Attacks Answers

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

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 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

How can I help with my anxiety surrounding driving?

Hello!!! Thank you so much for taking the time to ask this quesiton. I know that often when we have anxiety in one are of our lives, there is anxiety that is impacting many areas of our lives.  One of the first things that I would ask you about is what you are noticing in many areas of your life. So, how is anxiety at home, how is anxiety at work? How do you do wth functioning at a workplace with co workers and bosses?    I believe that it is important to look at all aspects of someone's life, and not just the initial place that they are recognizing the anxiety.  However, I want to make sure that you are able to get your questions ansered to the best of my ability - without knowing more information. Often I would be asking more inquiring questions about what you are asking.    When you have anxiety about a speific trigger, the first thing I wonder, is if there was a specific trauma that brought that on. Often times people can have resposness to triggers that are impacting their daily functioning, and those triggers can vary. You identified a significant issue with driving, and that impacting your daily life. I immediately am curious about asking more about your life. Is driving something that is necessary for you life? Do you need to drive within your community? Or are you living in an environment where you are able to ride public transit without issue. if this is the case, then there is some pause to the "immediacy" to dealing with driving issue. You do not have to worry about accomplishing this goal immediately. if driving is keeping you from being able achieve your workplace goals, family goals, or many comitments, then it is imptant that we are working on these skills urgently.    One of the techniques that we can explore is exposure therapy. This technique explores the small moments that will build on itself to help you feel more comfortable with driving. When we pause and look at how it feels to sit behind the wheel of the car, and just sit there. Within the safety of the driveway, how does that feel? Working through a grounding skill in that moment to be able to bring yourself to a place of calm, and then work up to being able to be on a small side street for 5 minutes, and on and on. This is something that does take time.    WIth the right supports in your daily life in addition to the supports that you get within this platform, I feel that this is something that you will be able to overcome. I wish you all the luck on this journey. Remember, that we are all on a process of moving forward, and we can do that by taking one step at a time, and your reaching out for help is a big step. 
(MA, LMHC, CMHS)
Answered on 07/08/2021

Techniques to overcome agoraphobia, crippling anxiety and emetophobia? It all seems too much

I am so sorry to hear that you are struggling with so many different forms of anxiety  It will be important to recognize when your feelings have a purpose versus when they do not.  We of course want positive feelings in our lives, but sometimes negative feelings are there for a reason and we need to live out that purpose in order for it to get better.  If we do not live out the purpose of our feelings, it likely leads us to feel worse.  For example, something as simple as having anxiety about needing to get the chores done has the purpose of getting us motivated to get the chores done.  Therefore, if we do not live out that purpose and the chores remain undone, that can lead to more bad feelings, such as, “I am lazy” or “I am worthless.”  This is a simple example of how if we do not pay attention to our feelings and live out the purpose, they can become much, much worse.  So, I would encourage you to try and separate out the thoughts that have a purpose from the thoughts that do not have a purpose and are more intrusive.    For the ones that do have a purpose, it can be helpful to allow yourself to think through the anxious thoughts because anxiety has a nasty way of going to the worst possible scenario.  If you can wrap your head around that scenario, it can make it less scary.  For example, I had a client that was very anxious daily about being single for the rest of his life.  Thinking to that extreme is clearly anxiety and it just lingers there.  So, then he was able to think through that scenario and come up with a plan to make it less scary.  He then came up with that if he really is going to be single the rest of his life, which is highly unlikely, he is going to work towards being able to live close to the ocean since that is a dream of his.  Thinking about it now does not make him as scared because he recognizes he could be happy with that. So, try to think through specific things you are anxious about that have a purpose and make sure you have a specific plan on how to improve those things. For example, having a specific plan for how to face specific fears and how to expose yourself to them.   Intrusive thoughts tend to not have a purpose and it can be really helpful to try and overpower those before they are accepted as truths.   We can have power over our thoughts and I want to help you not engage in these thoughts that make you so upset.  The easiest example of this that I can think of is if I went skydiving.  If I went skydiving I would have some obvious, rational, anxious thoughts.  If I really have a desire to skydive though I will need to not engage in those thoughts.  I might have thoughts such as, "My parachute could fail, I will hit the ground, I am going to pass out, etc."  However, since I really want to follow through with skydiving, I would want to stop those thoughts in their tracks with, "I know this is going to be really fun, they inspect the parachutes ahead of time, people hardly ever get hurt doing this, etc."  By focusing on those thoughts and not engaging in the others, I would be able to follow through with skydiving. Try to sort through any thoughts that get you down about yourself and that you can’t handle all of this and try to overpower those.  These types of thoughts are very common when dealing with this type of anxiety in the body.   As you do those processes it can be helpful to validate yourself as someone that is able to cope with anxiety, even though it is not desirable.  Something that could be helpful for you is what I like to call centering thoughts.  These are thoughts that are predetermined and unique to you for you to turn to in low moments.  They need to be powerful enough to bring you back to your center.  It is important that these thoughts are accessible for you to look at when you need to.  Some clients prefer to read and re-read them and some prefer to write and re-write them until they feel better.  I have clients that write these somewhere they will see daily such as their bathroom mirror or phone background, while others simply have them in their phone to pull out when they need to.  An example of a centering thought would be from a client I had that related to nautical themed things and her thought was, "I will not let this sink me."  Another example is from an Olympic skier that actually had difficulties with negative thinking getting in the way of her performance so she went to therapy.  She mentioned that she learned about centering thoughts to battle all of the people telling her she “should be” or “should do.”  To battle those thoughts, she uses the simple centering thought of, “I am.”  She can then remind herself that she is good enough, that she is confident, and that she does want to still compete, which really affirms her own feelings and not others.  Hopefully you can come up with something that helps validate the times you have been able to cope with your anxiety.    I hope that some of this is helpful and that you can apply it to your circumstances.  I hope that you can lean on some family and/or friends through this.  Doing so can help take weight off of your shoulders as well as hopefully get some valuable advice from them. Try to take the healing one day at a time and adding one positive thing back into your life each day.  I wish you all the best and I hope that you are staying safe.
(MA, LPC, NCC)
Answered on 05/24/2021

Can you write an accommodation letter for extended time on tests due to anxiety and panic disorder?

Hello Austin!   Thank you for submitting your question regarding testing accommodations. It is a great question to ask. It is not uncommon for individuals to experience anxiousness and discomfort when facing an exam or test. Test anxiety can be overwhelming and sometimes impact how individuals perform. There are several things that you can do to help alleviate the panic symptoms that you are experiencing that I'd like to discuss; however, lets begin by addressing your initial question.      Initially, it is important to understand what level of academia you are in. Assuming you are a college student, it is imperative that you reach out to the department that handles students with disabilities. Most colleges provide support for individuals that have diagnosed mental health or disabilities and offer testing accommodations. They usually require documentation from your therapist, psychiatrist or physician. The school can provide you steps to follow in order to access accommodations for testing. If you are in high school, you can access testing accommodation through the support of an IEP (Individual Educational Plan) or a 504, which is similiar. This can be addressed by reaching out, once again, through your school counselor or administration. In addition to the above- It never hurts to discuss your concerns with your educator - directly. Sometimes, they have the avilibility to work with you directly and may not require a lot of formalities. Whatever the scenario, your mental health provider can walk you through this and provide the necessary documentation to back up your diagnosis.      All that said, it is super important to stay dedicated to your self care plan. This includes doing mindfulness practices, such as deep breathing, meditation and making sure you are getting rest and eating well.  Being a student during this time is challenging, for sure. If you are taking prescribed meds, make sure that you are staying on top of those and sharing with your doc that you are still experiencing panic symptoms. It always helps the day of the test to do some meditation and visualization! Take a few moments to do a visual of you taking the test and feeling great! It really helps. When you go in, breathe! Remind yourself that you are fine and that all your hard work is going to pay off.       I hope that this was helpful and I wish you great success and that you get the support that you are seeking for academically,  Sincerely, Stephanie Stavinoga, LPC-MHSP      
(LPC-MHSP, CCMHC, Licensed, Hypnotherapist)
Answered on 01/27/2021

What cbt techniques can I use in an anxiety and overwhelm spiral when I have to be with other people

This is a great question. As an introvert, you probably feel recharged after spending time on your own and may feel drained after being in a group of people. This is all very normal. Cognitive Behavioral Therapy, or CBT, helps us learn the ways that our thoughts and behaviors are linked. Broadly, CBT encourages us to challenge our distorted thoughts and notice patterns of thought that may be holding us back. I think there are a few techniques from CBT that can be useful to you here.  First, Thought Stopping or Replacing is a very useful technique. When you are in a group and becoming anxious or overwhelmed, you may start to have thoughts like "This is too much," "I can't do this," "I'll never get out of this," or however the anxiety shows up in your thoughts for you (thoughts are different for everyone!). Having thoughts like this is very normal, but it can become unhelpful when it increases your feelings of anxiety or disrupts your work or relationships in the moment, which it sounds like maybe the case for you. With Thought Stopping, you use your mind to pause that particular unhelpful thought and prevent it from escalating. Some people find it helpful to picture a stop sign or imagine hearing a bell ring. Then, you want to focus your mind on something around you or a more helpful thought. For example, you may want to refocus on the conversation you are having or a neutral sound in your environment. You can also practice replacing the unhelpful thought with something more realistic, like "I can deal with this a little longer." I do want to mention that thought stopping and thought replacing can be challenging. It is best to practice these techniques in an environment that is low-pressure like perhaps your long solo walks.  Deep breathing is a very helpful relaxation technique that can be done even when other people are around. Since you practice some breathing techniques already, you make take to this one easily. To do a very simple and inconspicuous breathing exercise, just breathe in through your nose and let your belly expand with air. When your lungs are full, pause, and then exhale slowly through your mouth. Notice your belly going back in. Repeat a few times until you feel calmer.  Finally, I would encourage you to challenge the belief that being at work or around family means that you cannot spend any time alone. Think of it this way - if your colleagues are all together and one person begins coughing, they may excuse themselves to step outside for a moment, get a glass of water, etc. The same applies to you. If you are among your family or friends or coworkers and you start to feel overwhelmed, it is okay to excuse yourself for a few minutes, go outside or somewhere private to recharge, and then come back. The length of time that you can be away of course depends on your situation. However, you may find that even spending 60 seconds somewhere quiet will help you reorient yourself. You don't need to explain in detail why you are stepping away. A simple "I need to step outside for a moment" is perfectly acceptable. I have also worked with clients who pretended to take calls or reply to emails or text messages.  If you'd like to learn more about these techniques or others, a mental health professional with training in CBT could be very helpful. Best of luck to you.  
Answered on 01/16/2021

Why am I scared of driving and how can I get over this fear?

I am glad that you felt you could present your question to us. I would want to interview you further to give you a more direct and streamlined answer but I believe that without knowing the cause I can still provide a general answer to your question. It appears that you have anxiety about driving and events related to driving. There are many productive ways you can address driving. Cognitive Behavioral Therapy has many forms of addressing anxiety and lessening anxiety and its effects. Coping skills are but one of thos methods which is effective in reducing anxiety. which may be keeping you from driving. Dialectical Behavioral Therapy also has many forms of addressing and lessening anxiety and its effects which may be keeping you from driving. Another method of treatment which may also be very effective in reducing and lessing anxiety is EMDR which is also called Eye Movement Desensitization and Reprocessing. The benefit of this last method is that it frequently produces lasting results faster than other methods of treatment. Dialectical Behavioral Therapy involves five areas - Dialectics which involve being able to see and accept the differences between your point of view and that of others and to accept that both points of view have equal possitility of being right. The second area is Mindfulness which teaches you to non-judgmentally observe and pay attention in the present time. The third is Distress Tolerance which teaches you skills to tolerate worry and distress. It uses Activities, Contributions to others, healthy Comparisons between yourself and others, changing Behavior to create a different Emotion, Pushing away the problem until later, directing your Thoughts to helpful activities adn Thoughts, and distracting yourself to healthy Sensations (ACCEPTS). It also involves IMPROVE the moment through Imagery, Meaning, Prayer, Relaxation, doing only One thing at a time, taking Vacation time, and Encouragement. The fourth is Emotional Regulation. One regulates emotion by engaging in self care using the acronym PLEASED. The fifth is interpersonal effectiveness. Interpersonal Effectiveness uses the acronyms FAST, GIVE, and DEAR MAN. Be Fair, no Apologies, Stick to values, and be Truthful (FAST). Be Genuine, show Interest, Validate and use an Easy manner (GIVE). Describe Details, Express opinions and emotions, ask or say no Assertively, and Reward other for meeting your requests (DEAR). Mindful of goals, Appear confident, and Negotiate (MAN). Cognitive Behavioral Therapy has many similar goals and methods. It focuses on how situations affect thoughts and beliefs and also emotions; how emotions and thoughts and beliefs affect each other and how they in turn affect behaviors. EMDR put simply invovles mindfulness, self soothing exercises and resources; external physical bilateral stimulation; and processing information. Any of these is within your power of choice and may reduce any anxiety, distress, or worry about driving.
(Psy.D., LISW-CP/S, CACII)
Answered on 09/24/2020