How Do I Know If I Need Therapy?

By Annabelle Parr

Each May we celebrate Mental Health Awareness Month to draw attention to and reduce stigma around mental health issues. According to the National Alliance on Mental Illness, or NAMI, 1 in 5 people will be affected by mental illness in their lifetime. And as we discussed last May during #CureStigma, “while 1 in 5 Americans are affected by a mental health condition, 5 in 5 Americans know what it is to feel pain. The frequency, intensity, and duration can vary, but pain itself is a function of being human. When culture stigmatizes the 1 in 5 and simultaneously dichotomizes illness and wellness, the resulting message is that it is shameful to struggle and to feel pain. In essence, stigma says that it is shameful to admit our own humanity.”

Do I need therapy?

Given that all of us will at some point encounter painful experiences and emotions, this year we are discussing how to know when it might be helpful to seek therapy. Though it may be clear that those affected by a previously diagnosed mental health condition could benefit from therapy, for those who are either undiagnosed or are struggling with anxiety, stress, grief, sadness, etc. but do not meet diagnostic criteria for a mental health disorder, it may be harder to discern whether therapy is warranted.

How am I functioning in the important areas of my life?

For nearly every condition in the Diagnostic and Statistical Manual (DSM-V; APA, 2013), clinically significant impairment in an important area of functioning is a required criterion to receive a diagnosis. In other words, the presenting symptoms must be making it very difficult to function at work or school, in relationships, or in another important life domain (e.g., a person is feeling so anxious that she is not able to make important presentations at work, or so stressed that he is finding it difficult to connect with his loved ones).  When life has begun to feel unmanageable in some capacity, or if something that was once easy or mildly distressing has become so distressing it feels impossible, it may be worth considering therapy.

Could things be better?

It’s also important to note that you do not have to feel as though things are falling apart before you seek professional counseling. Therapy can be helpful in a wide range of situations. It can help you not only navigate major challenges or emotionally painful periods, but also can enhance your overall wellbeing by helping you to identify your values and lean into them. Maybe things are going fine, but could be better. A therapist can help you identify what could be going better and can help you learn to fine tune the necessary skills.

I want to try therapy, but where do I start?

Whether things feel totally unmanageable or it just feels like they could be better, it’s important to find a therapist with expertise relevant to what you would like assistance with. Working with children requires different expertise to working with adults, just as working with couples and families requires additional expertise to working with individuals. Different conditions also correspond with particular evidence based practices. For stress and anxiety disorders – including social anxiety, generalized anxiety, panic disorder or panic attacks, and phobias – evidence based practices include Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT). The gold standard of treatment for obsessive compulsive disorder (OCD) is Exposure and Response Prevention (ERP), and evidence based treatments for PTSD include Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT) (all of these—ERP, PE, and CPT --fall under the CBT umbrella). So no matter what you are seeking treatment for, ensuring that the therapist you choose has expertise that aligns with the types of concerns you are struggling with is critical. For some more tips on finding and choosing a therapist, click here and here. For more information on the different kinds of licenses a therapist may have, click here.  

Though there is no right or wrong answer as to whether or not you need therapy, if you are unable to behave in ways that make life manageable and/or fulfilling because of difficult thoughts or feelings, you may find therapy beneficial.

CSAM IS HERE TO HELP

If you or someone you love might benefit from cognitive behavioral therapy (CBT) or acceptance and commitment therapy (ACT) for anxiety, panic, phobias, stress, PTSD, OCD, or insomnia, or if you would like more information about our therapy services, please contact us at (858) 354-4077 or at info@csamsandiego.com

Phobias, Fear, & Exposure Therapy

by Lucas Myers

At the Center for Stress and Anxiety Management Halloween has got us thinking about fear. We deal with it all the time, but at CSAM we call fear by another name: Phobia. Classified as a form of anxiety disorder, a phobia is a persistent, irrational, and severe fear of a particular situation, object, or activity. A phobia is much more intense and persistent than ordinary fears. The desire to avoid the source of terror is very powerful. People might avoid certain situations, things, and conditions in an effort to circumvent their fears. Most of those suffering from a phobia recognize that the fear is excessive or unreasonable. More than 12 percent of individuals develop phobias at some point during their lives. In fact, these fears may change over time. For example, fears of crowds, separation, injury, illness, and death are more common among people over 60. Among 20 year olds, common fears included snakes, heights, storms, enclosures, and social situations. 

There may be as many as 700 different phobias. Many of them may only be uncomfortable or embarrassing, but the ones listed below can be so severe that they cause major changes in the way you live your life.

• One of the most well known phobias, arachnophobia is also believed to be one of the most common. If spiders make you feel overwhelmed by extreme anxiety and fear, you have arachnophobia. 

• According to a 1980 study by the Boeing Aircraft Corporation, 25 million Americans suffer from aerophobia. Celebrities Billy Bob Thornton and Cher are two household names that have reported suffering from this powerful aversion to flying in airplanes or hot air balloons.

• Halloween can be tough if you experience necrophobia. Caskets, dead bodies, funeral homes, and funerals or anything that invokes thoughts about death can cause extreme fright. This phobia may develop from attending a loved one's funeral when the painful memory sticks around and develops into a fear of anything related to death.

• You may have Social Phobia if the thought of being watched or scrutinized by other people causes overwhelming panic. Social and performance anxiety can be experienced by anyone but Social Phobia like other extreme fears, can cause nausea, sweating, and a racing heart. Those with Social Phobia may become very reclusive.

• Another common phobia is claustrophobia, an anxiety disorder that sometimes develops in response to an occasion, often in childhood, when a person was trapped in an enclosed space with no way to escape. Claustrophobic individuals may find themselves irrationally fearful of elevators, airplanes, trains, or subways.

• A bout of agoraphobia can really wreck your plans. It can include fear of wide, open spaces, tunnels, bridges, traffic, crowds, airplanes, and public transportation. In it’s most severe form, agorophobia can cause people to refuse to stray far from home. If you have agoraphobia you're in good company. According to many reports, Oscar winning actress Kim Basinger struggled with panic attacks and severe agoraphobia, publicly sharing how difficult it has been for her friends and family to understand.

• Those that suffer from acrophobia are likely to have a convenient excuse when it comes time to visit the Empire State Building with their family, or disappear to the bathroom when everyone gets in line for the Ferris Wheel. That's because acrophobia is the fear of heights. It isn't always seen as very serious, after all, how hard can it be to avoid ladders? For some people though, acrophobia can be a huge problem because it prevents them from crossing bridges. Imagine doubling the length of your commute just to avoid taking the bridge home.

• An irrational fear of germs can be referred to as germophobia, bacterophobia, or mysophobia. Some believe Michael Jackson may have suffered from mysophobia. This is because he was often photographed wearing a surgeon's mask out in public. Others with mysophobia may feel compelled to wash their hands all the time in an attempt to remove germs. Mysophobia is often a form of obsessive compulsive disorder.

If you are suffering from a phobia, there is hope! Specific Phobias can be treated using a powerful intervention called exposure therapy. Exposure therapy involves systematically and gradually exposing individuals to the objects or situations they dread. Exposure therapy works because once individuals have faced the source of their fear, they learn the object or situation is not as dangerous as they previously believed and they learn they can cope with the object, situation and their fear. Ample research has demonstrated the efficacy of Exposure Therapy for phobias and other anxiety disorders as well (e.g., obsessive compulsive disorder, panic disorder, post-traumatic stress disorder).. 

If you would like to talk to one of our expert therapists about a phobia, or any anxiety disorder, contact us at CSAMSanDiego@gmail.com or call us at 858-354-4077.

References:

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013. Web. [access date: 24 Octorber 2013]. dsm.psychiatryonline.org doi:10.1176/appi.books.9780890425596.744053

Comber, Ronald J. 2008. Fundamentals of Abnormal Psychology: Fifth edition. New York: Worth.

Smolowe, Jill. “Too Hot to Handle”. People Magazine, Vol. 55, 4. Retrieved on October 24th 2013 from: http://www.people.com/people/archive/article/0,,20133526,00.html

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