Anxiety and depression are the most common forms of mental health disorders. According to the World Health Organization (WHO) Report 2017, 38 million Indians suffer from Anxiety disorders. While severe cases require supportive medication for treatment, many therapeutic techniques have been found to be useful in coping with anxiety.
There are several identified forms of anxiety disorders like panic disorder, obsessive-compulsive disorder, generalized anxiety disorder, social anxiety disorder, and post-traumatic stress disorder. Both counseling for anxiety and therapy for anxiety have been found to be beneficial in coping with these disorders.
There must be multiple instances in life when you can recollect having experienced anxiety- before an exam, giving a presentation in front of class or colleagues, sitting for an important viva or interview, and even with your crush passing by. It can feel like butterflies in the stomach, heart racing faster than usual, tightness in the chest, upset stomach, pain in the limbs, feeling numb, nauseous, restless, or even difficulty in breathing.
While some extent of anxiety is normal and part of our daily lives, when it starts getting out of hand preventing us from realizing potential and living life to the fullest affecting personal, social, occupational functioning, it is indicative that we need to seek help and do something about it. Anxiety disorder is characterized by persistent and excessive worry. It is a diffuse, vague feeling of fear and apprehension- ‘Something bad is going to happen.’
As anxiety has many bodily manifestations, most people first reach out to general physicians and doctors to make sense of the situation to realize that there is a psychological explanation for it.
Therapy for anxiety disorders helps in understanding root causes, identifying triggers, and regulating emotional and behavioral responses. Therapy can also be helpful in recognizing and reframing negative thinking patterns which also leads to a change in how you feel and respond towards it. Anxiety may manifest differently for different individuals and therapy is tailored according to the unique needs and strengths of individuals. Intensity, duration of symptoms are also factors under consideration while devising treatment plans.
Choice of therapeutic approach is influenced by factors like an individual’s personality, symptom severity, preferred therapeutic modality of the therapist, and others. Some of the most commonly used approaches in anxiety counseling and anxiety therapy are listed below.
Cognitive Behavioral Therapy
This is the most popular approach used in treating anxiety disorders. The basic tenet of cognitive behavioural therapy is that thoughts about a situation, rather than the situation itself, are responsible for how you feel and how you react. A negative thinking pattern leads to the experience of difficult emotions like sadness, anger, anxiety further making you behave in an unhelpful manner.
When you are able to identify and replace negative unhelpful thoughts with functional ones, you tend to feel better about the situation and are able to adopt effective ways of functioning to cope with the situation at hand. In this approach, a therapist acts like a coach helping you learn effective strategies like understanding common distortions in thinking- all or none, generalization, catastrophizing, personalization, and many others. It takes consistent efforts to adopt these strategies and develop coping skills for managing emotions.
When there is anxiety around any particular situation, event, object it is likely that the person keeps avoiding the particular trigger. As avoidance helps the person feel safe, this way anxiety keeps getting reinforced. The premise of exposure therapy lies in the fact that exposure is the best way to conquer any fear, discomfort, anxiety surrounding a situation.
This may involve making a list of most feared to least anxiety-provoking situations. The person is first trained in relaxation techniques, then exposed to the least anxiety-provoking situation, helped to deal with it while remaining calm and composed, eventually moving towards situations perceived as more threatening for the individual.
The graded exposure alongside the use of relaxation techniques is called systematic desensitization. Exposure to a feared stimulus can be real, imagined, or virtual.
Dialectical Behavioral Therapy
Dialectical behavioral therapy helps to develop an alternate perspective, gain acceptance while working towards change. DBT helps in dealing with anxiety by targeting four areas of mindfulness, building distress tolerance, managing interpersonal relations effectively, and emotional regulation.
Mindfulness allows the person to be consciously present in the ‘here and now’. It allows the person to notice his/ her thoughts without engaging with them, taking away their power to disturb them. Distress tolerance refers to learning active skills to manage anxiety while dealing with a triggering situation by the use of various grounding techniques.
Counseling for anxiety may include learning to manage interpersonal relations effectively by being able to communicate your needs clearly, having difficult conversations, and ability to say no.
Psychoanalytic therapy for anxiety
According to this approach, anxiety stems from unresolved conflicts. The nature of these conflicts can also be unconscious in some cases and may require years of work in therapy to uncover these hidden conflicts. Innate deepest thoughts, fears, and desires are explored in-depth to develop awareness and insight into anxiety.
Once conscious awareness is developed, it is likely that the individual is able to understand herself/himself in a better way and make conscious choices with available information and resources.
have started gaining more acceptance and popularity in recent times. Targeting thought may not work for all individuals in dealing with anxiety. Experience-oriented therapy has been found to be useful with such clients. It may involve the use of art, movement, music to connect with the present moment, understand and process emotional experience.
These modalities can help to practice mindfulness along with providing additional relaxation. It may be used alone or in combination with other approaches.
While all these therapeutic modalities have their strengths and limitations, the approach that works best for you is a matter of discovery, exploration, experimentation in the journey of healing. If you feel that you have been living with anxiety for a while now and it affects your day-to-day functioning, it is important that you reach out and seek support from a mental health professional.
If you feel that your concerns are stemming and culminating from present-day stressors and feel uncomfortable delving deep into childhood, you can convey that to the mental health professional and opt for anxiety counseling rather than therapy for anxiety. In some cases, however, focusing on present life issues might not be enough in eradicating anxiety requiring work on deeper issues through therapy for anxiety.
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