Category Archives: anxiety

Counseling At A Distance

Back in May. 2015 I wrote my first blog about telephone counseling. Over the last few months, I concentrated on becoming a Distance Certified Counselor. Many states are recognizing the benefits of working in creative ways to reach clients, who because of geography, chronic disease or disability are unable to receive counseling in the typical face to face method. My new credential looks like this: Distance Certified Counselor, or DCC.

Distance Counseling is nothing new. Sigmund Freud often corresponded with his patients by letter in between regularly scheduled appointments.  Its popularity has increased over the last 20 years as the therapeutic world embraced the digital world. I participate in distance counseling in order to reach a wider range of people in various locations and to reach people who are unable to participate in typical face to face sessions.

Distance Counseling is an approach that takes the best practices of traditional counseling as well as some of its own unique advantages and adapts them for delivery to clients using electronic means.  I prefer using telephone, teleconferencing, and texting when working with my clients. We now know some clients prefer the anonymity of a distance counseling relationship and are more likely to open up and self-disclose than they would be in a traditional counseling setting.

Distance Counseling is accessible.

            Distance Counseling is convenient.

            Distance counseling provides anonymity.

For those individuals who are ambivalent about therapy or who may be uncomfortable with traditional models of therapy, Distance Counseling may be your answer. This is particularly true for individuals who are suffering social phobia, agoraphobia or anxiety disorders.

If Distance Counseling if intriguing to you, please be give me a call.

 

 

Climbing Mt. Everest

This writing was shared with me by one of my clients. With her permission, I am sharing it with you. Enjoy!!!

I watched the Everest Imax movie in high school.

Climbers buy the best quality gear to help them in their quest to the top.  They search out the warmest, lightest outwear to protect themselves from the elements.  They hire the most experienced, capable guides to lead them.

Yet still, they need to climb.  They need to put one foot in front of the other.  They need to trudge through snow, and balance themselves on ice covered cliffs.

True, without the gear, the protection, and the guides you wouldn’t last thirty seconds moving towards your goal.  But all the money in the world, the best guide and the latest model gear cannot get you up to the peak of the mountain if YOU are not willing to climb.

This is how I sometimes feel about battling my anxiety.

I have the best therapist, an awesome doctor, a sensitive husband, a supportive and understanding family, and the sweet love of my children.

I have researched and found medicine that works for me, increasing my serotonin to normal levels.  I do stretching and breathing exercises, and occasionally get a massage.

But I still need to be the one to climb the mountain.  I need to put one foot in front of the other when I feel like I’m about to throw up from the intense anxiety pushing at my chest.  I need to trudge through my thoughts and feelings to figure out if there is, and if so, what might be the source of why I feel this way.  I need to carefully balance my priorities so I don’t waste precious mental energy and time.

It’s so different from my experience with a physical illness.

Sure, having Crohn’s disease is no picnic.  It’s painful, embarrassing and can get quite annoying (yes, I can make a directory of all the public bathrooms in the city.)

But really, it’s more like a very long international flight that gets delayed about half the day so you almost miss your connection.  You wait for hours in a stuffy, dirty, overcrowded waiting area.  You sit in a narrow seat on the plane flanked on either side by people who could either use a shower or are wearing a nasty smelling deodorant.  And sometimes you even have to run through an airport to catch a flight.

It’s not a pleasant experience, but you are not the one physically doing the work.  There are pilots flying the plane, and flight attendants who actually offer you a drink.

It took time to find the right doctor, and alternative care, but really in the end all I had to do was show up for appointments and make it through the prep for surgery without vomiting, (ok so I did vomit, but who cares?).

And people understand physical pain.  They get it.  They are sympathetic.  And somehow, that helps.

But even if everyone in the whole world understood emotional pain, if I didn’t put one foot in front of the other, there is no way to get any closer.

Brighten Your Days: Don’t Be SAD

By Marla Chalnick, Ph.D., LPCsad-winter-depression

Winter means different things to different people. Aside from having to deal with ice, I look forward to the crisp temperatures with great anticipation.  Others may see winter as just the inconvenient interlude between summers. For many people, winter can be down right depressing. They may be suffering from seasonal affective disorder (SAD); a condition that is similar to depression, except it appears only in the winter months.

SAD affects roughly 6% of the adult population of the United States. Women are more affected by SAD, but there are cases of men and children who experience it as well.  SAD can begin as early as September and last until April. The most difficult months are December, January and February because SAD is directly related to the amount of light that is absorbed through the eyes.

The symptoms of SAD occur regularly each winter and may include a number of the following: sleep problems (too much or too little), lethargy (feeling fatigued and unable to carry out daily tasks), difficulty concentrating, overeating (craving carbohydrates and sweet foods), depression, anxiety, and withdrawal from friends and family. In children, symptoms include irritability, difficulty getting out of bed and school problems in the fall and winter.

Dr. Norman Rosenthal, clinical professor of psychiatry at Georgetown University, helped discover the disorder and its treatment in the 1980’s. Dr. Rosenthal described his arrival in the United States from South Africa to complete his residency in psychiatry.

“I was born and raised in South Africa where the geographical climate is very, very pleasant, the seasons blend into one another. And then I came to New York City. I arrived in the summer, and the days were wonderfully long and I was full of energy and enthusiasm.

But then as the days got shorter, something began to happen to me, especially after the daylight savings time change occurred. Suddenly, I felt myself slowed down, less able to carry through on all the projects I picked up during the summer, reluctant to get out of bed and get going in the morning. I sort of soldiered on through the winter until the spring, when it all seemed to get better.”

Light therapy has proven to be an effective therapy in up to 85 per cent of cases of SAD. It consists of using a light box with high intensity florescent lights. Treatment consists of daily half hour to two-hour sessions of sitting in front of the light box, where you can read, eat or do other daily activities. While light therapy is generally the first line of defense, antidepressant medication maybe helpful.  Counseling or any other complementary therapy that teaches relaxation, stress management, adaptation and coping skills can also be useful.

And, if you are very fortunate, take a winter vacation to a warm, sunny place. Spending a week or two in the warm sunshine will have lasting benefits when you return to your winter climate. It’s like “recharging” your batteries. I’ve always wanted to go to Bermuda, how about you?

Winter means different things to different people. Aside from having to deal with ice, I look forward to the crisp temperatures with great anticipation.  Others may see winter as just the inconvenient interlude between summers. For many people, winter can be down right depressing. They may be suffering from seasonal affective disorder (SAD); a condition that is similar to depression, except it appears only in the winter months.

SAD affects roughly 6% of the adult population of the United States. Women are more affected by SAD, but there are cases of men and children who experience it as well.  SAD can begin as early as September and last until April. The most difficult months are December, January and February because SAD is directly related to the amount of light that is absorbed through the eyes.

The symptoms of SAD occur regularly each winter and may include a number of the following: sleep problems (too much or too little), lethargy (feeling fatigued and unable to carry out daily tasks), difficulty concentrating, overeating (craving carbohydrates and sweet foods), depression, anxiety, and withdrawal from friends and family. In children, symptoms include irritability, difficulty getting out of bed and school problems in the fall and winter.

Dr. Norman Rosenthal, clinical professor of psychiatry at Georgetown University, helped discover the disorder and its treatment in the 1980’s. Dr. Rosenthal described his arrival in the United States from South Africa to complete his residency in psychiatry.

“I was born and raised in South Africa where the geographical climate is very, very pleasant, the seasons blend into one another. And then I came to New York City. I arrived in the summer, and the days were wonderfully long and I was full of energy and enthusiasm.

But then as the days got shorter, something began to happen to me, especially after the daylight savings time change occurred. Suddenly, I felt myself slowed down, less able to carry through on all the projects I picked up during the summer, reluctant to get out of bed and get going in the morning. I sort of soldiered on through the winter until the spring, when it all seemed to get better.”

Light therapy has proven to be an effective therapy in up to 85 per cent of cases of SAD. It consists of using a light box with high intensity florescent lights. Treatment consists of daily half hour to two-hour sessions of sitting in front of the light box, where you can read, eat or do other daily activities. While light therapy is generally the first line of defense, antidepressant medication maybe helpful.  Counseling or any other complementary therapy that teaches relaxation, stress management, adaptation and coping skills can also be useful.

And, if you are very fortunate, take a winter vacation to a warm, sunny place. Spending a week or two in the warm sunshine will have lasting benefits when you return to your winter climate. It’s like “recharging” your batteries. I’ve always wanted to go to Bermuda, how about you


 

 

Being a Loner and Finding Love: Is It Incompatible?

 

I recloner loveently read an article on the Lonerwolf website (http://www.lonerwolf.com) discussing this apparent opposition and I thought you might be interested in it as well.

Alethia Luna suggests that being a loner comes with an unspoken “job description.” 1) You like spending most of your time alone. 2) You are self-sufficient and don’t “need” other people to fill your life, and 3) Socializing is your nemesis.

If you consider yourself a loner, this job description may give you a sense of relief from social burdens, but also a sense of loneliness just below the surface.  But how can you be a loner that enjoys your solitude but still desire to find a friend or a lover? Isn’t this completely incompatible with who you are? I think not and here’s why:

  1. Wanting to find love and friendship is normal-for any personality type.
  • Aristotle once said, “Man be nature is a social animal.” This doesn’t mean that he always enjoyed socializing, but may naturally gravitate towards collaboration with others.
  1. You don’t have to be inauthentic to find someone you authentically connect with.
  • Pretending to be someone you’re not is a certain recipe for disaster. There are unlimited ways to find and connect with people who resonate with you.
  1. Don’t let your self-definition bog you down.
  • When identifying with a label can make you feel accepted and understood, it can also box you in and restrict you. You may be a loner, but you are also many other things. You are multilayered!
  1. Think about what is really holding you back from finding love.

Perhaps your identification with the loner label is holding you back, or perhaps something else. Close relationships may have wounded you in the past, creating fear, anxiety and inability to trust in the present. Making new connections is difficult for most everybody. You are not the only one struggling with this. Consider counseling if this is an issue you can’t seem to wade through by yourself.

Besides from giving you self-concept a space to breathe, REMEMBER TO GIVE YOURSELF TIME. It is difficult to go from a homebody to a socialize overnight. Take baby steps ad be patient, but don’t give up on finding LOVE.

 

 

 

 

 

 

Help for worrying about worrying

worrying  In following up on “When to worry about worrying,” there are 3 strategies you might consider to cope with chronic worrying. It is important to understand what worrying is, since the beliefs you hold about worrying play a huge role in triggering worry. You probably feel like worries come from the outside-from people, events that are stressful or situations you’re facing. In fact, worrying is self-perpetuating. The trigger may come from the outside, but your internal dialogue keeps it going! When you’re worrying you are likely obsessing on worst case scenarios and if you are focusing on ‘what ifs’ your worrying is unproductive. If you can give up the idea that your worrying somehow helps you, you can begin to deal with your worry and anxiety.

Many people with anxiety don’t know how to calm down quickly. Some ideas for self care to create calm include:

  • Exercise, a natural and effective anti-anxiety treatment
  • Get enough sleep, limit caffeine, avoid alcohol and nicotine.
  • Start eating healthy

You will also benefit from learning relaxation techniques-deep breathing, progressive muscle relaxation, meditation and yoga. Be aware of what you can do for yourselves and design a self care program that works for you. Be flexible-does this mean you can never have a glass of wine? Absolutely not-everything in moderation!

If you have given self care a good shot and find you can’t seem to shake your worries and fears, you might consider seeking help from a mental health professional. Cognitive Behavioral Therapy (CBT) is one type of therapy that is particularly helpful. CBT examines distortions in our ways of looking at ourselves and the world. It can help you identify automatic negative thoughts that contribute to your anxiety. For example, if you are the type of person who catastrophizes, always think of the worst case scenarios, you might learn to challenge this tendency through asking yourself questions such as: Has this ever happened before? What is the likelihood it will happen now?, What are some more positive outcomes that are more likely to happen? With the help of a mental health professional it is possible to change your mind set and alleviate your worry and anxiety. This might not come easy to you, but with repeated practice you can retrain your thoughts and consequently your feelings.

Finally, with the assistance of a physician it is possible to alleviate your anxiety with the use of medication. Anti-anxiety medications relieve anxiety by slowing down the central nervous system. Their relaxing effects have made them very popular. Common anti-anxiety drugs are Xanax, Klonopin, Buspar, Valium and Ativan. Your physician can advise you about the pros and cons of these and other drugs to treat your anxiety. It’s important to remember that medications alone aren’t the cure. Therapy and lifestyle changes should be incorporated into your treat plan when you’re worrying about worrying!

 

For further information, visit:

www.healthguide.org

www.americanfamilyphysician.org

www.anxeties.com

 

 

When to worry about worrying

A recent article in HEALTHbeat, a publication of the Harvard Medical School, caught my eye. The title: When to worry about worrying. The article suggests there is no shortage of things to worry about-from personal concerns about your family, your job, your health, to fears related to larger issues such as political conflicts, terrorism and natural disasters. Temporary anxiety can be a healthy response to uncertainty and danger, but constant worry about things real or imagined may be a sign of a more serious problem-generalized anxiety disorder.

A generalized anxiety disorder involves chronic worrying, tension and nervousness. It is diffuse or free floating, not connected to anything in particular. People with a generalized anxiety disorder can’t shake the feeling that something bad is going to happen and they will not be prepared. Some people even worry about worrying too much. Does this sound familiar?

“I can’t get my mind to stop-it’s driving me crazy!”

“He’s late-he was supposed to be here 20 minutes ago! He must have had an accident!”

“I can’t sleep-I just feel such dread…and I don’t know why!”

Worries, doubts and fears are a normal part of life. The difference between “normal” worrying and a generalized anxiety disorder is that the worrying becomes:

excessive

intrusive

persistent

disruptive.

Emotional symptoms of generalized anxiety disorder

  • Constant worries running through your head
  • Feeling like your anxiety s uncontrollable; there is nothing you can do to stop worrying
  • Intrusive thoughts about things that make you anxious; you try to stop thinking about them, but you can’t
  • An inability to tolerate uncertainty; you must know what’s going to happen next
  • A persuasive feeling of apprehension or dread

Behavioral symptoms of generalized anxiety disorder

  • Inability to relax, enjoy quiet time, or be by yourself
  • Difficulty concentrating on things, like reading a book
  • Putting things off because you feel overwhelmed
  • Avoiding situations that make you feel anxious, like driving or being in a crowd

Physical symptoms of generalized anxiety disorder

  • Feeling tense; having muscle tightness or body aches
  • Having trouble falling asleep, or staying asleep because your mind won’t quit
  • Feeling edgy, restless or jumpy
  • Stomach problems, nausea, constipation or diarrhea

You will need a doctor’s help to know if you are dealing with a generalized anxiety disorder.

Self diagnosis is never a good idea!

Specific therapies like cognitive behavioral therapy (CBT) helps people recognize when they are misinterpreting events, exaggerating difficulties, or making pessimistic assumptions, and offer new ways to respond to anxiety-provoking situations.  For some people, medications maybe an important part of treatment. There are also many things you can do for yourself (self-care) to foster anxiety reduction. It is not one choice or another, but a combination of several options designed specifically for you to help you get a handle on your anxiety. In my next post, we’ll concentrate on the specific treatments for help manage a Generalized Anxiety Disorder. Stay tuned, I’ll continue this discussion next week!