AMAZING!  Best, Kathy Link, LCSW  
(MSSW, LCSW)
Answered on 09/13/2021

Can I really overcome retroactive jealous ocd?

The short answer is yes, of course, you can overcome retroactive jealousy. The more complicated answer is that it will take time, effort, and reflection on your part. Relationship obsessive-compulsive disorder (ROCD) is a form of obsessive-compulsive disorder (OCD). Obsessive-compulsive disorder is an anxiety disorder, which is a broad category of treatable disorders. Untreated anxiety disorders such as OCD can impact relationships with others and take a toll on the individual decreasing one's quality of life. Cognitive-behavioral therapy is a recommended therapeutic modality when working with a therapist for an anxiety disorder. Most mental health clinicians have the education and training to treat anxiety disorders but some specialize in working with anxiety disorders. Often there is a lot of fear and insecurity underneath the manifestation of any obsessive-compulsive behavior. This will need to be explored with a trusted professional who can help you uncover what may be driving some of the jealousy and feelings of insecurity that are negatively affecting the ability to feel safe in one's current relationship with another. Trauma and childhood abuse can be contributing factors that can impact the emotional and psychological health of adult relationships. Reconciling with the idea that people have had past lives before a current relationship and that there is nothing that anyone can do to change what has already happened in the past. The jealousy and rage that can emerge when one considers one's partner's past may be an indicator of an abusive and controlling nature in you. Abuse and control are serious issues that impact relationships in various and hurtful ways for both parties. Professional help is recommended. Love and loving someone is very strong emotions that can escalate feelings of need and fear of loss. These feelings can sweep over everything and drive one into actions that are overbearing and extreme. It can be very confusing for both because, on one hand, a person may feel that because my partner loves me so much he or she is a sense has a right to feel jealous yet in actuality love that is mixed with extreme expressions of jealousy are often controlling relationships that indicate emotional immaturity and insecurity. Yes, you can overcome retroactive jealousy, but you will have to work very hard and be willing to look deep within yourself as a person to gain insight as to why you might be feeling insecure in your current relationship. Trauma treatments such as Eye Movement Desensitization and Reprocessing (EMDR) may be an option for helping with irrational thoughts and lessening the impact of images that are difficult to stop thinking about. I sincerely hope that you can learn from this, grow as a university student, and relax into accepting what you cannot control. This will allow you to offer more compassion toward yourself and others and enjoy the present situation without obsessing over what was or what will or will not happen. Based on what you wrote, I imagine that this is impacting your concentration and ability to focus on your studies and other responsibilities as well as how you are being in the relationship with the person you love. You do not want to smother her or you could push her away. Everything will work out the way that it is meant to work out if you could step back a little, let go, and breathe - yes, literally breathe. Practice some deep breathing and mindfulness-based approaches such as meditation and yoga for example as ways to reduce the anxiety that you are feeling around this issue. As you become more confident about who you are as an adult whether you are in this current relationship or not you will begin to overcome some of the barriers within yourself that may very well be fueling your anxiety. I think it would be important for you to work with a therapist to explore any underlying issues from your past and from your childhood or adolescent years that could be contributing to worry, fear, and insecurity on your part. When one begins to gain insight as to what might be triggering feelings of jealousy, anger, fear, or any other negative emotion for example one can grow in ways that will be beneficial overall. I wish you well as you take this big first step toward understanding yourself better! It takes motivation, commitment, and courage to ask hard questions and to ask for help. Take care of yourself and treat your partner whom you say you love with respect and kindness and that will go a long way in building a strong relationship. Learn to trust the people whom you can trust as long as they have given you no reason to distrust them. Work on calming your own jealousy feelings with positive self-talk and rational, reasonable, and logical thoughts. Stay in the present. There is no reason to dredge up what anyone has done in the past. The past is the past. Learn from it. When we tell others about who we are and we tell our stories from the past to others because we want them to know us better we are continually learning and making meaning of our experiences, but remember that we are living in today and the opportunity for change and growth are in today not yesterday. Tell yourself that you will not obsess over the past actions of your partner before the two of you were together. Use self-talk to tell yourself that this is not helpful. Tell yourself that if you continue to behave this way you will only drive the person you love away. Take a breath, enjoy the feeling of loving someone in a healthy manner, and relish being young (I am assuming) and in love. At any age or stage of life love is a sweet gift so do not spoil or tarnish the love you feel with jealousy feelings and controlling or manipulative behavior. Get the help you need so that you can live your best life. Study hard!
(NCC, LPC-MHSP)
Answered on 09/11/2021

How to overcome the fear of doing what I want?

Hello! 1st, thank you for reaching out and asking this question. This is such an important step to take for your own mental health, wellness, and happiness. Our bodies are very much wired to naturally be motivated by 'wins'. When we experience a win, it reinforces that choice that we made. Failure doesn't produce the same motivation, naturally.  If you have established what your goals are as well as the steps it takes to achieve that goal, the process can produce some anxiety. Remember that anxiety lives in the future or the past. Using grounding techniques can help you to regain emotional composure. This is the place where you can problem-solve or try new things with a more calm and clear mind.  In order to begin to approach doing something new or something hard in order to reach our goals, answer the question for yourself: "Why do I need/want to achieve this goal? How will achieving this goal affect my life? How much do I need/want that end result?" Asking these questions can help illuminate things that you can utilize as motivation to accomplish the goals you've set for yourself OR inform you on ways you may need to adjust your goal to create reasonable steps for growth.  You can also utilize your support network. Who do you have in the life that can partner with you on the journal of accomplishing those goals? Who can you talk to when you feel like you've failed or allowed your anxiety to overpower your will, that can speak to you in a defeated place and help you re-establish your footing to go back and try again. At times, the change that sees for ourselves requires a "village" of support in order to overcome the personal challenges that stand between you and the life that you see for yourself. At times, you are better suited to communicate and journey through with someone to experience that "win" to strengthen you for the next journey. I hope this makes sense.  Establish your goals. Why did you choose these? What is the 'why"? (why is this goal necessary?) What is the block? ( what makes this scary or produces anxiety in you?) Find your tribe. Utilizing your support network in critical or difficult places can change the game for you in a very positive way.    As always, utilize the support of a licensed therapist to help you talk through things that may be difficult for you so that you are able to continue to achieve the progress you have set for yourself. Good luck to you, moving forward! 😊
(MAMFT, LPC)
Answered on 09/08/2021

What's my mental health issue?

What is my mental health issue? Hi, you shared that you suffer from numbness to crying excessively. You also shared that back in 2019 you and your mom lived alone and that your mother had suffered from kidney disease. You shared that one morning you saw her dead on the couch. You also shared that in order for you to move on currently you moved out of your hometown and started college. Now, you shared that the pandemic came and you had to move back and it made you feel the pain you felt in 2019 again. But after 9 months you shared that you went back to your college neighborhood and at first it was so happy and stress-free. You also shared that you met a new best friend which made you so happy but now things have changed. You shared that you do not know why but you feel so alone. You also shared that you feel so worthless. You shared that your past still haunts you, and now your best friend will not talk to you, your girlfriend will not respond to you, your dad has cancer, and your siblings always invalidate what you are feeling. You also shared that you are indeed tired and that you give up. You questioned what is your mental illness. Based on your question, I would highly recommend that you first start with seeking mental health therapy from a professional counselor and or professional therapist locally in order to effectively get a proper diagnosis. A professional counselor and or professional therapist can properly assess you for an official diagnosis. Along with a diagnosis, a professional counselor and or professional therapist can support you in assessing your specific mental health needs in regards to creating a treatment plan specifically for you. Licensed Professional counselors and Professional Therapists on the Betterhelp platform are not able to diagnosis you because we cannot see you in person to get a thorough assessment. Therefore, I highly encourage you to continue to search for a local Licensed Professional Counselor and or Professional Therapist in your local area who can properly diagnosis you to help you find out what your specific mental health issue is at this time. A professional counselor or therapist can be very beneficial in supporting you with discussing and processing what happened when you were a child. Traumatic experiences can cause psychological trauma which can cause damage to an individual's mind as a result of one or more distressing events. The distressing event can cause overwhelming amounts of stress that can surpass the individual's ability to cope or understand their emotions which can lead to serious long-term negative consequences. With the help of a professional counselor and or therapist, you can receive adequate help in regards to your counselor and or therapist providing you with effective and or appropriate skills and techniques to learn how to develop and implement effective skills and strategies for you to effectively deal with the traumatic experience that you experienced as a child that continues to cause problems and or concerns for you as an adult. Behavior interventions, Psychotherapy, and Cognitive Behavioral Therapy (CBT) have all been beneficial in helping people to express their thoughts, feelings, and emotions in regards to a traumatic experience that you experienced as a child that continues to affect your relationships as an adult. A professional counselor and or professional therapist can assist you in learning how to effectively implement coping skills, techniques, and strategies to decrease your panic attacks in public. A professional counselor and or professional therapist can introduce you to deep breathing techniques, calming techniques, stress management techniques, progressive muscle relaxation, grounding techniques, positive interpersonal social skills, and imagery as a means of decreasing you're mental and emotional distresses. Based on your statement, “I give up.” I am very concerned with you sharing that you want to give up. I am not sure if you have suicidal thoughts at this time. However, I do want to be upfront and honest with you by letting you know a little more about the Betterhelp platform. I do want to share with you that being suicidal is considered a medical emergency. When you share that you have thoughts of suicide or wanting to give up, I recommend that you get an assessment from a professional counselor or therapist immediately. If you are not sure who you can go to, you can go to your local emergency room or call 911. Please understand that the services provided through BetterHelp are not intended for crisis situations such as individuals who are having currently thoughts of suicide and or urgent needs. In a crisis situation, please call 911 or your local emergency services or you can also visit the nearest emergency room. Once you have sought the proper mental health treatment to discuss and process your suicidal thoughts. Then, I would highly recommend that you start seeking mental health therapy with a professional counselor or professional therapist or that you continue seeking treatment from a mental health professional counselor and or mental health therapist if you are seeing someone. In an effort to decrease your current mental and emotional distresses, you can also try to commit to changing the way you think. It will take a lot of practice, dedication, and determination to alleviate what triggers your mental and emotional distress. However, trying to do this will help you feel better and it can lead to your feeling much better and becoming more productive. You can recognize when it is happening and when you find it happening you can choose to think about something more productive. You can also look for solutions by committing to learning from your mistakes and solving your problems so you can productively move forward, set aside time to think when you notice you are feeling mentally and emotionally distressed outside of that scheduled time, remind yourself that you will think about it later, distract yourself with a self-care activity and you can practice mindfulness. Mindfulness is the key to living in the "here and now." When you become mindful, you will be completely present at the moment. It can be like a form of meditation that takes a lot of practice, but over time and with consistency, it can be very beneficial in decreasing your mental and emotional distress in an effort to help you experience an overall healthier mental well-being. Overall, I highly recommend that you seek help from a professional counselor and or professional therapist and a medical provider if needed for medication management. The help of a mental health professional counselor and or professional therapist can be quite beneficial in helping you to properly get a better understanding of what triggers your mental and emotional distress, as it can look different for everyone. Also, please remember that mental health is not a one-size-fits-all, so it is very important to get personalized treatment for your specific and current mental and emotional needs in reference to your current life transitions that are causing you to be mentally and emotionally distressed at this time. I hope this helps. Best regards to you!  
(EdS, LPC-S, NCC, BC-TMH)
Answered on 08/29/2021