Worry Answers

How can you stop unwanted thoughts? Sometimes they can be inappropriate or violent or scary?

There are many reasons people have unwanted thoughts and a discussion about your thoughts and personal history is needed to know what the best course of action is to reduce their frequency and impact on you. Some people have intrusive thoughts due to trauma and others have psychological conditions where intrusive thoughts are part of what is going on with them psychologically. Some people have substantial worries that are based on something situational that is out of their control (e.g. a personal medical condition or that of a loved one, or a change in their living situation or employment status). Some questions I might ask would be: What are the thoughts about? When did they start? Have these intrusive thoughts become more intense and frequent (and when)? What is your family history? Personal history? Medical history? Have you acted on these thoughts? What level of anxiety are they causing you? Have you had recent or historical personal trauma?  I would also ask questions about personal circumstances. Unwanted thoughts often reflect very deep emotions that have been unexpressed and may be subconscious. Some people are more biologically prone to having unwanted thoughts. These thoughts can sometimes be scary and anxiety producing because of the intense feelings that accompany them. Talking through your feelings about what is going on in your life with a psychotherapist can be helpful. In between sessions, doing something very ordinary like brushing your teeth or refocusing your attention on something unrelated can sometimes break the cycle of repeated thoughts. Often a fresh air break and a walk or a talk with a friend or a family member about a neutral topic can help to refocus. Anxiety with unwanted thoughts has many origins and talking with a therapist to explore the origin of these thoughts can help. Depending on the person, sometimes medication can help with intrusive thoughts from depression and anxiety. If anxiety about intrusive thoughts  is affecting your activities of daily living to a significant degree, medication might be a recommended course of therapy. A visit with a psychiatrist for an evaluation would determine if this course of action is appropriate. The psychiatrist would prescribe the medication and follow up about how it is working on a regular basis. Medication in combination with psychotherapy has been found to be most effective if medication is needed. 
(LCSW)
Answered on 01/20/2022

How to overcome social anxiety?

Thank you for asking your question. It can be frustrating and sad when you feel that others are not paying attention to you and your needs, and you feel alone. If you’re having a hard time expressing yourself, it may help to write out your thoughts and feelings. Journaling can be a helpful coping technique to allow you to express yourself. Also, other expressive artistic methods may help, such as drawing, painting, dancing, and writing musical lyrics or poems. Choose a form of expression that fits your style to let out what you’re feeling. Also, it can help to remember your personal strengths. You are a person filled with strengths, as you shared that you are a compassionate person who helps others. You have other strengths, too. By focusing on what you do well and what positive characteristics are part of you, you can use those to overcome or lessen negative or sad thinking by developing plans to use those strengths in new situations. When we think back on a time when we were able to use a certain strength, it helps us see new possibilities and possible outcomes. Perhaps combining the expressional methods above with looking inside yourself at your strengths can help you find a way to use those strengths to ask for what you need. And, reflecting on your personal strengths can help you achieve a more balanced view of yourself. In addition, self-care and coping techniques can be beneficial. Deep breathing, using imagery, journaling (mentioned above), replacing negative thoughts with neutral/positive thoughts (altering your thinking), recognizing triggers and patterns that lead to your anxiety, focusing on what you can control, and caring for yourself (healthy eating, proper sleep, etc) are some ideas to help proactively manage anxiety. Another suggestion is to watch for “never”, “always”, “constantly” – those words are red flags that you are engaging in absolute (or all-or-nothing) thinking, which is a form of a cognitive distortion. It’s rare that statements using those words are true. It’s usually a form of negative thinking. If you find yourself using those words, think of an exception to the statement. For instance, “I never do things right”. Counter that with, “that’s not true – I do ___ well”. 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 hope some of those suggestions help and 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 01/20/2022

How to get through a very hard time with anxiety when the anxious what if thoughts are too much?

Hi there and thank you for your question. Anxiety, put simply, is a pervasive feeling which often ramps up the speed of our thought process to a point where it becomes uncomfortable or unbearable. The thing you are doing in trying to accept the thoughts is very important. That is the best way to move beyond the thought. We used to teach, in psychology, that you had to destroy the thought which was bothering you but we figured out this was not the way to get past these thoughts. In fact, it only made them stronger. The best thing you can do is to accept the thought and see it for what it really is. For much of our thinking in this area we know draw upon what is known as a 'Third-Wave CBT' and also 'mindfulness based CBT'. CBT is Cognitive Behavioral Therapy, which you may have heard of before, and in this formation it exists with a mindfulness component. A format of this which is very popular is known as: Acceptance and Commitment Therapy (ACT). I utilize this model to a great extent and would encourage you to work with a therapist, if you move into doing therapy, who also utilizes this model. One solution this model proposes, among many, to the problem you've described above is to use internal verbal conventions. You can also verbalize these out loud and that may help. You might say, to yourself, something like: "I notice the thought that (fill in the blank and describe the problematic thought to yourself), I accept that the thought is present AND I am choosing to not believe what it is telling me". You would actually verbalize this as you are thinking through it. And as you do this you might have a subsequent thought, which your mind throws at you, that basically communicates you don't believe what you are saying. That is also natural. And the response to that, from what you say out loud, would be: "...and I accept that thought, also". If all of this seems a little odd or abstract you would not the first person to have thought that, however, these techniques work well. You can learn more about these techniques from the well known Australian ACT Psychologist, Russ Harris. He has a book and you can get it on Amazon. It's called: The Happiness Trap. It is a good starting point if you want to learn more about getting through your specific presentation of Anxiety. I think it will help you greatly. Take care and good luck! 
Answered on 01/20/2022

Is it possible for regular things you do affects a panick attack?

Dear Unique,   Thank you for your message and sharing with me how you've been interacting with yourself, especially on how you've been handling unpleasant feelings and emotions. As you said this has also affected your life significantly. Perhaps by addressing how to handle unpleasant emotions in a healthier manner, we can dive into addressing the issues in your life as well?   Often the experience we've had about anxiety (or any strong emotion such as stress / depression) was so terrible (even physically) that our body sort of become traumatized to it. We naturally become nervous about these unpleasant feelings because we don't like these sensations and experiences. As a result we would do everything we can to avoid / fight these anxious feelings, often using numbing techniques such as using substances or distracting ourselves. Yet only to find that the anxiety gets stronger over time because we have never been able to make peace with it.   Therefore rather than trying to "change" / "fight" / "get rid of" these unpleasant sensations, perhaps the best thing that we can do is to make room for these feelings and even sensations, while staying on track to do what brings us meaning and fulfillment. Floating without judging / blaming ourselves through the anxiety experience, while focusing on making room for anxiety can be helpful.   Here is a short video put up by the author of the book "The Happiness Trap" which does a good job explaining this concept:   Please take some time to watch this and share your thoughts later :) I also highly recommend picking that book as well to supplement this therapy process.   https://www.youtube.com/watch?v=rCp1l16GCXI    We as human beings do not like sufferings, therefore often times we would be doing our best to fight it. However just like the analogy of swimming vs floating that we have talked about before, the more we fight it, the faster we sink. While if we can learn to float with these waves, we will realize that we won't sink.   Radical acceptance / Expansion is about accepting of life on life's terms and not resisting what you cannot or choose not to change. Radical Acceptance is about saying yes to life and all that life brings (including all sorts of emotions such as joy, sadness, peace and pain), just as it is without forcing our ways into our lives.   Why do we want to accept life as it is? Because with anything that we do in life that brings us meaning and fulfillment, it always accompany a wide range of emotions, we can't possibly just choose the ones that we like and fight / avoid those that we don't like. Learning to experience all emotions as they are, is a sign that we are living our lives to the fullest.   To do so we must learn to accept (and make room for) any unpleasant sensations, feelings or thoughts that we experience.   We don't want to fight it because the more we fight, the stronger they will come back.   We don't want to avoid it either because the more we avoid, the more we'll be afraid of it.   So the key here is to make room for these sensations, feelings and thoughts, while continue to do what brings us meaning and fulfillment in life.    Learning to "co-exist" with these feelings will naturally reduce the intensity of them.   Floating, is a form of learning to accept these feelings and make room for it.   Let me give you some practical guidelines on what I mean by accepting these feelings and make room for it.   You can look up "expansion technique" under Acceptance and Commitment Therapy (ACT) for more information as well.   How to accept our emotions (and make room for them):   1. OBSERVE. Bring awareness to the feelings in your body.   2. BREATHE. Take a few deep breaths. Breathe into and around them.   3. EXPAND. Make room for these feelings. Create some space for them.   4. ALLOW. Allow them to be there. Make peace with them   Some people find it helpful to silently say to themselves, 'I don't like this feeling, but I have room for it,' or 'It's unpleasant, but I can accept it.'   • When you're feeling an unpleasant emotion, the first step is to take a few slow, deep breaths, and quickly scan your body from head to toe.   • You will probably notice several uncomfortable sensations. Look for the strongest sensation - the one that bothers you the most. For example, it may be a lump in your throat, or a knot in your stomach, or an ache in your chest.   • Focus your attention on that sensation. Observe it curiously, as if you are a friendly scientist, discovering some interesting new phenomenon.   • Observe the sensation carefully. Notice where it starts and where it ends. Learn as much about it as you can. If you had to draw a line around the sensation, what would the outline look like? Is it on the surface of the body, or inside you, or both? How far inside you does it go? Where is the sensation most intense? Where is it weakest? How is it different in the center than around the edges? Is there any pulsation, or vibration within it? Is it light or heavy? Moving or still? What is its temperature?   • Take a few more deep breaths, and let go of the struggle with that sensation. Breathe into it. Imagine your breath flowing in and around it.   • Make room for it. Loosen up around it. Allow it to be there. You don't have to like it or want it. Simply let it be.   • The idea is to observe the sensation - not to think about it. So when your mind starts commenting on what's happening, just say 'Thanks, mind!' and come back to observing.   • You may find this difficult. You may feel a strong urge to fight with it or push it away. If so, just acknowledge this urge, without giving in to it. (Acknowledging is rather like nodding your head in recognition, as if to say 'There you are. I see you.') Once you've acknowledged that urge, bring your attention back to the sensation itself.   • Don't try to get rid of the sensation or alter it. If it changes by itself, that's okay. If it doesn't change, that's okay too. Changing or getting rid of it is not the goal.   • You may need to focus on this sensation for anything from a few seconds to a few minutes, until you completely give up the struggle with it. Be patient. Take as long as you need. You're learning a valuable skill.   • Once you've done this, scan your body again, and see if there's another strong sensation that's bothering you. If so, repeat the procedure with that one.   • You can do this with as many different sensations as you want to. Keep going until you have a sense of no longer struggling with your feelings.   • As you do this exercise one of two things will happen: either your feelings will change - or they won't. It doesn't matter either way. This exercise is not about changing your feelings. It's about accepting them.   Looking forward to talking with you more, Jono
(MSW, LICSW, LMHC)
Answered on 01/20/2022

How to stop having compulsive thoughts? How to boost self esteem?

Hello, Thank you for reaching out on The BetterHelp Platform with your question: How to stop having compulsive thoughts? How to boost self esteem? I will share some information and tools you can implement yourself.  I would encourage you to reach out for some professional support from a mental health therapist - someone who can teach you effective coping skills to manage the negative thoughts and your compulsion to pull out your hair - a condition known as trichotillomania. What is Trichotillomania? In simple terms, trichotillomania is hair pulling, but it's a little more complicated than that for those who live with it. You may have a sibling that tugs on your hair as a sign of affection or teasing, or you may be someone who twists their hair when frustrated or nervous. These things are not signs of trichotillomania, at least, not on their own. For those with this disorder, it's an impulse they feel they can't control, and it causes them to pull on their hair to the extent that they pull it out. When we think negative thoughts on a regular basis, we are wiring our brain to believe that these negative thoughts are reality. Just like any habit, the more you do it, the more it becomes part of your everyday routine. Repeating negative thoughts over and over in your mind is also referred to as rumination or perseverative thinking. Outcomes of Negative Thinking *Effects on the Brain: Memory is disrupted. The processing of information is slowed. The amygdala, which controls the fight or flight response, becomes unregulated. When a stressful situation occurs, the amygdala cannot differentiate between a life-or-death situation and an annoyance. The outcome is then an overreaction to any stressful situation, whether it is a small annoyance or an actual traumatic occurrence. This could result in a dangerous situation or an inability to deal with any type of stress. *Depression: Depression does not just influence your mind. It can also have damaging physical results like ongoing joint pain, arm/leg pain, and appetite changes. Sleep is often disrupted. Your immune function is decreased. Left untreated, depression can lead to or worsen other mood disorders. *Loneliness: If someone is thought of as a constant negative thinker, they may not have a huge circle of friends. Most people want to steer clear of negativity and find friends who lift them up, not drag them down. This loneliness can also add to feelings of depression. *Job Instability: People who are negative thinkers may not want to try hard at work. They may give up because they think there is no way to solve a problem. Employers want people who are willing to do whatever it takes to get a job done, so a negative mindset will not be a marketable skill. This may show through as early as an interview, and it may be hard for those negative thinkers to get any type of skilled position. *Relationship Issues: Individuals want a life partner who is there for them, who they can talk to, and who they can rely on for feedback. They want someone who is a shoulder to lean on, a cheerleader, and a problem solver. If someone has acquired a negative mindset, it will be hard to endure a long-term relationship because issues are bound to pop up. You need to be able to see someone else’s side or look for productive ways to help the other person resolve their issue. *Bodily Consequences: With negativity comes a decrease in energy. Thinking your appearance is less appealing may affect how you care about yourself, not giving care to physical appearance. A radical negative sensitivity can also lead to an eating disorder in some cases. This isn’t to say that everyone doesn’t have some negative thoughts or feelings throughout their lives. No one goes through life with only positive, happy thoughts. It is when negative thinking is constant, long-term, and repetitive that problems may occur. Reverse It The brain may have been wired to think negative thoughts. That means it can be rewired to think positive thoughts. A habit takes about 21 days to be ingrained, so doing some of the following tasks may have you on your way to positive thinking in three weeks. *Gratitude Journal: Writing 3-5 things you are grateful for every day can give you an enormous positive boost. It doesn’t have to be anything huge or earth-shattering. As a matter of fact, writing about the little things can have a bigger influence on your everyday attitude. It’s those little things that add up to the big things in life. In order to be motivated to do this every day, buy yourself a journal just for this purpose. It can be a notebook, a special journal, or an app on your phone. Just make sure to do it every day to get the best outcome. *Journaling: Writing down your thoughts and feelings can help you to track your thought patterns. It can also open up your mind to why you have the thoughts that you have. Writing and re-reading your thoughts can help you to express yourself and perhaps break your cycle of negative thinking. *Random Acts of Kindness: If you search online, you can find a plethora of kindness type challenges. They usually come in the form of a calendar that lists a random act of kindness that you can do each day. They don’t have to be huge deeds. Like the gratitude journal, the little things can have the biggest impact. These kind acts will return themselves as good karma in your life. *Books to Read: –Self-Talk: How to Train Your Brain to Turn Negative Thinking Into Positive Thinking & Practice Self Love, authored by Aston Sanderson –Beyond Positive Thinking: A No-Nonsense Formula for Getting the Results You Want, authored by Dr. Robert Anthony –Success Through A Positive Mental Attitude, by Napoleon Hill –Everyday Positive Thinking, authored by Louise Hay –The Power of Positive Energy: Powerful Thinking, Powerful Life: 9 Powerful Ways for Self-Improvement, Increasing Self-Esteem & Gaining Positive Energy, Motivation, Forgiveness, Happiness, and Peace of Mind, authored by Andrian Teodoro –The Power of Positive Thinking, authored by Norman Vincent Peale –The Four Agreements: A Practical Guide to Personal Freedom, authored by Don Miguel Ruiz –Positive Thinking: The Most Efficient Guide to Positive Thinking, Overcoming Negativity and Finding Success and Happiness, authored by Jack Morris *Konmari your Friends: If you haven’t heard about the Konmari method, it comes from the book The Life-Changing Magic of Tidying Up by Marie Kondo. Basically, this method has you hold up items that you own and ask yourself, “Does this bring me joy?” If it doesn’t, you get rid of it. As far as your friends go, if they are not bringing you joy, then you may want to break ties with them. You are influenced by those around you, so you want to have positive, uplifting, supportive people in your closest circles. *Meditation: Meditation doesn’t have to be a long process. Even 5 minutes of meditation can be good for your soul and mindset. In meditation, it is not about controlling your thoughts so that you are thinking of nothing. It is about not letting your thoughts control you. There are many podcasts and apps that can help you focus on being present. After you meditate, you will feel lighter and more positive. Start the day with this routine, and you will be able to face anything that comes your way. *Spirituality: Spirituality can come in different forms. Some people may feel a strong pull towards specific organized religion. Others may feel a connection to a higher power that isn’t “God.” None of these alternatives is the right or wrong choice. Having a spiritual custom gives many people a belief in something bigger than themselves that they can rely on and turn to in moments of sadness, hardship, or difficulty. It puts many people in a positive frame of mind where they feel that can deal with any situation that arises. *Breathing Techniques: Breathing exercises can reduce your heart rate, which can make you less anxious and tense. When you reduce anxiety and tension, you have a more positive state of mind. Specific breathing techniques will help you stay in the moment and reduce worry so that you can deal with the current situation. *Yoga: We are put on this earth to be balanced and productive beings. When negative thoughts continuously enter our minds, they make us unbalanced. Our physical bodies can become unbalanced also. When you enter a yoga practice, you are balancing your body and your mind. When you practice yoga, you are encouraged to stay in the present moment, think about why you are there, and consider what you want to get out of that practice at that time. Entering into a yoga routine tends to have a calming, contented effect on all participants. *Replace Negative Thoughts: If you can’t get rid of all negative thoughts, try replacing them with a positive thought. When a negative thought pops up, stop yourself and replace that thought with something positive. For instance, if you have a large job to do, instead of saying, “I’ll never finish this,” say, “I will break this down into smaller pieces and get it done.” For some, patterns of negative thinking create a nuisance in their lives. For others, they lead to serious negative consequences. If you fall in the latter category, you may want to get in touch with an online therapist from BetterHelp. There is a good chance that you will see strong, positive results. Online therapy has been practiced for decades in one form or another. And since its launch, clinical researchers have studied how it works. You might be surprised to know that, today, psychologists believe that online therapy can deliver the same results as most in-person treatments. There’s simply no reason to continue operating under a negative thought cycle. Whenever you make the choice, you can get treatment and advice from licensed mental health practitioners from BetterHelp. The platform allows you a high degree of convenience in gaining treatment. You can get in touch with your counselor via chat, call, or videoconference.    There is hope, recovery is possible and there is help available for you!   I wish you much luck with the next step you take.   In Kindness, Gaynor   
(MA, LCSW)
Answered on 01/20/2022

How do I feel less overwhelmed with work and life at home?

"How do I feel less overwhelmed with work and life at home?"  The easiest solution would be to balance the two but we know it isn't that easy because we feel that is what we are trying to do.  It sounds like you are "burned out".  There are many things on your plate.  I understand that you are tyring to express yourself to your husband and staff with what your needs are but what boundaries are you putting in place and are you able to follow through with consequences of boundaries being ignored or violated. I wonder what expectations do you have for yourself with the restaurant job and the work with your husband.  Are these expectations you set or are they from others.  How can you reduce the expectations and have them be more realistic?  When you shared that "everything seems to making me frustrated".  I would want to ask you about your own self care and what attention that is getting.  How are you sleeping, healthy eating and physical exercise?  What healthy routines have you developed with these areas?  Are you putting yourself first or last.  If these areas of our life are interrupted or not nurtured it can effect our physical health as well as our mental health.  I also read that you have experienced anxiety attacks.  Have these anxiety attacks taken you to the hospital?  What happens before, during and after?  Before the attack what is happening, how is your body feeling the panic attack come on?  Are you able to face it before it comes?  During the attack do you have control of your thoughts, your breathing.  After the attack can you see where the triggers were that brought anxious thoughts on.  Can you focus on using thought stopping skills to help reduce the frequency or the intensity of the panic attack.  Finding a healthy balanced person that you trust to share these thoughts with can help reduce the anxiety.  My last thought would be how codependent are you with this cycle.  Can you function without having to stay in the cycle.  What would it be like to set healthy boundaries for yourself and not be codependent on others?  Why do you feel that you have to be the one to keep everyone together.  Do you feel that if you stop everything would fail?  Take a deep breath and see how you can communicate assertively with healthy boundaries and follow through when boundaries are not respected. 
(M.A., LMFT, M.A., LPCC)
Answered on 01/20/2022

How to deal with anxiety pertaining to physical Symptoms/worrying about death when they occur.

Dear Anon1,   Thank you for your message and sharing with me how you've been interacting with yourself, especially on how you've been handling unpleasant feelings and emotions. As you said this has also affected your life significantly. Perhaps by addressing how to handle unpleasant emotions in a healthier manner, we can dive into addressing the issues in your life as well?   Often the experience we've had about anxiety (or any strong emotion such as stress / depression) was so terrible (even physically) that our body sort of become traumatized to it. We naturally become nervous about these unpleasant feelings because we don't like these sensations and experiences. As a result we would do everything we can to avoid / fight these anxious feelings, often using numbing techniques such as using substances or distracting ourselves. Yet only to find that the anxiety gets stronger over time because we have never been able to make peace with it.   Therefore rather than trying to "change" / "fight" / "get rid of" these unpleasant sensations, perhaps the best thing that we can do is to make room for these feelings and even sensations, while staying on track to do what brings us meaning and fulfillment. Floating without judging / blaming ourselves through the anxiety experience, while focusing on making room for anxiety can be helpful.   Here is a short video put up by the author of the book "The Happiness Trap" which does a good job explaining this concept:   Please take some time to watch this and share your thoughts later :) I also highly recommend picking that book as well to supplement this therapy process.   https://www.youtube.com/watch?v=rCp1l16GCXI    We as human beings do not like sufferings, therefore often times we would be doing our best to fight it. However just like the analogy of swimming vs floating that we have talked about before, the more we fight it, the faster we sink. While if we can learn to float with these waves, we will realize that we won't sink.   Radical acceptance / Expansion is about accepting of life on life's terms and not resisting what you cannot or choose not to change. Radical Acceptance is about saying yes to life and all that life brings (including all sorts of emotions such as joy, sadness, peace and pain), just as it is without forcing our ways into our lives.   Why do we want to accept life as it is? Because with anything that we do in life that brings us meaning and fulfillment, it always accompany a wide range of emotions, we can't possibly just choose the ones that we like and fight / avoid those that we don't like. Learning to experience all emotions as they are, is a sign that we are living our lives to the fullest.   To do so we must learn to accept (and make room for) any unpleasant sensations, feelings or thoughts that we experience.   We don't want to fight it because the more we fight, the stronger they will come back.   We don't want to avoid it either because the more we avoid, the more we'll be afraid of it.   So the key here is to make room for these sensations, feelings and thoughts, while continue to do what brings us meaning and fulfillment in life.    Learning to "co-exist" with these feelings will naturally reduce the intensity of them.   Floating, is a form of learning to accept these feelings and make room for it.   Let me give you some practical guidelines on what I mean by accepting these feelings and make room for it.   You can look up "expansion technique" under Acceptance and Commitment Therapy (ACT) for more information as well.   How to accept our emotions (and make room for them):   1. OBSERVE. Bring awareness to the feelings in your body.   2. BREATHE. Take a few deep breaths. Breathe into and around them.   3. EXPAND. Make room for these feelings. Create some space for them.   4. ALLOW. Allow them to be there. Make peace with them   Some people find it helpful to silently say to themselves, 'I don't like this feeling, but I have room for it,' or 'It's unpleasant, but I can accept it.'   • When you're feeling an unpleasant emotion, the first step is to take a few slow, deep breaths, and quickly scan your body from head to toe.   • You will probably notice several uncomfortable sensations. Look for the strongest sensation - the one that bothers you the most. For example, it may be a lump in your throat, or a knot in your stomach, or an ache in your chest.   • Focus your attention on that sensation. Observe it curiously, as if you are a friendly scientist, discovering some interesting new phenomenon.   • Observe the sensation carefully. Notice where it starts and where it ends. Learn as much about it as you can. If you had to draw a line around the sensation, what would the outline look like? Is it on the surface of the body, or inside you, or both? How far inside you does it go? Where is the sensation most intense? Where is it weakest? How is it different in the center than around the edges? Is there any pulsation, or vibration within it? Is it light or heavy? Moving or still? What is its temperature?   • Take a few more deep breaths, and let go of the struggle with that sensation. Breathe into it. Imagine your breath flowing in and around it.   • Make room for it. Loosen up around it. Allow it to be there. You don't have to like it or want it. Simply let it be.   • The idea is to observe the sensation - not to think about it. So when your mind starts commenting on what's happening, just say 'Thanks, mind!' and come back to observing.   • You may find this difficult. You may feel a strong urge to fight with it or push it away. If so, just acknowledge this urge, without giving in to it. (Acknowledging is rather like nodding your head in recognition, as if to say 'There you are. I see you.') Once you've acknowledged that urge, bring your attention back to the sensation itself.   • Don't try to get rid of the sensation or alter it. If it changes by itself, that's okay. If it doesn't change, that's okay too. Changing or getting rid of it is not the goal.   • You may need to focus on this sensation for anything from a few seconds to a few minutes, until you completely give up the struggle with it. Be patient. Take as long as you need. You're learning a valuable skill.   • Once you've done this, scan your body again, and see if there's another strong sensation that's bothering you. If so, repeat the procedure with that one.   • You can do this with as many different sensations as you want to. Keep going until you have a sense of no longer struggling with your feelings.   • As you do this exercise one of two things will happen: either your feelings will change - or they won't. It doesn't matter either way. This exercise is not about changing your feelings. It's about accepting them.   Looking forward to talking with you more, Jono
(MSW, LICSW, LMHC)
Answered on 01/20/2022

Why does my anxiety, now, control my life? And how can I be myself again?

Anxiety stemming from multiple traumas can be difficult to manage, pending on what you have experienced. Everyone experiences trauma differently, whether through physical or  emotional abuse, or in combination. Despite knowing few details, I believe there are strategies that can help you learn more control over your anxiety.  The most important element to remember is to give yourself grace. It is normal for trauma survivors to feel ashamed of what happen, or blame themselves for not managing stress effectively. Recovering from trauma is a process and you are going to stumble from time to time. Take mountain climbing as a metaphor. If you stumble on the mountain, you don't go all the way back to the beginning. You are still on the trail making progress. Even if others do not recognize it, what matters is that you recognize your progress. You are not expected to become an expert over night. In addition, be sure to take time to reflect on your anxiety triggers. Maybe it is something people say, their tone, or you are reminded of a particular event in your life, and feel like you're reliving it. Being more mindful of what triggers your anxiety can assist you in avoiding them and improve coping with them. Sometimes they may not be easily avoidable (like rnning errands or driving your car). If you have not started counseling yet, please do so. Talking with a professional can help you learn effective tools to cope with your anxiety. They can also help you determine if you are experiencing Generalize Anxiety Disorder (GAD), Major Depression, or Post-traumatic Stress Disorder (PTSD), and create a treatment plan to best assist you. Symptoms can often be misinterpreted as something different, and a professional can differentiate them for clarity. For now, it's important to understand the two stages of coping. These include deescalation and reflection.  Deescalation focuses on grounding methods to help relax the body and calm your mind to make more sound decisions. Some strategies include deep breathing, redirection skills, guided imagery, and thought stopping. You can use these one at a time, or in combination for more effectiveness. Deep breathing is the easiest strategy to learn as you need to slow your breath rate down to 3 to 4 seconds of inhaling and exhaling. You will eventually feel more relaxed after a few seconds. Redirection skills may include saying the alphabet backwards, counting backward from 100 by threes, or identifying five nearby objects of the same color. This helps redirect your mind away from overwhelming negative thoughts. Guided imagery may help focus your mind on a positive image, like a person or memory. It may encourage more positive feelings to counter the anxiety and stress. Finally, thought stopping involves either saying aloud "Stop!", or thinking of a stop sign in your head when your thoughts form. Despite sounding stupidly simple, this strategy can assist you in gaining more control over your negative thoughts. The second stage, reflection, is conducted when you are calmer. It helps to try to develop an outside persective of your intrusive thoughts. Even though you know they are unlikely true, anxiety tricks us into believing they are. Now that you can think more practically, you are more likely to recognize an irrational thought and maintain more self-control. Sometimes it's not always easy. Some thoughts are very strong and reifnorced by years of personal experience. Take time to reframe these thoughts to shed the negativity that comes with them. For example, you may carry the thought "I am a burden to my friends and loved ones." A reframed version of this thought may look like "My true friends and loved ones love me as I am. The ones that say I am a burden are not worth my time and energy." The more you practice reflection and reframing, the easier the process will be for you. Lastly, the best strategy to help you become more comfortable leaving your house will be exposure. If you begin slowly, and gradually build up to leaving (either going to smaller, uncrowded places to bigger places with lots of people), you can get more comfortable over time. It's important to start out smaller so you are not overwhelmed at first. Ultimately, it requires consistency and effort on your part. It may be uncomfortable some days, but that sense of discomfort means you are gradually increasing your resiliency. If you get through it the first time, it's mroe than likely you will get through it again. I hope this was helpful for you. I wish you the best of luck manging your anxiety going forward. And remember to be patient and take care of yourself. Happy Holidays!
(MSW, LCSW)
Answered on 01/20/2022

How do I best cope with the anxiety of job insecurity and not wanting to move for another opportunit

It certainly sounds like you have some tough decisions and it is understandable you are feeling a combination of feelings that bubble up and make the decision seem overwhelming.   Feelings are messengers.  They reveal to us when needs are met as well as when they are unmet.  As messengers, they sometimes show up like "children".  Have you ever seen a toddler who wants something?  It doesn't matter of the time, place, location, the toddler makes his/her feelings known.  Unless and until they are acknowledged, their display becomes bigger, louder, "dramatic".  Feelings are erratic, volatile, and do not operate on the basis of logic and rationale.  Thoughts, on the other hand, do follow the course of logic and rationale.  There are also thoughts that form on the basis of feelings, and this would fall into the realm of irrational thought.    It may be helpful to distinguish between your current thoughts and the feelings that are present.  Also to differentiate between rational and irrational thought.   With regard to feelings, you have identified feeling anxious and sad.  Are there other feelings also present?  Identify and acknowledge their presence.  Avoid explaining, simply identify.   Anxiety often comes about as a result of fear.  Breaking things down into digestible pieces can offer clarity and make fear be more manageable.  What is triggering the fear?  Is it realistic?  For example, a fear of a dark closet is very real yet unrealistic.  The darkness of the closet cannot cause harm.  Understanding that the fear is unrealistic and still feels very real can help make it more manageable.  How does the fear benefit you?  Using the same example, whenever afraid, the person was comforted by a loved one thus holding onto a fear of dark closets benefits by creating opportunities to receive comfort.   With regard to the options, write each one down independently.  One at a time, consider each option, draw two columns, and create a list.  What are the pros (things you find appealing) and what are the cons (things that are challenging/difficult)?  Review each list.  What stands out to you?  Is there any information that is missing and necessary to make a decision?   Explore each option.  What are your beliefs around taking that option?  What are the fears related to each option?  What resources do you have available to contend with the fear?  What lends to you believing you would not be happy in Texas?  Are you basing that on a feeling (thus an irrational thought) or on concrete evidence?  What are the things you love about Pittsburgh?  Have you explored the availability of these things in Texas?  What are the things you love about your current company?  Have you concretely determined that your current company is the only one offering those things?   Just a note:"Positive" feelings provide the message of a need that is met.  For example, the feeling of confidence reveals the need for having established security in that area as met.  "Negative" feelings offer the messaging that there is an unmet need.  For example, disappointment indicates a loss - something didn't occur that was needed (and/or desired).   It is also important to tap into the supports available to you and actively engage in regular activities of self-care.  Sometimes taking a step away for the moment to relax or have fun can offer perspective.  Be kind to you!
(M.S.Ed, LPC, CCTP)
Answered on 01/20/2022

How can I help to stop my head from overthinking and be able to calm down ?

Hello! I am glad that you reached out. I am sorry to hear that you have been feeling overwhelmed from overthinking the smallest of things. It sounds like you are doing a lot of worrying throughout your day. This can feel very frustrating and may be based from a form of anxiety or possibly stem from another root concern. A thorough assessment from a professional mental health provider could assist with identifying the root cause of your worries and the best treatment approach. Therapy can be an effective treatment for a host of mental and emotional problems, including reducing feelings of anxiety and depression. Talking about your thoughts and feelings with a supportive person can often make you feel better. It can be very healing, in and of itself, to voice your worries or talk about something that’s weighing on your mind. And it feels good to be listened to—to know that someone else cares about you and wants to help. While it can be very helpful to talk about your problems to close friends and family members, sometimes you need help that the people around you aren’t able to provide. When you need extra support, an outside perspective, or some expert guidance, talking to a therapist or counselor can help. While the support of friends and family is important, therapy is different. Therapists are professionally-trained listeners who can help you get to the root of your problems, overcome emotional challenges, and make positive changes in your life. You don’t have to be diagnosed with a mental health problem to benefit from therapy. Many people in therapy seek help for everyday concerns: relationship problems, job stress, or self-doubt, for example. Others turn to therapy during difficult times, such as a divorce. But in order to reap its benefits, it’s important to choose the right therapist—someone you trust who makes you feel cared for and has the experience to help you make changes for the better in your life. A good therapist helps you become stronger and more self-aware. Finding the right therapist will probably take some time and work, but it’s worth the effort. The connection you have with your therapist is essential. You need someone who you can trust—someone you feel comfortable talking to about difficult subjects and intimate secrets, someone who will be a partner in your recovery. Therapy won’t be effective unless you have this bond, so take some time at the beginning to find the right person. It’s okay to shop around and ask questions when interviewing potential therapists. The good thing about Betterhelp is that you have so many qualified therapist to choose from. As you start to resolve your past and current root issues you are more likely to reduce negative thoughts, increase your confidence with your decisions and be on a path to a healthier future. I wish you the best on finding professional support in order to address the root issues of your worries and to receive the best treatment to address them!
Answered on 01/20/2022

What can I do to either stop or avoid beating myself up over the little mistake I made ?

Hello! I am glad that you reached out. It sounds like you are doing a lot of worrying throughout your day. That can be based from some sort of anxiety or another root concern. A thorough assessment from a professional mental health provider could assist with identifying the root cause of your worries and the best treatment approach. Therapy can be an effective treatment for a host of mental and emotional problems, including reducing feelings of anxiety and depression. Talking about your thoughts and feelings with a supportive person can often make you feel better. It can be very healing, in and of itself, to voice your worries or talk about something that’s weighing on your mind. And it feels good to be listened to—to know that someone else cares about you and wants to help. While it can be very helpful to talk about your problems to close friends and family members, sometimes you need help that the people around you aren’t able to provide. When you need extra support, an outside perspective, or some expert guidance, talking to a therapist or counselor can help. While the support of friends and family is important, therapy is different. Therapists are professionally-trained listeners who can help you get to the root of your problems, overcome emotional challenges, and make positive changes in your life. You don’t have to be diagnosed with a mental health problem to benefit from therapy. Many people in therapy seek help for everyday concerns: relationship problems, job stress, or self-doubt, for example. Others turn to therapy during difficult times, such as a divorce. But in order to reap its benefits, it’s important to choose the right therapist—someone you trust who makes you feel cared for and has the experience to help you make changes for the better in your life. A good therapist helps you become stronger and more self-aware. Finding the right therapist will probably take some time and work, but it’s worth the effort. The connection you have with your therapist is essential. You need someone who you can trust—someone you feel comfortable talking to about difficult subjects and intimate secrets, someone who will be a partner in your recovery. Therapy won’t be effective unless you have this bond, so take some time at the beginning to find the right person. It’s okay to shop around and ask questions when interviewing potential therapists. The good thing about Betterhelp is that you have so many qualified therapist to choose from. As you start to resolve your past and current issues you are more likely to reduce negative emotions, increase your confidence and be on a path to a healthier future. I wish you the best on finding the root issues of your worries and the best treatment to address them!
Answered on 01/20/2022

How do I copy with my anxiety?

Hello and thank you for your question.I recognize that you may want identify how come you are feeling so nervous. I really using therapy as a tool to build more insight on understanding how come your anxiety has been increasing. By communicating with a therapist, you will likely begin to identify where your anxiety stems from. I want to focus on how you can begin coping with your anxiety on your own. One of the forms of therapy techniques I often use to address anxiety is Acceptance and Commitment Therapy. Often, anxiety is related to being uncertain about things or worried about the future. The mind is focused on the “what if”. The desire to focus on the future can often be driven by wanting to control internal experiences arising out fear of what could happen. I want to suggest you begin by developing a different understanding of anxiety emotion. It is important to note that anxiety is an emotion we all experience and is not necessarily bad. Moreover, anxiety is an emotion that will pass just like others. However, many patients will ask, “Am I going to feel this way forever?” or say, “No matter what I do, it will always be this way.” If you are thinking this way, you are correct about certain things.  Humans are thinking, feeling, sensing creatures, and there is always something to be thought or felt. It is also most likely true that you will experience the thoughts and feelings that you don’t want to experience many more times. However, I want you to keep the following in mind: anxiety will come and then it will go; fear will come and then it will go; the thoughts will rise and fall. People will forget about this process because they begin to worry about things never being different in the future or by trying to control the future with worrying rather than experiencing what is happening in the now. For example, you are anxious about the upcoming semester which is considered the future. Ultimately, we cannot tell the future and we cannot control it so naturally your anxiety will increase. You have to be careful to not get to a place where you are having anxiety about your anxiety. Instead, practice being present in the moment and being aware that thinking and feeling are ongoing experiences that change. The idea in Acceptance and Commitment Therapy is that you are stuck in a paradox. If your goal is to keep the anxiety away you may something like (“I don’t want to ever have this anxiety again”), and you work hard to make sure this comes true by avoiding all things related to your anxiety, but the result will be the anxiety stays present. Your past becomes your future. Thus, you can begin to practice mindfulness meditation to sit and observe the flow of your emotions and thoughts rather than getting hooked by this process.When you can see a thought or feeling as just that, a thought or feeling, rather than something that you are, then you no longer have to try to control it or make it something different. Moreover, the anxiety and worrying no longer have the control over your life that they seemed to have. You are free to make choices that are consistent with your values. I attached a link to mindfulness meditation you can begin with. Keep in mind that finding a therapist to help guide you some more in managing anxiety is always recommended to help you see better results using these techniques. https://www.youtube.com/watch?v=O-6f5wQXSu8&ab_channel=Goodful
(MA, LPC, Doctoral, Candidate)
Answered on 01/20/2022

how to move on from negative thoughts cause by panic attacks and anixety disorder,

  Hello Houssem,   Thank you for reaching out on The BetterHelp Platform with your question: How to move on from negative thoughts cause by panic attacks and anxiety disorder? I am glad you reached out with what you are going through in your life at the moment.  I can see that your anxiety symptoms are seriously interfering with your life.   I will share some information about your anxiety symptoms and how it can lead to a cycle of negative thinking that is hard to stop.   I will share also re some tools you can try yourself.  I would encourage you to reach out for support and guidance with learning how to manage your negative thought patterns.  Proven Techniques to Learn How to Deal with Anxiety How to Know if You Have Anxiety Anxiety is diagnosed by a trained professional, a psychologist or psychiatrist, but there are specific symptoms shared by most people with anxiety. Anxiety causes symptoms that are both mental and physical. These symptoms vary from person to person, and it is best to see a professional for diagnosis, but it never hurts to learn all you can in the meantime. Mental symptoms include excessive worry, apprehensive thoughts that disrupt your daily life, feelings of dread and fear that do not have a logical explanation, and exaggerated thoughts that make it difficult to focus and be productive. Physical symptoms include excessive sweating, blotchy skin, hives or rashes, racing heart, vomiting, headache, hyperventilation, numbness in the extremities, shortness of breath, weakness, dizziness and in some cases chest pain and heart palpitations. For people with anxiety, the apprehension of "what if" leads to behaviors that are disruptive to their life. The distraction caused by anxious thoughts is only one piece of the puzzle. When anxiety goes unchecked, the anxious thoughts and behaviors begin to take their toll physically. Techniques for Dealing with Anxiety Dealing with anxiety can seem overwhelming and for some, dealing means avoiding situations that trigger anxious feelings and behaviors. There are many ways people try to deal with anxiety, and most of them hurt rather than help. It is important to understand that anxiety cannot be "cured", but it does not have to take over your life. You can learn to deal with anxiety in a constructive way that will help you control your reactions and behavior, when you are faced with anxiety. Anxiety begins with anxious thoughts; these thoughts can take on a life of their own. Social anxiety and panic attacks can accompany general anxiety or GAD. The techniques below will also help you deal with GAD and social anxiety too. When you notice anxiety beginning to take hold, use these proven techniques to learn how to deal with it in a constructive way: Control anxiety with thought recognition and behavioral modification Overcome social anxiety by challenging your negative thoughts Calm anxiety by practicing mindfulness and meditation Treat panic attacks with breathing exercises and physical exercise Talk to someone about your anxiety. Therapists, psychologists, and psychiatrists understand, and they can help relieve anxiety by listening and providing more personalized techniques Reduce anxiety with diet and exercise Learn to Control Anxiety Dealing with anxiety requires some understanding and a few proven tools to help you deal with it. Learning to control anxiety isn't about stopping anxiety or fighting anxiety, it is all about regulating your reactions and modifying your behaviors. You can learn to control your reactions to anxiety and modify your behaviors if you learn to identify the situations that trigger anxiety and learn to recognize anxious thoughts when they arise. Once you know your anxiety triggers, you can actively modify your behavior. The following proven techniques will help you identify your triggers, modify your behavior, and work to control your anxiety before it controls you. Recognize Rumination ·          Rumination is the act of overthinking and mulling over thoughts that worry you and distract you from the present. During rumination, you will notice that your thoughts may be exaggerated and your decision making and problem solving is diminished. Once you recognize you are ruminating, you will be able to calm yourself by accepting the rumination as a symptom of anxiety and not something you need to act on. Recognize distortions in thought Once you recognize rumination, you will learn to recognize distortions in those ruminating thoughts. Thoughts that are stressful and worrisome cannot be ignored, that will just make things worse. If you learn to recognize these distorted thoughts, you will have the ability to let them pass without acting on them. These feelings and thoughts are real because they trigger anxiety, but you can learn to let them pass without acting once you recognize them for what they are. Sometimes these techniques are not enough to help you control your anxiety and admitting that is ok; as a matter of fact, admitting you cannot control everything is another technique for controlling anxiety! Everyone is different, so don't be harsh or judgmental with yourself. A professional therapist can help you use these techniques and others to help you control your anxiety. Overcoming Social Anxiety Social anxiety is characterized by an intense fear of social situations. For some, it may only surface during certain situations such as public speaking or attending a party; for others, it disrupts everyday living. Social anxiety has many facets and only a professional can diagnose this condition, but if you have symptoms of social anxiety, working on what you can is a step in the right direction. The most important thing to remember about social anxiety is that you are not alone, many people experience social anxiety and many of them have very public careers. Do not judge yourself for feeling the way you do, just accept that you cannot change everything and work on what you can change. The best way to change what you can is diffuse your negative thoughts and feelings. Examples of how to diffuse negative thoughts: When you think, others are thinking bad things about you, diffuse this thought by asking yourself "Why would this person or people think bad about me?" and/or "They don't even know me, they can't possibly be thinking bad things about me," or "They have enough going on in their lives, too much to be overly concerned with thinking critically about me." If you are thinking, "I know I am going to embarrass myself if I go to that party, I always embarrass myself." Diffuse this thought by asking yourself why you believe you will embarrass yourself, "always" is a strong word, are you sure you "always" embarrass yourself? Diffusing negative thoughts by questioning the reasoning behind the thought works quite well for easing social anxiety. Once you begin to question yourself and ask why you think or feel the way you do, you are forced to rationalize your thoughts and feelings. Rationalizing and anxiety don't mix, and in time as you practice, you will be able to classify your thoughts as rational or not and then decide about action based on that rather than the thoughts themselves. Calming Anxiety with Mindfulness and Meditation Mindfulness and meditation are both calming techniques that work by relaxing the mind and allowing it to release stress. Anxiety will not disappear because you practice mindfulness and meditation, but it will lessen, and you will gain a sense of calm that is hard to achieve without these techniques. Mindfulness and regular meditation can provide stability when anxiety threatens to take over. Mindfulness is the act of being present, in the moment, and aware of what is around you. Mindfulness is awesome in its simplicity, and with practice you will be able to calm your racing thoughts by tuning out and tuning in to something grounding in the moment. There are many free and helpful apps available to help you begin a mindfulness practice. Mindfulness should be cultivated daily to strengthen it as a skill, not just when anxiety is present. Note the things in your environment and really let them absorb you as you describe each one to yourself mentally. Meditation takes many forms, and it does not matter which one you choose. Meditation teaches us to be in control of our breathing and to clear our thoughts. Meditation helps put us in touch with our autonomic nervous system, and this has the potential to put us in control of lowering anxiety. Treating Panic Attacks with Exercise Panic attacks are sudden intense episodes of anxiety and fear that trigger physical reactions when there is no obvious danger or cause. Panic attacks can be disabling and completely disruptive to daily activity. Those who suffer from panic attacks know that the stress experienced earlier in the week can trigger a panic attack days later. If you think you suffer from panic attacks, it is important that you seek professional help for them, but it never hurts to do what you can to ease your symptoms. Exercise and breathing exercises can and do help those who suffer from panic attacks. Regular exercise can reduce the amount of adrenaline in your system because the body will work to regulate the adrenaline during and after exercise. Exercise changes the body's chemistry, and these chemical changes can lessen the occurrence and severity of panic attacks. Breathing exercises during a panic attack can lessen the duration of the attack itself. Breathing exercises can be as simple as counting the number of breaths you are taking, to focusing on regulating your breathing. Many times, panic attacks include hyperventilation or shortness of breath, so practicing breathing exercises will make it easier for you to focus on these exercises during an attack. Practice inhaling deeply for several seconds, holding your breath for a few seconds, and then taking several seconds longer than you inhaled to release that breath. This helps signal your body that your sympathetic nervous system can relax and that you aren't in danger. Although breathing exercises and physical exercise can and do help to treat panic attacks, you should still seek a professional diagnosis. Therapists, psychologists, and psychiatrists can provide more diverse forms of treatment for panic attacks including support during or after an episode. Reducing Anxiety with Diet and Exercise If you suffer from anxiety, your diet and exercise patterns can affect the severity of your anxiety. What we eat has a huge impact on how our body and mind reacts to stress. Without the proper nutrition, we are vulnerable to the effects of anxiety in ways we don't even realize. The chemistry of our body changes depending on the food we eat, and this chemistry has a lot to do with anxiety. Sugar and caffeine should be avoided as both are stimulants. Stimulants can irritate the nervous system and place it on alert, making you more likely to experience anxiety or panic. Alcohol is a commonly used self-medication for anxiety, but with poor results. Alcohol should be avoided. Exercise releases endorphins and endorphins make everything seem brighter and better. The chemical changes that take place during and immediately after exercise work wonders for stress and anxiety. Stress levels lower the more you exercise and regular exercise eases and reduces anxiety because the mind and body are focused on the activity and the endorphins will make sure you feel good about yourself. Talk to Someone These tips and techniques are meant to help you deal with anxiety, but nothing beats the help of a therapist or other mental health professional. Talking to someone who is a knowledgeable, trained professional, is one of the best ways to deal with anxiety. A therapist can provide insight, and help you develop a strategy for dealing with your anxiety. Talking to someone can ease your fears, keep you positive, and provide the support you need to continue moving forward. There is hope.  Recovery is possible and there is help available for you.   I wish you much luck with your next step in managing your symptoms of anxiety.   In Kindness, Gaynor 
(MA, LCSW)
Answered on 01/20/2022

What is the best way to tell if a person is bipolar?

Hello Conscious_Explorer,    Thank you for this question.  Let me start by explaining what bipolar is and what the diagnostic criteria is.  There are two types of bipolar, bipolar 1 and bipolar 2.  Bipolar 1 is where a person experiences a full manic episode.  A full manic episode is where they have a distinct persistent and abnormal elevation of goal directed activity lasting a week or more where the goal directed activity is persistent for most if not all of the day.   There is an inflated sense of grandiosity or inflated self-esteem.  Limited need for sleep, very talkative, racing thoughts and the manic episode is severe enough to cause significant impairment with social and occupational functioning and/or the need for hospitalization to keep a person safe from harm to self or others.  A person who would have bipolar 1 may not have a full manic episode, but they can experience a hypomanic episode.  The difference between full manic and hypomanic is that the person with a hypomanic episode has all the other features of a manic episode, except, social and occupational activities are not severely impacted and a need for hospitalization is not needed.  Also, with a hypomanic episode, the increased elevated mood lasts for at least 4 days vs an entire week with a full manic episode.   A person with bipolar 1 also has to have experienced a major depressive episode.  This includes a loss of interest in activities of interest, unexpected gain or loss of weight and a feeling of losing energy most of the day.  There are more features to list, but in general there is a loss of interest and a general feeling of being tired and heavy most of the day.     Bipolar 2 is characterized by all of the symptoms of a major depressive episode and a person has to have a major depressive episode, but a person diagnosed with bipolar 2 does not have a full manic episode, they only need to have a hypomanic episode.  Either way, a person who has bipolar experiences difficulty regulating.     A person may not have bipolar 1 or 2, but may have anxiety and also experience depression. Anxiety and depression are two separate diagnoses.  The key that I have found is that people experience anxiety, especially with covid here, there has been an increase in anxiety.  What happens is that they experience anxiety and then when the anxiety provoking situation subsides, they experience depression as they have a feeling of not been good enough and should be able to deal better with the situation.  I have found this to more common at least in my practice that a client will have both anxiety and depression, but not have bipolar 1 or 2.  Usually, a combination of medication and psychotherapy are used in any of these diagnoses along with teaching mindfulness skills.   Thank you for the question and warm regards,    Mike Arieta MSW, LICSW, LCSW, PACC, Licensed School Social Worker
(MSW, LICSW)
Answered on 01/20/2022

How can I trust others ?

  Hello Jessi, Thank you for reaching out on The BetterHelp Platform with your question: How can I trust others? I cant trust myself or others, i always check if i left the door open many times, i do all the homework or tasks by myself because i cant trust my classmates work.   I am glad you reached out for some guidance and support.  I wonder if you might be struggling with some anxiety in your life and whether you might be having some symptoms of Obsessive Compulsive Disorder.  Of course, this is just based on what you shared with me today so explore what might be going on with you would take further assessment from a professional medical provider. I will share some details about OCD to see if this resonates with you before you consider what your next step might be to manage these symptoms.   Regardless of what we might call it there is hope and there is help for you.    Is OCD An Anxiety Disorder, And Do I Have It?   According to studies, obsessive-compulsive disorder (OCD) is quite a common psychiatric condition, at least compared to the past. Nowadays, it is frequently cited in lists involving the most common mental obstacles found in patients, alongside depression and addiction. Anxiety often tops these lists as well. Anxiety is often a significant symptom in those who are affected by OCD, but is OCD an anxiety disorder? This article will guide you through information about OCD, such as its general symptoms, its various forms, and its categorization in the medical world. Lastly, treatment for OCD and anxiety will be discussed for those who think they may have the chronic condition. What Is OCD? (Symptoms And Different Forms) When people think of obsessive-compulsive disorder (OCD), the thought of someone aggressively cleaning or being extremely hygienic usually comes to mind first. However, obsessive compulsive disorder is much more complicated than that and can encompass many different topics.  Despite this, OCD, in general, has a specific diagnostic criterion. Here are some of the signs of OCD: Obsessions Recurrent and persistent thoughts, impulses, or images that are intrusive and cause marked anxiety or distress, in contrast to worrying about a real-life issue; The person purposely tries to ignore these thoughts, impulses, or images, by thinking about other things. The person knows that the obsessions are a product of his or her mind, as opposed to being delusional. Compulsions Repetitive actions (physical or mental) that the person feels compelled to perform in response to an obsession; The behaviors or mental actions are designed to prevent or reduce distress towards a particular setting; These actions might not always be affiliated with the content of the obsessional theme; The symptoms of OCD are not caused by anything else, such as a concurrent psychiatric condition or a substance. Individuals with OCD and anxiety often find that their symptoms are excessive and unreasonable. Despite recognizing this, and that their conditions are not delusional, this condition is very burdensome and distressing to them. Different Forms Of OCD OCD can present itself early in life; it is most commonly seen appearing during adolescence and adulthood. No matter the age, OCD can take many different forms and can vary between individuals. In the previous section, contamination was briefly mentioned. This type of OCD is just one of the themes that the disease can manifest as. OCD can have a darker side to it. Patients with OCD and anxiety commonly report that they fear to harm other people, have violent images that are intrusive, or may have unwanted sexual thoughts about things that are considered taboo or forbidden.  These thoughts can often be categorized as Harm or Sexual OCD. It is important to note that someone experiencing Harm OCD is not a threat to anyone. These thoughts are intrusive to these people, and they are distressing. They are unwanted, and it seems like the thoughts are a result of some of their biggest fears. Hoarding, homosexuality, and religion are also common OCD topics. No matter the particular subject of OCD, individuals can display common, time-consuming behavioral traits. This can include: Repetitive actions (such as hand-washing) An urge to check (to be sure a crime did not occur) Mental rituals or mantras (counting or saying certain phrases) Avoidance Behaviors (purposely staying away from triggers) Ruminations (explicitly thinking about an intrusive thought over and over) Because the fear and anxiety can be powerful, this is why people ask, "is OCD an anxiety disorder?" The following section will answer that for you. Do I Have OCD or Anxiety? What's the Difference? OCD can have many faces, but one thing is for sure: it is problematic and can be an initiator of severe anxiety and stress for many people. Since the two are affiliated, is OCD an anxiety disorder? So, to answer the question, "is OCD an anxiety disorder?" It would be accurate to say that it once was considered one, but clinicians believed that it was distinct enough to have a new category. This distinction resulted in its revision in the DSM-5. Despite this, OCD causes anxiety and worry to those affected by it, and it can be very debilitating. By following the criteria, you can also answer the question, "Do I have OCD or anxiety?" If you are encountering any of the symptoms listed in this article, you may be dealing with OCD and not a case of anxiety. Someone with anxiety usually does not engage in the behaviors commonly seen in OCD. Treatment Options Treatments for OCD and anxiety are available. If you believe you’re experiencing symptoms, one of the first steps that you should take is to get a diagnosis from a licensed professional. This diagnosis will allow you to properly get treatment for OCD and anxiety, which is usually in the form of therapy, medication, or a combination of the two. A form of psychotherapy known as CBT, or cognitive-behavioral therapy, has been particularly successful in those who were suffering from OCD. It usually requires the individual to confront their sources of fear and anxiety. The confrontation strategy is a specific type of CBT, known as exposure and response prevention (ERP). This type of therapy results in modification of thoughts, perceptions, and emotions to the problem areas. In a sense, the brain is being trained to react differently (or not respond at all) to something that was once dreadful. As for psychiatric medication, this can be prescribed to those who have been diagnosed with OCD. Typically, antidepressants such as SSRIs (Selective-Serotonin Reuptake Inhibitors) are the main course of prescriptions for OCD.  SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors) are another option if SSRIs are unsuccessful. Keep in mind, antidepressants come with risks and side effects, and if they are unbearable, speak to your physician so you can taper off properly. It can be dangerous to stop the use of an antidepressant abruptly. Also, antidepressants take time to work. It may take weeks before improvement in OCD and anxiety is displayed, or side effects diminish. Summary OCD is a complex condition that can have different faces. The image of someone obsessing over cleanliness is misleading to just what the term entails. This article aimed to shed some light on what the condition is all about and to answer the question, "Is OCD an anxiety disorder?" The main two symptoms of OCD consist of obsessions and compulsions. Within these symptoms, a patient may attempt to suppress their unwanted, intrusive thoughts. These thoughts cause anxiety and distress and individuals often realize that the images are materialized by their brains, and are not delusional. They understand that these thoughts are irrational. Individuals may perform repetitive actions, frequently check things, avoid situations, or have other mental rituals to provide relief. These are the compulsive responses to the obsessions. OCD can manifest itself in different ways, but it will always have some of these symptoms. OCD and anxiety usually go hand-in-hand. Regardless of its category, there is treatment available for OCD and anxiety. First, a proper assessment should be made by a professional. Following diagnosis, therapy is often a useful and practical option for patients. However, sometimes patients are afraid to talk about their OCD problems because they fear judgment (due to the content of the thoughts). Rest assured; licensed professionals deal with many cases of OCD every day, and know precisely what the condition entails. Patients can speak freely in these settings, and finding a therapist is accessible at BetterHelp.com. Psychiatric medication is also an option for those who need or wish to get a prescription from their doctor. SSRIs are the main course of drug treatment for OCD and anxiety, followed by SNRIs. These drugs may come with side-effects and do take some to take effect. If you find that these don't work, Navigating OCD with BetterHelp Research suggests that obsessive-compulsive disorder can be managed through online therapy services. A Cambridge study found internet-based cognitive-behavioral therapy (CBT) was effective in decreasing symptoms related to OCD. Researchers noted specifically that online interventions for OCD were an accessible option. These findings can be added to an already large body of research suggesting the accessibility of online therapy based on its cost-effectiveness, decrease in time constraints, and elimination of therapist availability issues. Internet-based platforms provide easy access to useful tools like counseling sessions, worksheets, and other remotely retrieved resources. As mentioned above, if you’re living with OCD, online therapy can be a vital component in your treatment plan. With internet-based counseling through BetterHelp, you can meet with a therapist from the comfort of your home. And you’ll have the opportunity to reach out to your counselor outside of session time. If you’re feeling overwhelmed, or as though you’re repeating unhelpful behaviors, you can send a message in the moment, and your therapist will get back to you as soon as they can. BetterHelp’s qualified mental health professionals can give you the tools to manage your OCD.   No matter what you might be experiencing there is hope.  Recovery is possible.  I wish you much luck with pursuing your next step in figuring out what you might be experiencing. In Kindness, Gaynor    
(MA, LCSW)
Answered on 01/20/2022

How do you overcome social phobia (aniexty)

Hello,   Thank you for reaching out on The BetterHelp Platform with your question: How do you overcome social phobia (anxiety)? I am glad you reached out with the anxiety you are currently struggling with in your life.  I will share some information about social phobia and some self-help tools you can try as soon as today.  I will also send some information on how you can get some support and guidance with your anxiety (social phobia).   Social phobia, also known as social anxiety, is the third most common mental disorder in the United States. There are more individuals who are not diagnosed but still suffer from fear and anxiety in social situations, so the numbers are most likely even higher. Dealing with social phobias and social anxiety can result in physical, emotional, and behavioral symptoms that can hinder your ability to go through daily life and make it more difficult to have relationships. While there are some things that you can do yourself to help minimize the impact of social anxiety in your life, working with a professional counselor can help give you the tools needed to cope with and overcome it. Individuals working with professional counselors who use Cognitive Behavioral Therapy alone have a high success rate of improving or recovering from their social anxiety. Social Phobia This is when you may feel overwhelmed by thoughts that someone doesn't like you or will think what you say is stupid, unintelligent, or unpleasant. It seems impossible to get rid of these thoughts, so, eventually, you'll start making excuses to friends and family to get out of going to events that you have planned with them. Before you know it, you are only doing the things you absolutely have to do, and you're avoiding everything else that involves social interaction with others. Ways to Overcome Social Phobia Social anxiety can hinder your ability to fully enjoy your life. This makes it hard to have a job. It makes it hard to have relationships. And, it can make it hard to experience the things you used to enjoy. While it may seem like an impossible task, there are things that you can do that can help you start the journey toward overcoming your anxiety. Challenge Irrational Thoughts If you're not speaking up in a business meeting, refraining from attending a party, or not asking for help in a department store because you don't want to speak, then you are exhibiting a social phobia in some way. The first step is to challenge the irrational thoughts that are hindering you from talking with strangers.  Talk to your colleagues, co-workers, friends, and family. Try to eliminate your safety nets one by one. Get rid of your training wheels a little at a time. Stop rehearsing what you will say in your head. Just say it. Don't drown your phobia in alcohol or drugs, as these forms of "courage" will only make matters worse. Rate Your Anxieties About Talking With Strangers Write down what makes you anxious about talking with someone you don't know. Then, rate each of those anxieties on a 0-10 scale. Level 0 would be feeling no anxiety, and level 10 would be a full-fledged panic attack or another intense side effect. Once you rate them, work your way up the scale and address each one. You'll start with the things that only bring you small amounts of anxiety. Once you push yourself to do that activity a few times, you will see that it doesn't put you in danger, and you will start to become more comfortable with that activity.   You can then move your way up to the next item. As you slowly become more comfortable with each action, you will work your way up the ladder. Eventually, you'll be able to take on and conquer the things on your list that used to cause you the most amount of fear. Begin To Practice Mindfulness Meditation If you have social anxiety, mindfulness meditation can help you in multiple ways. The first is that you will learn deep breathing exercises that can help you to calm yourself when you're faced with a situation that makes you feel anxious. Learning how to breathe deeply helps you to slow your heart rate and calm a nervous mind. When you become comfortable with the breathing exercises, they are something you can easily put into practice wherever you are and whenever you feel the anxiety coming on. You will also learn the practice of being mindful. Mindfulness is when you purposely focus your thoughts on something that is either neutral or pleasant. So instead of constantly thinking about the upcoming situation that makes you nervous, you choose to think about the way it felt when you were on the beach during your last vacation. You'll remember what the waves sounded like as they lapped around your ankles, what the saltwater smelled like, and how the warm sun felt on your skin. Then you will picture something like the sun setting over the horizon, and with this relaxing image, you will start to settle down. This works because instead of trying to get you not to worry about something, it gets you to purposefully focus your mind on something that's healthier for you to think about. Talk Where You Feel The Most Comfortable While it's important to help get over your fears of talking with someone you don't know, you can start by communicating where and with whom you feel most comfortable. Email a work request. If you don't receive an answer, then follow up in person or via phone. The more you do something, the more comfortable you will be. Talking more within your comfort zone will help ease you into getting over your phobia by making you feel like you are doing it on your terms. Track Your Successes Tracking the success that you're having is a good way to build confidence and encourage you to keep trying new things. Every time you're able to do something in a social situation that you had wanted to avoid, add it to your list of successes. You can even journal about the activity. When you are struggling in the future, you can look back on these for strength. Journal Keeping a journal can help you sort through your thoughts, help you identify patterns, track your successes, and allow you to recognize when you start to fall into old habits. All of this can be helpful in overcoming social phobia or anxiety. Practice Self-Care It's easy to let yourself go and focus on how you are feeling rather than making sure you are staying healthy. Practice a bit of self-care, such as eating healthy, taking a warm bath, exercising regularly, and other activities that nurture and promote your physical and mental health. Join a Support Group Join a support group that connects you with other individuals who are struggling with similar challenges and gives you a safe space to start working through your phobia and anxiety. One example is Toolmasters International which is a well-known support group for public speaking and can be a good place to meet new people and make new friends. Be Kind To Yourself The most important thing you can do throughout this entire process is to be kind to yourself If you had a bad day, it doesn't mean that you're a failure. It only means that you need to focus on the present and to continue practicing the techniques you are using to overcome your anxiety. See a Therapist If you have tried implementing the techniques listed above and still find that you have social phobia, enlisting the help of an in-person or online counsellor can help give you some new perspective and even new techniques. A therapist will also provide emotional support and understanding as you work through your phobia. BetterHelp Can Help You Overcome  One of the key characteristics of social phobia is a fear of going outside and interacting with others. This is what makes online counseling options like BetterHelp so great. With BetterHelp, you can talk to a licensed counselor via messaging, chat, phone, or video, whichever is most convenient and comfortable for you. You can also do this from the comfort and privacy of your own home. Working with a counselor as soon as you notice you are starting to struggle in social situations can help make the recovery process easier. Through BetterHelp, a counselor will help you find the tools and techniques that are best suited for you and your particular needs.
(MA, LCSW)
Answered on 01/20/2022

How to change my anxiety trigger

Dear iMacki,   Thank you for your message and sharing with me how you've been interacting with yourself, especially on how you've been handling unpleasant feelings and emotions. As you said this has also affected your life significantly. Perhaps by addressing how to handle unpleasant emotions in a healthier manner, we can dive into addressing the issues in your life as well?   Often the experience we've had about anxiety (or any strong emotion such as stress / depression) was so terrible (even physically) that our body sort of become traumatized to it. We naturally become nervous about these unpleasant feelings because we don't like these sensations and experiences. As a result we would do everything we can to avoid / fight these anxious feelings, often using numbing techniques such as using substances or distracting ourselves. Yet only to find that the anxiety gets stronger over time because we have never been able to make peace with it.   Therefore rather than trying to "change" / "fight" / "get rid of" these unpleasant sensations, perhaps the best thing that we can do is to make room for these feelings and even sensations, while staying on track to do what brings us meaning and fulfillment. Floating without judging / blaming ourselves through the anxiety experience, while focusing on making room for anxiety can be helpful.   Here is a short video put up by the author of the book "The Happiness Trap" which does a good job explaining this concept:   Please take some time to watch this and share your thoughts later :) I also highly recommend picking that book as well to supplement this therapy process.   https://www.youtube.com/watch?v=rCp1l16GCXI    We as human beings do not like sufferings, therefore often times we would be doing our best to fight it. However just like the analogy of swimming vs floating that we have talked about before, the more we fight it, the faster we sink. While if we can learn to float with these waves, we will realize that we won't sink.   Radical acceptance / Expansion is about accepting of life on life's terms and not resisting what you cannot or choose not to change. Radical Acceptance is about saying yes to life and all that life brings (including all sorts of emotions such as joy, sadness, peace and pain), just as it is without forcing our ways into our lives.   Why do we want to accept life as it is? Because with anything that we do in life that brings us meaning and fulfillment, it always accompany a wide range of emotions, we can't possibly just choose the ones that we like and fight / avoid those that we don't like. Learning to experience all emotions as they are, is a sign that we are living our lives to the fullest.   To do so we must learn to accept (and make room for) any unpleasant sensations, feelings or thoughts that we experience.   We don't want to fight it because the more we fight, the stronger they will come back.   We don't want to avoid it either because the more we avoid, the more we'll be afraid of it.   So the key here is to make room for these sensations, feelings and thoughts, while continue to do what brings us meaning and fulfillment in life.    Learning to "co-exist" with these feelings will naturally reduce the intensity of them.   Floating, is a form of learning to accept these feelings and make room for it.   Let me give you some practical guidelines on what I mean by accepting these feelings and make room for it.   You can look up "expansion technique" under Acceptance and Commitment Therapy (ACT) for more information as well.   How to accept our emotions (and make room for them):   1. OBSERVE. Bring awareness to the feelings in your body.   2. BREATHE. Take a few deep breaths. Breathe into and around them.   3. EXPAND. Make room for these feelings. Create some space for them.   4. ALLOW. Allow them to be there. Make peace with them   Some people find it helpful to silently say to themselves, 'I don't like this feeling, but I have room for it,' or 'It's unpleasant, but I can accept it.'   • When you're feeling an unpleasant emotion, the first step is to take a few slow, deep breaths, and quickly scan your body from head to toe.   • You will probably notice several uncomfortable sensations. Look for the strongest sensation - the one that bothers you the most. For example, it may be a lump in your throat, or a knot in your stomach, or an ache in your chest.   • Focus your attention on that sensation. Observe it curiously, as if you are a friendly scientist, discovering some interesting new phenomenon.   • Observe the sensation carefully. Notice where it starts and where it ends. Learn as much about it as you can. If you had to draw a line around the sensation, what would the outline look like? Is it on the surface of the body, or inside you, or both? How far inside you does it go? Where is the sensation most intense? Where is it weakest? How is it different in the center than around the edges? Is there any pulsation, or vibration within it? Is it light or heavy? Moving or still? What is its temperature?   • Take a few more deep breaths, and let go of the struggle with that sensation. Breathe into it. Imagine your breath flowing in and around it.   • Make room for it. Loosen up around it. Allow it to be there. You don't have to like it or want it. Simply let it be.   • The idea is to observe the sensation - not to think about it. So when your mind starts commenting on what's happening, just say 'Thanks, mind!' and come back to observing.   • You may find this difficult. You may feel a strong urge to fight with it or push it away. If so, just acknowledge this urge, without giving in to it. (Acknowledging is rather like nodding your head in recognition, as if to say 'There you are. I see you.') Once you've acknowledged that urge, bring your attention back to the sensation itself.   • Don't try to get rid of the sensation or alter it. If it changes by itself, that's okay. If it doesn't change, that's okay too. Changing or getting rid of it is not the goal.   • You may need to focus on this sensation for anything from a few seconds to a few minutes, until you completely give up the struggle with it. Be patient. Take as long as you need. You're learning a valuable skill.   • Once you've done this, scan your body again, and see if there's another strong sensation that's bothering you. If so, repeat the procedure with that one.   • You can do this with as many different sensations as you want to. Keep going until you have a sense of no longer struggling with your feelings.   • As you do this exercise one of two things will happen: either your feelings will change - or they won't. It doesn't matter either way. This exercise is not about changing your feelings. It's about accepting them.   Looking forward to talking with you more, Jono
(MSW, LICSW, LMHC)
Answered on 01/20/2022

How can I stop deriving my identity from people and love myself unconditionally?

Many individuals deal with social anxiety and low self confidence. The physical and mental symptoms can make a person feel stuck and interfere in daily activities. Events and experiences from the past can affect a person's current experience. The same can go for more recent events. Sometimes we can be unsure of why we feel a certain way. Regardless of what has led us to feeling uncomfortable we are able to treat the symptoms. The first step in improving your mood and confidence begins with awareness. Recognizing thoughts and triggers that may lead to worry is beneficial in healing. Developing specific coping skills for each area of concern is a great plan to combat triggers. I recommend the use of relaxation skills and breathing techniques to assist in feeling more at ease. Going easy on your self rather than beating yourself up about the past or events that have occurred is therapeutic. Finding new ways to improve your outlook on life and becoming more active can ease a person into social situations and healthy interactions with others. Recognizing the importance of self care relates to growth as well. Investing in wellness activities can be a great release of energy. Physical activities if approved by a physician helps produce endorphins which are known as the happy chemicals. The more you take care of yourself, the more you will be able to have balanced relationships with others. Setting boundaries and being assertive assists in keeping relationships healthy. Allowing thoughts and feelings to come and leave rather than fighting them off is a great way to let go of unwanted thoughts. Practicing awareness and mindful skills regularly can prepare an individual for triggering events. Lots of practice even when not needed can assist in preventative care. As we become more present in the current moment and comfortable in our skin things may seem more manageable. When learning skills in therapy or on your own, continue to add these skills to your toolbox. Anxiety and low moods can creep back when unexpected. Ongoing care of yourself will lead to a better outlook on life, self confidence, and a feeling of peace.
(MA, LMHC, CAP)
Answered on 01/20/2022

How do you stop worrying about the future?

Hello AK,   Thank you for reaching out on The BetterHelp Platform with your question: How do you stop worrying about the future? I am glad that you reached out with what you are struggling at the moment.  Worrying about our future can be normal - depending on why and what your choices are and so on but if you are overwhelmed with worry and it is causing you anxiety then it is time to take some action to master this. I will share some information about anxiety.   I will also share some tools on what you can do to help you overcome your anxiety and worry about your future.  I would encourage you to reach out for porfessional support from a mental health professional counselor.  Talking with someone can be very beneficial for overcoming stress and worry about such matters.  A counselor can support and teach you some effective coping skills with your anxiety. Anxiety is diagnosed by a trained professional, a psychologist or psychiatrist, but there are specific symptoms shared by most people with anxiety. Anxiety causes symptoms that are both mental and physical. These symptoms vary from person to person, and it is best to see a professional for diagnosis, but it never hurts to learn all you can in the meantime. Mental symptoms include excessive worry, apprehensive thoughts that disrupt your daily life, feelings of dread and fear that do not have a logical explanation, and exaggerated thoughts that make it difficult to focus and be productive. Physical symptoms include excessive sweating, blotchy skin, hives or rashes, racing heart, vomiting, headache, hyperventilation, numbness in the extremities, shortness of breath, weakness, dizziness and in some cases chest pain and heart palpitations. For people with anxiety, the apprehension of "what if" leads to behaviors that are disruptive to their life. The distraction caused by anxious thoughts is only one piece of the puzzle. When anxiety goes unchecked, the anxious thoughts and behaviors begin to take their toll physically. Techniques for Dealing with Anxiety Dealing with anxiety can seem overwhelming and for some, dealing means avoiding situations that trigger anxious feelings and behaviors. There are many ways people try to deal with anxiety, and most of them hurt rather than help. It is important to understand that anxiety cannot be "cured", but it does not have to take over your life. You can learn to deal with anxiety in a constructive way that will help you control your reactions and behavior, when you are faced with anxiety. Anxiety begins with anxious thoughts; these thoughts can take on a life of their own. Social anxiety and panic attacks can accompany general anxiety or GAD. The techniques below will also help you deal with GAD and social anxiety too. When you notice anxiety beginning to take hold, use these proven techniques to learn how to deal with it in a constructive way: Control anxiety with thought recognition and behavioral modification Overcome social anxiety by challenging your negative thoughts Calm anxiety by practicing mindfulness and meditation Treat panic attacks with breathing exercises and physical exercise Talk to someone about your anxiety. Therapists, psychologists, and psychiatrists understand, and they can help relieve anxiety by listening and providing more personalized techniques Reduce anxiety with diet and exercise Learn to Control Anxiety Dealing with anxiety requires some understanding and a few proven tools to help you deal with it. Learning to control anxiety isn't about stopping anxiety or fighting anxiety, it is all about regulating your reactions and modifying your behaviors. You can learn to control your reactions to anxiety and modify your behaviors if you learn to identify the situations that trigger anxiety and learn to recognize anxious thoughts when they arise. Once you know your anxiety triggers, you can actively modify your behavior. The following proven techniques will help you identify your triggers, modify your behavior, and work to control your anxiety before it controls you. Recognize Rumination ·          Rumination is the act of overthinking and mulling over thoughts that worry you and distract you from the present. During rumination, you will notice that your thoughts may be exaggerated and your decision making and problem solving is diminished. Once you recognize you are ruminating, you will be able to calm yourself by accepting the rumination as a symptom of anxiety and not something you need to act on. Recognize distortions in thought Once you recognize rumination, you will learn to recognize distortions in those ruminating thoughts. Thoughts that are stressful and worrisome cannot be ignored, that will just make things worse. If you learn to recognize these distorted thoughts you will have the ability to let them pass without acting on them. These feelings and thoughts are real because they trigger anxiety, but you can learn to let them pass without acting once you recognize them for what they are. Sometimes these techniques are not enough to help you control your anxiety and admitting that is ok; as a matter of fact, admitting you cannot control everything is another technique for controlling anxiety! Everyone is different, so don't be harsh or judgmental with yourself. A professional therapist can help you use these techniques and others to help you control your anxiety. Overcoming Social Anxiety Social anxiety is characterized by an intense fear of social situations. For some, it may only surface during certain situations such as public speaking or attending a party; for others, it disrupts everyday living. Social anxiety has many facets and only a professional can diagnose this condition, but if you have symptoms of social anxiety, working on what you can is a step in the right direction. The most important thing to remember about social anxiety is that you are not alone, many people experience social anxiety and many of them have very public careers. Do not judge yourself for feeling the way you do, just accept that you cannot change everything and work on what you can change. The best way to change what you can is diffuse your negative thoughts and feelings. Examples of how to diffuse negative thoughts: When you think, others are thinking bad things about you, diffuse this thought by asking yourself "Why would this person or people think bad about me?" and/or "They don't even know me, they can't possibly be thinking bad things about me," or "They have enough going on in their lives, too much to be overly concerned with thinking critically about me." If you are thinking, "I know I am going to embarrass myself if I go to that party, I always embarrass myself." Diffuse this thought by asking yourself why you believe you will embarrass yourself, "always" is a strong word, are you sure you "always" embarrass yourself? Diffusing negative thoughts by questioning the reasoning behind the thought works quite well for easing social anxiety. Once you begin to question yourself and ask why you think or feel the way you do, you are forced to rationalize your thoughts and feelings. Rationalizing and anxiety don't mix, and in time as you practice, you will be able to classify your thoughts as rational or not and then decide about action based on that rather than the thoughts themselves. Calming Anxiety with Mindfulness and Meditation Mindfulness and meditation are both calming techniques that work by relaxing the mind and allowing it to release stress. Anxiety will not disappear because you practice mindfulness and meditation, but it will lessen, and you will gain a sense of calm that is hard to achieve without these techniques. Mindfulness and regular meditation can provide stability when anxiety threatens to take over. Mindfulness is the act of being present, in the moment, and aware of what is around you. Mindfulness is awesome in its simplicity, and with practice you will be able to calm your racing thoughts by tuning out and tuning in to something grounding in the moment. There are many free and helpful apps available to help you begin a mindfulness practice. Mindfulness should be cultivated daily to strengthen it as a skill, not just when anxiety is present. Note the things in your environment and really let them absorb you as you describe each one to yourself mentally. Meditation takes many forms, and it does not matter which one you choose. Meditation teaches us to be in control of our breathing and to clear our thoughts. Meditation helps put us in touch with our autonomic nervous system, and this has the potential to put us in control of lowering anxiety. Treating Panic Attacks with Exercise Panic attacks are sudden intense episodes of anxiety and fear that trigger physical reactions when there is no obvious danger or cause. Panic attacks can be disabling and completely disruptive to daily activity. Those who suffer from panic attacks know that the stress experienced earlier in the week can trigger a panic attack days later. If you think you suffer from panic attacks, it is important that you seek professional help for them, but it never hurts to do what you can to ease your symptoms. Exercise and breathing exercises can and do help those who suffer from panic attacks. Regular exercise can reduce the amount of adrenaline in your system because the body will work to regulate the adrenaline during and after exercise. Exercise changes the body's chemistry, and these chemical changes can lessen the occurrence and severity of panic attacks. Breathing exercises during a panic attack can lessen the duration of the attack itself. Breathing exercises can be as simple as counting the number of breaths you are taking, to focusing on regulating your breathing. Many times, panic attacks include hyperventilation or shortness of breath, so practicing breathing exercises will make it easier for you to focus on these exercises during an attack. Practice inhaling deeply for several seconds, holding your breath for a few seconds, and then taking several seconds longer than you inhaled to release that breath. This helps signal your body that your sympathetic nervous system can relax and that you aren't in danger. Although breathing exercises and physical exercises can and do help to treat panic attacks, you should still seek a professional diagnosis. Therapists, psychologists, and psychiatrists can provide more diverse forms of treatment for panic attacks including support during or after an episode. Reducing Anxiety with Diet and Exercise If you suffer from anxiety, your diet and exercise patterns can affect the severity of your anxiety. What we eat has a huge impact on how our body and mind reacts to stress. Without the proper nutrition, we are vulnerable to the effects of anxiety in ways we don't even realize. The chemistry of our body changes depending on the food we eat, and this chemistry has a lot to do with anxiety. Sugar and caffeine should be avoided as both are stimulants. Stimulants can irritate the nervous system and place it on alert, making you more likely to experience anxiety or panic. Alcohol is a commonly used self-medication for anxiety, but with poor results. Alcohol should be avoided. Exercise releases endorphins and endorphins make everything seem brighter and better. The chemical changes that take place during and immediately after exercise work wonders for stress and anxiety. Stress levels lower the more you exercise and regular exercise eases and reduces anxiety because the mind and body are focused on the activity and the endorphins will make sure you feel good about yourself. Talk to Someone These tips and techniques are meant to help you deal with anxiety, but nothing beats the help of a therapist or other mental health professional. Talking to someone who is a knowledgeable, trained professional, is one of the best ways to deal with anxiety. A therapist can provide insight, and help you develop a strategy for dealing with your anxiety. Talking to someone can ease your fears, keep you positive, and provide the support you need to continue moving forward.   There is hope and there is help for you.   I wish you much luck!   In Kindest, Gaynor     
(MA, LCSW)
Answered on 01/20/2022

How do i get rid of social withdrawal and self hate?

Helllo Kailie, I am glad you reached out for support at this time.  I am sorry you are struggling in this moment.  I would encourage you to start to work with a therapist to help you learn skills to help you overcome your struggles.  If we were to meet I would first talk to you about the counseling process through our site and how together we could help you obtain your goals going forward, how I work as a counselor and how I would try to help you through the counseling process.  I would also take the first session to get to know you by asking you a few questions to get a better understanding of your struggles, so that I am able to focus on a plan and goals to work on going forward. I want you to know that you are not alone during this time even through you may feel like you are alone at this time.  During the therapy process you can have support 100% of the time as you are able to reach out and talk to a therapist 24 hours a day 7 days a week.  I am going to send you some skills and tools to help you during this time of struggle you are having.  If we were to work together we would be going over these and more tools to help you through our struggles and be able to ask for support from others. I wanted to send you a reading and skills to help start to build your Self-Esteem.Establishing a strong sense of self and truly loving yourself is a challenging task to master. It's incredibly easy to fall into a rut and become discouraged. With the world constantly criticizing individuals for every little thing and living in a culture that continually praises beauty over substance, it is easy to feel like you are worthless and invaluable. But fear not! Here are some helpful tips that will allow you to learn to love yourself and improve your self-esteem and confidence, and give you the tools to always strive for growth, success, happiness, and self-love. Make a list of the things you love most and why, and prioritize these items on a scale of one to ten, and promise yourself you will engage with these activities every day, week, or month, as appropriate. The key to happiness is to do what you love, and by engaging with some of your favorite activities on a regular basis, you’ll instantly boost your self-confidence.Low self-esteem can keep you from enjoying your life. It can also keep you from socializing and maintaining friendships.Self-esteem is one of those intrinsic qualities that develop slowly over time. If you suffer from low self-esteem, everyone will notice it when you walk into a room. Those with low self-esteem might lack certain social skills, lack assertiveness, or even walk into a room with their shoulders slumped. Body language is a telltale sign as to how much self-esteem you genuinely have. FAST AcronymF – Be FairA – No ApologiesS – Stick to ValuesT – Be TruthfulF stands for being fair to yourself as well as other people. It’s important to learn that your needs are just as important as someone else’s needs. This is also about being assertive and learning to speak your truth.A means no unjustified apologies; in other words, don’t be overly apologetic. Don’t apologize for having an opinion or disagreeing with others.S means stick to your values and don’t compromise or abandon your values trying to please others or conform.Finally, T means being truthful and not making excuses. This requires being honest and not exaggerating or telling little white lies.Quiz For Self-Esteem:This self-esteem Questions is not meant to diagnose any psychological disorder, but it is a good way to gauge how someone feels about themselves. If you score on the low end, that might mean you need to practice more self-love or self-compassion.Answer the following questions with “most of the time,” “some of the time” or “almost never.”1.      My feelings get easily hurt.2.      I get upset if someone criticizes me, even if they mean well and offer constructive criticism.3.      I get angry at myself if I make a small mistake, even if it is an honest one.4.      I typically ask other people what they think I should do, instead of making my own decisions.5.      I typically go along with the group, even if I don’t necessarily agree.6.      I am uncomfortable when accepting compliments.7.      I don’t feel like I measure up or feel good enough.8.      It’s common for me to self-criticize or say negative things about myself, like telling myself I am stupid or fat or just no good.9.      When I look in the mirror, I don’t like what I see, and I don’t feel attractive.10. I find myself apologizing for things all of the time, even for things that aren’t my fault.Five steps to mental wellbeing Below are five things that can really help to boost our mental wellbeing: 1. connect - connect with the people around you: your family, friends, colleagues and neighbors. Spend time developing these relationships. 2. be active - you don't have to go to the gym. Take a walk, go cycling or play a game of football. Find an activity that you enjoy and make it a part of your life. 3. keep learning - learning new skills can give you a sense of achievement and a new confidence. So why not sign up for that cooking course, start learning to play a musical instrument, or figure out how to fix your bike? 4. give to others - even the smallest act can count, whether it's a smile, a thank you or a kind word. Larger acts, such as volunteering at your local community center, can improve your mental wellbeing and help you build new social networks. 5. be mindful - be more aware of the present moment, including your thoughts and feelings, your body and the world around you. Some people call this awareness "mindfulness". It can positively change the way you feel about life and how you approach challenges. Practice mindfulness Change your story Don’t compare yourself to others Channel that inner rock star Move your body more Volunteer Practice forgiveness Realize that you are not your circumstances  I am the architect of my life; I build its foundation and choose its contents.10.   Today, I am brimming with energy and overflowing with joy.11.  My body is healthy; my mind is brilliant; my soul is tranquil.12.   I am superior to negative thoughts and low actions.13.   I have been given endless talents which I begin to utilize today.14.   I forgive those who have harmed me in my past and peacefully detach from them.15.   A river of compassion washes away my anger and replaces it with love.16.  I am guided in my every step by Spirit who leads me towards what I must know and do.17.   (If you're married) My marriage is becoming stronger, deeper, and more stable each day.18.   I possess the qualities needed to be extremely successful.19.   (For business owners) My business is growing, expanding, and thriving.20.   Creative energy surges through me and leads me to new and brilliant ideas.21.  Happiness is a choice. I base my happiness on my own accomplishments and the blessings I've been given.22.  My ability to conquer my challenges is limitless; my potential to succeed is infinite.23.  (For those who are unemployed) I deserve to be employed and paid well for my time, efforts, and ideas. Each day, I am closer to finding the perfect job for me.24.  I am courageous and I stand up for myself.25.   My thoughts are filled with positivity and my life is plentiful with prosperity.26.  Today, I abandon my old habits and take up new, more positive ones.27.   Many people look up to me and recognize my worth; I am admired.28.   I am blessed with an incredible family and wonderful friends.29.  I acknowledge my own self-worth; my confidence is soaring.30.   Everything that is happening now is happening for my ultimate good.31.   I am a powerhouse; I am indestructible.32.   Though these times are difficult, they are only a short phase of life.33.   My future is an ideal projection of what I envision now.34.   My efforts are being supported by the universe; my dreams manifest into reality before my eyes.35.   (For those who are single) The perfect partner for me is coming into my life sooner than I expect.36.  I radiate beauty, charm, and grace.37.   I am conquering my illness; I am defeating it steadily each day.38.  My obstacles are moving out of my way; my path is carved towards greatness.39.   I wake up today with strength in my heart and clarity in my mind. These may be simple things, but they can be powerful things. Being mindful, for example, can help you learn to live in the present moment and not get caught up in worrying about the future or obsessing about the past. Mindfulness also enables you to stop that negative self-talk by helping you be more aware.You can also change your story and start thinking differently. You don’t have to carry the same old sad story around. Taking the time to examine your story can help you understand it and move beyond it.Comparing yourself to others is a recipe for disaster. Comparisons only lead to feeling worse about yourself. When you stop comparing yourself, you begin to realize you are unique.When all else fails, you can channel that inner rock star. Everyone has a strength or talent. No one is good at everything, so taking the time to find your natural talent can help you feel better about yourself.Exercising can also help you feel better about yourself with the release of your body’s natural endorphins or feel-good chemicals. You might be surprised at how good you feel after a brisk walk.Doing things like volunteering and practicing forgiveness can also be helpful. Doing unto others and taking the time to forgive yourself can go a long way to boosting your self-esteem.Last but certainly not least, it’s important to remember that you are not your circumstances. This too, shall pass.Questions for Self-Esteem1.    What are some things you can do to strengthen or balance your emotions? What can you stop doing?2.    How would you feel three months from now if you stuck to your goal? How would your life be different?3.    What is one small thing you can do this week that will help you feel more in control of your life?4.    What are some things you are passionate about? What kinds of things excite you, motivate you or interest you? What can you do to feed these passions daily or weekly?5.    Think of some times when you felt motivated and confident? What were you doing; who were you with; where were you?6.    What kinds of things can you do to start developing a stronger relationship with yourself? What kinds of things do you feel you need to overcome so that you can get closer to self-acceptance and confidence?7.    Do you have relationship problems with your family, friends, or coworkers? What are your options to overcome them?8.    What kinds of activities excite you? Which ones make you feel happy? How can you integrate more joyful and exciting activities into the next couple of days?9.    What habits, if any, do you need to change in order to improve your happiness and confidence this year? What is one habit that you can start to work on in the next couple of days? What would it feel like to do this every day?10. What can you start doing, or stop doing, to deepen your relationships with friends and loved ones?11. Who are the people in your life that are supportive and will help you nurture your dreams and goals? How can you spend more time with them?12. What stands between you and feeling happy? What steps can you take to bridge the gap?13. In terms of money and finances, what kinds of changes could you make to feel more confident financially?14. How can you reduce your expenses this month? How would this make you feel about yourself?15. What would it feel like if you stuck to one healthy habit for the next few months? How could that improve your life? The power of positivityHow we think plays a significant role in how we feel. The more you focus on the positive things in your life (close friendships, fun plans for the weekend, the things that are going well at school and with your family) the more likely it will be that you will enjoy a sense of well-being. Positive thinking brings positive responses in your body which can boost your mood and diminish stress.What is positivity?Positivity is the ability to meet challenges and situations in life with an “I can do it,” “I’ll figure it out,” “things will work out” attitude. People who use the power of positivity face the same disappointments, challenges and stressors in life that everyone else does – the difference is that they choose to react to these challenges by finding a productive and positive way to cope and respond.Ways to bring positivity to your lifeSurround yourself with positive people; it’s OK to avoid people who bring you down and who don’t bring out the best in you. Find the areas in your life that bring you joy, help you maintain your sense of humor and give you a sense of well-being – keep those things in your life as you go off to school, meet new people, face new stressors. Be familiar with situations or areas in your life that bring out the “negative” in you – when a situation can’t be changed, try to focus on the positive; if a situation can be changed, then do so! Find ways to give to others, help others, be compassionate and kind. Doing things for others is a powerful way to help you create positivity in your own life. Make an effort to keep a mental list (or write down a list) of all the things that are going well in your life, of the things that bring you joy and the things you are grateful for. Focusing on the aspects of your life that are going well for you can promote a positive attitude in the rest of your life.Make an effort to find a positive side in everythingYou can’t control what happens to you, but one thing you can control is how you respond. It’s up to you to look for the right side in everything and react most positively.For example, when you are waiting for your friend and he is late, don’t get angry, rather make it an opportunity to develop your patience level.What positive changes do you want to make in your life?●       On a scale of 0-10, how content are you with your life?●       Do you regularly set positive goals for your work life, your relationships or health, and relaxation?●       What is your attitude about change?●       What are these goals?●       What keeps happening repeatedly that frustrates you achieving them?Always be gratefulIt is impossible to feel depressed in life if you have so many things to be grateful. No matter how inferior things may turn out, you must realize that we still have things in our lives what most people on earth don’t have. The research found that your brain always focuses on the negative elements of life, like tragedies, failures, worries, etc. That’s why we need to focus more on good things. To do so, you should make a gratitude list and read them whenever you get a chance. It will attract more blessing, and you will feel much better in life.Create a positive environmentIt is vital to have positive people around you who will help you to stay positive in negative situations. Circle yourself with people who will support you and lift you instead of dragging you down.You can also spend time reading positive books, watching motivating movies, or listening to good music.Assess how you feel around people. One useful way to determine if people are toxic is to pay attention to how you feel around them.[3] You can "check in" at certain points while you are around people. Ask yourself the following questions:●     Am I feeling drained right now? Does it seem like the person is draining my emotions?●     Am I walking on eggshells? Am I afraid to say the wrong thing because they might react negatively?●     Am I ignoring my own voice? Is the person making it hard for me to listen to myself and follow my own values?●     Do I feel smaller and less important around this person?Express yourself effectively.[4] Since tension is bound to occur in friendships and relationships, it is crucial that you can express your feelings clearly. When you are owning and examining your feelings, you have the opportunity to handle this tension smoothly. And, speaking expressively will open space for other people to express how they feel, and work through these different feelings together.●     Start by listening. Make sure to acknowledge what the person is saying before you counter with your own views.●     Use "I" statements. A simple way to avoid being too confrontational is to tell people what you're experiencing rather than what they're doing wrong. For example, you can say "When you're late to our coffee dates, I feel like you don't value my time" rather than "You're always late and it's really rude." Speak firmly and assertively. This ties into effective arguing, but speaking assertively is something you can do all the time, whether you're arguing or not. Being an assertive speaker will help improve your communication and relationships.●     Try to figure out where you could use some improvement. Maybe you're easily intimidated and people tend to step all over you, especially if they have a toxic personality. Identify the problem area as a first step.●     Reflect on tactics for specific situations. Maybe your toxic friend asks you for money and you have a hard time saying no. What can you do in these situations?■         Could you rehearse a simple script for the next time they ask?■         For example, you could say "I care about you, but I'm not able to give you any more money."●     Practice responding assertively in your life. You can use techniques like the "broken record," where you simply repeat yourself if they argue about what you've said. Start small if this is difficult for you, such as saying no (when appropriate) to family members or non-toxic friends.  Exercise moreExercising daily releases good mood endorphins, which makes your mood better. Exercise has both physical and mental benefits. It will keep you in better shape and boost your self-esteem.Help othersVolunteering or doing charity can boost your spiritual health and give you internal peace. Buying a big house and cars will not increase your overall happiness in the long run. Contributing to the betterment of the people will also make you realize how much fortunate you are than others, this has a significant effect on our happiness. This is because our total focus will be on how you can give or be of service to others and paying less attention to negative people and things around you.Go outdoorsNature always gives us positive energy and helps us think positively. In today’s busy world and working from home or desk-bound jobs, it has become impossible to go out and spend some time with nature. Spending some time outside in good weather will increase your energy, boost your mood and help you work efficiently. If going out isn’t an option, you can always surround your workplace or home with plants.  With working from home can you take your computer outside or move your computer to a different location in your house to give yourself the feel of a different work space?MeditationMeditation will improve your focus, attention, clarity and will keep your mind calm. It keeps you from getting stressed out and keeps you happy in the long run. It is beneficial for both the body and mind. Meditation helps you to concentrate and pay attention to the present and accept it without judging. It is useful in forgetting about the past and not worry about the future.Get enough sleepWhen we don’t get enough sleep, negativity takes over our mind. Your body needs to recover from the day before stress. There are tons of natural remedies to help you sleep better. Sleep helps your mind to stay focus, be productive and happier. People who get good sleep tend to feel less anger and stressful.Express your feelingsThere is a lot of things keep happening in our life, which we hold inside ourselves. And when we express those emotions, we feel relief. You should always have someone trustworthy you could talk to and someone who can understand what you are going through. And if you don’t find that right person, you can just write it down.Step by step guide to avoid unnecessary conflict The first thing you should ask yourself is if your response is a reaction to something that happened? If so, why are you triggered? This is important because the way you initiate the communication will be different. If you are reacting to the trigger...you may want to assess your timing of the conversation.  Assess your timing○        Trying to communicate something at the wrong time can cause an unnecessary argument.○        How can you respond in a way that is non-aggressive if/when you are triggered Prepare your message ahead of time○        In the example you gave with dumping out the sand. You know now you have something you want to communicate. Prepare the message ahead of time and know what it is you want to say (be assertive)Be assertive (please review the worksheets on assertiveness and communication styles)○        Focus more on the message you are trying to communicate, instead of the response of the person○        Stay away from the words "you" and use "I" Statements○        I'm feeling overwhelmed. Be specific, what do you want "right now" (in the moment)○        What would be helpful in that moment of distress?Improving the communication (practice reflecting, and go to the worksheet on reflections)○        Reflecting listening and providing feedback○        Eye contact, body language○        Do not make assumptions○        Ask questions if you do not understand or if you are unsure○        If you already have a response immediately after the person is done talking, you were not listening? Why? Because you have spent the entire conversation preparing your message, instead of listening to the other person's message.○        It's not about being right or wrong (the war between being right and wrong ruins relationships) (dominance of power roles)○        Apologize if necessary Improving communication●        Attentive Listening: If by the time he is done talking, you already have your message, you were not listening. It means the entire time he was talking, you were thinking. Therefore you may not have the full understanding of the message.●        Questions: Ask questions to avoid making assumptions about what was said.●        Processing: Communicating back to the other person what you heard them say using the specific words they used●        Reflecting: It is hearing the message and describing what was said to you back to the person●        Assertive Communication: Using :"I" statements to communicate the impact of what was said to you to the other personReduce your worriesWorrying habit about anything is a powerful reason to destroy anyone’s thinking. Most of the thing you fear in your life never happens. They are just like nightmares of your mind. It grows stronger day-by-day and leaves you feeling stressed.Accept and find solutionsMost people are repellent and can’t accept the change in their life. They must learn to accept that change will happen. We continually go through changes, because this is how life is meant to be. You can experience the worst phase of your life, but you should look for the positive aspect and find a solution to your problem. When you train your brain for staying positive in all situations, even tragedy can’t destroy you, this maybe hard to do at first but with practice it is something you can do more often in your life when you are dealing with troubling things in your life.ConclusionIf you think that there are a lot of problems and responsibilities in your life and it’s too impractical to stay positive all the time, think again. It’s never too late to live a positive and happy life. I hope these were helpful for you and that you are able to try and implement them in your daily life.   I hope that these skills have been helpful for you in your struggles you have been facing at this time. I am going to give you my information if you are wanting to start to process through and work on your struggles going forward, please reach out to Betterhelp and ask to be matched with Crystal Westman, or reach out to me through Psychology today for sessions through private practice.  If we were to work together we would work on more skills and tools to help you when you are struggling and get back to a positive space.  I encourage you to reach out for support at this time to help you get to the best version of yourself.
Answered on 01/20/2022