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Anxiety Disorders

Anxiety is a blanket term that covers a range of mental disorders. Although  I am trained to work with specific anxiety disorders, you do not need a diagnosed anxiety disorder to start therapy. Although general anxiety / stress / worry etc. is a natural part of human experience, a lot can still be done to reduce these feelings.

 

Specific anxiety conditions that I work with include generalised anxiety disorder (GAD), panic attacks, agoraphobia, social anxiety disorder, specific phobias, post traumatic stress disorder (PTSD), and obsessive compulsive disorder (OCD).

For many people, anxiety is experienced as a feeling of worry, dread, or apprehension about something in the future; and is experienced by all of us at some point in our lives. When severe, anxiety can hold us back from accomplishing what matters in life, as the feelings of worry become blown out of proportion.

 

Fortunately, there is a lot that can be done to reduce these unwanted feelings, so that you can get back to living life more fully. There are two different neurological pathways that create anxiety. In our sessions we will work with both of those pathways to maximise the effects of therapy.

Anxiety
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Generalised Anxiety Disorder

The core feature of Generalised Anxiety Disorder (GAD) is worry. The sense of apprehension, or worry isn't focussed on one thing in particular, but is best thought of as a broad sense of apprehension, fear, or dread that encompasses many different areas of life. Alongside these feelings of worry, someone with generalised anxiety disorder may also experience difficulty concentrating, and may become irritable more easily.

Generalised Anxiety Disorder also has physical symptoms that are experienced alongside the cognitive components mentioned above. The physical symptoms may include: difficulty sleeping, fatigue, restlessness, muscle tension, heart palpitations, shortness of breath, excessive sweating, stomach aches, nausea, and headaches.

Generalised Anxiety Disorder can often be a chronic condition, that in many cases precedes the onset of depression. It's not possible to completely get rid of anxiety, but various interventions can significantly reduce the symptoms, leading to a much happier, more fulfilling life.

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Panic Disorder

Panic disorder otherwise referred to as panic attacks describe a sudden onset of discomfort, or fear. People commonly feel a sense of loosing control, a fear of death, a fear they are 'going crazy' or a sense of unreality / detachment. These feelings are accompanied by very intense physical symptoms, such as dizziness, shortness of breath, heart palpitations, trembling or shaking, chest pain, nausea, excessive sweating, light headedness, hot or cold flashes, and a sense of choking.

Having a panic attack can be a terrifying experience. Due to the nature of the intense physical sensations, it's not uncommon for someone to jump to the conclusion that they may be having a heart attack. This may prompt a visit to A and E, where more serious conditions will be ruled out.

Panic may be experienced as a part of other anxiety disorders, where it is preceded by worrying thoughts, or a specific stressful event. What differentiates those bouts of panic from Panic Disorder specifically, is that the occurrence of the attack is unforeseen (not connected to a specific situation, of thought process). It's as though the attack starts for no specific reason, and comes out of no where.

Once someone has experienced a panic attack they may become apprehensive about going out, or avoid going to the same place or environment where the attack occurred. Unfortunately these avoidance behaviours can lead to agoraphobia, and a general worsening of the the condition.

Panic attacks usually last between 5 and 20 minutes, but despite the intense physical symptoms they are not usually dangerous - assuming that more serious, physical health problems are ruled out.

There is a lot we can do to reduce the occurrence, and severity of Panic Disorder, if you have been experiencing panic attacks, please get in touch to find what can be done.

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Agoraphobia

Agoraphobia is a complex anxiety disorder characterised by an intense fear and avoidance of situations or places that are perceived as difficult to escape from or where help may not be readily available. People with agoraphobia often feel a sense of panic, discomfort, or dread when facing such situations, leading them to actively avoid them or endure them with extreme distress.

 

Individuals with agoraphobia commonly avoid places like crowded public spaces, or public transportation, or situations where they might be far from home. The fear of having a panic attack or experiencing embarrassing symptoms in public becomes a significant concern, contributing to avoidance behaviors. This fear is often disproportionate to the actual danger posed by the situation, but the person's perception is driven by anxiety and the desire to avoid distressing experiences.

 

Agoraphobia can significantly impact one's daily life, limiting their ability to participate in social activities, work, or even carry out routine tasks outside the home. The condition can cause feelings of isolation, frustration, and a sense of being trapped. Over time, the avoidance behavior can lead to a self-perpetuating cycle, reinforcing the fear and making it increasingly difficult for individuals to break free from its grip.

 

The causes of agoraphobia are multifactorial and can involve a combination of genetic, environmental, and psychological factors. Traumatic experiences, such as a history of panic attacks, a traumatic event, or a previous experience of feeling trapped or helpless, may contribute to the development of agoraphobia. Some individuals may also have a genetic predisposition to anxiety disorders, making them more vulnerable to developing agoraphobia.

 

Cognitive-behavioral therapy (CBT) is often used to help individuals identify and challenge irrational thoughts and beliefs that contribute to their anxiety. Reducing avoidance behaviours also plays a key role in agoraphobia interventions.

It's important for individuals with agoraphobia to seek professional help from a qualified mental health practitioner who specialises in anxiety disorders. With appropriate support, many people with agoraphobia can experience significant improvement in their symptoms, and are able to regain a better quality of life.

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Social Anxiety Disorder

Social anxiety disorder, also known as social phobia, is a mental health condition characterised by an intense and persistent fear of social situations. People with social anxiety disorder experience excessive anxiety and become overly self-consciousness in social interactions, leading to significant distress and impairment in various areas of their lives.

 

Individuals with social anxiety disorder often worry excessively about being judged, embarrassed, or humiliated by others. They may fear that their actions, appearance, or speech will be negatively evaluated, which can trigger intense anxiety symptoms. Social situations that commonly provoke anxiety include public speaking, meeting new people, participating in group activities, or even simple everyday interactions.

 

The fear and anxiety experienced in social situations can be so overwhelming that individuals with social anxiety disorder may avoid or endure these situations with extreme discomfort. In response to this, a person with Social Anxiety Disorder may isolate themselves, decline invitations, or rely heavily on safety behaviours such as avoiding eye contact, rehearsing conversations in advance, or develop maladaptive coping strategies, such as using alcohol, to alleviate the anxiety.

 

The causes of social anxiety disorder are complex and can involve a combination of genetic, environmental, and psychological factors. An individual's genetic predisposition, combined with environmental factors like upbringing and life experiences, can contribute to the development of the disorder. Traumatic or embarrassing experiences in social settings, such as bullying or public humiliation, may also play a role.

 

Cognitive-behavioural therapy (CBT) is a commonly used psychotherapeutic intervention for social anxiety disorder. CBT helps individuals to identify and challenge negative thought patterns and beliefs which are associated with social situations. The aim of the interventions are to gradually exposing the individual to feared situations which helps build confidence, and reduce anxiety.

 

It is important for individuals with social anxiety disorder to seek professional help. With appropriate interventions and support, many people with social anxiety disorder can experience significant improvement in their symptoms and enhance their ability to engage in social interactions, leading to a more fulfilling and balanced life.

Specific Phobia

Specific phobias are anxiety disorders characterised by an intense and irrational fear of specific objects, situations, or activities. Unlike General Anxiety Disorder (GAD), which may involve a range of concerns, specific phobias are focused on a particular trigger which cause significant distress. Distress caused by Social Phobia is often associated with avoidance behaviours, which tend to result in the exacerbation of the phobia.

 

The fear experienced in specific phobias is excessive and disproportionate to the actual threat posed by the trigger. Common specific phobias include fear of animals (such as spiders, snakes, or dogs), fear of heights, fear of flying, fear of needles, and fear of enclosed spaces.

 

When confronted with the phobic trigger, individuals with specific phobias may experience immediate and intense anxiety symptoms. These can include rapid heartbeat, shortness of breath, trembling, sweating, and a strong desire to escape or avoid the feared stimulus. The anticipation of encountering the phobia can also lead to persistent anxiety and preoccupation.

 

The causes of specific phobias can be multifactorial. Some phobias may develop in childhood due to a traumatic or distressing experience involving the feared stimulus. For example, a person who was bitten by a dog as a child may develop a phobia of dogs. Other phobias may have a genetic or familial component, suggesting a predisposition to anxiety disorders. Cultural and environmental factors can also influence the development of specific phobias.

 

The main intervention for specific phobias often involves cognitive-behavioural therapy (CBT). One commonly used CBT technique is exposure therapy, where individuals are gradually exposed to the feared stimulus in a controlled and supportive environment. This exposure allows them to confront their fears and learn that the perceived threat is not as severe as initially believed. CBT also involves identifying and challenging negative thoughts and beliefs associated with the phobia.

 

It is important for individuals with specific phobia to seek professional help from a qualified mental health practitioner. With the right support, many people with specific phobias can experience significant improvement in their symptoms and regain some control over their fears, allowing them to live more fulfilling and less restricted lives.

Grief and Bereavement

Grief and bereavement are natural responses to the loss of a loved one. They encompass a range of emotions, thoughts, and behaviours that individuals experience when faced with the death of someone significant to them. The grieving process is deeply personal and varies from person to person, often being influenced by cultural, and religious factors.

 

When someone experiences a loss, grief is the emotional response that follows. It is a complex and multifaceted experience that can involve intense sadness, disbelief, anger, guilt, confusion, and a profound sense of emptiness. Grief can also manifest physically, leading to changes in appetite, sleep disturbances, fatigue, and various somatic symptoms. It is important to note that grief is not a linear process and does not have a specific timeline. It is a unique and individual journey that evolves over time.

 

Bereavement refers to the period of mourning and adjustment following a loss. It encompasses the various tasks and processes individuals go through to come to terms with their loss and adapt to a life without the presence of their loved one. Bereavement can involve psychological, social, and practical challenges as individuals navigate the emotions and changes brought about by the loss.

 

The grieving process typically involves several stages, as described by Elisabeth Kübler-Ross: denial, anger, bargaining, depression, and acceptance. However, it is important to remember that these stages are not necessarily experienced in a linear or predictable manner. People may move back and forth between stages or experience them differently. Each person's grief journey is unique and influenced by their own circumstances, and coping mechanisms.

 

Support from family, friends, and the community plays a vital role in the bereavement process. Having a network of understanding individuals who can provide emotional support, practical assistance, and a safe space for expression can be incredibly beneficial. Grief support groups and counselling services are also available to help individuals navigate their grief and provide a sense of validation and understanding.

 

It is crucial to allow oneself to grieve and to honour the memory of the deceased. This can involve rituals, traditions, or personal acts of remembrance that hold significance for the individual and their culture. Taking the time and space to process emotions, share memories, and find meaning in the loss can contribute to the healing process.

 

While grief is a natural response to loss, some individuals may experience complicated grief, which is characterised by prolonged and intense symptoms that significantly impair their ability to function. In such cases, seeking professional help from a mental health practitioner or grief counsellor is recommended.

 

Grief and bereavement are deeply personal experiences that reflect the unique bond and connection individuals had with their loved ones. It is important to approach them with compassion, understanding, and patience, allowing individuals to navigate their grief in their own way and at their own pace.

 

As well as the Kübler-Ross model mentioned above; William Worden's task-based model is a widely recognised framework that outlines the tasks involved in the process of grief and bereavement. This model provides a helpful structure for understanding and navigating the various aspects of grieving. 

The grieving process is highly individual, and there is no "right" or "wrong" way to grieve. Each person's grief journey is unique, and the model simply provides a framework to support individuals in their healing process.

Depression

Depression

Depression, also known as Clinical Depression or, Major Depressive Disorder, is more than just feeling a bit down. Depression is characterised by extreme or persistent sadness, and/or sense of hopelessness that lasts for 2 weeks or more. Depression can also involve a loss of pleasure, or interest in most activities.

 

Many of us will become depressed at some point in our lives. Often we become depressed when we’ve experienced big changes in our lives, that create feelings of loss, and a sense that things aren't the same as they once were.

There are many different symptoms of depression, and although an all-encompassing sense of low mood is the main constituent of the disorder, people do experience aspects of depression differently. Depression has a range of psychological, physiological, and social / behavioural symptoms such as:

  • Felling down or upset 

  • Regularly feeling tearful

  • Feeling agitated or irritable

  • No longer feeling pleasure from the activities that you would usually enjoy

  • Feeling hopeless

  • Feeling a sense of despair

  • Experiencing an overbearing sense of guilt

  • Feeling a sense of worthlessness, or helplessness

  • Feeling lonely, isolated or as though you are unable to relate to others

  • Feeling that you have lost your confidence

  • Having low self-esteem

  • Having recurring thoughts of death or suicide

  • Moving or speaking more slowly than usual 

  • Changes in appetite, or weight

  • Changes in bowel movements

  • Unexplained aches and pains

  • Lack of energy

  • Loss of libido

  • Changes in menstrual cycle

  • Disturbed sleep

  • Struggling to concentrate

  • Avoiding social interactions

  • Being less interested in life, and things that would usually bring joy

  • Neglecting keeping up with hobbies

In some cases, depression can also be caused by some medications, and drug, or alcohol dependency.

Many of the symptoms listed above can also be experienced by people who are bereaved, but despite an overlap of symptoms, we wouldn't refer to bereavement as clinical depression. Regardless of this, it can often be useful for people who are experiencing grief, and bereavement to come forward for therapy.
 

Depression can be mild, moderate, or severe, but it is always best to seek help sooner rather than later; if you think you are depressed.

OCD

OCD

Obsessive Compulsive Disorder, also known as OCD is a serious anxiety disorder, that should not be overlooked. OCD has a wide range of presentations, where many of the associated behaviours are concerned with checking things, fears of becoming contaminated, mental contamination, hoarding, ruminating, or experiencing unwanted, intrusive thoughts. In OCD, these behaviours, or compulsions, are driven by obsessions. An example of this might be that someone is worried that their house will be broken into, and so they feel compelled to check that the door is locked an excessive number of times.

 

If left unmanaged, the self exacerbating nature of OCD can begin to have a seriously debilitating effect on a person’s livelihood.

stress

Stress

The stress response is our body’s natural response to dangerous situations, and also the general pressures of daily life. When stressed, we often feel as though we are rushing around doing a million things, but that we are not getting anything done. Being highly stressed can seriously interfere with our ability to deal with life’s responsibilities efficiently, and it is important we learn useful techniques for reducing our stress levels.

 

People often think of stress as a mental state, but really it’s an extreme physiological response, or state of arousal. This heightened state of arousal has a damaging effect on our bodies, which is why it’s important to take action if we feel stressed on a regular basis.

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