What is anxiety?

Generally speaking, anxiety is a normal part of life. A mild to moderate degree of anxiety can even be helpful in motivating us to act in ways that serve our best interests, like to get an important task done or leave a potentially dangerous situation. However, anxiety can become problematic when it becomes excessive and chronic, and interferes with our social, work/school or other important areas of functioning.

According to the American Psychological Association’s (APA) website,

Anxiety is an emotion characterized by feelings of tension, worried thoughts and physical changes like increased blood pressure.

People with anxiety disorders usually have recurring intrusive thoughts or concerns. They may avoid certain situations out of worry. They may also have physical symptoms such as sweating, trembling, dizziness or a rapid heartbeat.1

What is depression?

Depression often goes along with anxiety; understandably the effects of anxiety can negatively impact one’s mood and self-image. Certain symptoms of depression, like difficulty sleeping or feelings of agitation or restlessness, can also occur in the case of anxiety making it hard to differentiate between the two.

The following are common symptoms of depression:

  1. Depressed, sad, or hopeless mood
  2. Loss of interest or pleasure in activities
  3. Significant weight loss, or decrease or increase in appetite
  4. Inability to sleep (insomnia) or sleeping too much (hypersomnia)
  5. Physical agitation or sluggishness
  6. Fatigue or loss of energy
  7. Feelings of worthlessness or excessive or inappropriate guilt
  8. Difficulty thinking or concentrating, or indecisiveness
  9. Suicidal thoughts or behaviors

What is PTSD?

PTSD stands for Posttraumatic Stress Disorder and has been classified under “Trauma- and Stressor-Related Disorders”2. As the name implies, it occurs after the experience of a traumatic event. The particular type of trauma that typically leads to symptoms of PTSD involves exposure to actual or threatened death, serious injury or sexual violence. PTSD symptoms can be categorized into four different clusters: (1) intrusion symptoms (e.g., recurrent memories, nightmares); (2) avoidance behaviors related to reminders of the trauma; (3) negative alterations in thinking and mood (e.g., self-blame, guilt, emotional numbness); and (4) hyperarousal or increased reactivity (e.g., angry outbursts, sleep disturbance).

How do I know when it’s time to see a therapist?

There is not a one-size-fits-all answer to this question. However, typically a person decides it is time to seek professional help when she feels increasingly overwhelmed and does not see a clear way out of this situation using her usual resources and coping mechanisms. In some cases the person may not be as aware that she could benefit from seeking outside help as those closest to her are. The most obvious situation in which seeking professional help is recommended is when any safety concerns are present, as in the case of suicidal thoughts and any attempts, and other high-risk behaviors, like self-injury and severe drug and alcohol use.

Why can’t I just talk to a close friend?

Relying on the support of close, trusted friends can certainly be a helpful coping strategy when you are feeling stressed out or overwhelmed. However, sometimes it is more beneficial to speak to someone who has the training and experience to help you deal with a particular problem. Friends are usually well-intentioned but often are unable to take as objective a perspective as a trained therapist can. When speaking to a professional confidentiality is also guaranteed. Further, you don’t have to worry about your relationship getting negatively impacted in some way as you potentially do when you open up to a friend or family member about a particular problem. For example, once you start feeling better you could start avoiding your confidant so you are not reminded of that difficult time in your life.

How does therapy work?

Generally speaking, therapy works by providing new perspective and ways to deal with the issues with which you’ve been struggling. The unique qualities of the therapeutic relationship or environment, e.g., confidential, non-judgmental and supportive, promote healing and growth as you feel more comfortable sharing your innermost thoughts and feelings. Further, therapy can instill hope and confidence that your life can improve as you begin to see your issues as more manageable and gain new tools and coping strategies.

Don’t you get tired of listening to people’s problems all day long?

My answer is rarely.  A large part of my extensive training as a therapist is in how to set healthy, appropriate boundaries with clients that will facilitate growth and positive change.  When I first sit down with someone who has sought out my therapy services, I experience a real sense of hope as this person has taken the first and often most difficult step to getting a handle on that with which they’ve been struggling.  I agree with therapist Mary Pipher when she says, “I’m not listening to people’s problems, I’m listening for solutions.”3 Another essential aspect of my work is self-care; as therapists, if we’re not taking care of ourselves, then we’re not in a position to be taking care of others’ mental health needs.  Therefore, I make it a priority to try to live a healthy, balanced lifestyle.

Can you prescribe medication?

No, I cannot. Medical doctors and psychiatrists specifically most commonly have the training and experience to be able to safely and effectively prescribe psychotropic medication. I can facilitate a referral to a psychiatrist if needed.

A note on the use of therapy in addition to medication management: Engaging in therapy and gaining new tools and coping strategies can enhance the effects of medication. This experience can also be helpful in preventing relapse if you and your prescribing provider decide at some point that you no longer need medication.

What is a Psy.D., versus a Ph.D., versus a MFT, versus a MSW?  How do I know which type of therapist I should see?

Therapists with Psy.D. and Ph.D. degrees are all considered psychologists. Psy.D. stands for “Doctorate of Psychology” and Ph.D. stands for “Doctorate of Philosophy.” In their purest forms, Psy.D. programs tend to be more geared towards training practitioners or therapists, while Ph.D. programs in clinical psychology tend to be more geared towards training researchers and academics. However, some Psy.D. programs tend to be more research-oriented than others while some Ph.D. programs tend to be more practice-oriented than others. The overall quality of programs can also vary; e.g., typically the highest quality, most reputable programs are accredited by the American Psychological Association (APA).

“MFT” stands for Marriage and Family Therapist and “MSW” stands for Master of Social Work. A main distinction between these providers and Psy.D.’s and Ph.D.’s are level of training; masters versus doctoral. Key differences between MFT’s and MSW’s are type of educational experience and practical requirements for licensure, i.e., number of supervised training hours needed.

One recommendation for deciding which type of therapist to see is to inquire further about his or her training, experience and specialty areas and base your decision on what seems like the best fit for your particular situation. Personality fit is another consideration, but you likely will have to meet with the therapist face-to-face before you can decide whether or not you are a good match in this regard.

Do you take insurance?

Currently I do not take any insurance. But depending on your particular insurance provider, you may be able to receive some reimbursement for services if you have out-of-network mental health coverage. It is recommended to contact your insurance carrier to inquire further. I can provide appropriate documentation of services, like an invoice or super bill, to submit to your insurance provider for reimbursement purposes.

1American Psychological Association. Anxiety. Retrieved from http://www.apa.org/topics/anxiety/
2American Psychiatric Association. (2013). Desk Reference to the Diagnostic Criteria from DSM-5. Washington, DC: American Psychiatric Publishing.
3Pipher, Mary. (2003). Letters to a Young Therapist. New York, NY: Basic Books.