Knowing what triggers anxiety not always necessary to successfully treat it

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Knowing what triggers anxiety not always necessary to successfully treat it

DEAR MAYO CLINIC: I am 34 and over the past few months have been feeling anxious and worried more often than not. I’ve never had issues with anxiety or depression before, and can’t pinpoint anything that’s led to my anxiety. What causes anxiety? At what point should I see a doctor?

ANSWER: Anxiety often stems from a combination of factors. A person’s individual makeup — your biology and genetics, for example — certainly plays a role. But your circumstances and experiences have an impact, too. Sometimes it can be hard to identify the exact cause of anxiety. The good news is you don’t always need to know what triggered anxiety to have it successfully treated. If anxiety is interfering with your daily life, see your doctor.

A variety of anxiety disorders exist. Some are conditions that have specific triggers and symptoms, such as obsessive-compulsive disorder, post-traumatic stress disorder and phobias. In other cases, though, ongoing anxiety may come from a wide variety of sources. That condition is known as generalized anxiety disorder. It sounds like your situation could fall into this category.

Uncertainty is a big part of anxiety disorders. Of course, uncertainty is part of life. No one really knows how something is going to turn out. Whenever we get into a car, for example, there is always a possibility that the car could break down. But, for the most part, we don’t worry about it. Generally, we accept that things will be OK unless we see a warning sign of danger.

For people with an anxiety disorder, that reasoning is flipped. Instead of feeling everything is OK unless there is a sign of a problem, they look for proof that everything is safe. If that proof is not evident, it’s hard for them to shake their worry or fear.

Anxiety disorders are among the most common mental health disorders in the United States. But they often go untreated. Studies show that only about 30 percent of people with an anxiety disorder get treatment. That’s unfortunate because in many cases, anxiety disorders can be effectively treated.

Being unable to identify what led to anxiety is not necessarily an obstacle. Often it is more important to understand what a person is afraid of, or what is keeping the cycle of anxiety going. Once that’s identified, then the cycle can be broken. One useful way to do that can be through behavior therapy.

 

 


When people are anxious, they get caught up in their own thoughts, asking “what if” questions. When they try to turn off those fearful thoughts or push them away, it may help for a moment. But the thoughts creep back in quickly. In behavior therapy, professionals experienced in dealing with anxiety encourage people to face and accept their thoughts. Eventually, those thoughts begin to lose their power. They may still be annoying, but they become less frightening and more manageable. In time, they may go away and the anxiety fades with them.

A core part of many anxiety disorders is feeling hopeless, helpless, or out of control. People feel there’s nothing they can do to make a difference. That can be very upsetting. Therapy for anxiety can help you feel more in control and able to take action to improve your situation. When you feel in control, it can help you feel better overall.

Of course, this is much easier said than done. Most people need professional help to effectively deal with problematic anxiety. For some, behavior therapy alone may not be enough, and medication can be useful in managing anxiety. If you feel anxiety is making your daily life difficult, set up an appointment to see your doctor. He or she can either help with treatment directly or put you in touch with a psychologist, psychiatrist, therapist or counselor in your area that has experience managing anxiety disorders. — Stephen Whiteside, Ph.D., Psychiatry and Psychology, Mayo Clinic, Rochester, Minn.

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Online therapy, California

What is online counseling

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Online counseling is the latest way for therapists to be able to engage with clients in a meaningful way.

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Online counseling has a variety of options including real time services such as:

  • web chat over a secure server
  • real time instant messaging
  • real time video conferencing
  • telephone calls

or time delayed formats such as:

  • therapeutic e-mails

Too many people do not have access to quality mental health services, some due to geography, some due to small children at home, and some due to disabilities which prevent them being able to access the care they need.

Numerous studies (citations included below) show that online therapy can be just as effective as face to face therapy for issues including anxiety (fear, worry), anger management, couples counseling (relationship issues), and mild depression. Online therapy is also great for individuals who enjoy to interpret their dreams.

Online therapy is not suitable for major depression or suicidal clients. Online therapy is also not suitable for bipolar disorder, or schizophrenia.

If you choose to seek out some form of online therapy, please take time to ensure that the therapist you choose is   qualified to help you. In California you can verify the license of anyone offering therapy at this link:   http://www.bbs.ca.gov/quick_links/weblookup.shtml

I offer different options for  virtual therapy including telephone calls, video chat, real time instant messaging or texting, and time delayed e-mails.

Online counseling is still really new. So new that is still called by many different names by different people (tele health, telehealth, telemedicine, online counseling, online therapy, etherapy, virtual therapy, itherapy, wed therapy, internet counseling, and I am sure the list goes on).

Some of the benefits of using online counseling include:

  • reduced stress from traffic (a big deal in LA)
  • environmentally friendly
  • no need to pay a sitter
  • help is literally at your fingertips
  • you have the safety and comfort of your own home
  • no need to pay for parking
  • great for busy professionals
  • excellent for people with no nearby mental health providers
  • parents with small children
  • easy same day sessions for unexpected problems
  • private and discreet
  • people who travel a lot can access their therapist even on business trips (over the road truck drivers, film production, and many more)

Online therapy can also be a great resource for caregivers trying to process the stress of caring for loved ones who may be suffering with mental illness or long term physical illness such as post traumatic stress disorder (ptsd), bipolar disorder, schizophrenia, eating disorders, Alzheimer’s and other related forms of dementia.

Some of the risks of online therapy include:

  • there are sometimes technical failures (distorted images, dropped calls, difficulty with sounds)
  • if your therapist does not use proper encryption, your records could be accessed by unauthorized persons.

I believe in therapy so much that I offer a wide array of services in an effort to make therapy available to as many people as possible. I use a hipaa compliant e-mail and a hipaa compliant web chat program which are both free and easy to use in order to reduce risk of emails or web chat sessions being accessed by any outside parties.

By providing online services, I do not have to maintain an office (rent, electricity, furniture, etc) and this helps me keep my fees low and affordable. In many cases my prices are not much over what you would pay to use your health insurance.

As a therapist, I love that technology is finally catching up with therapeutic services. Most of us communicate electronically with others on a daily basis already. Most of us are already online, and most of us are already comfortable with this type of communication.

Citations:

http://www.mrt.com/top_stories/article_841fa4cc-e476-11e3-a3df-0019bb2963f4.html

http://www.wowktv.com/story/25602125/huntington-va-medical-center-offering-online-counseling-to-help-more-veterans

http://www.goodtherapy.org/blog/petition-for-association-for-counseling-and-technology-051914

http://www.bustle.com/articles/3552-online-therapy-may-be-just-as-effective-as-face-to-face-session-study-suggests

What is home-based therapy?

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Home-based therapy takes place in the client’s home rather than in the therapist’s office. Home based therapy is beneficial for many reasons. It can be challenging to get to an office for a therapy appointment due to: 

  •  illness
  • disability
  • personal crisis 
  • lack of finances
  • difficulty with transportation,
  • no childcare,
  • hospice
  • people who would otherwise have a difficult time accessing therapy.

As a home-based therapist, I recognize that in-home therapy can often be a solution to these obstacles.

When therapy is provided in the home, clients are more relaxed in the safety and comfort of their own home rather than in an unfamiliar office setting. As a result, progress and healing can occur more readily.

Sometimes office-based therapists offer in-home services when specific skills, like ADHD coaching or parenting skills can be demonstrated and practiced in the home. This allows me to observe the parent-child relationship in action, providing insight into family dynamics. For example, home-based therapy can be particularly beneficial in therapy for children showing disruptive behavior patterns and for children with high-needs or developmental delays. Other benefits may include:

  • Ensuring all family members are in attendance and engaged in the therapy process.
  • Offering support to foster parents and children, especially in new placements.
  • Focusing on family preservation for families who may be facing the removal of a child into foster care. 
  • Removing barriers and defenses in teens by meeting on their territory and allowing the therapist to learn more about the teen by observing his or her personal space.
  • Offering assistance to newly blended families through either adoption or remarriage.

Therapy that takes place in the home can raise concerns regarding therapeutic boundaries, confidentiality, and role confusion. For example, a therapist may have a difficult time maintaining the focus of a therapy session due to the presence of a rambunctious dog, a fussy child, or other distractions. Similarly, the presence of other family members, friends, or neighbors may make it impossible to maintain confidentiality or for the client to speak openly. For this reason it is important to schedule your session time when you can expect privacy.

As a home-based therapy provider, I make a concerted effort to maintain professional boundaries during home visits including arriving in an unmarked car and wearing casual clothes, arriving on time and leaving on time, as well as keeping the focus of the visits on your stated issues.

Treatment can take place:

  • living room,
  • bedroom,
  • porch,
  • backyard,
  • car,
  • nearby park,
  • library,
  • school,
  • church, 
  • hiking trails.

If you live in the San Fernando Valley and you would like to experience a new way of doing therapy, call or text me at 818-648-5605 to determine how to proceed. When and how often in-home therapy sessions occur will depend on your personal needs. Home-based therapy can be used intermittently, as a supplement to office sessions, or as the primary approach. 

Learn how to have the life relationships you want.

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We can learn how to have the life relationships we want whether they are romantic relationships, work relationships, family relationships, our relationship with our self, and relationships with our friends.

  • YOUR SEXUAL IDENTITY?
  • FEELING MISUNDERSTOOD?
  • ARE YOU A PRODUCTION WIDOW OR WIDOWER?
  • GETTING ALONG WITH OTHERS? 
  • POST TRAUMATIC STRESS DISORDER?
  • FEELING LIKE A WALKING CONTRADICTION?
  • WISHING YOUR KIDS WOULD LISTEN INSTEAD OF ARGUE?
  • THINKING THAT YOU JUST AREN’T GOOD ENOUGH?
  • FEELING ALONE IN A ROOM FULL OF PEOPLE?
  • NEEDING AN ADHD COACH? 
  • ANGER MANAGEMENT?
  • BEING EASILY OVERWHELMED?
  • SPENDING TOO MUCH TIME IRRITATED?
  • UPSETTING THOUGHTS THAT YOU JUST CAN’T SEEM TO GET RID OF? 
  • STILL REPLAYING CHILDHOOD TAUNTS?
  • AUDITION ANXIETY?
  • FEELING LIKE A SQUARE PEG IN ROUND HOLE?
  • BICKERING IN THE WORKPLACE? 
  • SOCIAL ANXIETY?
  • ​PROCRASTINATION?

I can help with communication skills and conflict resolution. Both of these skills help us learn to ask for what we want in a way that makes our relationships better rather than hurting them. 

“Too many of us are not living our dreams because we are living our fears.” Les Brown

Services provided online using web chat, email, and texting, and by telephone.