Anxiety, OCD, & Panic Therapy
When you attempt to eliminate risk from your life, you eliminate along with it, your ability to function.
- Fred Penzel
Severe anxiety - whether it be in the form of OCD, Panic Disorder, Agoraphobia, or Generalized - can be debilitating. It can feel impossible to stay present, to keep relationships, to leave the house, to experience new or different environments, to eat, or even feel normal body sensations without distress.
In the pursuit of safety, you feel your world getting smaller and smaller.
Whether you’ve been struggling for years or this is a new development - you’re not alone. There is hope.
Let’s Break it Down
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Obsessive Compulsive Disorder (OCD) is often called “the doubting disorder”. OCD is the label for the collection of symptoms involving obsessions and compulsions. It is not just a preference or things to be in order, clean, or perfect.
Obsessions are intrusive, unwelcome experiences such as thoughts, images, urges, or feelings. They can have themes, such as contamination, or be more abstract. Compulsions are sometimes called “rituals” that a person does to reduce (or stop or avoid) the anxiety that they feel because of the obsession. Compulsions can be observable like blinking or repetitive hand-washing or mental, like rumination.
OCD is diagnosed by distress, impairment, and the time spent performing the rituals. On the outside, someone might look like they are functioning well, but on the inside they feel like they are losing control and in great distress.
It’s hard to live the life you want to live when we are at the whims of intrusive thoughts and OCD.
For more information about OCD - check out my resources.
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Panic disorder is characterized by recurrent and often unexpected panic attacks. A panic attack is when your body goes through a fight or flight response - an autonomic nervous system response - that can include:
rapid heart rate
sweating, chills, or heat sensations
chest pain, body pains
difficulty breathing, swallowing, or feeling of choking
numbness or tingling in lips, face, or extremities
shaking or trembling
nausea or gastric issues
dizziness, vaso-vagal reactions, lightheaded, faint
impending sense of doom/fear of dying/
fear of going crazy or losing control
depersonalization or derealization
It is common for people with panic disorder to worry about having another panic attack. Someone might make behavioral changes as a result of this fear, such as avoiding people, places, or things that they associate with the attacks.
It is possible that someone could have panic attacks but not have panic disorder, as panic attacks can occur due to other issues. Panic attacks are also seen in other anxiety disorders, such as post-traumatic stress disorder and generalized anxiety disorder.
Living a life full of your values and desires can feel difficult - or impossible - when you are struggling with avoidance caused by panic attacks.
Check out my resources for more information and self-help guides.
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While the word literally means “fear of wide, open spaces”, people who have the diagnosis of agoraphobia might have extreme fear or anxiety of other types of situations:
being outside of safe place (home, office, etc.) alone without a support person
being in a crowd or standing in line
using public transportation
being enclosed places such as movie theaters or stores
Someone who has agoraphobia might avoid these situations because they are fearful that they will not be able to escape or get help if they develop panic-like symptoms or other incapacitating or embarrassing symptoms. In turn, that significant distress causes the person to avoid these situations and significantly impair major areas of functioning.
It is possible that someone could have anxiety or avoidance symptoms but not have agoraphobia. For example, if someone only avoids social situations, a social anxiety disorder might be diagnosed instead. Likewise, if a person avoids places that remind them of a traumatic event, post-traumatic distress might also be a better fit. Other issues associated with avoidance are depression, specific phobias, OCD, and separation anxiety if symptoms are better accounted for.
Lastly, if a person is avoiding these situations due to concerns related to a medical condition, the anxiety and avoidance must be excessively impairing (limiting the life someone wants to live).
Living a life that is meaningful to you can be difficult when managing agoraphobia’s avoidance.
Check out my resources for more information and self-help guides.
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Generalized Anxiety Disorder (GAD) is characterized by “persistent and excessive worry” about many things. People who struggle with GAD find it difficult to control their worry and may not be able to ‘turn off’ concerns about money, health, family, work, etc. They might worry about actual events or spend time catastrophizing - or expecting the worst - even when there is no apparent reason for concern.
GAD’s symptoms are diagnosed by excessive worry occurring more days that not for at least 6 months about a number of events (i.e. not just focused on a couple themes like OCD).
Living your life feels full & meaningful to you can feel impossible when trying to manage symptoms of generalized anxiety.
Check out my resources for more information and self-help guides.
My approach to anxiety, panic, & OCD therapy.
Anxiety, panic, & OCD symptoms feel different to each person and usually focuses around the things you care about. I use a blend of assessments to give us a good picture of how the effects of anxiety - like avoidance - is showing up in your life.
We will discuss what diagnosis - or none at all, if preferred (see FAQ on diagnosis) - fits and then design your own personalized goals in therapy.
I am trained to use various modalities specifically researched to treat anxiety, panic, & OCD symptoms, regardless of your choice to pursue a diagnosis. Some of my most used are: Acceptance & Commitment Therapy (ACT), Exposure & Response Prevention (ERP), Inference Based Therapy (ICBT), Internal Family Systems (IFS)-informed Parts Work, Emotional Freedom Techniques (EFT), and Somatic/Experiential interventions. These modalities focus on changing your relationship to anxiety, calming the autonomic nervous system, providing crucial empowering psychoeducation, and can utilize safe & compassionate exposure techniques.
I will always approach exposure work with what works for you and will never ask you to do something that I have not done before or would not be willing to do myself. Please read more on Exposure & Response Prevention here.