Attacks Answers

What is the best thing to do to calm down when having a full blown panic attack?

When a person has a panic attack, their brain functions in the fight or flight responsive part of the nervous system;  this affects their impulse control, executive functioning, reasoning, and other brain activities related to safety. It is possible to recover from the physical symptoms of a panic attack. The first thing the person will want to do is ensure they are in a safe place; that means if they are driving, pulling into a parking lot, or in a meeting excusing themselves, stepping out into the hall, taking a seat so they can focus on Mindfulness and Breathing. Dialectical Behavior Therapy (DBT) is an effective skills-based therapy for treating many mental health ailments, including panic attacks. One of the group categories is called distress tolerance. TIPP is one of the distress tolerance skills that are highly effective.  TIPP stands for temperature, intense exercise, paced breathing, and progressive muscle relaxation.  T - Temperature = changing your core body temperature, drinking ice water, taking a hot or cold shower (not too hot or cold so that you burn yourself), splashing cold water on your face, rubbing ice on the back of your neck.  I- Intense exercise - speed walking, jogging, jumping jacks; the idea is to raise your heart rate and begin to produce endorphins.  P- Paced Breathing. My favorite technique is starfish breathing because it focuses on slow-paced breaths, and you trace your hand, stimulating a tactile response. P- Progressive Muscle Relaxation. There are a lot of techniques for Progressive muscle relaxation, but when at the moment, after your paced breathing, it has helped lots of people to do a small shoulder and/or neck role and shake their hands, shaking off the anxious energy.  Sometimes people will only need to use one of these techniques to control a panic attack other times; they will need to utilize all four techniques to regulate their panic attack. Practice makes perfect. Having a plan helps reduce the fear of an impending panic attack. The more you utilize these skills before a panic attack, the more likely you are to use them during a panic attack.  I hope this helps, and don't hesitate to contact a BetterHelp therapist if you have any questions or would like more support.
Answered on 11/07/2022

What is the best step to deal with continuous anxiety, lack of self-confidence?

This spinning world seems to pick up speed every day. If you're finding modern life overwhelming, you're not alone. Anxiety diagnoses are on the rise. This is in part due to the falling stigma against mental disease, but it is also due to a rise in stimuli. As humans continue to live in bustling cities with demanding lives, it can be difficult to control your anxiety. Technology has not made it easier. With constant notifications and excessive screen time, your attention can be pulled in many different directions. These stimuli exacerbate anxiety. If you're dealing with big life changes or inner dilemmas, the background noise just piles on to that. The sense of everything building and pressure rising, can lead to a full blown panic attack if you're not careful. So how do you limit and tame your anxiety? The first step to calming yourself is to recognize when you are anxious. Does your body tense up? Do you get short of breath? Do you feel like any extra pressure added will make you snap? These are signs of stress and anxiety. Being self-aware enough to know when you're anxious is crucial to reducing your anxiety. You will get better at this over time. At first, you may only know you're anxious when you're about to blow your top. Reflect on what caused that feeling and the points that increase your anxiety. Realizing what compounds your anxiety will make you more prepared the next time you are in a similar situation. Once you can identify situations that trigger anxiety, the next step is to observe it. Picture yourself on a runaway train. As you speed along the tracks, you feel scared and helpless. This train is made of everything that triggers your anxiety. Now picture yourself, not riding on the train, but watching it from a safe distance. You watch everything that adds stress to your life, and instead of choosing to ride on the train, you just observe. From this vantage point, you can have a lot of clarity. To choose not to ride the train, to observe, if even for a moment, you buy yourself time to come up with a plan. If a situation in your life is raising your anxiety, after observing it mentally, focus on what you can control. Often, lack of control is a major contributor to anxiety. By focusing on things you can control, you can regain a sense of agency over your anxiety. This focus means blocking out the things you can't control as well. Like everything, this requires practice. The key to this step is realizing that, by allowing yourself to be anxious over what you can't control, you are sapping energy away from what you can control. Any energy you spend on being anxious is energy you are taking away from something else in your life. In specific terms, this means that if you're spending your day fretting about the weather, you're not spending that energy engaged in your work or being present with your friends and family. By focusing, you can channel anxious energy and use it as a motivator towards what you can control. The more work you do while you're relatively calm means, the more you'll be prepared for anxiety. Developing a plan to cope with your anxiety before it hits means that all you have to do is carry out the plan when you're feeling anxious. If it's within your means financially, consider consulting a professional.  Whether it's your family doctor, a licensed therapist, psychiatrist or the help from a life coach they all have tools and resources to help you. The stigma against taking care of your mental health is falling, with more people taking medication and seeking therapy. Do not let this stigma get in the way of improving your health. Not only can anxiety make your life miserable, but the added stress can also cause health problems down the road. As you navigate your anxiety, developing coping methods are essential to handling stress. Learning how to identify anxiety, distancing yourself from it, and channeling it all takes time and practice. With the help of BetterHelp this can all be easier. Taking care of your mental health is essential to improving your overall health. Your quality of life will improve as well. With anxiety in check, you will have more room for actually living.
Answered on 10/30/2022

I wanted to know how I can manage anxiety?

Hi Kelly, I am sorry to hear that you have been affected by anxiety recently, to help you make a balanced decision on how is best for you to manage it, I will give you some general information on what it is and how therapists may work with it. I think the first thing to note about anxiety is that it is a natural process our minds and bodies go through and it is experienced by everyone at some point. With this in mind, it is beneficial to remember that anxiety is only an issue when it becomes life limiting in some way. The function of it is to keep us safe when we perceive a threat or danger. The Amygdala in our brain does this by producing chemicals that tell our heart to divert blood flow to the muscles and lungs so that we are ready to take action. Often, our brain unconsciously perceives a threat and can start the physical process before we are even aware there is a threat in our vicinity. So when we begin to sweat, our breathing becomes faster and our heart rates speed up without us understanding why, it can be quite disconcerting.  This process has been a part of our self-preservation instincts since we were cave people and the fact that you are here means that your ancestors saw the lion in the savannah and ran, rather than stopping to admire the scenery. The issue in our modern world is that the same level of anxiety that would be raised if we were confronted with a lion can also be raised when we are faced with social events or new experiences. Something that is present when anxiety is active no matter the situation that has provoked it, is that we feel out of control about something. Part of our basic needs in order for us to be content and happy as humans is the need to feel in control, as this gives us security and the feeling of being safe. It sounds to me from the information you have provided that this was the case in both experiences you had with anxiety. The pandemic, although implemented to keep our societies safe, has indeed caused issues with mental wellbeing for a lot of people, especially as there was no fixed dates of when lockdowns would lift and life could return to normal. This would most certainly provoke a feeling of being out of control for the majority of the population. We are social animals which means that we thrive on connection and deteriorate when segregated. This combined with personal difficulties or issues within the home, means that we as therapists have seen an unprecedented dip in mental wellbeing as a result. Your father being taken to hospital would be an especially difficult time for you I am sure. The worry of the impact of his illness on not only your father but also wider consequences would certainly provoke a feeling of being out of control. Your feelings of security that are embedded within your relationship with your father, would only serve to maximize the feelings of anxiety the longer he was absent from your life also. I do hope that he is recovering well. Anxiety can be treated in a number of ways, including but not limited to Cognitive Behavioral Therapy (CBT), and Mindfulness techniques. Through CBT we are able to work with changing how the mind perceives the threat that triggers anxiety, Mindfulness can help to manage symptoms of anxiety through relaxation, breathing and visualization techniques. There are many ways that anxiety can be treated to improve your quality of life, lots of clients choose a multilayered approach to their treatment which can work really well. Not all therapists will have specialisms in every approach so if you are looking to experiment with what works best for you, it may be a good idea to look for a therapist who practices an integrative approach. This is a therapist who has experience in more than one type of therapy and will be able to guide you in your journey.  I hope that my answer has helped you come to an understanding of what anxiety is and has given you reassurance that there are interventions that can help you manage it. I wish you well with your mental wellbeing in the future.  Best Wishes  Claire Howdle
(Psychodynamic, Counsellor)
Answered on 10/28/2022

How to control and live with everyday anxiety and panic attacks?

Thank you very much for sharing asking the question and sharing your current situation. I know it's a difficult position - the one you are living in right now  - and I am very sorry about it. Nevertheless, the good thing is that there are things to change the situation for the better and there are things you can do to improve your current situation.   Panic attacks and anxiety are indeed things that are going to be there in life always, it's not possible to completely remove them from our life, as we are talking about withdrawing the emotion of Fear, which is an important part of life. Anxiety is a way of feeling Fear when we have a challenge to face or there's a situation that worries us and Panic is the emotion of Fear in its highest degree of intensity, which is extremely unpleasant and not very useful.    As we cannot withdraw Fear from our lives, we need to learn how to deal with it and with the rest of our basic emotions (mainly Anger, Joy, and Sadness) as they have an important weight in our day-to-day stuff. It's important to hear our emotions, experience them and see where they come from, as they are there for some reason.    You are struggling now to find the triggers of that anxiety of yours and those panic attacks. I would recommend taking a look at the main areas of your life to see if there are things that you don't like within them. Try to find if there is something to be changed in your social life, your life in a couple, your family life, your life work or study wise and your personal life (the relationship that I have with myself, how much I like myself). I think you will be able to find some situations that you don't like about them. Also, talking to a friend, relative or a professional about it can be very helpful to find the cause. Finally, try to remember if any thoughts around those situations are involved.   I hope things go better for you, I honestly think you will be able to deal with it better after some time working with your emotions and once you have changed what you need to change in your life. Wish you the best. 
(Master's, Degree, in, Third, Generation, Psychological, Therapies, Bsc, in, Psychology, Msc, in, Prevention, of, Addictions)
Answered on 10/27/2022

I would like to question if I suffer from anxiety

Hi Ciho,   Thank you for your question. It sounds as if you are worried about whether you suffer from anxiety. It sounds as if you experienced shortness of breath and shaking which has reoccurred since the initial instance. Thinking about the first time this happened also leads to worry and panic of being out of breath. I wonder if this anxiety prevents you from doing things you would like to, and it is getting you down? It sounds, too, as if you don’t know if you are anxious but you do recognise something does not feel right for you. So, I am glad you have also reached out for help.   It might surprise you that it isn’t uncommon to feel this way and uncertainty around why we have experienced something, especially when it doesn't make sense, can be very difficult to sit with. Some people might call it something else, or have a name for it, which can be isolating. The most important thing to know is that this is how you feel, it is your reality, and it is valid. At the moment, working out why you feel this way and how to change it is hard, which is why counseling can help.   The first step in learning to cope with how we are feeling, about feeling short of breath, is to listen to the wisdom of your body. You want to freely admit and be honest, accepting that just because you're struggling with how you feel doesn't mean you're weak, it just means you're human. Perhaps list all your sources that might be making you anxious and how you might react to them differently and with empathy for yourself. And coming to terms with a problem is difficult, unless we stop denying that there is a problem with how it is responded to. You have been fine up until now, good enough is more achievable than perfect, but if you want to get up and face the day, something needs to change.   The kind of thoughts that we tell ourselves when we feel we can't cope gives us permission to continue to stay in denial and not deal with our emotions, because that can be kind of scary, dealing with emotions, because what does that mean? It doesn't mean you don't want change things; but it might mean you may need help to see the resources you have to cope with what you are experiencing right now.   Thinking about this incident in the cab can be difficult. Sometimes, when we lose control of a memory, we lose track of ourselves, including the things, people and connections that are important to us. I'd invite you too, to have a think about the quality of the relationships you have. How do you know your friends are just that and what stops you from talking openly about how you are feeling? Emotional intimacy, active listening, support, and companionships are all important. When these are missing in your life, it could lead to feelings of emptiness and loneliness, too. Think about how you would be with a friend if they were going through what you are experiencing. Often, we don’t speak to ourselves the same way we do our friends, which damages our relationship with ourselves.   Likewise, to improve our relationship with ourselves, it can be helpful to set goals that feel manageable given where you are at the moment. What can you do with regards to worry about your experience and memory of this past event?   When we have an expectation of ourselves that is asking too much, it can be aspirational, but unrealistic expectations seem to get in the way of consistency at least as often as they support it. For example, it might be you expect yourself to 'just move on' and 'never think of this again'. Is that fair? Is it realistic? This was impactful and has left you with something.   Sometimes our expectations and plans can be so lofty we forget where we are and don't take into consideration how we feel, it is disempowering. As an alternative, we can create a simple list of things you feel able to do that moves you towards the general direction of your goal. For example, you could break down not thinking about this incident into smaller, manageable steps.   Organic growth over time helps identify what we can do with the resources we have. It helps to appreciate that our energy levels change, and our resilience can ebb and grow. And anything that gets us to happily show up every day is the mechanism- expectations that are too high lead to feeling like we want to shut down.   Even if it feels overwhelming and painful, thinking and talking about significant feelings, events or thoughts that trouble you may help you process them. Depending on how strong you feel about these events, going through the process with a counsellor is highly advisable.   Take care of your physical needs. When bodies are run down, you're more susceptible to burnout. Make sure you have a good diet, especially your breakfast, eat something healthy. Avoid abusing yourself with rigid diets. Try to get as much exercise as you realistically can, avoid addictive substances and get plenty of sleep. Attend the basic needs you're not attending- don't work out for hours every day, just your basic needs- eating healthy, not too much caffeine and being mindful of getting enough sleep.   And then you also want to nurture yourself more than others. You need to show up for you as your own carer. You need to have a better balance and you do have a choice, although it is hard, to do so. I want you to always ask yourself, what am I doing today to nurture myself while I'm still there for others and away with my concerns?   It is important to remember that everyone needs support sometimes and care always, including you. Sometimes social media can impact this. Be mindful when you're on social media how much time you spend there and, what type of accounts you follow. How people present themselves is often different to their life- they present their best or worst parts of their day, but rarely show everything, particularly the mundane or things that won’t get them ‘likes’. It can cause comparative behaviour, where one never scores higher than the ones that seem ‘perfect’ or like they have their lives together.   Making time for self-care and listening to yourself is an important part of life. Not taking care of your needs can cause problems of self-worth which could also impact feelings of needing to be more and, do more, too.
(MA, Counselling, Cognitive, Behaviour, Therapy, Level, 5, PGDIP, Integrative, Counselling)
Answered on 10/26/2022

How to deal with anxiety and intrusive thoughts relating to ADD (ADHD)

Hi Snail! Thank you very much for asking this valuable question on the "Ask a Licensed Therapist" forum. Based on your question, I can tell that you are seeking out advice on how to manage symptoms of anxiety and ADHD as well as keep a healthy balance in your relationship. It is really good to see that you are reaching out for support on this important topic. Based on what you wrote in your initial question, I can tell that you have been feeling anxious and have been experiencing intrusive thoughts. How would you describe your overall symptoms of anxiety? How often do you feel anxious? Would you be willing to rate your anxiety on a Likert scale of 1 to 10 on a daily basis? It might be a good idea for you to complete the GAD-7, which is a standardized assessment for measuring anxiety. This will give you an idea as well as a base line for your symptoms of anxiety. In addition to keeping track of your anxiety symptoms and practicing self assessment skills regarding your experience of anxiety, I recommend trying some relaxation and mindfulness techniques. These methods include deep breathing, sensory grounding techniques, mindfulness meditation activities, and progressive muscle relaxation. From my perspective, mindfulness simply means being present in the moment and focusing on the here and now. If you need some assistance with getting started with utilizing these approaches, check out the myriad of handouts available on Therapist Aid. Also, would you be willing to keep track of your thoughts and feelings by participating in some therapeutic writing or drawing exercises? If you have not done so already, I recommend that you practice writing in a therapeutic journal. Utilize the feelings wheel as a means to connect to your emotional self and document those feelings. Through the process of journaling, you may be able to achieve some greater insight into your experience. Also, you may want to make steps towards identifying your areas of strengths as well as your areas on concern. After some time, you can certainly begin seeking out themes that come up in your writing. It may be helpful for you to create some therapeutic drawings about your thoughts, feelings and experiences. Start with creating a simple scribble drawing when you are having heightened moments of anxiety or stress. The spontaneous aspect of scribble drawings can be an awesome outlet for creative expression. This technique can foster a holistic, healing experience. Did you know that coloring within a circle can produce a sense of relaxation and even lower heart rate and blood pressure? Check out the free mandala outlines that are available online. You can print or purchase a mandala coloring book and draw within the circular format. Perhaps you may want to write your thoughts in the circle as a means to organize the intrusive thoughts that you have been having. Ultimately, it is completely up to you how you want to process and address your thoughts. It is a great thing that you feel like you are in an equal relationship with your partner at this time. What has that been like for the two of you to be in a loving relationship? It sounds like that despite the fact that you are in a loving relationship, you have thoughts that your partner might leave you. When did you begin having these thoughts? How long have you been feeling concerned that you may be emotionless? It appears you have the ability to be consciously aware of your thoughts and that you have been trying your best to rationalize your ways of thinking. I recommend checking out the Wise Mind concept, which is a dialectical behavioral therapy approach. This concept purports that there are three aspects to the mind: the rational, emotional and wise mind. The ideal of the wise mind is to combine the rational and emotional aspects and be intuitive. Do what you can to create a thought balance and combat each negative thought with a more positive one!It seems like it would be helpful for you to check in with your partner and tell your partner how you are feeling. I know that you mentioned that you are in a long distance relationship. Perhaps you may consider writing a letter to your partner or sending a greeting card with a hand written and personalized message. If you can coordinate a scheduled time to talk on a weekly basis, that could be great for both of you to continue to maintain a healthy relationship. I can tell that you are trying to navigate the challenges of having a long distance relationship, which is a really good sign.At this time, I recommend individual counseling sessions on a weekly or bi-weekly basis. BetterHelp offers counseling appointments on the phone, through live chat or via video conferencing. You can also join a group or attend a groupinar. If things do not improve after some time, you could certainly connect with a therapist and your partner in a couples therapy session. Essentially, it is up to you to decide what will work best for you, your individual needs and your situation. Lastly, I want to touch base about the symptoms of ADHD that you have been having. It sounds like you believe some of the anxiety symptoms that you are having are related to ADHD. When were you diagnosed with ADHD? What treatment recommendations has your primary care provider made for you thus far? I can forward you the following information that may clarify your concerns about ADHD. I hope that information in these pdf documents will be useful to consider: http://downloads.pearsonclinical.com/videos/100317-BASC3/BASC-3-ADHD-Diagnosis-Evaluation-and-Treatment-of-ADHD-Webinar-Handout-100317.pdf http://images.pearsonclinical.com/images/assets/basc-3/basc3resources/DSM5_DiagnosticCriteria_ADHD.pdf Thank you again so much for asking this valuable question on the BetterHelp platform! I really admire your goal of trying to reassure yourself as well as maintain an equal and healthy relationship with your partner. I hope that my response will benefit you in some way. Take good care and have a nice day!
(LMHC, ATR-P, MS, NCC)
Answered on 10/25/2022

How do I rid myself of a negative mindset?

Typically, a negative mindset is the result of our core beliefs.  Core beliefs are developed in childhood and usually during stressful situations.  It is our core beliefs that shape our view of the world.  For example, if your core belief is that the world is unsafe, you will start to believe that you are in danger even in situations that appear safe to most people.  Think of it like a tree, if your core belief is the trunk, and that core belief is negative, then all of the branches of that three will be negative (your thoughts).  So the branches will sprout thoughts like "I'm in danger", "I cannot trust anyone", or "I'm not safe".  It is important to remember that our thoughts directly correlate to how we feel.  That means if the thoughts are negative, then our feelings are negative.  In order to get rid of the negative thoughts, you have to first identify the core belief that is driving the thought and then ask two very important questions: 1. Is this thought accurate?  Often times the negative thought that drives our negative emotions is an inaccurate thought.  For example, if I think "I cannot trust anyone", that would be an inaccurate thought because of course I can trust someone.   2. Is this thought helpful?  Much like inaccurate thinking many of the negative thoughts that drive our negative emotions are unhelpful.  For example, if I think "I'm going to die".  Well, the reality is we're all going to die at some point, but if I'm healthy then always thinking that I'm going to die is unhelpful. So, if the thoughts are inaccurate or unhelpful ways of thinking, then we change the thoughts to more accurate or more helpful ways of thinking.  This sounds easy, but the reality is, it's a difficult task to do.  More importantly, if you have conditioned your brain to believe inaccurate and unhelpful thoughts, then when you start telling yourself accurate and helpful thoughts, your brain will struggle to believe them, at first.  So remember, change takes dedicated practice.  You will need to practice telling yourself accurate helpful information in order to rid yourself of a negative mindset.
Answered on 10/18/2022

How do I get through my anxiety attacks?

Anxiety can be one of those tricky issues that seem to come out of nowhere. Sometimes it's hard to understand where the influx of feelings is coming from. So easily if not managed, anxiety can truly do a number to control your life. When you say that your life in your household is causing you anxiety, do you indicate that as the move or from going to living by yourself to now cohabitating? Most of the work in reducing anxiety attacks, is to first identify your trigger patterns and when you get upset. In those moments, using your identified coping skills can help reduce those before they get out of hand. Self-care is a great indicator of how you manage stress. If your self-care is lacking, your stress levels will generally reflect and show that you may be overwhelmed. So, keeping a journal of triggers or onset anxiety attacks can help you determine the patterns and the overall stressors. One of the first things to remember when you are there, in the midst of an attack, is that it is only temporary. The worst of the anxiety in the attack is in the first 10 minutes and then will usually subside. An important idea to remember is that you are uncomfortable, but are not truly in active, physical danger. To help alleviate symptoms, deep breathing is an extraordinary technique to do so. Whether you are box breathing or 4-4-4 breathing, being able to utilize this skill is helpful. I find that using mindfulness and visualizations can also be helpful in these cases. Grounding is especially helpful to regain awareness. The 5-4-3-2-1 method is one of my personal favorites in mindfulness. Your therapist may have assigned you this to practice when becoming overwhelmed, but the basic premise is this: When you are looking for the 5 things, make sure they are 5 different items that you can see. Spend time thinking about each one. Next the 4, you are listening for 4 sounds in the space. It could be the humming of the dryer or the beeping of a microwave. Next, you will touch 3 items. Notice the texture, shape, and weight of that item. You can even think about how you can use the item. After that, you will follow up with 2 things you can smell. Whether it be a perfume or the smell of fresh baked bread (if you are in that environment because who can resist that smell!), take time to breathe into that smell. The 1 thing is something you can taste. That can be the taste of leftover coffee you can still taste or you can try something small like candy or gum to have a taste. Muscle and progressive relaxation can also be beneficial. This is where you tense a muscle and then relax that muscle. You can start from your toes and work up the body.  I hope this was helpful!
Answered on 10/13/2022

How do you cope with the fear of losing your parents?

Hi Floss,   Thank you so much for reaching out and I am so sorry to hear of your struggles with fear of death and losing your parents.    Worry and sadness of loss are normal things to encounter. If someone matters to you, why wouldn’t you be afraid of this loss? It sounds more of a problem that this anxiety is leading to panic attacks. It also sounds as if the frequency of the thoughts around losing your parents is increasing.    The most important thing to know is that this is how you feel, it is your reality, and it is valid. At the moment, working out why you feel this way and how to change it is hard, which is why counselling can help. It might be a number of smaller factors contributing to how you’re feeling, which may also be why it is tricky to work out why you are feeling how you do.   It’s not “crazy” to be worried about a perfectly healthy parent passing away. Something to consider here is that if you have experienced unexpected loss in the past, you can be more prone to this type of worry. These fears can also manifest at times of experiencing stress, upset, unhappiness or vulnerability.   Although it would be unfair to try to diagnose what is happening from your message, generalized anxiety disorder (GAD) is another common reason for preoccupation with an unlikely death. People with this disorder spend a lot of time worrying about bad things happening, to the point where it interferes with their day-to-day functions, which is why this may be relevant. If you feel this applies to you, it might be worth considering talking to your GP or referring yourself to therapy.   This anxiety that you are experiencing sounds as if it has a hold of you at the moment. There are some ways below that can help to loosen this experience for you.    Firstly, worry is your brain’s way of trying to feel safe and in control. Try to explore the meaning of the thoughts of losing your parents. When our thoughts are future focused, it can also be known as dwelling, it takes us away from the resources we have in the present. It can be helpful to think about the things you can control in each situation. Taking action to control how you respond when you are afraid is a good example of this. You can control how you respond to people and yourself. Counselling can help with this, as certain types of therapy can help empower you to see the choices you do have and why you feel anxious since your panic attacks, too.   By focusing on what you can and are able to do, this moves the thought processes away from dwelling, to actively doing. There are situations you cannot control, for example, we cannot control people or, that death may happen. We also cannot control how others respond to us, though in both cases, we can control our emotional and thought responses to them. This can be hard to do and is another example of where therapy can help provide support. Actively working with how you feel and your emotions is important. How you feel right now is how you feel, it is important you work to avoid suppressing or avoiding this, which will only increase your belief that you cannot handle loss in the future. Even if the situation is not one you can control, you can still work with your emotions to address how it makes you feel. This can reduce the anxious and stressful feelings. There are certain types of therapy that can help with fear of death, too.   It is not uncommon to adopt behaviours to try to cope with feeling uncomfortable. As well as overthinking, it might be that you need constant reassurance, or even avoid situations. However, these strategies do not prevent the unknown from happening. Reality often lies on a spectrum- it is neither very good nor horrible all the time. So, as you actively challenge your horrible conclusions, consider what is most likely to happen, as well as the good or bad.   Challenging these behaviours may help reduce the need to dwell. Each time you are faced with a thought of death, consider what the advantages of not knowing are as well as the disadvantages. Not all future outcomes are bad, but perhaps it doesn’t feel like that right now? Learning to sit with uncertainty helps being able to respond to what is happening in front of you, adapt and overcome the challenge. For example, what could you do with your parents in the next 5, 10, 15, etc. years to feel like your relationship is fulfilling and rewarding?   Sometimes, our thoughts convince us that certainty gives us control in a situation, but what does certainty really bring? No matter how certain we feel about something, it can always change. So, craving certainty and feeling as if horrible conclusions are inevitable, does not make it certain, but it does leave you feeling anxious.   Within this, try to consider what your need is to reason your thoughts? Do you think something bad will happen? Or does it mean something bad will happen because you think it will? Even if something bad does happen, does that mean you won’t be able to cope with it? It might not sound easy but try not to underestimate yourself. You do have the resources to cope with your thoughts and events that may happen in the future. What would it be like to ask a friend or family member how they cope with fear of dying? Likewise, if it were a friend struggling with worrying about death, what would you say to them?   It can also be helpful to notice when your fear or anxiety around death starts and the need for certainty begins. The physical signs, the things you notice in your body, tell you when thoughts are becoming irrational. Sickness, tension in muscles and headaches can be a time to notice what action you may need to help alleviate how you are feeling. It is important to allow yourself to feel the effects of your thoughts and work through them. It may feel uncomfortable, and it will pass eventually. It can be helpful to think of ways to find it believable that the discomfort will pass, too. Focusing on the present, what is going on around you, will help you feel and experience what is happening in the present, rather than your thoughts about the future. Staying present, or grounding, is a group of techniques that can be learnt either through counselling or, internet tutorials can also help with this.   Do not be afraid to seek help with this as you explore it further. Be kind to yourself and listen to your needs as you are getting to know these aspects of yourself that help you heal.
(MA, Counselling, Cognitive, Behaviour, Therapy, Level, 5, PGDIP, Integrative, Counselling)
Answered on 10/11/2022

How can I help motivate myself to do the things that I want/need to do.

Content/Trigger Warning: Please be advised that the article below might mention trauma-related topics that include types of abuse & violence that could be triggering.   Thank you for reaching out Kori, I will do my best to provide you with useful information, and hopefully, that will help answer the questions that you have. I will go in parts so that you get each issue addressed. The first thing that I will say is that if you are committing self-harm, you need to contact your local mental health clinic or emergency room/center and make sure that you reach out for help so that you don’t continue to self-harm. Self-harm can be controlled once it stops, but in order to stop it, you will need the intervention of a clinical team or group of professionals that can help you exit that crisis state.   Another issue that you mention with the information that you included with your question is the fact that you believe that you have undiagnosed PTSD from childhood traumas and abuse. As a trauma counselor, I can say that it seems that you would fit the criteria for trauma counseling simply based on the types of traumas that you mentioned going through. I would recommend going to get evaluated for PTSD as soon as possible since untreated PTSD can bring a myriad of additional problems throughout your lifetime.    It is important that your trauma is addressed and treated. The most effective way to treat trauma is through something called EMDR. If you want to find out more about EMDR and how that can help you treat your traumas, you can go a simple Google search and find the official website for EMDR providers, which will have all of the information you need in order to get that process started.   You mentioned panic attacks and anxiety, which are directly linked so that would make a lot of sense to also treat them as soon as possible. Through psychotherapy you can learn multiple different approaches and techniques to handle both anxiety and panic attacks, so doing therapy will be your best bet here. Anxiety is the root of many other more severe issues, so it is very important to learn anxiety management techniques and coping mechanisms.    People who pick their skin out of anxiety usually stop the negative behavior once the underlying cause of their anxiety is controlled. This you can most likely also achieve through therapy. In terms of not liking yourself, focusing on self-worth and how to grow your self-worth is another thing that you can work through in therapy. Nowadays, online therapy is a very good and practical way to dive into the therapy realm, so I would highly recommend it, here or on any other platform, so that you can start your healing journey.  I hope that this was helpful, and if you have any more questions, please do not hesitate to reach out, and I wish that you have a great day Kori :)
(MA, LPC)
Answered on 09/30/2022

How can I stop thinking about death? What should I do to stop fearing death?

Hello and thanks for reaching out! It sounds like thoughts about your family members passing away happen daily and are really painful to think about.  It must be difficult to be located in another country and physically so far away from them, even if you don't normally see them a lot. You mentioned your Mom has lung disease and you worry about her frequently and I think that's understandable.  It's scary to have a loved one who has medical issues.  There's that lack of certainty if the treatment(s) will work or not and concerns about their level of comfort.  And then of course, worst case scenario dealing with someone passing and whether you are ready to deal with that pain. While you won't be able to prevent your Mom from eventually passing (we all pass eventually as part of the life cycle), you can make sure you spend time with her (on the phone, in person) and share how much you love her and some of your happy memories together.  Try to remind yourself to stay in the present moment, in the here and now.  Today, she is alive and on this earth so make use of your time together. As for your brother who struggles with a substance use disorder (alcohol), it sounds like you worry about him taking care of himself and/or making safe or unsafe choices. I'm going to assume he's an adult and capable of taking care of himself physically, if he chooses.  If that is correct, sometimes the best thing we can do for ourselves and our loved one(s) is to remind ourselves that we can't control other people or their behaviors.  The only thing we can control is ourself/our responses.  Try to do something to take care of yourself (physically, mentally, spiritually) while educating yourself more about substance use disorders.  You can control how much time you spend with your brother, you can control making calls to him and/or visiting him, and expressing how you feel (if you feel comfortable with that), but he has to be willing to make different choices for himself to prevent health issues or other consequences from alcoholism.  Panic attacks can be scary and super disruptive.  I'm sorry you have to experience those.  They aren't fun!  Distraction can be helpful (focusing on things around you/outside yourself), as well as different forms of mindfulness, using positive self-talk to remind yourself that in this moment you are safe and these feelings are just feelings and will pass, progressive muscle relaxation, etc. Have you taken time to track what happens before a panic attack? What feelings or thoughts or situations are happening before you experience a panic attack?  Here's a link to a no-cost community resource available here in the U.S. - Adult Children of Alcoholics and other dysfunctional families (ACA).  You can visit the website and look for online, phone, or in-person meetings in your area.  I think you'd benefit from the information and support. WWW.ADULTCHILDREN.ORG I wish I could help you resolve the distressing feelings/worries and panic attacks with just one written message, but I don't have a magic wand.  I'm happy to support you with working through these feelings and developing skills to manage if you'd like to connect.  Either way, take good care! 
(MSW, LCSW)
Answered on 09/27/2022

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

Anxiety?

I'm so sorry to hear this. You are having a panic attack, in which your body perceives that you are in danger, and is trying to either fight it or flee from it. Panic can be triggered by many things, phobias, for example, or post trauma, i.e. something bad has happened and you are being reminded of it via visual, auditory, touch, or smell. Either way, it is most unpleasant. I would advise you to work with a therapist to identify triggers, issues, and to learn to self calm, and know the signs of impending panic moments. Self care, sleep, diet, exercise is also important, as well as having a support system. In the meantime, look for warning signs that a panic attack is about to happen. For example, does your head ache, chest feel tight, breathing become shallow/more difficult? Your body is warning you that something bad is about to happen. In those brief moments, look for ways to de-escalate, or to self calm. Grounding is a good way to stay in the moment and to slow the world down. For example, walking barefoot, lying on the ground, in the grass, wading in a pool or other body of water can prove helpful in lowering anxiety. In addition, using a weighted blanket, special grounding socks or a grounding mat can also help. The easiest way to remember grounding is the 5-4-3-2-1 technique: 5 things you can see around you, 4 things you can touch, 3 things you can hear, 2 things you can smell, and 1 thing you can taste. Deep breathing, in particular, box breathing can slow one down until the panic/anxiety subsides. Find a comfortable seat or mat, sit in a relaxed, upright position. Breathe in slowly, on a count of 4, up through the diaphragm, which is below the chest, through the nostrils. Next, hold breath for 4 seconds. Step 3 is slowly exhaling through the mouth, as if you were blowing through a straw, for 4 seconds  Finally, sit without breathing for another 4 seconds. And then, repeat the cycle.  I like to also incorporate mindful meditation, which works well using box breathing. Find a comfortable seat in a quiet place. I like to use meditation music, which is available, free on different apps, like YouTube, for example. Put that on in the background. Begin box breathing. Clear your mind of all thoughts. The mind is blank. Eventually, thoughts, worries, regrets may drift into your mind. Clear them away. Imagine that the negative thoughts are little white balloons drifting across your view. Gently, take your hand and push them away, until they drift up to the sky and disappear. Do this exercise first thing in the morning and last thing at night for calmer days and more restful nights. 
Answered on 07/21/2022

How can I rest? Get more energy throughout the day?

Hello and thank you for taking the time to share some of your experiences.  If it often difficult to manage work and personal stresses in our daily lives.  I think it is safe to say that our body reacts to stressful situations in a number of ways and yes, the reactions often include what you are experiencing.  With this being said, there are a couple of things I would like to suggest for you to try to integrate into a daily routine to assist you with stressful situations.  First, daily self-care is so important as it allows us to reset our body (physically) and our minds (emotionally). Self-care behaviors are good to implement daily, at least one hour per day. Self-care does not have to be complicated as it is a way to reduce overthinking and over exertion of our mind.  So, watching a funny show or movie, taking a long bath with soft smelling candles and some soft music, taking a walk in the park or on the beach, mediation or yoga with soft music and maybe soft smelling candles, going to the gym/exercising, dimming your lights to a soft yellow or orange color, refraining from serious or in-depth conversations, refraining from working, refraining from taking care of your children (if you have any), and/or refraining from any outside distractions during your self-care time.  It takes exercising these self-care behavioral patterns daily, until it becomes a routine without you even thinking about it.  Second, being okay with taking 5-10 minute breaks during work hours and walk around outside in the sun or sitting in your car or walking around the parking lot.  This will allow you to breathe in some fresh air throughout your day and release tension in your shoulders and back areas. It will also assist you with developing pro-active behaviors and not be reactive.  Count to 5 or 10 before responding to confrontations and/or conversations that others engage you in.  It is not always what is said, it is also how it is said (initiating and responding). Try not to feel that you have to eat lunch with others or spend your break times with others.  Take time to be by yourself, because this is your personal time.  Often times, eating lunch by yourself can help, because it reduces the need to engage with others when you do not wish to do so.  It allows you to take that pressure off of yourself and be okay with your "self-time."  Others may not agree or or understand your positions, but that is okay.  It's okay to agree to disagree.  Third, it is okay that you are not okay.  Everyone handles stresses in different ways, because we are all different.  Our body chemistry is different.  It is okay that you want or need to take a break for yourself after work.  Go for an hour or 30 minute drive after work to allow yourself to leave work at work and focus on what your evening will be like.  Allow yourself to breathe and be okay with enjoying the rest of your day doing what you want to do.  Try not to pressure yourself to please others or receive approval (validation) from others about your decisions.  Fourth, take an entire day at least once a week to focus on you.  You deserve it and you work hard for it.  Fifth, take one day at a time, one hour at a time, one minute at a time, and one second at a time.  Rome wasn't created in one day and we are unable to create and solve our situations in one day.  Tomorrow, will take care of itself when it gets here.  Live for today and let tomorrow starts when it gets here.  Sixth, enjoy embracing the good and the positive in your life.  Utilize drawing, coloring, painting, writing, reading, or any art or craft you can do to keep your mind from being idle.  If you do not have a hobby, identify one and embrace it. An idle mind is the devil's workshop.  Guard your mind with peaceful thoughts and positive actions.  Seventh, self-talk is what we tell ourselves to be true, even if it is not.  Change your self-talk to positive constructive actions.  Handle or work to resolve what you have control of and let the rest go. As we often say, everyone should stay in their lane.  We only have control over ourselves and we cannot make anyone do anything. Eighth, manage your diet in the amount of caffeine you drink (if any). Eat fruits and vegetables daily. Feed your body healthy foods, so it can provide your brain and body with healthy nutrients.  Be sure you are getting checkups from your doctor and sharing your concerns with him/her.  An unhealthy body is an unhealthy mind.  The body and mind works together to create an overall healthy YOU.  Lastly, forgive yourself for whatever is holding you back or has held you back. Forgive yourself for the decisions you made that did not turn out as you expected them to.  Let it go, because you cannot change what is already done.  We learn from choices and our decisions so we can do better.  Seek professional individual help, if you feel like you need it.  Do not let it fester until it is out of control.  Professional help is here and ready when you are ready! I hope I have said something to encourage you to "Embrace Life Responsibly" in being the best version of YOURSELF!! Take care, Wendy
(MA, MFT, LPC)
Answered on 06/23/2022

How can I help myself when I started having odd panic attacks when I never use to have them before?

Hello Capetwo, I can see you have struggled with your panic attacks for a while.  Panic attacks can feel excruciating and so painful. It's hard to know how to deal with a panic attack when you experience them frequently. When someone has a panic attack, they might feel like they're dying. A panic attack feels like what one might imagine is a heart attack, only it isn't. You may feel shortness of breath, numbness and tingling throughout your entire body, which is extremely uncomfortable and can be terrifying. The truth of the matter is, you are not in danger even if you feel like you are. They are deceptive too and, if left untreated, can steal your enjoyment and yes lead to some symptoms of depression. Panic attack treatment can vary from person to person. I am wondering if you would benefit from visiting your doctor to consider a full assessment and evaluation of what might be happening for you. A doctor may recommend medications to treat your anxiety and panic attacks or therapy or a combination of both. There are things you can do to help yourself during an attack. In this article, you can learn how to stop panic attacks in their tracks.   What to do when you feel a panic attack coming on:   Acknowledge it. Talk your way through your panic either out loud or to yourself – something like this "I have a panic attack, it will pass, I will be okay." When you identify what your signs are, you are reclaiming your power.  This will go away. Panic attacks, though awfully rough and out-and-out petrifying, will pass. Knowing your panic attack will ultimately stop can eliminate your fear that it won’t stop. Relief in your future. Focus on the physical and emotional symptoms and begin to take control. During a panic attack, adrenaline levels are high. Adrenaline increases blood flow, making us physically stronger.  We become hyper-aware of potential dangers armed to take them on. When we are hyped on adrenaline, we experience physiological symptoms associated with panic. When we experience a panic attack, our body mimics how it would react if we were in actual danger. It's like it imagines that a tiger is after you and you need to defend yourself, only it's not true. You are not in any real danger, but your brain perceives that you are.   It can be frightening to experience panic attacks and not know where they came from and it seems this way for you.  I do see a pattern with your attacks being related to when you are in social settings – not traditionally in anticipation of a social gathering but they seem to happen later when you are familiar with your setting. When you can't identify the symptoms, you can feel powerless to control these attacks. This is an illusion; you have the power to breathe through a panic attack, you just need to learn some essential techniques to do so.   Remember to Breathe Panic attacks might feel like they last forever, but the reality is that they peak at around 20 minutes. The attack will start to lessen in intensity. The key is to ride out the attack using a technique called "urge surfing." When you're feeling anxiety or panic, you might be having racing thoughts. You might struggle to tell one thought from the next. Close your eyes, take a slow and deep breath in through your nose and out through your mouth. Let the thoughts be there.  You do not have to understand or fix them, but rather imagine the words of the thoughts rolling down a river. Focus on your breath and let it ground you. As you breathe focus on connected to the ground.  Focus on our feet being firmly fixed on ground.  You can control is your breathing.  Keep breathing and feeling your feet connected to the ground. Focus on Something you can see Focus on one thing in the room. Pick an object and stare at it and continue taking slow deep breaths in through your nose and out through your mouth. This helps keep you grounded and send a signal to your body that it's okay relax and start to calm down. Name 5 things you can see, hear, touch, feel or taste. Pick one of the 5 senses and then name the 5 objects or sensations that go along with it. This resets your brain and sends a message to your mind to focus on something else. Distraction is an effective technique during the panic. Mindfulness Panic attacks happen when we worry about something that "could" happen. This means instead of focusing on the "right now" our minds are looking to the future. It also might be that you're worried about something terrible happening and your mind goes into anxiety overload. Whatever reason your mind has abandoned you, it's time to reign it back in. Bring yourself back to the present, not tomorrow, not yesterday but right this minute. You don't have to fix it or change what's going on. Release Your Muscles When you experience intense panic, muscles and your body often tense up. Using these relaxation techniques, help to relax your body one at a time. Close your eyes, and first focus on your breathing. Take slow deep breaths, focus on one part of your body that feels tight. Maybe it's your neck or perhaps your shoulders. As you inhale, tighten that muscle, as you exhale release the tension in that part of your body. This exercise helps release and relax your body making panic disperse gradually. You will feel grounded and less tense. Find a Mantra A Mantra can help you through a brutal panic attack is a key phrase that empowers you. Mantras can help you feel more in control over symptoms of anxiety. When you feel tingling in your body or, heart palpitations, and wonder if this attack will ever end, say this mantra to yourself in your head or out loud. For instance: "I know I can do this." "Don't give up." "This is just anxiety, It will pass." "Breathe just breathe." "I am ok, I am safe."   Find one that works for you!  Whatever phrase makes you feel calm or safe, use that. I hope you consider reaching out for some support with what you are dealing with so that you can overcome your anxiety and panic attacks.  Consider reaching out to BetterHelp to work with a therapist.  There are many effective therapeutic interventions to help you manage what you are dealing with in your life.  I think working with an experienced therapist can help you figure out what is causing your anxiety attacks and with work help you to deal with this. Best Wishes, Gaynor 
(MA, LCSW)
Answered on 06/19/2022

What techniques can l use to calm me?

Thank you for reaching out for support. When dealing with multiple areas of stress, loss, change, and worry, feelings of anxiety can build quickly. There are several easy-to-do-anywhere calming techniques you can use when feeling anxious. Such as deep breathing which is a simple technique for managing distressing emotions. Not only is deep breathing effective, it is also discreet and easy to use at any time or place. Breathe in through your nose, deeply enough that your abdomen rises. Hold the air in your lungs, and then exhale slowly through your mouth, with your lips puckered. Time the inhalation (4 seconds), pause (4 seconds), and exhalation (6 seconds). Practice for 3 to 5 minutes. We can also use our 5 senses to soothe ourselves in the moment. With sight you can look around the room and pick out all of the objects that are a specific color until you notice that you are feeling calmer. Listening to soothing music, meditations, or podcasts can help be helpful with taking our mind off of an anxiety provoking situation. The key with our senses is to focus our full attention on the sensations we are experiencing or noticing with the sense we have decided to use to assist us with calming down. Anxiety can be increased when we are experiencing irrational thoughts. For example, the thought that "Nothing ever goes right" can make it hard to feel at ease due to waiting for things to fall apart. By examining the evidence and challenging these thoughts, you can reduce anxiety. Choose a thought that has contributed to your anxiety. Gather facts in support of your thought and against your thought. Compare the evidence and determine whether your thought is accurate or not. Progressive Muscle Relaxation is another calming tool. It is a process of tensing and relaxing the muscles throughout your body. By doing this you can achieve a powerful feeling of relaxation. Progressive muscle relaxation will help you realize when you are anxious by teaching you to recognize feelings of muscle tension.  To do progressive muscle relaxation you will start by sitting back or laying down in a comfortable position.  You will tense your muscles tightly, but not to the point of strain. Hold the tension for 10 seconds, and pay close attention to how it feels. Then, release the tension, and notice how the feeling of relaxation differs from the feeling of tension. You can start with your toes and work your way down or vice versa. Another important thing to look at to support long-term reduction in anxiety is managing stress. Determining if there are areas in your life that you can reduce stress by problem solving situations, increasing use of supports, or using distress tolerance skills. 
Answered on 06/18/2022

What is wrong with me or what do I do

One major suggestion or recommendation would be to try and practice some "deep breathing" techniques to help your body relax. This will help enable more air to flow into your body which helps you to gain control over your breathing, heart rate, and help calm your nerves. By practicing deep breathing techniques, it will also help to decrease stress and anxiety. If you are able to fully relax your body, you may be able to fall asleep peacefully. Deep breathing works for some and some it does not.    If the "deep breathing" technique does not work, then try to use the "Imagery" technique. This will also help to reduce anxiety and stress. This is where you close your eyes and use your imagination to think of a peaceful or relaxing place in your mind. This technique should take place for 20-30 minutes at least. You could use some ear buds to put on some soft sound (sounds of water, raindrops, wind, etc). You will use your mind to only focus on doing something relaxing. This technique can help sooth anxiety and may help you fall into a natural sleep.    There are other methods and techniques to help combat your anxiety and panic attacks. Since panic attacks can be scary, it will be very beneficial for you to get very familiar with these two techniques, especially the deep breathing technique. The deep breathing technique is free and will allow you to do his anywhere (in your car, bedroom, bathroom, workplace, public places, etc). The deep breathing technique is free and does not cost a penny. It will be very useful to use in other situations where anxiety may be running high. Once a panic attack sets on, trying to gain control over your symptoms (pounding or racing heart, sweating, chills, difficulty breathing, chest pain) will be the most important thing to do during that moment. Deep breathing will allow you to do just that. Imagery is also free and does not cost a penny but timing may not be right to use "Imagery" during certain times.   If these techniques or other techniques do not work and you continue to exhibit extreme or severe panic attacks, it would be beneficial to connect with a licensure medical or psychiatric professional (psychiatrist, nurse practitioner). Be sure to connect with someone if the panic attacks become unmanageable. 
(LPC, EdS, MS)
Answered on 05/18/2022

How can I overcome my anxiety and self-loathing?

G,  Hello, it is very nice to meet you. I am sorry to hear that you are struggling with this anxiety. You did the right thing by reaching out for help. If you and I were working together in therapy, I would want to explore more about your background. You mentioned experiencing anxiety, even as a child. Anxiety is the illogical and irrational worry or fear about something. It can become a vicious cycle in which you worry about how much you worry about things!  I would want to explore with you the physical symptoms you experience when anxious. Take it from head to toe, what do you feel or experience - headache, tearfulness, dry mouth, teeth clinch, heart racing, stomachache, etc. When you are attuned to the signs and symptoms, this will help you better manage it. When you notice that the anxiety/panic is coming and increasing, take a step away from the anxiety provoking situation - step outside, get a glass of water, etc. I would also encourage you to get a medication evaluation from a psychiatrist or primary care physician. If it is indicated, medication along with therapy can be very effective treatment.  The self loathing feelings your describe is also part of anxiety. Anxiety can cause these intrusive thoughts. When you experience this, ask yourself if the particular worry or fear you are experiencing is valid or logical. Challenge the thoughts and question whether or not they are valid. When you have a negative thought about yourself, reframe it and identity a positive about yourself. Do this every single time the negative thoughts come in.  Try not to push or overwhelm yourself. It is okay to take it in small steps. Find things that you enjoy doing that are relaxing soothing for you, such as yoga, meditation, reading, taking a warm bath, etc. Journaling is also an excellent tool. Challenge yourself to go out in public, slowly. Take small steps and be kind and patient with yourself. I would also encourage you to consider working with a therapist who would be able to help you develop and improve on these anxiety management strategies.  Most importantly, don't feel hopeless! There is help out there and things can definitely improve for you. I hope that you found this information helpful and I wish you all the best moving forward in your journey!
Answered on 05/14/2022

How long have you been practicing?

Thank you for asking your question. To answer your first question, I’ve been a licensed Marriage and Family Therapist for nine years. I appreciate you sharing that you have anxiety. It’s unfortunately common, and the good news is: it can be managed. Plus, you shared that you have been able to manage your anxiety in the past, which points to your abilities to manage it now and in the future. Past successes point to future successes. To start, I suggest looking back on what you were doing previously to manage and explore why those techniques might not be working now. Perhaps being mindful, focused and consistent with using what has worked in the past may help to relieve some of your anxious feelings. And, as you stated at the end of your question – recognizing when your anxiety is starting to build is a good time to step in with some anxiety-busting interventions. Here are some common techniques to help with anxiety. Perhaps you have tried some of these? First, self-care and coping techniques can be beneficial. Deep breathing, using imagery, journaling, replacing negative thoughts with neutral/positive thoughts (altering your thinking), recognizing triggers and patterns, focusing on what you can control, and caring for yourself (healthy eating, proper sleep, etc) are some ideas to help proactively manage anxiety. Also, reflecting on your personal strengths can help you achieve a more balanced view of yourself, as well as bring some of those strengths to help with your concerns. Self-care and coping strategies should be tailored to what works for you, as each person is unique. This may take some trial and error to find what is effective for you. Talking over your concerns with a licensed therapist can help, as the therapist will listen to your concerns and offer ideas and perspectives to help with your situation. With anxiety, sometimes the thoughts a person has contributes to their anxiety. A therapist can listen and offer new perspectives (new ways of looking at a situation), which helps to re-frame the situation and lessen anxiety. Another suggestion are the Groupinars at BetterHelp. The Groupinar topics change every so often, so it’s helpful to check back every couple of weeks to see what’s been added. I wish you well on your healing journey. Better days are waiting for you! You are not alone – help is within reach at BetterHelp. So, please reach out to your therapist for more help. In wellness – Dr. Sally Gill, LMFT
(PhD, MS, LMFT, C.C.T.S.I.)
Answered on 05/13/2022

How do I beat panic attacks naturally

Hi Kitty, I'm sorry you're having such a rough experience with your new job. Panic attacks are actually pretty common. One positive here is that, based on your message, they seem to be situational. This makes them much easier to address than if they were occurring randomly. The key though is to determine what may be triggering them. There's certainly not enough information in your message to determine what key issues are present here. I'll guess and say that maybe there is some trauma history behind the panic attacks, or maybe they're occurring because of anxiety associated with performing the job duties competently. While I can't give targeted recommendations based on your message, here are some general recommendations: The best natural remedy for panic attacks (when they're occurring or about to occur) is breathing. When you have a panic attack your blood pressure and your heart rate become elevated. Through breathing in and out with long breaths (it's recommended that you breathe out for two seconds longer than you breathe in, so for example, five seconds in and seven seconds out), you can increase the oxygen that goes to your brain, reducing your blood pressure and heart rate. You may notice a bit of lightheadedness, and you'll have to find what works for you. While it may not be feasible during a flight, paced breathing is another great technique. With this you will need to watch a clock. There are other great coping skills, and if they're not that effective, consider using more than one at once (such as counting backwards while doing deep breathing, or muscle relaxation while counting backwards). Grounding techniques may be very effective if you're having intrusive thoughts. There are numerous grounding techniques, but they can include counting the tiles on a wall, noticing the corners of the room (or plane), paying attention to how it feels when your feet touch the ground, looking for everything of a certain color in the room (or plane), etc. The purpose is to orient yourself with the present. Dealing with the underlying issues, whatever they are, is key. If trauma is the cause, there are excellent treatments for trauma, and I highly recommend EMDR treatment. CBT treatment can also be effective with trauma, and it can help with other causes of anxiety. I highly recommend you give therapy a try.  Take a look at your lifestyle and whether there are certain behaviors that may be contributing. For example, not getting enough sleep could increase your risk of having panic attacks. Consuming caffeine could do the same. You may find it helpful to exercise and to talk about your anxious thoughts on a regular basis as preventative measures.] Challenging thoughts that cause you to feel anxious can help. I don't know what those thoughts are, but if you can identify them (therapy can help with that), you can use counter thoughts and positive self-talk statements to change the way you think. When you change the way you think, you change the way you feel and the way you behave.    These are just a few ideas, and again, without more information it's hard to know exactly what's going on. I would be happy to work with you, and whether you choose to receive therapy on BetterHelp or elsewhere, I do encourage you to give mental health treatment a try. Take care, Nick 
(MRC, LPCC-S, LICDC)
Answered on 05/11/2022