Dr. April Brown’s Cape Coral New Office February 7, 2019 by April Brown Leave a Comment Dr. April Brown now has services in Cape Coral
11 Reasons Why Many Women Might Not Have Orgasms January 25, 2019 by April Brown Leave a Comment New research identifies the reasons women give for reduced sexual pleasure. Posted Feb 17, 2018 “I demand that I climax. I think women should demand that. I have a friend who’s never had an orgasm in her life. In her life! That hurts my heart. It’s cuckoo to me.” —Nicki Minaj Source: Monkey Business Images/Shutterstock According to Rowland, Cempel, and Tempel, as reviewed in their recent study “Women’s Attributions Regarding Why They Have Difficulty Reaching Orgasm,” reports of difficulty or inability to orgasm in women range from 10 to 40 percent. Many factors can impede orgasmic capacity: age, hormonal status, sexual experience, physical stimulation, general health, type of stimulation, the kind of sexual activity (e.g., masturbation or not), and whether the relationship is a brief encounter or longer term. Further studies show that while the majority of women can masturbate to orgasm, up to 50 percent of women do not orgasm during sexual intercourse, even with additional stimulation. Why do women have difficulty with orgasm? There are many possible factors, ranging from reduced sexual desire, pain during intercourse, difficulty becoming sexually aroused, and psychological and relationship factors, including anxiety and post-traumatic symptoms. Researching sexuality is difficult because of complex and inter-related factors, including statistical challenges as well as social stigma and taboos around discussing sexuality. Yet, given the scope of the problem, research is required to guide clinical interventions for women and couples for whom decreased sexual satisfaction is a source of individual distress and relationship problems. In order to better understand what women themselves attribute orgasmic difficulties to, Rowland and colleagues surveyed 913 women over the age of 18, including 452 women who reported more severe problems achieving orgasm on initial screening. For women with more severe difficulty, 45 percent reported problems with orgasm during half of sexual experiences, 25 percent in three-quarters of sexual experiences, and 30 percent during almost all sexual experiences. Researchers first formed several focus groups to develop a set of commonly reported factors and then developed an online survey gauging demographic information, lifestyle, relationship status, how often they had sex, relationship quality, use of medication, sexual responses, physiologic factors (e.g., arousal and lubrication), and orgasm. Finally, they looked at the level of distress from difficulty with orgasm, which is not necessarily perfectly correlated with actual difficulty, as some women are not bothered by it or prefer to abstain from sexual activity for various reasons. Three groups were identified for comparison: women who had orgasm difficulty, but were not distressed by it, women who were distressed, and women who did not have orgasm difficulty. They were all asked about why they thought they had difficulty with orgasm, using 11 categories identified during the original focus group and study development, including a 12th “Other” category: 1. I am not interested in sex with my partner. 2. My partner does not seem interested in sex with me. 3. I do not enjoy sex with my partner. 4. My partner does not seem to enjoy sex with me. 5. I am not sufficiently aroused/stimulated during sex. 6. I am not adequately lubricated during sex. 7. I experience pain and/or irritation during sex. 8. We do not have enough time during sex. 9. I am uncomfortable or self-conscious about my body/appearance. 10. I feel that medication or a medical condition interferes with having an orgasm. 11. I feel that my stress and/or anxiety make it difficult to have an orgasm. 12. Other The most common overall reasons given by women were stress and anxiety, reported by 58 percent; lack of enough arousal or stimulation by nearly 48 percent; and not enough time by 40 percent. Moderately common issues were negative body image, reported by 28 percent; pain or irritation during sex from 25 percent; insufficient lubrication by 24 percent; and medication-related problems by almost 17 percent. The other factors were less commonly reported, by less than 10 percent of respondents. Some of these factors go together. For example, a lack of arousal was associated with stress and anxiety, not enough time for sex, lubrication issues, and genital pain or irritation. Women with a negative body image tended to also report stress and anxiety. A lack of lubrication, unsurprisingly, was associated with a lack of time and genital discomfort. When distressed women were compared to non-distressed women, researchers learned that more distressed women experienced anxiety and stress around sex and believed their partners did not like having sex with them. More distressed women, when asked to identify the single most important contribution to decreased orgasm, reported anxiety and stress, while non-distressed women reported less interest in sex and not having enough time to reach orgasm during actual sexual encounters. Many of these factors are seemingly straightforward to remedy and are likely reflective of relationship quality and partner inattentiveness, among other reasons. There are simple ways to improve the frequency and quality of orgasm via changes in technique and specific communication strategies, which improve overall sexual and relationship satisfaction. While many of these approaches to improving orgasmic and sexual satisfaction sound like common sense, barriers such as poor relationship quality, inadequate or dysfunctional communication styles, unaddressed individual issues, such as depression, anxiety, trauma, and sexual and medical disorders, are often difficult to actually address. Sexuality remains infused with pressure and shame for many people, in spite of greater positive and open attitudes. On personal and couple levels, people often rely on avoidant coping to deal with the anxiety and shame surrounding sex and sexual problems, solidifying pessimistic views, confirming negative self-image and amplifying low self-esteem, and reducing belief in their ability to make positive changes. Fortunately, by providing “esteem support,” partners can help one another with self-esteem and self-efficacy, making it easy to tackle challenges. In some cases, as with medications and medical conditions, making changes that would improve sexuality is more complicated. Nevertheless, quite often there are ways of modifying medications and treating medical conditions which can improve or restore sexual enjoyment. Even modest improvements in sexual satisfaction over time can greatly improve quality of life and are worth pursuing. In therapy and through self-help, individuals and couples can address psychological and emotional issues, improve communication and relationship difficulties, and thereby directly work on intimate behaviors to achieve better sex for both partners. Restoring self-esteem and self-efficacy, practicing more adaptive, active coping, cultivating realistic optimism, and modifying relationship behaviors provides relief of underlying issues and improves overall relationship quality and sexual enjoyment. Rather than setting unrealistic short-term goals, which leads to chronic failure and hopelessness, approaching challenges with investment in compassion for oneself and others, gratitude, curiosity, and patience paves the way for long-term gains. Please send questions, topics or themes you’d like me to try and address in future blogs, via my PT bio page. References David L. Rowland, Laura M. Cempel & Aaron R. Tempel (2018): Women’s Attributions Regarding Why They Have Difficulty Reaching Orgasm, Journal of Sex & Marital Therapy, DOI: 10.1080/0092623X.2017.1408046
3 Ways Partners Can Turn Down Sex Without Hurt Feelings January 17, 2019 by April Brown Leave a Comment Keep three key things in mind when turning down sex. Posted Jun 21, 2018 Source: stockfour/Shutterstock You’re cleaning up the house, thinking about the bills you have to pay, the friend you haven’t called in weeks, and that oh-so-awkward conversation you had with your new coworker yesterday, when your partner appears, touching your waist and giving you a sexually suggestive wink. Now what? Maybe sex seems like a fun and welcome distraction. In that case, great! Enjoy it. But maybe you’re thinking something more along the lines of “Are you kidding me? You want sex right now? That’s certainly not happening!” As I’ve written about previously, sexual rejection can be a difficult pill to swallow, particularly if one person is largely (or even entirely) responsible for initiating sex in a relationship. But being the person who is rejecting sex doesn’t feel that great, either. Maybe we are annoyed that our partner initiated sex and clearly couldn’t read our mood or the situation. And so we roll our eyes, criticize our partner’s timing and initiation strategy, or even push them away entirely. Or we might feel bad because we hate saying no and disappointing them, so we agree to have sex to make them happy. The latest sex research suggests that — compared to going along with sex to avoid negative outcomes — turning down sex doesn’t necessarily hurt relationship satisfaction, as long as we do it in positive ways.1 Here are three approaches to keep in mind. 1. Clearly explain why you’re saying no. If you’re not in the mood for sex when you’re partner initiates it, one of the best things you can do is explain to them why you’re not in the mood. That’s because many people naturally take sexual rejection personally. We can drive ourselves into a tizzy trying to come up with a reason why we’re being turned down, often landing on it having something to do with us (e.g., they don’t find me attractive anymore, they are angry with me, they don’t love me as much as they used to). So if you’re feeling too tired for sex, say that. If you had a long day, and you’re distracted by the stress at work, share that. It helps your partner understand your inner world a bit better and shows that your lack of interest in sex isn’t a reflection of your lack of interest in your partner. Or, if your lack of interest in sex has everything to do with your partner (e.g., you’re fighting or not getting along these days, and sex feels temporarily off the table), say that. It’s much more helpful to start that conversation (even if it’s difficult) than to let more tension build up with silences and misunderstandings. 2. Suggest another time — soon(ish). Think about rejecting sex similarly to making social plans with friends. If we invite a friend out for a bite to eat, and they just say “no,” it can feel pretty jarring. We might wonder: “Are they saying they don’t want dinner tonight? Or are they trying to hint that they want to hang out less frequently? Maybe they don’t like me as much as they used to?” It feels unsettling, because we don’t have all the information, and so we are left to fill in the gaps. On the other hand, if you invite your friend to dinner, and they say: “Sorry I really need to recharge and have a night at home tonight, but maybe could we try next week?” It clarifies that the “no” is just a “not right now.” You know where you stand, and there is a plan to spend time together again soon. Likewise, when it comes to sex, a flat out “no” can feel pretty harsh. We similarly tend to wonder, how long is that “no” for? And should we ask again in an hour? A day? A week? Never? Are they trying to tell me something else by turning down sex? But sexual rejection usually feels a lot more manageable when we’re given a safety net. Something like: “I’m not feeling it right now, but maybe we could try on the weekend, once my work deadline has passed? Or later tonight after I go for a run? Or in the morning before work, after I’ve had a good sleep?” 3. Find another way to connect. Just because you’re not in the mood for sex doesn’t necessarily mean you have to turn down other bids for connection and closeness. We know from the research that women and men get so much more from sex than just physical gratification (like feeling loved and feeling safe). So perhaps sexual activity is off the table, but a nice cuddle, hand holding, a meaningful conversation, or even a game or activity you both enjoy might feel pretty good. It might not be sex, but if your partner is reaching out as a way of feeling close, there are several different ways that this can be accomplished, even when sex doesn’t feel like an option. If there is some relationship-affirming activity you’re in the mood for that would make you feel good and closer to your partner, try suggesting that instead. Take Away Rejecting your partner’s sexual advances with these three tactics doesn’t ensure there won’t be any conflict or that your partner won’t be disappointed you said “no” to sex. But that’s not necessarily the end goal. Differing preferences for desired frequency of sex is one of the most common challenges in relationships and a key area of sexual concern for many, many couples. However, it’s important to keep in mind that it’s not conflict itself that hurts or strengthens relationships, but rather the way that couples manage conflict. Most people don’t like feeling rejected (or being the one to do the rejecting), but offering a “no” that 1) provides an explanation, 2) suggests another time in the near-ish future, and 3) provides an alternative way to connect can help you let your partner down a bit easier. References 1. Kim, J., Muise, A. & Impett, E. A. (2018). “The relationship implications of rejecting a partner for sex kindly versus having sex reluctantly,” Journal of Social and Personal Relationships, 35, 4, 485-508.
Do Foods Play a Role in Anxiety and Panic Attacks? January 9, 2019 by April Brown Leave a Comment TANYA J. PETERSON PRINT ON HEALTHY PLACE Foods play a big role in anxiety and panic attacks. While these experiences are complex with multiple contributing factors, they do have a significant physiological role. This brain-based component of panic is driven largely by nutrition. Research demonstrates the indisputable fact that foods play a role in anxiety and panic attacks. The Role of Foods in Anxiety and Panic Attacks Dr. Fernando Gomez-Pinilla is a researcher at the UCLA School of Medicine and works in the departments of neurosurgery and physiological sciences. He sees firsthand how important a role foods play in anxiety and panic attacks. Says Dr. Gomez-Pinilla, “Newly described influences of dietary factors… have revealed some of the vital mechanisms that are responsible for the action of diet on brain health and mental function.” To a large degree, we are what we eat. As food is digested, the body extracts the important molecular components and distributes them via the bloodstream to the brain. The materials that the brain needs to operate correctly and well come from the foods we eat; therefore, our experiences with brain-based anxiety and panic attacks are related to our nutrition. Two very important conditions are needed by the brain to prevent anxiety and panic attacks: Stable blood sugar levels Production of calming neurotransmitters like serotonin Blood sugar management happens through proper diet. Eating simple carbohydrates—refined and processed sugars—destabilizes our blood glucose levels, causing them to rapidly spike then crash. We can stabilize the ups and downs of the blood sugar roller coaster by consuming complex carbohydrates. They digest more slowly and steadily, creating a steady stream of nutrients and energy to the brain. Another contributing factor to anxiety and panic attacks is insufficient neurotransmitters such as serotonin. Serotonin is known as a calming neurotransmitter, and a lack of this chemical is associated with anxiety and panic attacks. The brain makes its serotonin using the amino acid tryptophan as well as nutrients found in complex carbohydrates. Where does it obtain its supply? From the foods we eat, in this case, proteins. Eating calming foods for anxiety and panic attacks that stabilize blood sugar and supply proteins to produce neurotransmitters is essential for living anxiety- and panic-free. Let’s take a closer look at foods for anxiety attacks. Foods That Play a Role in Anxiety and Panic Attacks To promote brain health and decrease anxiety and panic, seek foods that stabilize blood glucose levels and facilitate the production of calming neurochemicals. Think in terms of balance. Rather than looking for one super-nutrient that the latest craze says is an instant anxiety cure, go for a daily nutritious diet that will reliably provide the brain what it needs so you can reduce panic long-term. Great sources of nutrients and the best foods for anxiety and panic attacks include: Complex carbohydrates Dairy Fruits and vegetables Fatty fish and lean meats Water (for sufficient hydration) Foods play a role in reducing anxiety and panic attacks. Conversely, they can play a role in initiating and sustaining them. Your brain must work with what you feed it, and there are certain foods and beverages that either overstimulate the brain or rob it of nutrients so it can’t work properly. Some such foods that play a contributing role in anxiety and panic attacks are Caffeine (caffeine-induced anxiety is real) Processed foods Simple carbohydrates Together, anxiety-triggering foods cause blood sugar to fluctuate erratically, spiking and crashing in a cycle that leads to an anxious brain. Harmful foods also block the production of calming neurotransmitters that would otherwise minimize anxiety and panic attacks. What you eat and don’t eat, then, is connected to anxiety and panic. However, it’s not just what you eat but how you eat it. How You Eat Impacts Anxiety and Panic Attacks Like the type of food you eat, how you eat affects both your blood sugar levels and the brain’s production of neurotransmitters. The brain must have a regular stream of the right nutrients. Your eating habits can contribute to or detract from your brain’s nourishment. Consider these dos and don’ts: Do: Eat regular meals, small meals eaten frequently are helpful Create structure so you avoid grabbing chips and other junk food here and there when you feel hungry Opt for quality nutrition: complex carbs, protein, produce, nuts and seeds, Omega-3 Fatty Acids Create rituals so you are calm and relaxed when you eat; always being on the go can increase anxiety and panic attacks Don’t: Skip meals Use fad diets that advocate extremes (for example, diets that restrict carbohydrates and increase protein are shown to harm physical and mental health, including increased anxiety and panic attacks) The role of foods in anxiety and panic attacks is significant. The healthier and more wholesome you eat, the more stable your blood sugar will be and the more able your brain will be able to produce the necessary calming neurochemicals. Make gradual dietary adjustments and watch your anxiety and panic improve over time. article references Last Updated: 08 June 2018 Reviewed by Harry Croft, MD
Depression and Setting Goals for the New Year January 3, 2019 by April Brown Leave a Comment on www.healthyplace.com/blogs by JENNIFER SMITH print Depression often interferes with setting goals. Many people set resolutions for the new year, but doing so can lead to feelings of failure when these resolutions aren’t met. Therefore, I suggest setting goals that will help us cope with our depression throughout the year 2019. Rather than using these goals as a means to improve things we see as flaws in ourselves as people often use resolutions to do, we should view these goals instead as ways of taking better care of our ourselves and working toward improving our mental health. So, let’s get started on a list of goals that we’ll find helpful as we cope with our depression in 2019. Ideas for Goal-Setting with Depression Make relaxation time for yourself a priority. This can be done in five to 10-minute increments each day, but at least once a month I recommend a longer period of time for the best results. For example, I read for at least a few minutes each night before bed. That’s the nightly relaxation routine that helps me de-stress and cope with my depression so I can sleep better. For a more extended break, I meet a friend for lunch or dinner. Sometimes we shop or attend an event together. My goal is to do this at least once a month throughout the year 2019. Try making a list of things that you find relaxing and prioritize them this year. Let 2019 be the year you set and achieve goals to care for yourself so you can more effectively cope with your depression. Make physical activity a daily part of life. Movement improves both your body and your mind. Set a goal of getting in some sort of exercise each day (“The Best Exercises for Depression Treatment“). It could be a walk. It might be a simple workout at home or in the gym if that’s your thing. There are many classes available for all types of interests — find one that you’d like to try. I know how hard it can be to find the motivation to exercise. I’ve just gotten back into it myself after months of inactivity. I can honestly say that I feel much better now that I’m moving my body again. It’s helping me physically and also mentally. I have set a goal to move my body in some way every day during 2019. Learn to say no. Sometimes we make things harder on ourselves by trying to please others. Personally, I’ve allowed guilt over my mental illness and how it affects others to sway me into saying yes to things when I’ve really wanted to say no. I have set a goal for 2019 that I will no longer say yes to things unless I truly want to do so. Coping with depression can be enough for me on some days. Add to that caring for my family and working on my writing, and there are times I simply don’t have the energy or mental stamina left to take on other tasks. And that is okay. We don’t have to explain ourselves or feel guilty when we say no. Just simply say no. Give yourself and others grace. Those of us with depression are sometimes not very forgiving of ourselves and may also have trouble forgiving others as well. We tend to dwell on the worst of situations and events, and this can translate to people, too. So, for this upcoming year, I’ve set a goal of giving myself — and others — grace. I will remember that healing is not linear. I will also remember that most people mean well, even when their words don’t sound as if they do. By showing grace to myself and others, I plan to make 2019 my best year yet. What goals are you setting to help you cope with depression throughout 2019? Author: Jennifer Smith Find Jennifer on Twitter, Facebook, Google+ and her blog. View all posts by Jennifer Smith. Tags: depression and setting goals
How to Create Emotional Boundaries December 29, 2018 by April Brown Leave a Comment How to Create Emotional Boundaries By Maria Bogdanos on https://psychcentral.com/ ~ 2 min read Those who have experienced physical abuse are often advised by therapists to create physical boundaries with the abuser. In some extreme cases, that might warrant a restraining order. The same method should be employed when toxic emotional abuse arises between two people. It could very well be that a person turns to abusive behaviors after years of not exhibiting any, which will necessitate the need for a boundary. It’s normal to feel weird about setting up a boundary, especially if there has been no previous need to protect yourself against someone. People are not static beings, and circumstances change. The first thing to do is to ask yourself if you are indeed experiencing abuse and if you are at “the point of no return” with this person. Determine if it’s still possible to dialogue with this person. If not, look to see what is initiating the toxicity in the relationship. Are you picking a fight by being passive-aggressive or are you on the receiving end of someone’s abuse? Look at your motives to see if something has changed. If you are the toxic one who is crossing someone else’s boundaries, then you need to focus on yourself. If you are the recipient of someone’s abuse, then you need to set up a boundary. If you are the one to set up the boundary, then speak to that person in a neutral tone. Explain what you are seeing and the reasons it feels toxic to you. If the person dismisses your observations or takes no responsibility for their behavior, then the boundary is warranted. Sometimes an abuser will blame you for “making me act this way” but that is just more avoidance. All relationships should be built on mutual respect and trust, which also includes respecting yourself enough to protect yourself against emotional abuse. Even if it feels unnatural at the beginning to exercise your boundaries with people who are unwilling to respect you, it’s a necessary step to healing from and not experiencing more abuse. You will learn to become stronger at exerting your needs instead of allowing abuse. People who are caregivers especially have a hard time putting up emotional boundaries, partly because they like to accommodate and help others. There is nothing wrong with helping someone if you have extra resources, but you always need to consider the cost to yourself. It’s also important to recognize what is emotional abuse and what isn’t. If you are enabling abuse, then you will need to learn to enact boundaries because the person abusing needs to be held accountable and not be accommodated despite their poor treatment of others. Setting up emotional boundaries is not about keeping everyone out, it’s about knowing who is safe to let into a closer relationship with you. It’s wise to want to align yourself with people who are similar in emotional maturity. It doesn’t mean you can’t have friends who think differently than you; only that the friends you choose for your “inner circle” will be the safe friends. Enacting healthy boundaries is the protective fence around your personal space where only safe people are let into your life through the gate of wisdom. Auditing a person well before letting them through that gate is of paramount importance because then you will eliminate unnecessary toxic relationships from the get go. If you aren’t sure if they’re safe, don’t bring them closer until you do. There is no hurry and you’re better off with fewer friends than having many that need constant attention. Emotional boundaries are the “self-care necessity” to enjoying much healthier mental health!
How To Date and Support Your Partner With Anxiety May 21, 2018 by April Brown Leave a Comment By Juan Santos M.S., CRC, LPC on www.psychcentral.com ~ 1 min read How do you support your partner with anxiety? If you take a moment to look around, you’ll notice that more often than not people experience stress and worry. Some people experience a higher level of stress and worry that is connected to anxiety. The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the guide for health care professionals to diagnose mental disorders. In the manual is a disorder called, Generalized Anxiety. Generalized Anxiety Disorder is a mental health disorder that can be seen when someone experiences the following symptoms: Worry or nervousness Indecisiveness Overthinking Difficulty relaxing Problems focusing and concentrating A lack of interest in previously pleasurable activities Irregular changes to sleep Irregular changes in appetite. How To Begin Supporting Your Partner To support your partner with anxiety, you can take several avenues. The overall goal is to provide support. Below are areas to consider as you move forward in your journey of understanding anxiety and supporting your partner. I find education to be a great place to start. Become familiar with anxiety and basically knowing as much as you can about it. For that, I recommended Life Without Stress. It’s a self-help anxiety book that provides education and tools surrounding stress and worry. Take time to connect and understand your partner. You can do this by engaging in an open conversation that highlights: Listening Asking questions Taking notes Empathy and understanding Take time to have a conversation with a professional. Call your local counselor or schedule a virtual session. Utilize the counselor as a tool to connect you to your partner while taking into consideration the role anxiety plays in the relationship. As a couples counselor, this is something that I can support you with. Below are fun activities that can be used to connect and empower your relationship. Below are couple activities to address anxiety. Go for a walking together. Take a yoga class together. Get a massage together. Have a jar that you both use to write down on slips of paper what you are worried about. Practice meditation together. Do a puzzle together. Go to a painting class together. Create a scrapbook. Visit a dog shelter together. Have fun petting the animals! Pick a book to read and read it separately but come together to discuss each chapter along the way. Create a playlist for each other, then share why you selected each song. Write a letter to your future self in five years from now. Share your letters with each other. The next step to help overcome and address challenges in your relationship, join the Relationship Building Course. This is the first step to working on your relationship. CLICK HERE to see how the course can help your relationship. Utilize resources. Below are videos that can help you gain further understanding of anxiety and how to support your partner. After watching the video check out the article on helping your partner with anxiety. Juan Santos M.S., CRC, LPC Mr. Juan Santos is a professional counselor, private practice consultant and book author who specializes in relationship stability and understanding separation indicators. He has conducted hundreds of couples counseling sessions. Mr. Santos is the creator of two successful relationship strengthening courses: “A Marriage Preparation Course: For Premarital Couples” and “The Relationship Building Course: For struggling couples”. He is the author of the following self-help psychology books: Couples Workbook: Making Your Relationship Work; 100 Ways Married Men Can Remain Emotionally Connected; Life Without Stress, My Journal, and Parenting Education for Hispanic Families. Mr. Santos is the owner of Santos Counseling PLLC a counseling private practice located in Greensboro and Winston-Salem, NC. Mr. Santos is currently completing his doctoral studies at the University of the Cumberlands. He spends his time away from work with his family enjoying the great outdoors.
Anxiety Disorders May 16, 2018 by April Brown Leave a Comment By John M. Grohol, Psy.D. ~ 3 min read Anxiety disorders are a set of related mental conditions that include: generalized anxiety disorder, panic disorder, obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), social phobia, and simple phobias. Anxiety disorders are treated by a combination of psychiatric medications and psychotherapy. Sections: Symptoms Causes & Diagnosis Treatment Living With & Management Getting Help Anxiety, worry, and stress are all a part of most people’s everyday lives. But simply experiencing anxiety or stress in and of itself does not mean you need to get professional help or that you have an anxiety disorder. In fact, anxiety is an important and sometimes necessary warning signal of a dangerous or difficult situation. Without anxiety, we would have no way of anticipating difficulties ahead and preparing for them. Anxiety becomes a disorder when the symptoms become chronic, and interfere with our daily lives and ability to function. People suffering from chronic, generalized anxiety often report the following symptoms: Muscle tension Physical weakness Poor memory Sweaty hands Fear or confusion Inability to relax Constant worry Shortness of breath Palpitations Upset stomach Poor concentration These symptoms are severe and upsetting enough to make individuals feel extremely uncomfortable, out of control, and helpless. Anxiety disorders fall into a set of separate diagnoses, depending upon the symptoms and severity of the anxiety the person experiences. Anxiety disorders share the anticipation of a future threat, but differ in the types of situations or objects that induce fear or avoidance behavior. Different types of anxiety disorder also have different types of unhealthy thoughts associated with them. Anxiety disorders are the most commonly diagnosed mental disorders in the United States. The most common type of anxiety disorder are called “simple phobias,” which includes phobias of things like snakes or being in a high place. Up to 9 percent of the population could be diagnosed with this disorder in any given year. Also common are social anxiety disorder (social phobia, about 7 percent) — being fearful and avoiding social situations — and generalized anxiety disorder (about 3 percent). Anxiety disorders are readily treated through a combination of psychotherapy and anti-anxiety medications. Many people who take medications for anxiety disorders can take them on an as-needed basis, for the specific situation causing the anxiety reaction. Anxiety Symptoms Most people have experienced fleeting symptoms associated with anxiety disorders at some point in their life. Such feelings — such as having a shortness of breath, feeling your heart pounding for no apparent reason, experiencing dizziness or tunnel vision — usually pass as quickly as they come and don’t readily return. But when they do return time and time again, that can be a sign that the fleeting feelings of anxiety have turned into an anxiety disorder. The primary types of anxiety disorders include: Generalized Anxiety Disorder Symptoms (GAD) Panic Disorder Symptoms – What is a Panic Attack? Agoraphobia Symptoms Social Anxiety Disorder Symptoms (also known as social phobia) Specific Phobia Symptoms (also known as simple phobias) Causes & Diagnosis Anxiety can be caused by numerous factors, ranging from external stimuli, emotional abandonment, shame, to experiencing an extreme reaction when first exposed to something potentially anxiety-provoking. Research has not yet explained why some people will experience a panic attack or develop a phobia, while others growing up in the same family and shared experiences do not. It is likely that anxiety disorders, like all mental illness, is caused by a complex combination of factors not yet fully understood. These factors likely include childhood development, genetics, neurobiology, psychological factors, personality development, and social and environmental cues. Like most mental disorders, anxiety disorders are best diagnosed by a mental health professional — a specialist who is trained on the nuances of mental disorder diagnoses (such as a psychologist or psychiatrist). Learn more: Causes of anxiety disorders Anxiety Treatment Treatment of anxiety focuses on a two-pronged approach for most people, that focuses on using psychotherapy combined with occasional use of anti-anxiety medications on an as-needed basis. Most types of anxiety can be successfully treated with psychotherapy alone — cognitive-behavioral and behavioral techniques have been shown to be very effective. Anti-anxiety medications tend to be fast-acting and have a short-life, meaning they leave a person’s system fairly quickly (compared to other psychiatric medications, which can take weeks or even months to completely leave). The most effective type of treatment generally depends on the specific type of anxiety disorder diagnosed. The following articles cover treatment options available: Psychotherapy for Anxiety Disorders Generalized Anxiety Disorder Treatment Panic Disorder Treatment Social Anxiety Treatment – how social phobia/social anxiety is treated Simple Phobia Treatment – how specific phobias (like fear of heights or of flying) are treated Living With & Managing Anxiety What’s it like to live with an anxiety disorder on a daily basis? Is it always overwhelming, or are there specific strategies that can be used to make it easier to get through the day and manage anxiety successfully? Anxiety disorders are so common that we might take for granted that a person can live their lives and still suffer from occasional bouts of anxiety (or anxiety-provoking situations). These articles explore the challenges of living with and managing this condition. Living with an Anxiety Disorder 15 Small Steps You Can Take Today to Improve Anxiety Symptoms Fight or Flight? Taking on Anxiety and the Irrational Fears in Your Life Getting Help Peer support for anxiety disorders is often a useful and helpful component of treatment. We offer a number of resources that can help you feel that you’re not alone in battling this condition. Personal Stories Our complete Anxiety Library Join Our Online Support Group Although obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) are sometimes considered anxiety disorders, they are covered elsewhere independently on Psych Central. Take action: Find a local treatment provider More resources: Anxiety stories on The Mighty and Anxiety stories on OC87 References American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author. National Institute of Mental Health. (2018). Anxiety. Retrieved from https://www.nimh.nih.gov/health/publications/anxiety/index.shtml on March 25, 2018. 2302.6K John M. Grohol, Psy.D. Dr. John Grohol is the founder & CEO of Psych Central. He is an author, researcher and expert in mental health online, and has been writing about online behavior, mental health and psychology issues — as well as the intersection of technology and human behavior — since 1992. Dr. Grohol sits on the editorial board of the journal Computers in Human Behaviorand is a founding board member and treasurer of the Society for Participatory Medicine. He writes regularly and extensively on mental health concerns, the intersection of technology and psychology, and advocating for greater acceptance of the importance and value of mental health in today’s society. You can learn more about Dr. John Grohol here. APA Reference Grohol, J. (2018). Anxiety Disorders. Psych Central. Retrieved on May 11, 2018, from https://psychcentral.com/disorders/anxiety/
By John M. Grohol, Psy.D. ~ 3 min read Anxiety disorders are a set of related mental conditions that include: generalized anxiety disorder, panic disorder, obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), social phobia, and simple phobias. Anxiety disorders are treated by a combination of psychiatric medications and psychotherapy. Sections: Symptoms Causes & Diagnosis Treatment Living With & Management Getting Help Anxiety, worry, and stress are all a part of most people’s everyday lives. But simply experiencing anxiety or stress in and of itself does not mean you need to get professional help or that you have an anxiety disorder. In fact, anxiety is an important and sometimes necessary warning signal of a dangerous or difficult situation. Without anxiety, we would have no way of anticipating difficulties ahead and preparing for them. Anxiety becomes a disorder when the symptoms become chronic, and interfere with our daily lives and ability to function. People suffering from chronic, generalized anxiety often report the following symptoms: Muscle tension Physical weakness Poor memory Sweaty hands Fear or confusion Inability to relax Constant worry Shortness of breath Palpitations Upset stomach Poor concentration These symptoms are severe and upsetting enough to make individuals feel extremely uncomfortable, out of control, and helpless. Anxiety disorders fall into a set of separate diagnoses, depending upon the symptoms and severity of the anxiety the person experiences. Anxiety disorders share the anticipation of a future threat, but differ in the types of situations or objects that induce fear or avoidance behavior. Different types of anxiety disorder also have different types of unhealthy thoughts associated with them. Anxiety disorders are the most commonly diagnosed mental disorders in the United States. The most common type of anxiety disorder are called “simple phobias,” which includes phobias of things like snakes or being in a high place. Up to 9 percent of the population could be diagnosed with this disorder in any given year. Also common are social anxiety disorder (social phobia, about 7 percent) — being fearful and avoiding social situations — and generalized anxiety disorder (about 3 percent). Anxiety disorders are readily treated through a combination of psychotherapy and anti-anxiety medications. Many people who take medications for anxiety disorders can take them on an as-needed basis, for the specific situation causing the anxiety reaction. Anxiety Symptoms Most people have experienced fleeting symptoms associated with anxiety disorders at some point in their life. Such feelings — such as having a shortness of breath, feeling your heart pounding for no apparent reason, experiencing dizziness or tunnel vision — usually pass as quickly as they come and don’t readily return. But when they do return time and time again, that can be a sign that the fleeting feelings of anxiety have turned into an anxiety disorder. The primary types of anxiety disorders include: Generalized Anxiety Disorder Symptoms (GAD) Panic Disorder Symptoms – What is a Panic Attack? Agoraphobia Symptoms Social Anxiety Disorder Symptoms (also known as social phobia) Specific Phobia Symptoms (also known as simple phobias) Causes & Diagnosis Anxiety can be caused by numerous factors, ranging from external stimuli, emotional abandonment, shame, to experiencing an extreme reaction when first exposed to something potentially anxiety-provoking. Research has not yet explained why some people will experience a panic attack or develop a phobia, while others growing up in the same family and shared experiences do not. It is likely that anxiety disorders, like all mental illness, is caused by a complex combination of factors not yet fully understood. These factors likely include childhood development, genetics, neurobiology, psychological factors, personality development, and social and environmental cues. Like most mental disorders, anxiety disorders are best diagnosed by a mental health professional — a specialist who is trained on the nuances of mental disorder diagnoses (such as a psychologist or psychiatrist). Learn more: Causes of anxiety disorders Anxiety Treatment Treatment of anxiety focuses on a two-pronged approach for most people, that focuses on using psychotherapy combined with occasional use of anti-anxiety medications on an as-needed basis. Most types of anxiety can be successfully treated with psychotherapy alone — cognitive-behavioral and behavioral techniques have been shown to be very effective. Anti-anxiety medications tend to be fast-acting and have a short-life, meaning they leave a person’s system fairly quickly (compared to other psychiatric medications, which can take weeks or even months to completely leave). The most effective type of treatment generally depends on the specific type of anxiety disorder diagnosed. The following articles cover treatment options available: Psychotherapy for Anxiety Disorders Generalized Anxiety Disorder Treatment Panic Disorder Treatment Social Anxiety Treatment – how social phobia/social anxiety is treated Simple Phobia Treatment – how specific phobias (like fear of heights or of flying) are treated Living With & Managing Anxiety What’s it like to live with an anxiety disorder on a daily basis? Is it always overwhelming, or are there specific strategies that can be used to make it easier to get through the day and manage anxiety successfully? Anxiety disorders are so common that we might take for granted that a person can live their lives and still suffer from occasional bouts of anxiety (or anxiety-provoking situations). These articles explore the challenges of living with and managing this condition. Living with an Anxiety Disorder 15 Small Steps You Can Take Today to Improve Anxiety Symptoms Fight or Flight? Taking on Anxiety and the Irrational Fears in Your Life Getting Help Peer support for anxiety disorders is often a useful and helpful component of treatment. We offer a number of resources that can help you feel that you’re not alone in battling this condition. Personal Stories Our complete Anxiety Library Join Our Online Support Group Although obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) are sometimes considered anxiety disorders, they are covered elsewhere independently on Psych Central. Take action: Find a local treatment provider More resources: Anxiety stories on The Mighty and Anxiety stories on OC87 References American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author. National Institute of Mental Health. (2018). Anxiety. Retrieved from https://www.nimh.nih.gov/health/publications/anxiety/index.shtml on March 25, 2018.
10 Ways to Manage Unhealthy and Toxic People March 17, 2018 by April Brown Leave a Comment By Támara Hill, MS, LPC ~ 4 min read How would you know that a person is “toxic?” Would you know that a person is toxic right away? The word toxic is a very common word in today’s society. It’s even more popular online where you can find millions of articles on relationships and ways to survive in them. Sadly, despite frequent searches online about this topic, it’s easy to struggle to identify the behaviors of a toxic person until it is way too late. This article will provide some suggestions on how to deal with these kinds of personalities. A toxic person is someone who “infects” (like a disease) your thoughts, emotions, feelings, and behaviors in ways that are not good. They may be envious of you, they may try to limit or undermine you, or they may simply ignore any kind of progress you make. A toxic person can be anyone you come across in daily life, live with, work with, or see from time to time. The sad part about most toxic people is that they don’t always see themselves or their own toxicity. As a result, when you walk away they end up shocked, and sometimes confused. In last week’s article, we discussed unhealthy boundaries as being indicative of someone with toxic personality traits. Unhealthy boundaries are often very common in those exhibiting toxic behaviors. I talk a bit more about these kinds of individuals in the video below: Toxic characteristics may include but are not limited to: jealousy or envy control and manipulation fear and anxiety “flip-floppy” emotions and behaviors avoidance and denial physical, sexual, or psychological/emotional abuse triangulation (typically includes more than two people and is used to confuse all individuals involved) Sadly, many of us can become victims of a toxic relationship. We have to know when to say “enough” and move on. It is certainly easier said than done, which is why I often suggest exploring your values, turning to your faith or “anchor,” relying on people who truly know you and you trust, and/or seeking therapy to get another perspective. Sometimes the only thing we can do is manage the behavior. Some ways to manage a toxic relationship include: Observing MO (Modus Operandi): Take time to examine how toxic people operate and question their motives. Not everyone is out to get you, use you, or manipulate you. But some are. Examine how these people assert themselves toward you, how you feel when they are around you, and question what they could possibly want from you. It’s a sad way to exist but some people only like you because you can offer them something. Planing for the attack: Toxic people are not just a pain. They can be dangerous. By dangerous I mean manipulative, controlling, abusive, and demeaning. Some toxic people have a history of stealing, lying, cheating, conning, using charm to succeed, or using others. Once you identify the person’s tactics, thinking, and inappropriate behaviors, figure out how you should react, cope, or say goodbye. Re-routing your expectations and goals: Toxic people literally “pull” you into a relationship of some kind with them. They may want to become your spouse, your best friend, or your work partner. You have to be able to determine (based on what you know about them and how you feel in their company) if you need to re-route your goals and expectations. You would not want to set up long-term goals or expect great things from someone who simply wants to use you. If the person truly cares or likes and respects you, you’ll know. If not, you’ll know that too. Avoiding mental filtering: Mental filtering is what mental health professionals call cognitive distortions or thinking errors. It is a “skewed” way that we see reality based on emotion, incorrect ways we think about things, or skewed perceptions. Mental filtering is ignoring other aspects of something and picking out only one detail. If you find yourself picking out the positive aspects of the person and ignoring ALL of the bad, stop. It’s not going to help you. It’s hard but worth it. Considering your mental and emotional health: If the person is making you feel depressed, self-conscious, “stupid,” or any other negative emotion, move on. Some people, despite how kind you are, have an arrogant and detached demeanor that can offend others and make them feel less valued. Considering those you love and their needs: If the toxic person does not seem to mix well with those you love or makes those you love feel negative vibes, you may want to question why. Sometimes those closest to us can pick up on problems much faster than we can. Seeking therapy: Some toxic people, especially if they have been in your life for a long time, can ruin almost everything. Some people come to therapy for the simple purpose of “taking back” their lives after freeing themselves from a toxic spouse, parent, work partner, or friend. If you feel your relationship with the toxic person is heavily weighing on you, you might benefit from therapy to help you sort out what to do. Giving up the “yo-yo” pattern: Toxic people are often problematic people with behavioral and mental health problems. A toxic person may be so unhealthy that you begin to feel threatened or confused. When this happens, make plans to say goodbye, escape, or move on. A “yo-yo” pattern can include the person making you feel loved one moment and undermined the next, respected for a few weeks and disrespected during other weeks, praised one moment and demeaned the next. It’s not you, it’s them. Being determined to get out/move on: An unhealthy relationship of any kind is dangerous to your self-esteem. Unhealthy relationships often have no clear boundaries, little-to-no respect, no positive goals or aspirations, immature patterns of communication, and little-to-no positive characteristics. Getting out or moving on can be so very difficult. You might even begin to miss the person once they are gone. But you will have to figure out how to explore and work through this if the relationship is not worth the frustration you must tolerate. Understanding it is more than love / attachment / habit / dedication: Toxic relationships can feel like a “power” over you and that “power” does not always have to be love, attachment, or loyalty. Some people relate to this “power” as control, abuse, or manipulation. In other cases, some people refer to this power as a “spirit,” “sin,” or “evil power” that makes it hard to move on. So many of my former clients claim they were “held hostage” in their abusive relationships. What has been your experience with “toxic people”? As always, looking forward to your insights. All the best
The Difference between Panic, Manic, and Psychotic Attacks February 12, 2018 by April Brown Leave a Comment Panic Driving By Christine Hammond, MS, LMHC on www.psychcentral.com At first, everything seemed fine for Tess. She was driving back from visiting her parents a few hours away. Suddenly a flood of intense emotions, pounding heart rate, difficulty breathing, and erratic thoughts overwhelmed her. She pulled the car over hoping to catch her breath but things got worse. Life became a distorted kaleidoscope, with nothing familiar from before. She couldn’t remember where she was and where she was going. Even speaking was difficult. Having never experienced this before, Tess became frightened. The fear made her condition worse till she felt like her head was spinning out of control. It was impossible to rationally explain the event was so unlike anything she experienced before. In the past, the term nervous breakdowns described such an event. But this is not a diagnosable disorder; rather it is a cultural euphemism. Instead there are three possibilities for the condition described above. Each has unique characteristics with very different treatments. Panic Attack. One possibility is that Tess was having a panic or anxiety attack. For a person never experiencing this event, it can seem similar to the symptoms of a heart attack. The sudden onset of intense fear usually reaches a peak within minutes. Initially, most are unable to identify the fear that caused the event. It is only after some counseling that the trigger can be recognized and properly addressed. Other symptoms include: Pounding heart Sweating Trembling or shaking Shortness of breath Feelings of choking Chest pain Nausea Dizziness Chills or heat sensations Numbness or tinging sensations De-realization or depersonalization Fear of losing control Fear of dying It is important to rule out a medical condition first, so seek the help of a physician immediately. Once the physical symptoms have subsided and there is no finding other than a panic attack, a counselor can assist in discovering the cause. Untreated attacks can lead to an increase in the duration, frequency and intensity. Manic Episode. Another possibility is that Tess was experiencing a manic episode which may or may not be part of Bi-Polar Disorder or another type of depression. Unlike a panic attack, periods of mania tend to be longer lasting and have less panicky physical symptoms. Rather, the episode creates a larger than life impression. For a person experiencing this for the first time, it can increase anxiety so some of the symptoms of a panic attack could also be present. The main characteristics of mania are: Intense feelings of euphoria Fast speech, talkative Racing thoughts Impulsive and “high-risk” behaviors: shopping, gambling, sex Insomnia or feels rested after three hours of sleep Ideas of grandeur: can do anything Easily distracted Increase in goal-directed activity Discernable pattern of episodes It is best to see a psychiatrist to get a proper diagnosis of manic depression. The good news is that this condition is can be successfully treated with medication. This is a brain chemistry issue and not a manifestation of intense fear or anxiety. Brief Psychotic Episode. The last possibility is that Tess experienced a brief psychotic episode. While the name may sound a bit intimidating, the condition is more common than realized. This does not mean a person has a psychotic disorder, although it might be an indicator of one. Usually this lasts for a couple of hours to several days but not longer than a month. It has the following symptoms: Delusions (beliefs without any basis in reality) Hallucinations (hearing voices or seeing things that are not actually present) Disorganized speech Severely disorganized or catatonic behavior No discernable pattern of episodes To receive the best diagnosis, it is good to be treated in a mental facility for this condition. A combination of medication and rest might be just what is needed. Anyone can have a one-time episode; it is not a sign of weakness in any way. For Tess, it was determined that she experienced a severe panic attack. Her anxiety about the attack worsened her symptoms which made it look more like a brief psychotic episode. Once she learned how to manage the attacks, the intensity diminished.