Posted on: May 18, 2020 | Julie Rael, LCSW, CCO Valley Behavioral Health This week’s blog is a continuation of the mental health awareness blog series and a discussion of the various mental and behavioral health disorders. Last week’s blog explored Mood disorders. This week we will explore anxiety disorders. Symptoms of anxiety are not always apparent to the individual experiencing them, and the symptoms associated with anxiety disorders may differ from one person to the next. As we gain more of an awareness and understanding of these disorders, the better we can know when to seek treatment or support others in obtaining treatment. I also want to provide some insights into how stressors can cause us to feel more anxious and nervous at times. We will look at physical symptoms of distress and anxiety that manifest in our bodies. These physical symptoms can serve as signals to alert us to adjustments needed to improve our mental health. Anxiety disorders are categorized and diagnosed with the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013). These categories include descriptions, symptoms, and the necessary criteria for a diagnosis of an Anxiety Disorder. Anxiety disorders include generalized anxiety disorder, agoraphobia, specific phobia, social anxiety, and selective mutism. Obsessive-Compulsive Disorder and PTSD are often spoken about with anxiety disorders, but these were assigned their own categories with the revision and release of the DSM-5 in 2013. At Valley Behavioral Health, we treat all the disorders described above with evidenced-based treatments that may include medication and therapy. The medications used to treat anxiety are generally meant to be short-term solutions for patients while they work through the root cause and triggers of their anxiety with therapy. The common symptoms of anxiety disorders include intense fear, feelings of constant anxiety and worry, difficulty controlling the worry, restlessness, fatigue, difficulty concentrating, irritability, muscle tension, and sleep disturbances. Some individuals with an anxiety disorder also experience panic attacks. Panic attacks are short periods of time when an individual experiences intense fear and symptoms of physical discomfort that can include heart palpitations, sweating, shaking, shortness of breath or hyperventilation, chest pain or pressure, nausea, stomach discomfort, feeling lightheaded or dizzy and other uncomfortable sensations. I talked about fluctuations in mood as a normal human experience last week. Fluctuations in feelings of anxiousness due to problems at school, work, relationships, and other situations are also normal and expected as these problems occur. Every individual will respond to problems and stress differently from one day to the next. Some individuals are simply more naturally anxious than others. Our ability to cope with these changes can be further impacted by other aspects that affect our mental health such as our sleep, physical health condition, and stress management routine. It is important to know that having feelings of anxiety does not mean that you have an anxiety disorder, however, if you notice a dramatic decrease in your ability to cope and manage your stress and you have experienced an increase in anxiety symptoms that are interfering with your life, don’t delay in contacting us to schedule an appointment to discuss and explore treatment options. Some may ask what causes some people to develop an anxiety disorder while others only experience occasional anxiety or feelings of nervousness due to temporary stressors. According to the National Institute of Mental Health (NIMH)(2020), “Researchers are finding that both genetic and environmental factors contribute to the risk of developing an anxiety disorder”. NIMH goes on to explain that general risk factors include temperamental traits of shyness during childhood, exposure to negative events or stressful environments during one’s life course, a family history of anxiety or other mental health concerns, some physical health conditions or substance use. Exposure to negative events or stressful environments can lead to psychological trauma which can result in the development of an anxiety disorder and in some cases Post Traumatic Stress Disorder. The Substance Abuse Mental Health Services Administration (2020) defines trauma as “ results from exposure to an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life-threatening and that has lasting adverse effects on the individual’s functioning and physical, social, emotional, or spiritual well-being”. If you have experienced prolonged concerns with anxiety or new concerns, you can begin monitoring and documenting these as you prepare to start treatment. The information that you gather can help you and your treatment provider identify the possible causes or the root of your anxiety, inform treatment recommendations, and accelerate your treatment plan. If you are already in treatment and seeing a therapist, these methods can help you address your anxiety concerns in between therapy appointments and prepare for your upcoming appointment and help you to know which issues that occurred during the past week to address with your therapist. These methods include: Utilize a journal. Practice rating your feelings of anxiety on a scale from 1-10. Ten being the most intense. Record any physical sensations associated with your feelings of anxiety. Document daily events, your thoughts and rate your feelings of anxiety throughout the day. Consider how you feel around various people and why you feel that way around them. Notice how your thoughts can impact your anxiety. Examine patterns in your thoughts and how they impact your behaviors. Please know that the methods above are suggestions for monitoring your anxiety and not a requirement for treatment. Don’t worry about following these methods perfectly, and as you get started you will soon find the methods that work best for you. Remember to ask questions and guidance on what you can do in between therapy appointments to assist in your progress with treatment. Your mental health is important, and your therapist wants you to feel relief from your concerns as soon as possible. References American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.National Institute of Mental Health (2020). Anxiety Disorders. Julie Rael, LCSW, CCO Valley Behavioral HealthMs. Rael earned her Bachelor’s degree in psychology and her Master’s degree in social work with a substance use treatment certificate at the University of Utah. She began working at Valley in 2005 and is a licensed clinical social worker. Prior to obtaining her Master’s degree, she worked as a case manager in a homeless shelter connecting individuals to occupational and housing resources and as a social service worker teaching vocational and psycho-educational skills to youth, refugees, and adults with mental health and substance use difficulties. Ms. Rael enjoyed seeing the participants gain more skills and the confidence to move on to employment and further education. After completing her Master’s degree, she worked as a therapist providing individual and group psychotherapy with individuals with substance use and mental health difficulties. After obtaining her LCSW license, she transitioned to a team lead position that provided intense community treatment and outreach services for individuals needing more than traditional outpatient services. Ms. Rael went on to manage and further develop programing for two behavioral health clinics with multidisciplinary treatment teams. She has worked as Field Instructor training and supervising MSW interns for the University of Utah’s Social Work department for the past six years. Ms. Rael was promoted to a Director of Adult Mental Health services in 2017, and then began providing oversight of Valley’s Forensics clinic in 2018. She has also served as a board member and volunteer for a local non-profit that provides individuals the training and support needed to obtain meaningful employment after incarceration and recovery from substance use difficulties. Ms. Rael believes that evidenced-based treatments, collaboration with health care providers, and connecting individuals to recovery support programs are essential factors in obtaining effective treatment outcomes. She is passionate about working alongside individuals to discover their unique strengths, grow and continue to progress in becoming their personal best. In the role of Chief Clinical Officer, Ms. Rael will be working collaboratively with clinical and medical leadership to improve clinical processes, program development and identify those interventions which will best predict clinical success for each of the conditions that we treat. She will be a coach to all Adult and Children’s Clinical Directors and will serve on the Valley Academy team to ensure all Valley Staff feel properly trained and well prepared to bring Valley Behavioral Health’s systems of care to the forefront of our industry.