Anxiety

Anxiety is normal daily part of our lives. It really is. It's how we are wired. It's a natural response when we feel under stress, like when we have a job interview, a first date, or are trying to find parking at Costco. Anxiety manifests through our thoughts, feelings, and body. It's an emotion we feel when we're worried, tense, or afraid, particularly about things that are about to happen, or we think could happen in the future. We can become overwhelmed when we overestimate the "threat" and underestimate our ability to manage.

Generalized Anxiety Disorder (GAD). This is disorder occurs when worry gets out of control, when daily life feels like constant dread, fear, and worry. Someone with GAD may be waiting for disaster to strike your health, money, family, work, etc, or it could be related to everyday issues with no obvious reason. You may feel on edge nervous, worried, restless, or find that you can't concentrate or relax. You may also feel tired and experience a number of possible physical complaints like tension, stomach upset, headaches, nauseous, etc. There is a b association between major depression and generalized anxiety disorder.

Social Anxiety Disorder (SAD). This disorder is not just shyness! It is a persistent intense fear of being judged and watched by others, even in everyday situations in work or school, like talking to classmates or work colleagues. Many people with SAD "white knuckle" their way through social situations, but feel overwhelmed and tired afterwards. Or they may avoid social situations at all costs. I have had a number of clients who struggle with SAD and cope by using cannabis, but it does not change the roots of the problem. It can provide be temporary relief... until it happens again... and again.

Panic Disorder. This is when fear overwhelms unexpectedly and suddenly. Panic attacks are characterized by a sudden wave of fear or discomfort or a sense of losing control even when there is no clear danger or trigger. Racing heart rate, chest pain, difficulty breathing, dizziness, tingling, weakness are common panic symptoms. The anticipation of a panic attack is often a trigger to have a panic attack. Panic attacks will not kill you. Though they feel longer, panic attacks rarely last longer than 5 minutes, give or take, like waiting in a lineup at Starbucks... and then you are done.

Phobia. This is an overwhelming and debilitating fear of an object, place, situation, feeling or animal. Phobias are more pronounced than fears. They develop when a person has an exaggerated or unrealistic sense of danger about a situation or object. If a phobia becomes severe, a person may organize their life around avoiding the thing that's causing them anxiety. As well as restricting their day-to-day life, it can also cause a lot of distress. A common phobia is Agoraphobia, feeling anxious about being in a place or situation where escaping may be difficult if they have a panic attack. Agoraphobia usually results when avoiding situations such as being alone, being in crowded places such as a mall, or taking a bus. Many veterans I work with often experience agoraphobia, especially when they have to go to a public place with limited exits ("egress").

Obsessive Compulsive Disorder (OCD). This is when a person has uncontrollable, reoccurring thoughts (obsessions) and/or behaviours (compulsions) that they may feel the urge to repeat over and over. I've worked with clients who only had obsessive thinking about a particular aspect of themselves or a compulsive behaviour (e.g. checking doors, keys, stove). Exposure and response prevention is your friend here. Perfectionism and procrastination are the evil twins of anxiety. Many clients I see experience both. Perfectionism is the need to achieve high standards to avoid internal criticism and/or avoid mistakes. Sadly, perfectionism results in self-defeating thoughts and increased anxiety to perform. So the other twin, procrastination, often follows. Procrastination is a way to manage the stress and anxiety of perfectionism by avoiding or delaying a task or situation.

Imposter Syndrome. This appears in many clients who are actually quite competent and capable. If this is you, realize that while you may have struggled to get to where they are, but you are unable to be "good enough." Many people with imposter syndrome have negative critical self-beliefs such as "I don't belong to this...", "I'm not good enough", "if people find out the real me, they'll be disappointed".

ADHD ("Attention Deficit and Hyperactivity Disorder") Unfortunately, for quite a few clients I have seen, it can be difficult to get a professional to diagnose ADHD. Many who have ADHD have an inkling that they have it, but often end up attributing their struggles to other causes like being under stress, or their own perceived failings related to their personality, ability, etc. Sadly, they struggle with ADHD and a diminished sense of self, which can result in depression and/or anxiety. Substance use is often used to cope with ADHD.

I've helped clients consult with their physician and self-screen for ADHD symptoms. This allows them to do trials of ADHD medications, which often leads to a noticeable difference almost immediately.

Counselling is helpful for people with ADHD as part of living with it is dealing with emotional dysregulation (difficulty managing emotions), as well as sensitivity to rejection. Constant negative and distorted thinking are common. A person with ADHD can develop a poor sense of self when faced with people who think you're incapable or unreliable. If this is you, this is not due to personal flaws, rather it is due to your neurobiology, and counselling can help fix the distorted view that leads to your lack of self-worth.