You just saw your doctor and you’ve been given an anxiety diagnosis. But what does that mean? You have no idea what to do next.
Here are 5 things to think about that just might be important food for thought.
What Is Anxiety?
Maybe you aren’t exactly surprised your doctor said you have anxiety. You’ve lived with a lot of stress for a long time. Tried to tell yourself you’re just a high strung person. Or have a sensitive stomach. But, the symptoms can be so bad at times. Being told you actually have a “real thing” could be a relief. But, what is anxiety anyway?
There are many different symptoms. Here are some common ones:
- Feeling nervous, restless or tense
- Having a sense of impending danger, panic or doom
- Having an increased heart rate
- Breathing rapidly (hyperventilation)
- Feeling weak or tired
- Trouble concentrating or thinking about anything other than the present worry
- Having trouble sleeping
- Experiencing gastrointestinal (GI) problems
- Having difficulty controlling worry
- Having the urge to avoid things that trigger anxiety
These are universal symptoms of anxiety. But, the thing is: you are a unique person with your own history. No one’s anxiety is exactly the same. You have your particular reasons for being anxious. Some of them you know. But, the roots of anxiety are never entirely conscious. So, what’s your next step? What do you do to feel better?
Your doctor might have given you some options. Medication. Psychotherapy. You might not be someone who likes to take medication, but this anxiety is pretty hard to live with. And, if you’ve never been in psychotherapy before, you don’t know how you feel about that either. So how do you choose?
If you’ve lived with anxiety for a long time, you’re likely discouraged and it’s hard to believe things can change. If you have anxiety for the first time and are suddenly living with panic attacks or all of the anxiety’s very difficult symptoms, you might feel desperate for a quick solution. What’s the best option?
Do You Need Medication?
If you’re open to it, medication will give you some pretty immediate relief. And, if your anxiety is severe, or maybe even intolerable, medication can be quite helpful. Yet, it isn’t the answer to what’s creating your anxiety in the first place. And, in that sense, psychotherapy provides a deeper, longer-term solution.
If you decide to try medication, your primary care physician or internist will likely be able to prescribe it. Or, can give you a referral to a psychiatrist who specializes in medication for psychological conditions.
If you go the medication route, most often a combination of psychotherapy and medication is most useful. In this case, your therapist can give you a psychiatric referral. Once psychotherapy is underway, you may not need medication any longer. That is a personal decision and can be discussed as a part of your therapy.
If you haven’t been in psychotherapy before, you might be wondering where to begin. And, you might have no idea what kind of therapy is effective. If you’ve been in therapy before and didn’t find it helpful, it’s probably time for a different approach.
But, what are your choices? And how do you decide?
Psychotherapy Is The Best Option. What Kind?
You may have heard about different types of therapy, CBT (Cognitive Behavioral Therapy), psychodynamic, or psychoanalysis, but you have no idea how to choose.
The Mayo Clinic website describes CBT, session-limited psychotherapy, in the following way: “CBT helps you become aware of inaccurate or negative thinking so you can view challenging situations more clearly and respond to them in a more effective way.” CBT is a thinking and skill-based therapy that gives you tools to manage anxiety.
Both medication and management techniques for anxiety control can be helpful, but only to a point. These take the edge off, help you cope with your anxiety and offer temporary relief. Neither medication or anxiety management “skills” resolve the underlying reasons for your anxiety. And, that’s important in the long run.
Here’s why: one of the reasons you have anxiety is that you are (not consciously) controlling and pushing aside your feelings. Medication and behavioral techniques to manage your anxiety are other means of control.
If you’ve put away your feelings, you might have uncomfortable physical symptoms as a way these feelings express themselves. You might have constant anxiety, or you might have panic attacks. If you tend to unconsciously “compartmentalize” or put your feelings in boxes, neither medication or skills provide a safe place for your feelings.
Psychoanalytic or psychodynamic therapies, or psychoanalysis itself, offer a relationship with your therapist in which your feelings can be felt and known. Plus, not only do you need a safe place for your feelings, but to really resolve your anxiety symptoms, these methods help you get to the underlying roots.
Getting to the roots of your anxiety is most important. But, how does that happen?
Getting To The Roots Of Your Anxiety
Believe it or not, anxiety is not “the thing” that needs to be cured. Anxiety is a signal of something not-conscious going on. In fact, your symptoms are a plea for this “something” to be listened to and heard. Buried feelings, memories, or negative thoughts or beliefs about yourself are unconscious causes of anxiety.
For long-standing relief, these must be understood by someone who knows the special language of unconscious symptoms. That someone is a therapist trained in psychoanalysis or psychodynamic therapy, which means they know how to listen for what you can’t know yourself.
You should experience this kind of understanding even in the first session with comments or questions you haven’t thought of before. But, you’d probably like to know what sort of thing might they find, right?
The answer is individual to you. Generally, anxiety has its roots in unresolved childhood problems, trauma, or difficult feelings you did your best to “overcome.” You thought you were done with them. But, really, they’ve been blocked and put somewhere else in your mind.
Maybe as a child, there was no one to listen. Or your feelings were rejected. Or you felt ashamed. So, you closed down. The feelings you had to shut away re-surface in anxiety symptoms. Most often in challenging situations or times of your life. These can be understood and, now, you don’t have to do it alone.
The right therapy is a safe place to open up your feelings – at whatever pace you need to go. Your therapist should listen carefully and link your feelings back to childhood experiences, memories, traumas, and hurt. You’ll begin to know what makes you anxious and the ways the past still lives in your current life and relationships.
And, you and your therapist will work it out.
There Is Hope
You’re wondering. is there really hope for me? There’s definitely hope. But, if you’ve lived with anxiety for a long time, you’re probably pretty discouraged. Especially, if you’ve had periods of calm, only then to have your anxiety hit you over and over again.
You can get relief from any of the methods outlined above. Medication helps. CBT will give you tools. But, if you know you’ve had childhood trauma, struggle with low self-esteem, worry about illness or losses, are scared to open up and try to find love, working out what’s at the roots of your anxiety gives you the best chance for change.
Look for a psychoanalytic or psychodynamic therapist who makes space for all your thoughts and feelings to be understood. A therapist who doesn’t try to talk you out of anything, but encourages you to express whatever is on your mind. Who understands your experiences deeply, and links them to the past.
This kind of therapy gives you the best chance to stop the vicious cycle of your recurring anxiety loops. Talking things out will give you a great sense of relief.
A therapy that combines giving you space to feel all the feelings you’ve shut away, along with an understanding of their origins. changes not only your anxiety but your life. You’ll discover yourself in ways you didn’t think possible. And, your entire life will be much happier.
I’m Dr. Sandra Cohen, a Los Angeles based psychologist and psychoanalyst. I specialize in working with people suffering from all forms of anxiety. Including generalized anxiety, panic attacks, OCD, phobias, and states of fear and excessive worry. You don’t have to live this way. Psychotherapy can change your life.