Cognitive Behavioral Therapy for Anxiety

What is anxiety? Anxiety is a state of unrest in the mind and body. Each person perceives anxiety differently but typically it involves certain patterns of thinking (“what if …?” or, “I don’t feel ‘just right’.”). Some people have intrusive memories or nightmares about traumatic events that happened in the past. Some people experience obsessional thought patterns that are disturbing to them. They have a very difficult time stopping these thought patterns, if they can stop them at all. Also, many people feel anxiety in the body (e.g., muscle tightness, rapid heartbeat, shallow breathing, facial flushing, digestive changes, etc.).

Anxiety is not always bad. A certain amount of anxiety can be helpful in that it can be a clue for a person to take steps to improve performance on a task like speaking in public or taking an exam, or it can serve to motivate a person to take action or make a decision.

Too much anxiety can keep a person from living the life they want to live. Sometimes, when a person perceives their level of anxiety to be very high, they begin to choose to avoid situations that seem to prompt anxiety or do compulsive behaviors (or mental rituals) to lessen anxiety. The more a person engages in these rituals and/or avoids situations that make them anxious, the more they lose confidence and their natural ability to know when situations and thoughts don’t present real danger; they live in a cycle of fear and avoidance (and sometimes ritualizing). Over time, life becomes smaller, less enjoyable, and the person may feel sad or depressed.

The right treatment can help a person get back to living the life they want to live. Cognitive behavioral therapy (CBT) is a model of therapy in which a trained therapist helps a person understand and then change thoughts, feelings, and behaviors to achieve therapeutic goals. Research by psychologists has determined that CBT, done well, works to treat a variety of anxiety disorders (e.g., generalized anxiety disorder, panic disorder, social anxiety disorder, specific phobia) as well as other disorders that include anxiety as a core symptom (e.g., obsessive compulsive disorder and post traumatic stress disorder). It is evidence-based. CBT also works well to help people with less severe forms of anxiety that might not fit into a diagnostic category but still interfere with a person living they life they want to live. Additionally, CBT works to treat depression and many other behavioral and emotional issues that many people experience in combination with anxiety. Compared to some other forms of psychological treatment that might be more confined to talking in the therapy room, it is an “active” treatment. People who engage in CBT complete “homework” tasks designed to apply what they learn in the therapy office to their lives, where real change happens. Research suggests that people who actively participate in CBT experience reductions in anxiety, situational avoidance, compulsive behavior, depressive symptoms, and improvements in overall quality of life. We have specialized training in use of CBT to help people overcome anxiety; contact Dr. Farrell-Carnahan to discuss whether this treatment is right for you.

What about medication? Some people who have anxiety are prescribed certain medications called benzodiazapines and/or antidepressants. These medications can help to relieve anxiety, especially in the short term. However, research suggests, for long term relief from anxiety and situational avoidance, it is important to change the way one thinks, feels, and behaves in life. In other words, anxiety often comes back after the medications are stopped unless a person has learned new skills and ways of thinking through CBT. So, research suggests that CBT either in combination with medication treatment or alone, leads to more long-lasting benefits than medication alone. Because of this, if you choose to take medications while engaging in CBT with me, we will gladly work with your prescribing physician to coordinate care with your permission.