Anxiety & OCD Treatment

Anxiety & OCD Treatment

Offering behavioral therapy in-person and via telehealth for anxiety, OCD, & related disorders.

What is an Anxiety Disorder?

An anxiety disorder is when a person has excessive fear of a specific object or situation or has uncontrollable worries about potential future events, typically with fears that the worst-case scenario will occur and that one could not handle it. Anxiety is often accompanied by physical symptoms in the body, such as a racing heart, sweating, rapid breathing, stomach discomfort, or muscle tension, and perhaps alongside other symptoms like trouble with concentration or sleep, feeling restless or on edge, fatigue, or irritability.

When a person feels anxious, they may behave in certain ways to try to reduce their discomfort, such as avoiding or escaping certain situations, bringing “safe people” with them, seeking reassurance from others, or procrastinating.

Of course, some anxiety is normal and even helpful, but excessive anxiety that is persistent, difficult to control, interferes with life, or is distressing, is considered to be an anxiety disorder.

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The core feature of most anxiety disorders is an “intolerance of uncertainty,” that is, difficulties facing and accepting the unknown – and life is full of unknowns! If you believe you may be suffering from an anxiety disorder, you are not alone. Research has found that anxiety disorders affect 15.7 million individuals in the United States every year, and 30 million people in the United States at some time point in their lives.

There are several different types of anxiety disorders, which vary in terms of the types of situations or objects that cause the anxiety and/or are avoided. These subtypes include:

Generalized Anxiety Disorder:

Excessive, persistent, and difficult to control worry about a number of events or activities such as school or work, finances, relationships, health, safety, minor matters, or community/world affairs. These worries are often accompanied by symptoms of restlessness, fatigue, irritability, muscle tension, or difficulties with concentration or sleep.

Social Anxiety Disorder:

Strong anxiety of social situations in which one fears being negatively judged by others, or that one may do or say something that will be humiliating or embarrassing. These feared social situations may include social interactions (e.g., initiating conversations, talking on the phone), performance situations (e.g., giving a presentation), or being observed by others (e.g., eating in public, using public restrooms).

Panic Disorder:

Frequent panic attacks which are characterized by a sudden increase in at least 4 physical symptoms such as rapid heart rate, sweating, shaking, shortness of breath, feelings of choking, chest discomfort, nausea/stomach distress, lightheadedness, chills/heat, numbing/tingling, feeling detached, and a fear of losing control, going crazy, or dying. These panic attacks must also be accompanied by a persistent worry that one will have additional attacks or that there will be negative consequences, or changes in one’s behavior because of the attacks, such as avoiding certain places or activities or only going places with someone.

Agoraphobia:

Severe anxiety in at least 2 of the following 5 situations due to fear that one may have panicky or embarrassing symptoms and that escape may be difficult or help may not be available: i) enclosed spaces, ii) open spaces (e.g., parking lots, bridges), iii) transportation, iv) standing in line or being in a crowd, and v) being outside of the home alone. These places are often avoided or only visited with a trusted person.

Specific phobias:

Strong fear of a specific object or situation such as driving, flying, vomit, insects, heights, receiving a shot, and so forth. Typically, this object or situation is actively avoided, or if that is not possible, it is endured with intense fear. The fear or avoidance must be to the extent that it interferes with one’s life or is very distressing.

Illness Anxiety Disorder:

Also known as health anxiety. Excessive fear and concern about having or getting a serious medical condition or illness that is disproportionate to its true likelihood. This is accompanied by unhelpful health-related behaviors such as repeatedly checking one’s bodily symptoms or vital signs, spending hours searching the internet for health-related information, or avoiding going to the doctor or going too frequently.

Separation Anxiety Disorder:

Excessive fear about possible separation from close others (e.g., parents, caregivers) that is developmentally inappropriate. This typically involves frequent and excessive distress or physical symptoms of anxiety when thinking about or separating from home or a close other, persistent worry about losing close others or potential harm that may come to them, excessive anxiety about a negative event that may cause separation, recurrent reluctance to go out or be home alone due to fears of separation, or frequent nightmares about separation.

What is OCD?

Obsessive-compulsive disorder (OCD) is defined as having unwanted and intrusive thoughts, urges, or images that cause intense distress (i.e., obsessions), often with accompanying efforts to get rid of these thoughts by pushing them away or performing a ritual (i.e., compulsions). The main emotions that are typically present in OCD are high levels of fear, anxiety, disgust, guilt, and shame. OCD can cause significant impairment and distress in a person’s life, as it may take hours per day to perform all of the compulsions, or the thoughts may be present for much of the day causing severe distress. OCD is a common disorder, with a lifetime prevalence in the United States of 2.3%, meaning that it will affect about 7.6 million people in the United States at some time point in their lives.

Commonly known types of OCD include fears of contamination leading to cleaning rituals, or doubts about appliances being left on or doors being unlocked leading to checking behaviors. OCD can also take many other forms, such as doubting one’s sexuality or gender, having intrusive and unwanted thoughts about harming loved ones or vulnerable people (despite having absolutely no desire to do so), repeating tasks until they feel “just right,” or strong superstitious beliefs about having to do a certain activity in a specific way to prevent harm, just to name a few. It is important to note that compulsions are not always observable behaviors such as handwashing or checking, but often take the form of mental compulsions that are unobservable to others, such as mentally reviewing one’s past actions or repeating something in one’s mind. Another common behavior to try to manage OCD symptoms is avoidance of any potential triggers of one’s OCD, such as avoiding certain types of people, places, or objects, so as not to trigger the obsessions.

There are other difficulties that are related to but distinct from OCD, which include: