Dallas Anxiety Therapist

Everyone worries sometimes, and that's perfectly normal. What makes anxiety disorders different is that these worries last longer and often get worse over time if not addressed. There may not even be a source of the worry, such as being anxious about a big project at school or work, but rather a constant general sense of unease or sudden intense fear when nothing frightening happened. Many people with anxiety disorders also experience physical symptoms such as stomachaches or headaches. In fact, frequent stomachaches as well as restlessness are a hallmark of children with anxiety disorders. Children might not know how to label the actual feeling of anxiety, and the closest they can get is naming something they do know: "My tummy hurts!"

There are several different types of anxiety disorders, and the symptoms look different for each one. Here are some of the most common anxiety disorders and their symptoms.

Generalized Anxiety Disorder

Generalized anxiety disorder or GAD occurs when people experience ongoing worry about a variety of things. Rather than there being a specific trigger for anxiety, people with GAD worry about many different day-to-day things. This near constant worry contributes to additional symptoms of fatigue, restlessness, difficulty sleeping, and irritability. Unsurprisingly, it can be hard to get things done or socialize when you're worried all the time, so GAD can be quite disruptive to daily life.

Phobias

Phobias are actually the most common anxiety disorder, though it is in part because of how each separate one falls under the same broad category. Examples of phobias include the fear of spiders (arachnophobia), the fear of heights (acrophobia), the fear of blood (homophobia), the fear of throwing up (emetophobia), and so much more. The fear of social situations used to be known as social phobia, but now is its own separate disorder.

People diagnosed with phobias know that their fear is excessive and often irrational, but are unable to stop strong feelings of anxiety about specific things or situations. The intensity of the fear often impacts life as people avoid triggers, such as avoiding flying and missing out on personal or work trips.

Social Anxiety Disorder

Social anxiety disorder is an intense, persistent fear of being watched and judged negatively by others. It's a human response to want others to like us, but the intensity of the anxiety can feel debilitating to those with social anxiety disorder. While they want friends and to be close to people, just the thought of actually talking to someone can lead to a pounding heart, sweating, and difficulty speaking. These symptoms typically only reinforce the anxiety as individuals then worry that others will notice how worried they actually are.

People who are shy might have social anxiety disorder, they are not the same thing. It is common for people to feel uncertain and a little hesitant around new situations or new people. For some people, this comes out as shyness. Typically with a bit of time to adjust, shyness becomes easier to manage. However, social anxiety often persists before, during, and after the social situation unless treated.

Panic Disorder

Panic attacks are common. According to the Cleveland Clinic, about 1 in 10 people in the United States experience a panic attack every year. However, not everyone who has a panic attack has panic disorder. For this disorder, people experience panic attacks more regularly and often without any warning.

If you have had a panic attack, you might imagine how frightening it would be to get one on a regular basis. Sometimes people even mistake a panic attack for a heart attack due to irregular heartbeat or palpitations. While they feel scary and life threatening, panic attacks aren't physically harmful. But they can be mentally taxing, and many people worry about having one in public. That's why some people may also develop a related condition, agoraphobia. Agoraphobia is the fear of having a panic attack while around others and not being able to escape. This fear can result in people avoiding being around others entirely and staying home. However, some people with agoraphobia endure situations with intense fear, but they are still experiencing significant difficulty.

Separation Anxiety Disorder

Often people think of separation anxiety as only a childhood thing, and that kids will grow out of it. While this is true for developmentally appropriate separation anxiety, it isn't true for separation anxiety disorder. And separation anxiety disorder doesn't just affect children, but adults too.

So what is developmentally appropriate? According to Stanford Medicine, children under the age of three years old are likely to experience separation anxiety. Infants are still developing important cognitive skills to understand that when you leave the room, you aren't gone forever. By about three years old, children typically begin to understand that separations are temporary and adjust to periods without primary caregivers more readily. That doesn't mean that there won't be tears on day one of daycare, but by the end of the week, it should be a lot easier.

For children with separation anxiety disorder, they know that being away from home or loved ones is supposed to be temporary, but they can't stop worrying that something will happen to make it permanent. They might worry about a caregiver being sick or getting into an accident, or. that they will get lost and never find their way home again. Some even worry about being taken if they are alone in a room in their own house for more than a few seconds. Because they might not know how to talk about worries, these kids might also endorse headaches or stomachaches.

In adults, separation anxiety disorder often occurs alongside another anxiety disorder. Symptoms in adults is similar to that in children, but the focus might be different. Rather than worrying about being separated from caregivers, adults with separation anxiety may worry about being away from partners or spouses or even their own children.

Selective Mutism

Selective mutism typically begins before children are 5 years old, but may not be recognized until a child enters daycare or school. People with selective mutism have developmentally appropriate language skills and readily speak in certain environments, but not in others. You might have heard of "fight or flight," but there are actually more stress responses. While there are times that we may be able to run away or fight back, there are other times where neither are options. If you have nowhere to go and there's nothing to fight, then people can "freeze." In selective mutism, the anxiety associated with speaking becomes so great that they often freeze and literally can't. Some children with selective mutism can communicate in other ways, such as shaking their head or using thumbs up and thumbs down, but for others, any form of communication, verbal or nonverbal, are impacted.

There are also some mental health conditions that may be associated with anxiety, but aren't actually anxiety disorders. Obsessive compulsive disorder and post-traumatic stress disorder (PTSD) used to be classified as an anxiety disorders in previous versions of the DSM, but the DSM-5 separated them into their own categories. People with obsessive compulsive disorder also experience intense anxiety related to certain thoughts or actions, but the difference is that they are compelled to do something in response. For example, those who are worried about germs or illness may wash their hands after they touch anything, regardless whether or not it's dirty. Similarly, people who have experienced trauma might have post-traumatic stress disorder (PTSD) and experience symptoms of anxiety when reminded of the trauma. However, there usually isn't a specific memory that causes anxiety, but rather a broader situation that triggers worry.

The decision to start therapy is a personal one, and only you can decide what's best for you. Outcomes are never guaranteed, but some potential benefits from therapy include:

Development of Adaptive Coping Skills

Not all coping skills are created equal. Therapy helps you understand what coping skills you are using that are not that helpful and replace them with more helpful ones. For example, many think of procrastination as poor time management, but often it is a way that people deal with uncomfortable emotions. Maybe your child doesn't feel confident and are anxious about how well they can do something, so they avoid it. The project doesn't go away, but the discomfort does—temporarily. But as you're probably aware, procrastination only puts off the negative feelings, and those feelings may be more intense when your child realizes that now they have even less time to complete what you need to do. Helping children learn how to manage negative emotions and cope more effectively is one of the key benefits of therapy.

Better Physical Health

There is a strong link between mental and physical health. People with mental health issues are at increased risk of physical complications as well. For some people, particularly children, anxiety manifests physically in the form of stomachaches, headaches, and more physical symptoms. One recent study found that 70% of children with anxiety reported having stomachaches. For others, being anxious or depressed may make it hard to get out of bed and get exercise. By addressing mental health concerns, people can have not just better mental health, but physical health as well. Not only that, but many people with a substance use disorder have a diagnosable mental illness. Addressing anxiety disorders in youth can decrease the risk of later substance abuse.

Increased Life Satisfaction

Therapy can also help increase life satisfaction while also improving mood and general mindset. It makes sense that if you're feeling better emotionally (and likely physically as well) that you feel better about life in general. So it's no surprise that better mental health is strongly associated with increased life satisfaction.

Better Workplace and Academic Achievement

Another related benefit: people engaged in counseling typically use fewer sick days, experience less disability, report fewer medical problems, and endorse increased work satisfaction. Not only is your child or teen more likely to go to school, children engaged in therapy also have better overall academic achievement, including specific improvements in reading, language, and math.

Improved Communication Skills and Family Relationships

That improved language grade doesn't just show up at school! Counseling can help people of all ages develop communication skills that in turn improve the quality of relationships with family, friends, and others. When a child changes their thoughts, feelings, and behaviors, it can also benefit the entire family by reducing parental stress and sibling conflict.

Long-Term Benefits

Several different studies have found that the benefits from counseling interventions are substantial and continue to improve following therapy completion. Additionally, the benefits tend to be comparable or exceed those of medications alone for mental health issues.

In general, research finds that the specific treatment modality actually doesn't make that much of a difference. The relationship between the client and counselor is one factor that often generates the most improvement. Collaboration between the client and therapist, alliance, and empathy are generally regarded as the most important things for establishing a working therapeutic relationship, so I have made them the cornerstones of my practice. I also focus on utilizing forms of therapy that meet my clients where they are developmentally. I work with each client and their families to determine what form of treatment is the best fit for them personally.

Everyone is different, and the length of treatment can vary based on a variety of factors. According the the American Psychological Association (APA), about half of those in therapy recover after 15 to 20 sessions. Children may take slightly longer with an average of 20 play therapy sessions needed to recover according to the Association for Play Therapy. To put it another way: if those twenty sessions are conducted weekly, the average time spent in counseling would be approximately four months.

However, both the APA and Consumer Reports find that long-term treatment does better than short-term treatment. And depending on why people come to therapy, they may need more time to achieve their goals. People with co-occurring conditions (such as both severe anxiety and clinical depression) or significant trauma may require treatment for closer to 12-18 months.

So essentially: it depends. I work directly with my clients to create a treatment plan that’s customized to their needs. I've helped some children in only ten sessions, but I've worked with some children for much longer. I always collaborate with my clients and their families so that they understand the treatment that they are getting and have opportunities to discuss length of treatment.