Deborah Rasso, LMHC, LPC, NCC, CAP, ICADC, CH, QS


Anxiety, worry, stress, concern, apprehension, nervousness. It doesn’t matter what name you give it. It’s a horrible feeling. Anxiety comes when our minds focus on something in the future that feels like a threat. The body will respond as if it is in danger. The autonomic arousal system (our primitive fight, flight, freeze response) kicks in, causing surges in hormones and brain chemicals that prepare us to survive a life threatening attack. The baffling thing about anxiety is that we can be sitting in a chair in the safety of our home and suddenly our mind perceives that we are under attack. What the mind perceives, the body responds to. The heart may pound, thoughts may start racing, the body may sweat or shake, muscles may tense, the stomach may start to churn, all this in response to a perceived threat.

Anxiety disorders are on the rise. According to the National Institute on Mental Health in 2002, 18.1% of the US population suffered from an anxiety disorder. The lifetime prevalence was close to 23% of the population. Though the statistics have not been updated since 2002, those percentages have likely increased. There have been many anxiety-provoking changes since 2002, including the recession in 2007, which caused a marked increase in individuals experiencing anxiety.

The Diagnostic and Statistical Manual of Mental Disorders (DSM -5) identifies at least eleven different types of anxiety disorders. Amongst those are Generalized Anxiety Disorder, Social Anxiety Disorder, Specific Phobias, and Panic Disorders. Often, anxiety disorders begin in childhood and if untreated can persist over time. A person can even suffer from several different types of anxiety disorders at the same time. It is often difficult to give one simple diagnosis.

When you are suffering from this condition, you don’t really care what they call it. You just want to make the feelings stop. Your loved ones may say, “Don’t worry about that” or “Don’t think about that right now”. You may even hear “don’t act so crazy”. If only it were that simple! If you are in full panic mode, you may not be able to take your next breath. What you really need to hear is “you are safe, you are not alone, and you are loved.”

When the worry and stress of life gets too hard to handle, you should seek professional help. However, it’s important to go to the right care giver. You may walk out of the office with a prescription for a dangerous, addictive medication. Many doctors freely prescribe benzodiazepines (i.e., Xanax, Ativan, or Klonopin) to treat anxiety. If you tell them you have trouble sleeping, you may walk out of the office with hypnotic medications (i.e., Ambien, Restoril). These types of drugs can be highly addictive. If you stop taking them abruptly, you may have serious side effects.

The best way to begin your treatment is with a mental health professional like a counselor, psychologist or a psychiatrist. You will most likely be referred to a primary care physician for a full check up to rule out any medical cause for your symptoms. Once a medical cause is ruled out, you should begin working with your counselor to identify possible causes for the anxiety and to develop coping skills for the symptoms.

Most of the worries we have in our head are just an example of “catastrophizing” (thinking the worst will happen). Since anxiety begins with thoughts, that is the best place to begin treatment. The most common therapeutic modality for anxiety is called Cognitive Behavioral Therapy (aka CBT). CBT is based on the theory that your irrational thoughts cause your emotional reaction, which then changes your behavior. If you look more closely at the original thought and see that it is irrational (not true or proven), you will be able to change your reaction to the thought, which in turn changes your feelings. So in therapy, you are encouraged to identify the thoughts that are causing you to worry, for example “What if I fail the test and can’t graduate”. Once you have identified the thoughts that are causing you to worry, you will look at how realistic the thought is. For example, “Have I ever failed a test? Have I prepared for the test? Will one test really keep me from graduating”. When you ask yourself the right questions, you will more than likely feel that your worries are unfounded and your anxiety will fade.

Mindfulness and meditation are quickly becoming a popular tool to fight anxiety. Mindfulness has its roots in Buddhist meditation practice. Simply put, mindfulness is about being focused in the present moment. There are countless websites and app’s that can help with mindfulness practice. The beauty about practicing mindfulness is that it changes your brain over time. Mindfulness helps to develop the pre-frontal cortex of the brain. That part of the brain works diligently to calm the limbic system which is where the brain responds to perceived threats. The more you practice “staying in the moment” the easier it will be to calm yourself down when you become anxious.

When you begin to address your anxiety disorder, you may work with your counselor to determine when and why you became anxious. Once the root cause is identified, you may be a candidate for other therapeutic techniques. If you experienced a trauma and are diagnosed with Post-Traumatic Stress Disorder, your counselor may suggest EMDR (Eye Movement Desensitization and Reprocessing) as an alternative. This method has proven effective in reducing the long lasting effects of a traumatic incident. Depending on the complexity of the trauma, it can be a short treatment or a long process.

Another popular way to reduce anxiety is through hypnotherapy. Hypnotherapy is performed by a clinician trained in Hypnosis. This method is used to create a change in behaviors, attitudes and thoughts through the subconscious mind. The therapist may teach you “self-hypnosis” to calm yourself down when you are becoming anxious.

There are many other ways to address anxiety, stress and worry. Exercise, self-care, diet, support groups are among them. Take that first step towards change. Anxiety does not have to control your life any longer.

Deborah Rasso is a Licensed Mental Health Counselor and
Certified Addiction Professional. She is also trained in both EMDR
and Hypnosis. She is currently a Primary Therapist at The Palm
Beach Institute where she combines her background in music,
communications and counseling to create a unique blend of
expressive, experiential, and motivational tools to help clients make
the necessary life changes for long term recovery.