Can Therapy Make Anxiety Disorders Worse?

  “I don’t want to talk to a therapist, it will just make me feel more anxious.” Have you ever had this thought? Or have you ever heard an anxious friend or family member say this in response to suggesting therapy? It’s not uncommon to think this way, and it’s not wholly wrong. There’s truth to the notion that therapy may intensify emotions, including anxiety. However, it doesn’t tell the full story.   There’s truth to the notion that therapy may intensify emotions, including anxiety. However, it doesn’t tell the full story.

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WHAT IS ANXIETY?

Anxiety involves persistent feelings of anxiousness, tension, nervousness, or dread. It is the most common mental health disorder in the U.S., affecting more than 40 million Americans. This includes roughly 19% of adults and 7% of children ages 3-17, according to data from the National Alliance of Mental Illness. Anxiety manifests in different ways. The most common forms of anxiety disorders include:

• Generalized anxiety disorder
• Panic disorder
• Phobias
• Social anxiety disorder
• Obsessive compulsive disorder (OCD)
• Post-traumatic stress disorder (PTSD)

A psychiatric evaluation can help determine what type of anxiety you may have. In many cases, therapy may be recommended to help treat anxiety disorders.

WHAT IS THERAPY FOR ANXIETY?

Therapy is considered to be the most powerful method for treating anxiety. The fear that therapy will increase anxiousness is a common misconception that may dissuade people with anxiety disorders from seeking therapy. More accurately, therapy for anxiety is a process that requires facing what is driving one’s inner distress. It’s true that this can be anxiety-provoking short term. Addressing the root cause of an individual’s anxiety—whether it stems from negative beliefs, past trauma, or poor social skills—necessitates some level of temporary discomfort. Ultimately though, successful therapy yields lasting benefits of diminished anxiety and greater mental health and well-being. Here’s a more holistic look at therapy and how it can help you or a loved one struggling with anxiety.

WHY THERAPY CAN MAKE YOUR ANXIETY WORSE, TEMPORARILY

Let’s face it. There’s a lot about therapy that may make an anxious person even more nervous, initially. The very idea of needing help and accepting help from a stranger (albeit a credentialed, professional one) can cause anxiety levels to rise! Though there are many types of anxiety disorders, the American Psychological Association reports that research shows they all share certain similarities. For example, as a way to cope, anxious people generally tend to avoid situations or experiences that increase their anxiety. Yet while avoidance may offer temporary relief, it more often backfires and makes anxiety worse. Therapy will usually touch on the very things that make you anxious and encourage you to explore your feelings surrounding them. When your strategy has been avoidance, approaching tough issues directly can be very anxiety provoking at first. This is especially true if you carry shame about yourself or your own behavior in general. Therapy requires that you face many of your fears. The willingness to engage in therapy takes courage. Vulnerability is not easy. For example, if you go to therapy for support in recovery from addiction, you may be confronted with big feelings that have been pushed down, sometimes for years. It’s not uncommon for complicated grief to emerge as there’s a recognized bidirectional relationship between grief and substance abuse. Therapy provides a safe place for recovering addicts to confront painful feelings of grief, sometimes for the first time. Anxiety often lurks in these areas of the psyche, but frequently diminishes when feelings of grief are confronted and expressed. Addressing trauma can increase short-term anxiety too. If you carry traumatic memories, therapy can bring up a range of distressing emotions surrounding them. Anxiety is nearly always in the mix. What’s comforting though is that the therapeutic relationship is designed to provide a safe place to explore feelings that emerge. This even applies within the therapist-client relationship itself. This affords an opportunity for you to look at situations and relationships in a less frightening, kinder, more relaxed way. With greater awareness, acceptance, and understanding, an individual can observe the role they play in relationships and situations. With this understanding, they can gently make shifts and changes that better support their well-being. Although it may increase anxiety at first, therapy ultimately gives you the tools to overcome anxiety. And it teaches you how to use them outside of therapy in the real world where you need it most.

TYPES OF THERAPY FOR ANXIETY

There are many types of therapy for anxiety. Some of the most common forms of psychotherapy include:

1. Cognitive behavioral therapy (CBT):

Research suggests that cognitive behavioral therapy (CBT) is the “gold standard” treatment for anxiety disorders. CBT helps to reduce anxiety symptoms for people with generalized anxiety disorder, panic disorder, phobias, or social anxiety disorder. CBT is a talk therapy that helps a person learn a new way of thinking, reacting, and behaving. This can be helpful in situations and relationships to reduce anxious feelings. In particular, a method of CBT called exposure therapy focuses on confronting the fears underlying anxiety disorders. This helps people engage in the very activities they have been trying to avoid. It is often used along with relaxation exercises. CBT sessions usually run 30 to 60 minutes and 12 to 20 weeks to be effective.

2. Eye movement desensitization and reprocessing (EMDR):

Anxiety that’s rooted in trauma, such as PTSD, may be helped with EMDR therapy. Research has found that EMDR can also be beneficial for panic disorders and phobias. EMDR essentially helps individuals reprocess trauma. A therapist will guide the client through what’s called bilateral stimulation of the brain. This is done using specific eye movements, tones, or tapping, which serve to reprocess memories and decrease the associated stress that goes with them. EMDR can also help process life events that may have caused other types of anxiety like generalized anxiety disorder or panic disorder. Usually, sessions are about 90 minutes. It may take 4 to 12 sessions to see results, depending on the type and severity of anxiety.

3. Other helpful forms of anxiety therapy:

A number of additional types of therapy may be beneficial for overcoming anxiety, including:

• Acceptance and commitment therapy (ACT)
• Dialectical behavioral therapy (DBT)
• Interpersonal therapy (IPT)
• Psychodynamic therapy
• Expressive arts therapy

FINDING A THERAPIST FOR ANXIETY

It’s important to note that successful therapy is highly influenced by choosing a qualified, skilled mental health professional. To find a therapist, pay attention to credentials, ask for references, and go to an initial consultation. This can help you select the right therapist for you or a loved one. In some cases, even after performing your due diligence, it may not be a good fit. Unless an ethical issue is breached, experts recommend discussing any feelings of anxiety you have about therapy with the therapist. Of course, this may make you anxious if you are not accustomed to addressing conflicts in a relationship. Take it as an opportunity for growth. In many cases, discussing any issues with your therapist will reduce anxiety and increase resilience. This can be helpful in other relationships in life. Anxiety, panic disorders, and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.