Panic 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

What can I do to relieve and reduce panic attacks and dissociation when they occur?

What can I do to relieve and reduce panic attacks and dissociation when they occur? I read where you shared that you have struggled with social anxiety for several years with occasional panic attacks and dissociative episodes but you shared that within the past year those last two things have increased drastically to almost weekly occurrences where you have been experiencing some of them a few times a week at the worst. Based on your question, I would highly suggest that you first start with seeking mental health therapy from a professional counselor and or professional therapist to discuss effective strategies and techniques in regards to how you can effectively relieve and reduce panic attacks and dissociation when they occur. Meeting with a professional counselor and or professional therapist can be very beneficial in helping you learn strategies and techniques to be able to better cope with your symptoms of panic attacks and dissociation when they occur. It is important for a professional counselor and or professional therapist to guide you in learning what currently triggers you to experience panic attacks and dissociation. When you meet with a professional counselor and or professional therapist you can openly discuss how to effectively manage, decrease and or alleviate your experiences with symptoms of panic attacks and dissociation. Having trouble with symptoms of panic attacks and dissociation can be quite uncomfortable which is why it can be managed and or alleviated with therapy and at times medication may be needed if your symptoms are severe. A professional counselor and or professional therapist can help you process what it is exactly that keeps you experiencing symptoms of panic attacks and dissociation. A professional counselor and or professional therapist can also help you develop and implement coping skills to decrease your experiences with symptoms of panic attacks and dissociation. Behavior interventions, Psychotherapy, and Cognitive Behavioral Therapy (CBT) have all been beneficial in helping people who experience symptoms of panic attacks and dissociation. A professional counselor and or professional therapist can assist you in learning how to effectively implement coping skills to decrease your uncomfortable thoughts and feelings in regards to your current issues with symptoms of panic attacks and dissociation. A professional counselor and or professional therapist can also introduce you to anger management techniques, anxiety-reducing techniques, grounding techniques, deep breathing techniques, calming techniques, stress management techniques, progressive muscle relaxation, positive interpersonal relationships, social skills and imagery as a means of decreasing your uncomfortable thoughts and feelings about your symptoms of panic attacks and dissociation.   In an effort to decrease your experiences with symptoms of panic attacks and dissociation, you can try to commit to changing the way you think. It will take a lot of practice, dedication and determination to work on decreasing your symptoms of panic attacks and dissociation. However, trying to do this will help you feel better and it can lead to your feeling much better and becoming more productive. You can recognize when it is happening and when you find it happening you can choose to think about something more productive. You can also look for solutions by committing to learning from your mistakes and solving your problems, so that you can productively move forward, set aside time to think when you notice that you are becoming anxious about symptoms of panic attacks and dissociation then try to distract yourself with a self-care activity and you can practice Mindfulness.   Mindfulness is the key to living in the "here and now." When you become mindful, you will be completely present in the moment. It can be like a form of meditation that takes a lot of practice, but over time and with consistency, it can be very beneficial in decreasing your personal experiences of symptoms of panic attacks and dissociation. Overall, I highly recommend that you seek help from a professional counselor, professional therapist and or medical provider if needed. A professional counselor and or professional therapist can properly assist you in finding tools that can specifically help you alleviate, decrease or manage your symptoms of panic attacks and dissociation. Mental health is not a one-size-fits-all, so it is important to get personalized treatment for your specific and current mental and emotional needs in regards to your symptoms and or experiences with symptoms of panic attacks and dissociation. Best regards to you!    
(EdS, LPC-S, NCC, BC-TMH)
Answered on 06/09/2021

How can I overcome OCD and the thoughts?

Obsessive-compulsive disorder (OCD) and anxiety have often been confused, but there is a big difference between the two. Obsessive-compulsive disorder is characterized by obsessions and/or compulsions (a huge impulse or push from within). These could be anything from checking door locks over and over to driving by an X's house. Everyone does some of these behaviors, but stop before they become a problem. If these behaviors are problematic enough and last over an hour a day, they may be considered for diagnosis.   Anxiety is "a feeling of worry, nervousness, or unease, typically about an imminent event or something with an uncertain outcome" (Oxford Languages). If we didn't have anxiety we might forget our keys altogether. We might not pay attention at night when we should be safe and aware of our surroundings. We might not make a lot of sound in the woods where bears are and stumble into a crabby animal. So anxiety can be a good thing. Your anxiety has just taken the driver's seat. It can be for many reasons, 2020 may play a big role. We just have to use our voice of reason to talk anxiety out of driving when she's drunk.     To overcome either feeling it starts with you doing self-care. I'll explain a little more in-depth:     Often we have a negative thought which will trigger us like girls often get "I'm ugly, I'm not good enough." These negative thoughts are often tied to childhood memories. So if a boy rejects the girl she may be triggered and will react with a fight, flight or freeze response. Doing self-care several times a day builds muscle memory like soldiers in training are building muscle memory for combat. So when fight, flight or freeze are triggered you can use self-care to stop it. Like soldiers can fight the enemy instead of freezing and getting a response. We need to find things that you will like to do so the self-care, or coping skills, isn't a chore and you won't quit after a few weeks. For regulating our emotions, self-care skills are the things like: go get coffee, talk to friends and family, watch funny videos, play games, play with the dog, walk the cat, sing to music, fishing or knitting.     To fix it you have to work through these thoughts. It's an exposure and acceptance therapy. There are many variations of exposure and acceptance therapies. I offer EMDR therapy, which speeds up the process of exposure therapy by using bilateral stimulation (sound or tapping on both sides of your body) to help both sides of the brain fully link together.
(MSW, MN, LICSW, #26706, EMDRIA, Certified)
Answered on 01/31/2021

Help me, I think I have an Ocd, what should I do? I always feel I am unhappy, I can't do anything.

hi! thank you very much for your inquiry. If you have obsessive-compulsive disorder (OCD), you may find yourself trying to figure out how you can stop having OCD thoughts. You are not alone. However, what many people with OCD do not realize is that the distressing thoughts they experience are not necessarily something that they have (or can have) control over. While this fact might initially make you feel stressed, understanding how your OCD thinking works and why it happens will help you develop more effective ways to cope. Around 94% of people have the occasional odd (or even disturbing) thought pop into their heads on a daily basis.Referred to as “intrusive thoughts,” these strange happenings are actually normal, and most people don’t even notice them. The problem is when these thoughts become not just intrusive but obsessive. A person with OCD can experience intrusive thoughts relentlessly and with an intensity that can seriously affect their well-being. Rather than having a neutral response to a passing thought, a person with OCD experiences a response in their mind and body. The more they perseverate on the thought, the more anxiety they experience. The cycle can be distressing and may impact their ability to function. You may not be able to control whether an intrusive thought pops into your head, but you can control how you react to it. If you have OCD and struggle with intrusive thoughts, here is some key information about why these thoughts happen and how you can learn to cope with them. People with OCD may believe that simply thinking about something disturbing (such as molesting a neighbor or killing their spouse) is morally equivalent to carrying out such an act. This is called thought-action fusion, and it is one reason that intrusive thoughts are more distressing for people with OCD.As another example, someone with OCD might believe that just having a thought about getting into a car crash or contracting a serious disease makes it more likely that these events will happen. They may even believe that if they have the thought, it means the event will happen—unless they do something to prevent it. Instead of letting their thoughts come and go, people with OCD take personal responsibility for the thoughts they have. They also tend to interpret these thoughts as being more significant than they really are. Perceiving thoughts as being urgent and important makes a person feel that they must immediately act on or respond to them in the “right” way. A person with OCD may develop compulsions in response to their obsessive thoughts. These actions and behaviors are an attempt to alleviate the distress the thought causes. Compulsions can be a little like superstitions for people with OCD. Often, a person realizes that the behaviors are not rational (this is known as insight), but the fear of what they believe will happen if they do not perform them is compelling. Completing a ritual temporarily relieves the anxiety, but keeps a person stuck in the cycle because it reinforces the obsessive thinking. For example, a person who obsesses about their home burning down while they are at work might compulsively check that the stove is off before they leave the house every day. They may believe that if they do not complete the ritual (for example, checking a certain number of times or checking in a specific order), their home will be in danger. When they return home at the end of the day to see that their house has not burned down, it reinforces the belief that their ritual of checking was protective. If a person with OCD believes that their intrusive thoughts are dangerous, they may try to closely monitor them. It may feel like necessary vigilance, but the intensity with which someone monitors their own thinking can easily become hypervigilance. Once a person labels a certain thought as dangerous and becomes hyperaware of it, they can become overwhelmed. When this happens, they might respond by trying to push the thought away. While it might seem like a good solution, it’s not easy—and it doesn't necessarily work. Research has shown that the cycle of monitoring and thought suppression in people with OCD can lead to the development of more obsessive thoughts. Accepting the thoughts does not mean you are giving up. Understanding that you do not have control does not mean you are giving the intrusive thoughts control over you. The first step you take might be to simply pause when the thought comes up rather than immediately responding to its urgent demand. It might be uncomfortable to consider the thought from a distance and resist the urge to perform a ritual. Over time, defusing your obsessive thoughts this way can actually help you feel more in control. Once you are able to put some space between you and your thoughts, you can start to look at them more objectively. Then, you can figure out what triggers the thoughts and take a closer (but non-judgmental) look at how you react. Try not to be too hard on yourself or get discouraged during this process. It takes practice to distance yourself from your thoughts. Obsessive thinking is intense and persistent by nature. Sometimes, instructing yourself not to think about a thought only brings more attention to it. It’s very much like what happens when someone tells you not to think of a specific thing, and suddenly all you can think of is that very thing. The intrusive thoughts you experience are not necessarily a reflection of who you are, but when they become obsessive, they can be influenced by the things that cause you the most worry and anxiety. Moreover, your thoughts do not necessarily say anything about you. Having a “bad” thought does not mean that you are a “bad” person. Try to remember that intrusive thoughts do not always align with your core values, beliefs, and morals. In fact, OCD thoughts tend to attack and focus on the things that offend you. The same can be true for intrusive thoughts that cause fear, which tend to be based on what you are most concerned about (for example, the health and safety of their family). People with OCD can feel an overwhelming amount of fear and guilt about the intrusive thoughts they experience. They may also experience deep shame, embarrassment, and even self-hatred. Try to be kind and patient with yourself. Remember that everyone experiences intrusive thoughts at times, and they are not something you are expected to be in control of. It is a good practice to recognize the intrusive thought or feeling you are having, but that does not mean you have to identify with it. Once you accept that you cannot completely control the thoughts, you can start by building the habit of acknowledging them without letting them take control.    hopefully that helps! Take care, know that you are not alone, and feel free to reach out to a BetterHelp therapist for extra aid. 
(MA, LMFT)
Answered on 01/28/2021

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

How to get over my severe fear of driving?

Hi. First, I am so sorry to hear that this has been your experience. It's hard to feel those physical reactions in your body. Feeling out of control of your body reactions with something like driving, can enhance anxiety and make it hard to focus in other parts of your day too. Once those physical reactions become associated with driving, it can feel harder and harder to get them to stop. I am glad you reached out to ask this question. To manage this, is a process. I would encourage you to work with a therapist who has an understanding of trauma, as the reaction you are feeling in your body is resulting from an internal trauma experience. Are you aware of any particular trauma that connects with this? Sometimes it is obvious (like a car accident), sometimes it is not so obvious (like a connection with something that happened to someone you loved, for example). Working with a trauma therapist will help you to assess and address the brain response that's leading to this reaction, and over time, you can train your brain to rewire this. Brainspotting is a technique that I use with some clients who have experienced trauma, and it is helpful. You can find our more about brainspotting at brainspotting.com. Another option is EMDR (eye movement and de-sensitivation therapy), which I do not do, but therapists who are trained in EMDR are typically trauma informed and they list this as part of their credentials and speciality. As far as things that you may be able to begin to implement on your own, you could begin with the following, but only if it feels safe for you to do.: Talk to yourself with compassion: For example, "It's okay that this is hard for me. My brain is just worried about protecting me. I'm glad I have a brain that wants to protect me. I'm a capable person, and I am allowed to feel scared" Set a small incremental goal, each day/week, and only expect to work towards that one small goal that day/week: For example, "I'm going to get in the car today/this week" "Today/this week I'm going to turn the car on and put my foot on the pedal" "Today, I am just going to drive to the end of my block" "Today/this week I am going to ask a friend to sit in the car with me..." Celebrate every small incremental movement you make. Every single one of them matters, because every single one of them adds up together, to help move you towards your ultimate goal of driving. Take your time and offer yourself some love, patience and compassion.
(LCSW, MSW, MEd)
Answered on 10/07/2020

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