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Anxious?
Unable to sleep? 
Experiencing panic attacks?


Cognitive Behaviour Therapy (CBT) is the recommended treatment.

The articles below were written to help you learn more about anxiety and CBT as a potential treatment.  

 

Anxiety:
Different Causes, Different Experiences, Same Vicious Cycle

Anxiety can take many forms, from panic attacks to intense worries to inability to interact with others as the fear of being rejected or humiliated looms large.  The experience of anxiety can be overwhelming.

 

Symptoms of panic include racing heart, difficulties with breathing, nausea, dizziness and a profoundly convincing sense that something awful is about to happen.  Worry, a common feature across anxiety disorders, keeps the mind looping in search for solutions for problems that might not even happen.  Socially anxiety creates a sense of watching oneself from the outside and an internal voice that constantly points out all real or imaginary transgressions.

 

Anxiety might be caused by adverse life events, increased life demands or nothing in particular, as something just happens and our attention centers on the feelings of discomfort.  When anxious, we feel terrified in absence of actual danger.  Anxiety feeds on our very efforts to push it away.  Fortunately, irrespective of the initial cause or its current form, anxiety can be understood as a product of interaction between our attention (number 1 in the Cycle of Anxiety diagram), beliefs (2), physical sensations (3), behaviours (4) and triggers (5).  Older diagrams usually began with a trigger, however research has shown that how we pay attention and what we pay attention to is more important than triggers.  We react to our perceptions.

Cycle of anxiety Chart

Meet John, Leila, Grant and Anna.  John was in an accident a year ago and is about to lose his job, Leila is a new mum who wants the best for her family but remains paralyzed with worry, Grant just cannot bring himself attend classes at an art college that he always wanted to enroll in, while Anna spends her days in bed believing herself to be severely ill. Read on – their stories will guide your understanding of your own anxiety. 

Worried man
Worried black woman at home alone at night

Recommended Treatment

According to Canadian Clinical Practice Guidelines, cognitive behaviour therapy (CBT) is the recommended first line of treatment for anxiety disorders.  

 

CBT works by helping us understand how our thoughts, emotions, physical sensations and behaviours interact to keep us stuck and in unnecessary pain. 

 

Cognitive interventions (the C in the CBT) help us ensure that our thoughts reflect our reality and not our painful assumptions.  This is especially useful when we are wrought with worry. 

 

Behavioural interventions center on exposure.  Exposure exercises teach us to face our fears in a safe manner and learn from those experiences so that the previously dreaded situations no longer generate an anxious response.  Exposure has a bit of a PR problem with clients and clinicians alike shying away from this intervention.  That is unfortunate as exposure has been found to be much more effective than any of the other therapeutic approaches.

Mindfulness techniques are often woven into treatment to help with getting grounded amid an anxiety attack and to reduce distractibility.  Mindfulness helps savor life.  

The combination of cognitive, behavioural and mindfulness based techniques is the best bet to get you closer to the life that you want.

Tourists posing on a glass floor in a skyscraper

Worth Considering

You might have heard that you need to learn to live with anxiety.  That is actually quite true but it probably means something quite different than you thought.

Many persons affected by anxiety try to fight the feeling and avoid stress.  Others try relaxation strategies.  These strategies work only to a point. Imagine that you have given your best shot at visualization or a breathing technique before your exam, a date, driving or, heck, walking on the glass floor at the CN Tower.  You calmed down enough to approach your trigger and then: anxiety.  Relaxation strategies often help us calm down in absence of triggers. Yet triggers are everywhere.

Let's stay with glass floor as an example.  The first time you walk across it, your legs might give up.  The second time you manage to wabble across.  Few more times and you can walk across without problems.  You have "learned to live with anxiety".  You realized that anxiety is part of the process but it goes away once you have the opportunity to learn that the dreaded thing is actually quite safe or that you have the ability to overcome it.  Learning to live with anxiety allows you to expand your life and that is the key to reducing the overall anxiety. This principle, called inhibitory learning, is the core premise of modern exposure-based interventions. 

 

Learn About Some
Problem-Specific Interventions

Worry

Woman with Anxiety Disorder, Biting Fingernails, Talking to Mental Health Professional

Worry is a core symptom of generalized anxiety disorder.  Worry is overthinking, a spiral of what-if questions.  We worry about problems but cannot face them.  We imagine problems that we do not have and that might never happen.  Our energy drains.  Then we worry about worrying.

Panic

Panic attack in public place. Woman having panic disorder in city

Panic attacks are very physical.  Suddenly, the world spins, there is an uncomfortable awareness of beating of one's own heart or rapid breathing combined with feelings of suffocation.  Time between panic attacks is often spent worrying about and trying to prevent the next panic from happening.

Stress

When problems compound, it feels like everything is happening all once and needs to be responded to right at this moment.  Letting go feels irresponsible because the problems are real. So we worry.  We get exhausted.  We feel the sense of urgency and start panicking. Nothing gets done.  

Stressed city man
Content sitting senior

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