Input: How can I manage my budding anxiety?

Instruction: I have been thinking a lot about certain situations and having my worries about what others may think or say.

Output: I think it's a great idea that you are asking this question now while it's early on. The first thing I wonder is what age you are.  At different transitions and stages in life, it's really common for anxieties to come out of the woodwork.  First time this takes place at a greater level is during adolescence, because a teen's "job" is to figure out who they are within the context of other people.  Spikes in anxiety also can also occur after high school when you are leaving the nest and heading to college, or the late twenties when it feels like you are expected to have your life figured out and compare to where others are in their lives.  That same scenario can show up in mid-life as well for different reasons depending on the person.  Aside from age, certain circumstances can influence a jump in anxiety, such as a job change, switching schools, moving, opening a business, college finals, etc.  Take some time to explore where the anxiety might be coming from and just see what comes up.  It may be something you have some control over, or something that you can ask for help from someone else for--especially if it's social anxiety.  The more you practice social skills, the more confidence you'll have in the long-run.A metaphor I use with some people is gas for a car.  Anxiety is a necessary motivator for action, though you get to decide where to go with that anxiety.  An overfilled tank doesn't get you any further than a normally-filled tank, and more gas doesn't mean the gas is in charge of where you go.  Applying that to what I know about your situation--how much of that worrying is getting you somewhere, how much is just extra gas, and are the worries changing what you really want to do? Sometimes knowing the makeup of our anxiety gives us more power over how we deal with it, and I think you could for sure get there with some help.


Input: How can I overcome social anxiety?

Instruction: I have a fear of talking with people. I don't like to go out to social events. I'm always worrying about someone judging me.

Output: Thanks for reaching out and asking this question.  Social stuff is hard.  Even for people that don't have diagnosed social anxiety.  Some research outlines that our fear of public speaking is greater than our fear of death.  That's hefty!  Shame is often the culprit for social anxiety because we think other people will see the flaws in ourselves that we believe are there.  I've had experiences where I thought the person thought something awful of me, just to find out it was exactly the opposite.  That's how powerful our minds can be!What are other things that people may think of you?  Maybe you are very kind and easy to talk to.  Maybe you think differently than other people and some people enjoy hearing your perspectives.  It's even a possibility that they are worrying about the same things as you, even if they seem very confident.  Confidence can be easy to fake if it's how you cope with fear.To work through some of that, it's much better to force yourself out there and have conversations.  Avoiding people sends the message to your brain that not only are those situations dangerous (socially), but that you can't handle them.  The more you avoid, the harder it gets and the more anxiety is created by just the thought of being around people.  Take it moment by moment, too.  Thinking about all the conversations you are confronted with in a day is overwhelming.  Just focus on getting through each conversation, and give yourself credit for doing that---even if you felt awkward, embarrassed, etc.  Social skills can be taught at any stage of life, and there's always room for mistakes.  No one in society communicates perfectly and you don't need to put that pressure on yourself.The last thing I'd say is keep at least 1-3 people in your life that feel really good to talk to--like it's not a task.  Talking to acquaintances and random people is not to fulfill a need for close connection (unless you end up finding a great friend), but more to feel like you are definitely able to handle conversations without the threat of crippling anxiety.  You may even get to a place where you enjoy it (sometimes).  Reach out to people in your life if you need extra support!


Input: How can I stop worrying much?

Instruction: I have a bad habit of thinking and worrying about what others may think of me. I really want to stop it and enjoy things.

Output: We all experience that to a different level, depending on who you ask.  It's actually born out of a good quality---prosocialness.  When we care what others think of us, we are also attuned to how we are treating them and what's socially right vs wrong.  It definitely does feel like it's more about ourselves, however--meaning it feels like we worry about what others think because we don't want to be socially outcast or rejected.  That's also (again, to a certain level) a healthy quality.  It means you want connection.  Connection is crucial to mental health and, according to some available research, physical health.  No matter how mentally healthy or socially confident you are, if you care about connection, you're going to care about what people think of you to an extent.  So the work here is to figure out what worry is warranted vs what is just causing you suffering.  A good way to tell the difference here is to write it out in list form.  Write out all the socially-anxious thoughts you have and scale them from "needed" or "helpful" to "unnecessary" or "unhelpful".  Some may fall in the gray area here.  For example: if you worry that others think you are inconsiderate, so you often say sorry---weed out what's actually inconsiderate vs what you feel is maybe inconsiderate because you feel like a burden to others.  Getting in someone's personal space would warrant some worry and an apology.  Asking for help when you need it is something you don't have to apologize for.  Something else to consider here is there's probably some underlying shame.  Shame is a cluster of really tough feelings and if it had a voice, it'd say things like, "you're not good enough", "you aren't likeable", "you are annoying and no one wants to be around you", etc.  Those feelings typically create the worry you experience about others.  Shame survives and is strengthened by the attention you give to it.  The more you compete with it, the less powerful it becomes.  Sometimes that comes in the form of noticing the wonderful qualities in yourself.  Sometimes it takes practice putting yourself out there when it's really scary.  No matter what, shame's nemesis is connection---to yourself and to others.  That's how you prove it's wrong.  Try not to take shame at face value!If you are struggling with using these techniques or just don't know if they are right for you, a counselor can help you out and give you a more individualized approach.  Sometimes it's just figuring out that specific formula that works for you that makes all the difference.  And of course, counseling is built on a strong connection.I wish you all the best!


Input: How can I stop worrying much?

Instruction: I have a bad habit of thinking and worrying about what others may think of me. I really want to stop it and enjoy things.

Output: Thinking about what others think of us is a natural tendency. Human beings are social creatures and rely on feedback from the outside world of people, places, and things to let us know more about ourselves. We also have an inner voice, dialogue, conscience, etc. that helps us to determine the path for us. Often, when someone is worried about the external feedback, and focuses on this as the sole source of information, it can create a dependency that can become problematic. Balance is key to so many things in life. Your own voice is powerful and has strength to provide you the enjoyment you seek. Don't discount it and rely only on the voices of others.


Input: How can I stop repetitive thoughts and feel confident again?

Instruction: I have been repeating the same thought pattern for seven years and have completely lost control of any situation. I am in my early 30s, and I feel like I am trapped in my body, mind, soul, and house because I feel embarrassed to go anywhere or talk to anyone.

Output: There's SO much help for repetitive thoughts in the counseling world!  The one thing I'd for sure ask if we met in person is what those repetitive thought patterns look like.  Some repetitive thoughts are more like obsessive thoughts.  For example, that may mean that every time you leave a room, your obsessive thought is to switch the light on and off 5 times.  Or every time you touch a door handle, you think about the germs you came into contact with and washing your hands multiple times.  Sometimes it's more about the same thoughts repeating about bad things that may happen, or critical thoughts we have about ourselves.  Your statement about "feeling confident again" gives me the sense that maybe you struggle with the ways in which you think about yourself.Assuming it's obsessive thoughts: exposure and response prevention therapy is an excellent form of treatment.  Typically, obsessive thoughts influence compulsions, which usually show up as very strict, repetitive rituals in order to manage anxiety.  Exposure and response prevention exposes you to the things that increase anxiety, while response prevention helps you to sit through that anxiety response without performing a compulsion.  For example, you touch a door handle.  Your anxiety increases.  You obsess about the germs you came into contact with and have a strong urge to wash your hands multiple times.  Instead, you sit through the anxiety, let the anxiety decrease on its own, and slowly unpair that anxious response with the behavior.  The more you do this, the more it breaks up those thinking/behavior patterns that make you feel chained to them.Assuming it's self-critical thoughts: cognitive-behavioral therapy can work well here.  Everyone's brain has a default track, that when met with struggle, plays over and over like a broken record.  The more you give into that, the more it plays.  The trick here is creating a competing track, or turning the volume up on a track that boosts your confidence instead of shooting it down.  Some ways to do that are really identifying and writing down what those repetitive thoughts are.  You probably already know them pretty well if they repeat often.  Then next to them--write out a line that has an heir of confidence and/or gentleness.  For example, if your repetitive thought is that you are a failure, you may write out a sentence that is something like:  I may be struggling greatly with this situation, yet I am still trying super hard to get better and that's definitely not a failure.  Every separate repetitive thought can have its own competing sentence.  Initially, these new thoughts will feel weird, foreign, and maybe even like they don't do anything.  Give it time.  The repetitive thoughts have had years to grow, so these new thoughts need time, too.  They are, literally, new pathways in the brain and the more they are traveled, the stronger they will get.I'm also sensing that there's a combination of anxiety and depression.  I would assume that you are probably feeling pretty cut off from the world if you don't want to talk to anyone.  That can be so lonely and isolating.  Because connection is basically crucial for healing, it may be very beneficial for you to see a counselor or find a support that feels safe to you.  Counselors are usually trained very well in these types of issues and some offer telehealth if you are having trouble leaving your home.  It might feel scary and strange at first, but you are in a lot of pain and deserve healing.Hope this helps a bit.  Go with your gut and do what you feel is right for you!  I wish you all the best.


Input: What should I do about my stress before track meets?

Instruction: I am on the track and softball team. My school is small, so I play all four sports it offers. I feel obligated to do track because I'm not a horrible runner, and my dad wants me to. The catch is is that the days before a track meet and the morning of, I get sick and cry.

Output: Seems like you have some confidence in your track abilities, but feel pressured by your dad to continue something you don't really enjoy.  Are you maybe worried about disappointing your dad, or is it something about track itself that upsets you or overwhelms your body?When we try to push through stuff that's too much for our bodies (whether that's physical or emotional), that stress will show up no matter how hard we try to bury it.   Sometimes that shows up as crying or irritation, other times that shows up as physical symptoms.   For you, it could be both.  Based on the symptoms showing up days before a meet, it could be more emotional since it comes so long beforehand.  I'm assuming you are very active already, so extra exercise probably isn't too helpful and may only put more stress on your body.  Do you feel like you ever get a chance to truly relax?  Always running on overdrive with little gas is exhausting.  Try giving yourself permission during the period before the track meets to just do something that slows you down.  Doesn't have to be super long--even 10-15 minutes a day could give your brain and body a very needed break from that go-go-go lifestyle.Pay attention to your sleep as well.  I don't know anything about your nightly routine, but if you are struggling to sleep that could enhance the symptoms of anxiety before your meets.  Some calm activities before bed could help here.Of course, you could try talking with your dad about whats happening if you think he'd be able to support your needs.  That's not always possible, and if not, no worries.  There's a lot you can do to get through what's happening.  If you have another caregiver in the picture that feels approachable, you could talk to him/her about how you are feeling.  Also, take a look at strategies for performance anxiety online.  Even if you don't have that particular type of anxiety, the strategies are really great and can at least help a little if you are still engaging in track.


Input: What should I do about my stress before track meets?

Instruction: I am on the track and softball team. My school is small, so I play all four sports it offers. I feel obligated to do track because I'm not a horrible runner, and my dad wants me to. The catch is is that the days before a track meet and the morning of, I get sick and cry.

Output: Does anyone notice that you get sick and cry on track meet days?Have you told anyone?From what you write, as much as you would like to please your school and dad, something within you doesn't quite want to fully follow through.Step one in life always is to know what you want and what your limits are.   It already is difficult to avoid listening to your body.Try understanding what is difficult in telling your father that you'd like doing as he wishes, only are not able to do so because you are emotionally and physically distraught on the days you have track.After finishing the season for this year with your school's track team, then expect to concentrate on taking care of your own need to not do track.Hopefully your father will understand and care about your problem.   If he does not and track is more important than your well being, then you have a different problem entirely.


Input: What should I do about my stress before track meets?

Instruction: I am on the track and softball team. My school is small, so I play all four sports it offers. I feel obligated to do track because I'm not a horrible runner, and my dad wants me to. The catch is is that the days before a track meet and the morning of, I get sick and cry.

Output: It sounds like you are no longer committed to track emotionally.  It can be hard to talk to your dad about this, but he may think you love track and may not know you are getting so upset the days of meets.  An idea would be to first write a letter to your dad to see what feelings come out and then preparing to speak with him.  I think he will appreciate your honesty and maybe this conversation will bring you relief and also time to find something you really will enjoy.


Input: Can anxiety make me say foul language?

Instruction: I'm scared that my anxiety will make me say foul language. I don't want to say those words though. I'm only a teen and all my friends curse, but I don't want to. I don't know what to do.

Output: It's definitely possible that your response to anxiety is to swear, though you don't have to feel controlled by that reaction.  As a teen, you're developing your identity based on what feels right to you and what doesn't.  It's OK to be different than your friends, and just being around swearing doesn't mean you will for sure pick up that habit.  What is it that connects your anxiety to swearing?  If it feels like your automatic response might be to curse, you could try picking some words that don't go against your values to use as a default when you are upset.  You could also work directly with calming your anxiety, maybe in ways that make you feel in control.  Breathing exercises as well as thought replacement (replacing an unhelpful thought with a helpful one) are good for that.  Whatever you try, I wish you the best of luck!


Input: Can anxiety make me think I heard something about me?

Instruction: When I'm around people, I sometimes think someone has made a comment to me or asked me to do something. I will be focusing on something else and then randomly think I hear something about me. I never know if it was actually said.

Output: Sure can!  Especially social anxiety or anxiety in the form of paranoia.  Are there any patterns to when or where this happens most?  Does it ever happen with people you feel safe and comfortable with?  Or only when you are in an uncomfortable social setting?  If you notice any patterns, you can focus in on the anxiety surrounding them and build coping skills to help you get through those moments (if that's what would feel helpful).You could also seek help and talk to someone about what's happening to get a better assessment of your situation and more personalized techniques.  There's many counselors out there that are great at working with anxiety!


Input: Can anxiety make me think I heard something about me?

Instruction: When I'm around people, I sometimes think someone has made a comment to me or asked me to do something. I will be focusing on something else and then randomly think I hear something about me. I never know if it was actually said.

Output: Anxiety can absolutely make you think you heard something about you. When we are on high alert, we tend to look for threats and often the greatest threats we experience on a daily basis are social in nature.  To some extent this is normal, for example, when people experience late onset deafness, they often will worry people are talking about them (and usually not good things) because our brains tend to jump to that. Of course, I'm not saying you are going deaf or anything, just giving an example. Counseling can help you work through this anxiety. It may also be helpful to reach out to a counselor to rule out if there may be other things going on. Sometimes things like paranoia can blend in with anxiety, which is a very distressing experience. But both are absolutely treatable. Wishing you the best!


Input: Can anxiety make me think I heard something about me?

Instruction: When I'm around people, I sometimes think someone has made a comment to me or asked me to do something. I will be focusing on something else and then randomly think I hear something about me. I never know if it was actually said.

Output: It sounds like you are having difficulty knowing if people are saying things to you, or if you only thought someone was talking to you, and this is anxiety producing. It's understandable that it could be confusing and/or a bit scary to be unsure if people are speaking to you or not. It's hard to say exactly what is going on from just this description, but if you can work with a competent therapist, you may be able to get more insight into what is happening, get clarity about your social interactions, and develop some ways to deal with the anxiety.


Input: Why do I always feel anxious?

Instruction: It's especially bad at night time. I am scared of sleeping alone.

Output: Night is hard for a lot of people, so you are definitely not alone here.  Has anything scary ever happened to you at night?  Answering that question may give you the "why" of where that's coming from.  If you haven't had a bad experience at night, it may just be the time when you have nothing to do, which allows more intense thoughts and feelings to surface.  Here's a couple things to try:One thing you could do is sit down a couple hours before you go to bed and journal (if you can).  Try to reduce any distractions and just go for it.  The purpose of this is to slow down well before you go to bed, expressing some of the anxiety from the day.  Also take note of the things you can tackle that day vs what can wait until later.  This gives your brain a chance to sort through some of the "planning" type of anxiety that commonly comes up when you are trying to sleep.Another thing you can do is make a list of the things you have control over.  Anxiety is really good at putting everything you feel out of control of on a giant metaphorical projection screen.  Try projecting some of the things you have control over instead.  For example--you have total control over breathing patterns, what you choose to wear the next day, what you pay attention to if you go for a walk, etc.  You also have control over how you personalize that list to what matters to you.  Mindfulness is a great way to focus on how you control your breath, and also how letting go of breathing doesn't stop your body from doing what it's always doing to keep you alive.  Any google search will bring up lots of information on this!Something to remember is that experiencing anxiety is OK.  It doesn't mean something is necessarily wrong.  Anxiety is sometimes just a feeling that comes up without much of a cause.  If you can't identify that cause, it's probably because of a little misinterpretation in the brain.  Mindfulness can definitely help with that.


Input: Why do I always feel anxious?

Instruction: It's especially bad at night time. I am scared of sleeping alone.

Output: Being able to know you feel anxiety and write about it, is the first step to addressing and handling it!Generally, anxiety is deep fear of not being able to handle what comes up in life.  Somehow the person was insufficiently nurtured and so felt  insecure when very young.Usually the person had to fend on at least a psychological and emotional level for themselves before reaching an age when doing so would have been reasonable.Their inner feeling of overwhelmed from when very young, hasn't faced the reality that the grown person is now capable, even if this takes some practice. Try asking yourself what you are afraid of and theorize how you would handle these situations as a grown person.Also, sometimes anxiety comes from feeling lonely.  This loneliness is reminiscent of the loneliness that the grown person now, felt when being left to take care of situations as a child which were too difficult and complex for any child to address.


Input: Why do I see and hear things that are not real?

Instruction: I’m a teenager. I am almost always paranoid. Recently, I started to think they watch. I keep seeing in the corner of my eye someone moving. The other night, I heard breathing in my room, and my eyes focused on a black shape. I turned on the lights, but no one was there.

Output: I've worked with teens in a day treatment program for about 6 years now and it's been a theme that a lot of them see dark figures out of the corner of their eyes.  Pretty common with teens that have endured trauma--physical or sexual abuse, witnessing domestic violence, etc.  We don't have a lot of information on why this happens, but it's theorized that the brain projects the emotions outside of us in the form of dark figures--maybe just as a reflection of what is existing on the inside of the brain or even to give some emotional relief.  When we have kids that have experienced those types of hallucinations, they almost always disappear once they have worked through their trauma.  Sometimes visual and auditory hallucinations are symptoms of mental health disorders as well, though that's pretty rare for those to start as early as the teens years.  It's best to have your symptoms checked out by a medical professional and maybe even a psychiatrist to get a better idea of what may be happening.   Are you or have you been taking any medications that could potentially have these side effects?  If you do visit one or both professionals, make sure you or a caregiver is giving them all the details about your symptoms so they can help you as much as possible.A big question here is what is your sleep like?  Lack of sleep is notorious for causing hallucinations and can become severe after only a few nights of sleep deprivation.  If you are having trouble sleeping, that may be another topic to discuss with your doctor.No matter what it is, it's obviously scary otherwise you wouldn't feel paranoid.  Try some techniques to calm yourself a few times during the day, like deep breathing or movement-based strategies like yoga.  Whatever speaks to you.  And remember that while you are figuring this issue out, the hallucinations can't hurt you even if they get stronger.Glad you are reaching out to get some help!


Input: Why do I see and hear things that are not real?

Instruction: I’m a teenager. I am almost always paranoid. Recently, I started to think they watch. I keep seeing in the corner of my eye someone moving. The other night, I heard breathing in my room, and my eyes focused on a black shape. I turned on the lights, but no one was there.

Output: Sounds like anxiety and a strong imagination are getting the better of you.Do you sometimes have less confidence in yourself than you'd like to have?  Or doubt and question yourself in matters which in hindsight were easier to solve than you realized at first?These are two examples of anxiety blurring your vision of a situation.  Possibly imagining sights and sounds is also blurring an accurate assessment of what actually takes place in your room at night.Addressing anxiety is best done indirectly, not directly.Concentrate on knowing more of your reasons to question yourself so deeply in the first place.  Being a teenager certainly adds to overall anxiety.  And you may have good reason from your growing up personal history to have more than an average amount of self-doubt.If you felt humiliated, mocked, ignored, blamed, any type of interaction with meaningful people in your life while you were younger, then this probably set the groundwork to not have faith in yourself.Awareness of where you feel vulnerable is the first step to deliberately changing this into a strength!


Input: I keep on changing my life when things get tough

Instruction: I've been like this ever since I was in school; back then I transferred to another school. Now I'm thinking about changing my job.

Output: Is there a certain problem you feel about living the way you describe?As long as you feel satisfied with how your life is unfolding then you’re making wise decisions.If you feel tension or that somehow doing as you describe is wrong, then the first step is to identify the way you feel your methodology described above has a role in working against your best interest.Basically, define what is problematic in order to address it.


Input: I keep on changing my life when things get tough

Instruction: I've been like this ever since I was in school; back then I transferred to another school. Now I'm thinking about changing my job.

Output: There's a quote I love that says, "Wherever you go, there you are" and the book by the same name by Jon Kabat-Zinn may be very helpful for you. The thing about changing things up when they get tough is that they often aren't the things that need changing. The awesome (and challenging) thing about it is that when you work on the internal aspects that may need attention, you can learn to find a sense of centeredness that comes with practicing mindfulness and asking yourself who you really are and want to be. Through this deeper work, you can actually be in the midst of chaos and still feel that calm and peace within yourself. If you look for support in this journey from a counselor or therapist, I'd recommend looking for someone offering Acceptance and Commitment Therapy (ACT) or Mindfulness-Based Cognitive Behavioral Therapy (MCBT). Also helpful may be the online program of Mindfulness Based Stress Reduction (MSBR) found here. There are in-person programs across the country, but this online self-guided version is free and a great resource!


Input: I keep on changing my life when things get tough

Instruction: I've been like this ever since I was in school; back then I transferred to another school. Now I'm thinking about changing my job.

Output: It's great that you are at least aware of what pushes you to seek change in your life.If you were in session with me, one of the first things I'd explore is what "tough" means for you.  Is it relationship issues with other people?  Or tasks related to your job?  Or is it something else?  It's important to know what you may be trying to escape in order to work with it.  For example, if you tend to make changes when you are faced with a commitment, then there would be something about commitment that scared you and the work would be focused there.  One thing to think about is that most people tend to run from things that they believe they can't handle or get through.  Could this be happening in your situation?  If it is, there could be some underlying fears present that you are incompetent or you will fail.  What's interesting about that is that some people avoid change for the very same reasons.  It's actually quite amazing that you handle so much change in your life and have for a very long time.  That shows you can handle a lot!  The last thought I have is that the more you push through the tough stuff, the more you will have confidence in your ability to do that.  You don't have to feel confident to start the process--in fact, many people feel very vulnerable and terrified sticking with decisions that are out of their comfort zone.  Having social support, even if it's just one person, is so important when you're facing your fears.  That could mean counseling, or a partner, friend, family member, etc.  Doing it alone is another level of tough.You may be at the point in your life where you are just seeking some answers and aren't feeling ready to address what's happening and that's OK.  No one wants to go blindly into this kind of work.  There's no rush to figure it all out right now.  Give yourself some time to let things unfold!


Input: I keep on changing my life when things get tough

Instruction: I've been like this ever since I was in school; back then I transferred to another school. Now I'm thinking about changing my job.

Output: Many times when things become difficult to manage, is because we are getting out of our comfort zone, so we seek growth and change.  Coping with the difficulties does make you more resilient and helps you to build the confidence you need to solve problems in the future. Now I wonder:  are things getting tough in a way that you are not able to resolve them?  Do you need to move or change to save yourself or prevent any harm? If so, it is OK to know when to remove ourselves form situations that harm us more than helping us.   On the other hand, are the things getting tough because you need to learn a new skill?  If so, how can you learn them and is there someone who can help you overcome this challenge?  I help my clients to identify their strengths and areas where they can achieve growth, things like polishing up your resume and evaluate new job opportunities could help you discover a new you.If you would like to engage in counseling, I am licensed in Texas and Puerto Rico, you can contact me at 787-466-5478. Cada vez que las cosas se ponen difíciles, hago cambios en mi vida.He sido así desde que estaba en la escuela; antes me transfería de escuela.  Ahora pienso cambiar de trabajo.Muchas veces cuando las situaciones se tornan en difíciles de manejar, es porque nos sacan de nuestra zona de comodidad, con el propósito de buscar el cambio y el crecimiento.  Manejar las dificultades si te vuelve más resistente, y desarrolla tu autoestima para que puedas resolver problemas en el futuro.    Ahora, te pregunto: ¿se están poniendo las cosas difíciles al punto que no puedes manejarlas?  ¿Necesitas removerte de la situación para evitar que te hagan daño? Si es así, entonces está bien reconocer cuando nos debemos remover de una situación dañina que nos daña más de lo que nos permite crecer. O por el otro lado, ¿Se están poniendo las cosas difíciles porque necesitas a prender una nueva destreza?   Si es así, ¿cómo puedes aprender esa destreza y quien te puede ayudar?Ayudo a mis clientes a identificar sus fortalezas y áreas de crecimiento, el actualizar y pulir tu resume junto con explorar opciones de empleo, te puede llevar a descubrir nuevos talentos en ti.Si te gustaría hacer una cita, soy Consejera Profesional Licenciada en Texas y en Puerto Rico, llama al 787-466-5478.


Input: I keep on changing my life when things get tough

Instruction: I've been like this ever since I was in school; back then I transferred to another school. Now I'm thinking about changing my job.

Output: Sometimes changes make sense. It may be helpful to talk to someone who you trust to get a sense of whether the changes that you are making are those that are considered adaptable or important changes that allow us all to grow. Another possibility is that you are changing things in an effort to get away from something that is uncomfortable or difficult. There are many other possibilities along this continuum.I would ask you to consider the following:What is leading you to want to change your job?What feelings are associated with this change? (Happy, sad, scared, anxious/nervous, confused, motivated, etc.)How is the job that you are looking to transfer to going to be better or different? Are the concerns that you have now going to travel with you?If you are hesitating to get another perspective (from trusted friends or family or some sort of career advisor in your area), where is the hesitation coming from?


Input: I keep on changing my life when things get tough

Instruction: I've been like this ever since I was in school; back then I transferred to another school. Now I'm thinking about changing my job.

Output: I recommend that you make a list of all the reasons you should change your life and all of the reasons you shouldn't change your life. Can the problem you are in be fixed? Is there others you can lean on for support? Are there other people you know who have been through a similar experience and are willing to share their story with you? It is important to rely on your support network to help you get multiple points of view. If you believe you need additional help, I suggest seeing a professional.


Input: How can I wake up without having an anxiety attack?

Instruction: I have these dreams of men, and they always seem to try to hurt me. It's gotten so bad that I first wake at 4:30, then 4:45, and finally stay awake by 6:00. I'm always the last one to fall asleep and the first to wake. I hate falling asleep. The longest I've went without sleep is three days.

Output: No wonder you are scared to sleep if this is what you are going through.My first thought is that it's possible your dreams are your brain's way of trying to process something that scares you or has scared you.  There's not a lot of research on the purpose of dreams, but one theory is that stuff you don't want to deal with consciously is able to come through via your unconscious brain as a dream (or nightmare).  Another theory is more of Gestalt nature, where all your dream figures represent a part of you--for example, the part of you being attacked would be the side of you that feels weak, whereas the attacker is the side of you that you feel is bad or evil.  Either way, your reactions are definitely legit because nightmares tend to flood the brain in a pretty emotionally raw form.I am also curious if you had trouble sleeping before you started having these dreams. Is it because of these nightmares that sleep is an issue, or have the sleep issues been a part of your life longer than the dreams?  It may not mean a whole lot no matter what order they came in, but it would be interesting to know if the catalyst was actually the dreams to begin with.  The big question here is if not having these nightmares would improve your sleep and lessen your anxiety about sleeping, overall.As for the anxiety attacks, there's a lot here you can try.  Your brain is seeing sleep, nightmares, or both as a threat.  The way to signal safety to your brain is to practice some relaxation techniques--mindful breathing can be helpful or if you find it hard to sit still, you can do some walking mindfulness.  Maybe you've heard of the Calm app--it's so great for sleep issues.  They have sleep stories and soundscapes, as well as guided breathing exercises.  This is speaking more to the thinking process, but remind yourself that the dreams aren't real and they can't hurt you.  That doesn't mean you won't have anxiety and you have to fully believe it, it just means that you don't have to get caught up in the fear response.  You also mention that they "try" to hurt you.  Have you ever done things to fight them off? Or do you run?  It's OK if your response is to freeze--I'm just curious how you view yourself in that dream.  If you are feeling powerless (which would be normal) it may be worth your time to imagine how you want to fight them off.  What weapons would you choose?  What would escape look like?  Imagining you in charge may help change your experience of the dreams.Also remember that even though panic attacks feel awful, they won't hurt you.  It's a really terrifying feeling to be trapped in your body during an attack, but the response is meant to get us out of danger even though there is no real threat.  If you do a google search for panic attack help sites, there's so many that detail more of this response and how to move through an attack.  Of course, seeing a counselor might be beneficial if you are sensing that there's something bigger underlying the dreams.  Sometimes just having someone listen and understand can ease some suffering.I hope that helps and you find something that works for you!


Input: How can I wake up without having an anxiety attack?

Instruction: I have these dreams of men, and they always seem to try to hurt me. It's gotten so bad that I first wake at 4:30, then 4:45, and finally stay awake by 6:00. I'm always the last one to fall asleep and the first to wake. I hate falling asleep. The longest I've went without sleep is three days.

Output: That is awful! I am sure you are ready to start getting some rest. It's normal for us to wake a few times in the night, however, when we are dealing with high anxiety or stress, those times can turn into being up most night. Given that you are having these repeated dreams, I am wondering what might be going on in your life either now  or in the past that could be triggering stress or maybe memories. It can help to draw the dream out in the morning or even to look for metaphor. In the long run, seeking counseling can help you sort all that outIn the meantime, self-soothing strategies may help you in the night when you wake and can't get back to sleep. This can be anything with your senses----getting a snack like tea and focusing on that taste, smelling something pleasant, listening to some relaxing music, looking through a magazine, taking a shower. Anything you can think of that might help you relax. If it involves needing to get up, that's okay! Getting out of bed can actually help you get out of that mind space and helps you associate your bed with relaxation/sleep vs anxiety making it more likely you will fall asleep once  you lay down.


Input: How can I wake up without having an anxiety attack?

Instruction: I have these dreams of men, and they always seem to try to hurt me. It's gotten so bad that I first wake at 4:30, then 4:45, and finally stay awake by 6:00. I'm always the last one to fall asleep and the first to wake. I hate falling asleep. The longest I've went without sleep is three days.

Output: The good news about your dreams is that your fears are right at the surface of your mind so you can study them and release some of the harm from the terrifying experiences you had which created these bad memories in the first place.The bad news is the feelings themselves are sickening.Probably a therapist would be very helpful for guiding you to unfold these uneasy feelings and their source.This type of deep work is easier with emotional support from someone.  A therapist can give you this plus is knowledgeable about dynamics of someone having been emotionally harmed by another.Or, read a lot online and find out which articles resonate with your emotions.Luckily people are willing to express personal stories of recuperating a sense of peace and safety after being violated by someone.


Input: How can I deal with this anxiety that keeps me up all night?

Instruction: I've been having horrible anxiety for the last week. I can't sleep. I get a sense of doom, and it's hard to breathe. I feel like nothing I do makes it better.

Output: That really sucks to go through.  There are tons of ways to work with anxiety, both directly and indirectly that can help with what you are dealing with.Do you think you may be experiencing a panic attack?  Sounds like you are feeling some dread about what will happen to you and physical symptoms common with attacks.  Panic attacks are the body's way of trying to alert you to danger, whether that is real or perceived.  It's not something your body does against you, but instead to keep you safe by keeping you in a state where you could react quickly (run, fight, etc.).  This can happen even if there aren't any real threats and you logically know you are safe.  Even if you aren't having panic attacks, that heightened anxiety can still feel really awful and exhausting.What have you done so far that is not working?  When the brain is in that "danger" mode, talking it down tends to be unsuccessful--this is very evident in bounds of research we have on how the brain functions.  The part of the brain that senses threats and triggers anxiety responses reacts more effectively to body signals to relax---such as controlled breathing.  Mindfulness breathing techniques have a lot of value for this reason and there are many options available (apps like Calm and Headspace, youtube guided videos, etc).  Try to keep in mind that having anxiety doesn't mean that you are actually in any danger, and mindfulness is not meant to be an escape.  It does help to regulate and make you feel more in control of your body.  Your anxiety will always come back down--you can even track it to see the real-time changes that happen.  It's normal for it to rise and fall a few times during a panic attack, so if you notice a rise, it has no meaning other than that you're body is normally going through it's anxiety response.I think seeing a doctor is a great idea to rule out any other issues happening within the body.  Some medical issues can materialize as anxiety and depression.  Depending on your symptoms, they may even suggest a medication developed for these issues.Anxiety is one of the top researched symptoms, so we do have tons of research available on what works and what's less effective.  We know that talking alone doesn't reduce the body's fear response, unless talking is the method of exposure (talking about a traumatic experience, talking within a group if you have social anxiety, etc.).  For the brain to learn you are safe, it takes experience via exposure while riding the wave of anxiety.  For example, if you fear vomiting, you would expose yourself to things that remind you of vomiting and breathe through the anxiety you feel without avoiding the triggers.  That would teach your brain that those triggers are actually benign, and would no longer  create that panicky response. It'd be difficult to say what that may look like for you, or even if you need that, but it could be worth connecting with a counselor (even online) to discuss these options.  The brain is always flexible to some degree to change, so hang in there while you figure it all out!


Input: How can I deal with this anxiety that keeps me up all night?

Instruction: I've been having horrible anxiety for the last week. I can't sleep. I get a sense of doom, and it's hard to breathe. I feel like nothing I do makes it better.

Output: Anxiety is usually a sign of a current problem to which familiar emotional patterns of feeling similarly upset, attach themselves.Try to understand more about who you are, what you like, feel uneasy about, especially your deeper emotions of being emotionally harmed or injured by meaningful people.Anxiety is best addressed indirectly by understanding and kindly accepting previous hurt and fears from long ago.Once you feel at ease with dynamics of past situations then the current anxiety will decrease.  This is because you will have adjusted and found new ways of handling otherwise frightening and overwhelming interactions and involvements with others.


Input: How can I be less afraid of people?

Instruction: I am a female and in my early teens. I don't want to feel afraid of people. When I meet someone, I know that they are okay, but I still feel afraid.

Output: First off, this is totally expected for someone your age!  You are just moving into the phase of life where your "job" is to figure out your identity and who you are.  It's no surprise you are afraid of people, if that's the way you feel you are struggling.If you are worried about people harming you, that paints a different picture.  Do you struggle to trust your evaluations of others?  What makes someone safe (ish) vs. potentially dangerous?  Sitting down and coming up with some ways you have done this in the past or qualities of the people you trust now can help to disentangle what means safety and what means danger. We can never truly know how someone will behave, but if we always choose to never trust, then we miss out on connection as well.  Your brain is still growing so the great news is it's so flexible to change.  It remains flexible for the entire lifespan, but the teen years are really the last time it's so moldable.  If there's someone in your life you can trust, reaching out for help can make how you are feeling less intense.  It's never fun to deal with everything by yourself.  Hope this helps!


Input: How can I be less afraid of people?

Instruction: I am a female and in my early teens. I don't want to feel afraid of people. When I meet someone, I know that they are okay, but I still feel afraid.

Output: Maybe the problem is learning to trust yourself to not be afraid other people!Reflect on what you believe would increase your trust of believing your own judgement on whom to trust.If you've had any type of violation during your growing up years or witnessed someone in your family be violated, emotionally, physically or through some terrible accident or incident, then you may hesitate to believe other people are safe and not to be feared.Give yourself plenty of time and reassurance that as long as you are making sincere effort to increase you comfort around other people, eventually you will succeed.


Input: How can I learn to not shut down and say what's wrong with me?

Instruction: When I get talked to by my dad or stepmom, or if I'm in trouble, I will begin to cry and not say what's wrong with me. When my dad or stepmom ask what is wrong, I never know the answers or the words to put together what is actually wrong with me.

Output: I really admire that you want to express yourself to your parents!  It's very normal to have fear about how to talk to a parent, let alone two at the same time.  Most adults don't do what you want to do.Could you come up with what you want to say to them before you are feeling upset?  What do you really need them to know?  Also, do you want your dad and stepmom to meet certain emotional needs for you?  Maybe they would benefit from knowing that you have a hard time expressing yourself when you are upset and can help to come up with ways to help you through that.   Perhaps you need some space from them when you are crying, or maybe you need to talk to one parent alone vs both at the same time. You don't have to wait to be upset to have these conversations either--if you feel you can approach them when things are "calm" (whatever that means for your household), it may be easier to communicate.It's important to know they may not respond the way you want.  It's up to you to decide if you feel safe or not to express yourself, but it seems like you want to if you are seeking an answer for this dilemma!


Input: How can I learn to not shut down and say what's wrong with me?

Instruction: When I get talked to by my dad or stepmom, or if I'm in trouble, I will begin to cry and not say what's wrong with me. When my dad or stepmom ask what is wrong, I never know the answers or the words to put together what is actually wrong with me.

Output: Maybe you need more time to reflect and organize your thoughts.Try to figure out what would make you feel more relaxed about talking to your dad or stepmom.Also its possible you simply don't feel safe around either of them and so intuitively realize you're better off not talking with them about a delicate matter.Depending on whether you trust talking to dad and stepmom, you may simply wish to excuse yourself from speaking about yourself.There's no good reason to be heartfelt with people whom you don't feel are willing to accept or understand who you are.


Input: How can I get over my fear of public embarrassment?

Instruction: A lot of times, I avoid situations where I am to meet new people because I have a fear of embarrassing myself. I often avoid large groups of people, like parties, because I think they all constantly judge me.

Output: Hello, and thank you for your question. First, I want you to know that you are certainly not alone on this issue. Everyone, at some point in time, has a fear of public embarrassment. But for many people, this fear can become so awful that it begins to have a real negative impact on their quality of life.  They will try to avoid any situation that they even THINK will cause them embarrassment or anxiety. Escaping a possible embarrassing moment by avoiding or isolating may cause some relief at first, but then many times the avoidance will eventually lead to loneliness, isolation, and even despair. By avoiding, we can also miss out on things that make us feel alive and bring enjoyment. There are many self-help books that offer advice on this issue. You can do an internet search, and I recommend reading the reviews of the book. That is  great way to find out if others have found the book helpful. Another option is to seek a counselor to help you with this fear. I would recommend a counselor who specializes in helping people who have anxiety or social anxiety. Acceptance and Commitment Therapy is  a good choice for helping with anxiety, but there are many others. The truth is that anxiety and fear of embarrassing ourselves is not something that any of us will ever "get over", but we can learn to respond to those feelings differently. A colleague may offer some other advice, as well.. Be wellRobin Landwehr, DBH, LPC, NCC


Input: How can I get over my fear of public embarrassment?

Instruction: A lot of times, I avoid situations where I am to meet new people because I have a fear of embarrassing myself. I often avoid large groups of people, like parties, because I think they all constantly judge me.

Output: When I talk with clients about social anxiety sometimes I'll ask them what they would do if their anxiety was manageable.  Would you want to be more social?  Would that improve you quality of relationships in your life?  These answers can clarify what you want your life to look like and how much socialization you are truly interested in.It's normal to have thoughts and fears about what others are thinking of us, otherwise we'd be pretty shameless in our behavior!  Even though we feel as though we are in the spotlight, the truth is that most people are not focused on us.  There's hundreds of thousands of stimuli the brain processes (especially at a party!) and you are a very small percentage of that.  Think about it this way--if you are at a party with a bunch of other people, why would you be in "center stage" vs anyone else at that party?  When people are worried about embarrassment or judgment, they typically act in ways to be less visible in public.  Chances are, people notice you less than they notice others simply because of avoidance behaviors.I don't think it's needed to attend every social event because who has the energy for that?!  But pushing yourself to engage can teach your brain that you can push yourself through these events.  The more you avoid, the more your brain will because the situation is something to fear.  If you can, stick with someone you trust or connect to.  That could help you to enjoy the experience more and frame it somewhat positively.If you really struggle on your own, you could visit a counselor and work on some strategies that fit for you.


Input: How can I get over my fear of public embarrassment?

Instruction: A lot of times, I avoid situations where I am to meet new people because I have a fear of embarrassing myself. I often avoid large groups of people, like parties, because I think they all constantly judge me.

Output: Why not accept and tolerate that you naturally are a shy person who doesn't like large groups?This is not necessarily something to get over if it is part of who you are.People have the capacity to judge others regardless of whether the group is large or small.If you aren't afraid of being judged in small groups then study the factors which allow you to feel safe in small groups. Possibly you can generalize your findings to large group venues.If you try the and aren't successful, then likely you simply aren't naturally someone who cares for large group settings.Not everything a person doesn't like is a symptom of something is wrong w the person!


Input: How can I talk to my psychologist about upping my dose of Xanax?

Instruction: I’ve been on 0.5 mg of Xanax twice a day for the past month. It hasn't been helping me at all, but when I take 1 mg during a big anxiety attack, it calms me down. I was wondering how I can ask my psychologist to up the dose to 1 mg twice a day without her thinking I'm abusing them. I just have very big anxiety attacks. Should I stay on the 0.5mg and deal with the attacks or should I ask to up the dose? I'm afraid she will take me off them and put me on something else.

Output: It seems like what you are looking for is a way to advocate for yourself and that's so important in mental health! You know best what is working for you and what isn't, so you are the best person to speak out for yourself to the people that can help you. I have extensive training in substance abuse and medications used in therapy, and I work with many people that take Xanax.  Counselors may not prescribe, but with the right training we can educate and help you move through the complexities of medication usage when paired with therapy. There's definitely some debate about using medication in the counseling world, but many people are prescribed Xanax to cope with big emotional responses.  We don't know much about your situation here--if you are in counseling, what types of other coping skills you've tried to use, etc., so it'd be hard to suggest not taking anything for your symptoms.  You are obviously struggling and sometimes stabilization is the best you can do.  And the fact that you are considering dealing with the attacks as an option is a sign you are willing to negotiate your dosage and maybe even the intense fear you are experiencing.  That's seriously so courageous.A little bit about Xanax--Xanax is a drug in the Benzodiazepine family and is fast-acting.  That means it does only help short-term, but your body also builds a tolerance to it pretty quickly (just as people build tolerance to alcohol).  That could be why they aren't as effective for you at the dosage you are taking, especially if you are prescribed to take them twice a day.  It's really important that you discuss the symptoms you are still having with your prescribing provider, as well as when you are taking the medications so they understand the details of your situation and can determine if or how to modify your dosage.  These providers know a lot about the medication process and the more info they have, the better they can meet your needs.  They are ultimately the ones that will work with you to decide whether or not Xanax is the best for you and your situation.I definitely understand your concern that your provider may basically take away how you cope with panic attacks.  That's a scary thought!  Prescribing providers are typically trained in detecting medication abuse, and it is very common for people with anxiety issues to request higher dosages.  I have had plenty of clients ask for increased dosage.  Not only can this get you the assistance you need at the time you need it, but give you a voice in your treatment.  You may end up using that same voice for request to lower your dosage in the future.I do feel an ethical duty to let you know about some of the dangers of Xanax.  Benzodiazepines are depressants and work on the central nervous system (CNS) to do things like slow down your heart rate, breathing, etc. (as you can feel when they do work).  They should never be taken with any other depressants, such as alcohol, barbiturates, and other medications in the Benzo family.  Combinations like these could be fatal.Another danger is that there's a common pattern of relapse after discontinuing Xanax.  This means that symptoms tend to come back stronger than they were before taking the drug.  The reason for this is because when you are taking Xanax, your brain tries to intensify your fear reaction to override the drug.  So when you discontinue it, your fear reactions are still at those heightened levels.  Your prescribing provider can talk to you more about that and/or the process of tapering off the medication to make that less likely when that time comes for you.If you are in counseling and doing exposure activities, (being exposed to things you fear and sitting through the anxiety response) Xanax does interfere with this process.  The brain can't learn a different response if you feel calm.  This is something your counselor (if you have one) can discuss with you as well.The last thing I'd like to say is that there could be some value to practicing other ways to manage your anxiety if you want to make more long-term changes.  That decision is completely yours!  If/when you feel ready to do that, a counselor can help you learn how to move through anxiety without being as reliant on Xanax.  I hope this is helpful and you find what you need!


Input: How can I talk to my psychologist about upping my dose of Xanax?

Instruction: I’ve been on 0.5 mg of Xanax twice a day for the past month. It hasn't been helping me at all, but when I take 1 mg during a big anxiety attack, it calms me down. I was wondering how I can ask my psychologist to up the dose to 1 mg twice a day without her thinking I'm abusing them. I just have very big anxiety attacks. Should I stay on the 0.5mg and deal with the attacks or should I ask to up the dose? I'm afraid she will take me off them and put me on something else.

Output: Do you think you're abusing xanax?It is a highly addictive drug so maybe one reason you feel compelled to take more is bc you already are addicted.Drugs don't do anything helpful in solving life's problems.   Once the effect wears off, the stressful situation is once again waiting for you to address it.Think over your reason for not directly asking your psychologist about upping your dose.Also, do you ever talk about your life problems with this psychologist or only your need for drugs?    The more gradual path to a better life is to not need drugs in the first place. This consists of your willingness to face the matters that are creating such terrible feelings inside you.


Input: How can I talk to my psychologist about upping my dose of Xanax?

Instruction: I’ve been on 0.5 mg of Xanax twice a day for the past month. It hasn't been helping me at all, but when I take 1 mg during a big anxiety attack, it calms me down. I was wondering how I can ask my psychologist to up the dose to 1 mg twice a day without her thinking I'm abusing them. I just have very big anxiety attacks. Should I stay on the 0.5mg and deal with the attacks or should I ask to up the dose? I'm afraid she will take me off them and put me on something else.

Output: Staying on the lower dose may give you more room to learn strategies for coping with your anxiety.  Medications are so helpful, and needed at times, but it's also important to have a variety of tools you use to manage your responses to stress.  If you are not already seeing a therapist, consider finding one who can help you learn some effective strategies, like replacing self-defeating thoughts with ones that work better for you, or mindfulness, relaxation, or other tools to keep your anxiety in the manageable range!


Input: How can I talk to my psychologist about upping my dose of Xanax?

Instruction: I’ve been on 0.5 mg of Xanax twice a day for the past month. It hasn't been helping me at all, but when I take 1 mg during a big anxiety attack, it calms me down. I was wondering how I can ask my psychologist to up the dose to 1 mg twice a day without her thinking I'm abusing them. I just have very big anxiety attacks. Should I stay on the 0.5mg and deal with the attacks or should I ask to up the dose? I'm afraid she will take me off them and put me on something else.

Output: In general, Xanax is very short-acting. You mentioned that you are afraid that your medical provider will take you off of the Xanax and put you on something else. If the Xanax is not working well for you, I wonder if something else may work better. What is your reasoning there? Also, sometimes there are medications that you can take in addition to Xanax.In addition to talking with your medical provider about changing the medication, try to track your levels of anxiety on a scale of 1 to 10 throughout the day so you can get a pattern of what is happening. Also consider writing down what is happening before you have anxiety attacks. This may help your medical provider know what medication may be helpful to you or what changes could be made.As far as how to discuss this with your medical provider, I would suggest mentioning the symptom changes you are having (anxiety attacks that are not helped with 0.5mg of Xanax) and ask what they would suggest that might help. If your medical provider suggests taking you off of the Xanax, I would recommend talking about the reasons why you would prefer to stay on the Xanax and what your concerns are about coming off of it. You could also ask whether anything could be combined with Xanax.There are also many other anxiety medications. I have seen lots of people that take more than one medication to lessen anxiety that they are having.I would also consider talking with a therapist (unless the person who is prescribing a medication is also doing therapy with you). Getting more information about your anxiety and how it is affecting you may be greatly helpful to you.


Input: How can I talk to my psychologist about upping my dose of Xanax?

Instruction: I’ve been on 0.5 mg of Xanax twice a day for the past month. It hasn't been helping me at all, but when I take 1 mg during a big anxiety attack, it calms me down. I was wondering how I can ask my psychologist to up the dose to 1 mg twice a day without her thinking I'm abusing them. I just have very big anxiety attacks. Should I stay on the 0.5mg and deal with the attacks or should I ask to up the dose? I'm afraid she will take me off them and put me on something else.

Output: Hello, and thank you for your question. While counselors work closely with medical providers, and sometimes have discussions about medications with people, we rarely make recommendations about how much or what type of medication a person should be taking. This is because prescribing and advising on medication is out of our scope of practice. The only exception would be if a counselor is also a physician, nurse practitioner, physician's assistant, etc. Having said that, I certainly understand that anxiety is a real serious problem that many folks struggle with. If you are currently not in therapy to help you with these panic attacks, you should consider it. Medications can be helpful for anxiety, and medications like Xanax may help for immediate relief, but they do nothing to deal with the root of anxiety and may not help with anxiety long-term. Therapists who have experience in exposure therapies would be good people to start with. Exposure therapy has good outcomes for people with anxiety disorders and panic attacks. If you are interested in speaking with your provider about the Xanax, I think explaining it the way you did on here is just fine. The provider will then decide if they feel comfortable increasing your medication. Please remember that medical providers are not trying to give people a hard time. Medications like Xanax really are highly addictive. The more you take, the more you may feel you need. The more often you may feel you need to use it. Depending on the frequency and amount of use, some people suffer serious withdrawal symptoms when they do not take the medication. It is a good idea to talk to medical provider about all of those things so that you can partner on right course of action to manage this anxiety. I certainly hope that you get some relief.... I know anxiety is awful.Robin J. Landwehr, DBH, LPC, NCC


Input: How is it that I fear going to sleep?

Instruction: I just about fall asleep then I can't help but sit up and walk around.

Output: This is very common!  Sleep is when we are most vulnerable and it requires our bodies to let go of control and lose awareness of a lot of our environment.  Has anything bad ever happened to you at night or when you were sleeping? This could be something to consider.  Your body may be feeling a need to protect you by not letting you relax and instead keeping you awake and aware to anything around you.Could you be worrying about what is happening the following day?  It's also normal to have pressures of the next day rolling through our minds before our bodies commit to sleep.  If you pay attention to what you are thinking about before bed, that could tell you a lot about what you worry about in your life.Not everyone is into meditation or mindfulness, but these methods can help send the message to your brain that you are safe.  There are some pretty neat apps like Calm and Headspace, or mindfulness videos on youtube that have a variety of tools to fit what you may need.  It may take a while for these to really start to show results, so keep at it if you have the chance.Journaling can also be a great way to release some of the stress from the day and silence the mind a bit.  Consulting with a doctor may also be a plus if your sleep continues to be impacted.  Not having proper sleep can lead to more anxiety and reduce the body's capabilities to regulate emotion, leading to worsened sleep.  Sometimes having a buffer there can help get your sleep on a better track while you work on the anxiety.  Hope you find some of this helpful!


Input: How is it that I fear going to sleep?

Instruction: I just about fall asleep then I can't help but sit up and walk around.

Output: Maybe you are afraid to let go of your problems for a few hours.Although you didn't write this, usually what keeps people awake or prevents them from falling asleep are worries about certain situations in their lives.If this describes you then. maybe talk with yourself to convince you that you are entitled to a good night's sleep.Really we all are and feeling rested from the day and life's tensions will better you to handle whatever the particular matters are.Also, maybe you will be more enthusiastic to go to bed if you have a comfy mattress and nice pillows!  Make your bed an inviting place because this will tempt you to enjoy relaxing enough to go to sleep!


Input: How do I handle my extreme paranoia?

Instruction: I'm just an extremely paranoid person. I constantly feel as though I am in some sort of danger, like as though I live in a horror movie with no resolution. It worsens at night. It gets to the point I'm scared in my own home more so than anything. I have no access to the help I need so I'm desperate.

Output: That really sucks and I'm sorry that's happening to you.I'm curious what kind of paranoia you are experiencing--like someone will hurt you?  That something bad in general will happen?  Sometimes intrusive thoughts, like paranoid thoughts, are just thoughts.  They don't mean you are actually in danger or that something bad will happen, so pay attention to the meaning you apply to those thoughts.  If you've been through something traumatic such as rape, domestic violence, or any situation like that, it could provoke paranoia bigtime.  Your brain feels as if it has to be "hypervigilant", meaning it has to be extra attuned to everything around you to keep you safe.  That's exhausting.  If it's worse at night that probably means you aren't getting much sleep--also exhausting and contributes to heightened paranoia, so it becomes a pretty vicious cycle.It's not shocking that it's worse at night because night is generally a scarier time and sleeping is, physically, when we are in our most vulnerable state.  It can help to take a look at how much of that paranoia is actually helping you to protect yourself vs. how much is additional stress.  A way to figure that out is to ask the question, what behaviors are necessary to keep you safe?  So if you lock your doors, lock the windows, shut the curtains, have an escape plan (if needed--I'm not sure what your situation is), is that the most you can do?  Beyond that, are you performing other behaviors that may not be keeping you safe but exist to cope with the paranoia?  For example, if you are checking over and over to make sure the doors and windows are locked, those behaviors are more like compulsions/rituals that help you feel safe by reducing anxiety even though they use a ton of energy to perform.  Response prevention can be helpful here--this method involves avoiding your usual response so that you can sit with the anxiety rather than escaping it through the behaviors.  Let's say your anxiety rises and you feel the need to check the door lock.  You check the lock, it's for sure locked, and your anxiety is reduced.  At the same time, the behavior of checking the lock is reinforced by feeling better, so your brain decides if you want to feel better, you need to check the lock.  It becomes an exhausting habit that only temporarily makes you feel safe.  However, if you feel a bout of anxiety and sit through it without checking the lock, your anxiety will go back down and your brain learns that you don't need to perform that behavior over and over.  I'm so sad to hear you don't have access to help.  There may be some counselors right now offering reduced-rate or probono (free) sessions via telehealth due to COVID-19, so if you search around on google for your specific state, you may find someone that can help you from your home.  Counselors usually reserve space on their schedules for people that cannot afford therapy or need a lesser rate.You are always welcome to come back to this forum and ask additional questions!


Input: How do I handle my extreme paranoia?

Instruction: I'm just an extremely paranoid person. I constantly feel as though I am in some sort of danger, like as though I live in a horror movie with no resolution. It worsens at night. It gets to the point I'm scared in my own home more so than anything. I have no access to the help I need so I'm desperate.

Output: One approach is to be more accepting of yourself as someone who has fears.It is much easier to manage a problem when you're not fighting yourself for having a problem.Once you are willing to accept this quality within yourself you may start to feel a little more relaxed about handling the fears when they arise.One answer is to examine the facts about the fears.   Ask yourself fact based questions as to how you would handle the worse case scenario of your fears.Feeling prepared, whether or not the circumstance is highly unlikely to happen, may increase your peace of mind with living the great fears within your mind.


Input: Why am I scared to touch a girl?

Instruction: I don't know if I'm normal. I'm really scared to touch a girl. I'm a young adult and a virgin. My fiancée and I want to have sex soon, and this might mess everything up because she wants a baby soon as well.

Output: Only going off of the information in your question, it seems like you maybe have some performance anxiety and fear disappointing your fiance.  Fear can be tricky in the sense that it quite often masquerades as something that seems under our control.  For example, your fear of touching a girl may actually be a fear of being incompetently intimate or a bad fiance--It's easier to deal with those fears by avoiding touch because that gives you control and how else would you deal with those fears? I wonder if your fiance can be of any help to you.  It's scary to admit fears to people close to us but they can also offer some of the best support if that's been something you've experienced with her in the past.It sounds like you are really hard on yourself as well.  It's normal to have anxiety about your first time having sex---that's a really special milestone!  Maybe it's worth looking into performance anxiety tips?  That can help you feel more prepared without removing the spontaneity of intimacy.If it feels like nothing is working for you, you could see a counselor or sex therapist to explore more of that fear.  It's nothing to be ashamed about because it does happen to both men and women!


Input: Why am I scared to touch a girl?

Instruction: I don't know if I'm normal. I'm really scared to touch a girl. I'm a young adult and a virgin. My fiancée and I want to have sex soon, and this might mess everything up because she wants a baby soon as well.

Output: Your question is a good one!The best way to decrease the fear would be to talk with your fiancee about it.   Eventually she'll find out, and better to talk about it when there is less pressure than to be in the midst of a situation which frightens you.Also, she may feel similar to you, who knows?Discussing a topic which relates directly to your relationship is a good way to increase emotional intimacy.  And emotional intimacy has a lot to do with feeling at ease with physical intimacy.


Input: How can I be less stressed out?

Instruction: I shake and have panic attacks.

Output: So glad you are reaching out.  Panic attacks are very frightening.For some reason (and I promise there is one) your brain is sending off false alarms even though you are probably safe.  This is called the fight or flight response and part of the body's way of fighting off perceived threats (including those that are not genuinely dangerous).Some reasons people have panic attacks is if they are under too much emotional or physical stress, any type of exhaustion or lack of sleep, history of trauma, unprocessed emotions, etc.  You don't have to know why you are having panic attacks to work with them, but it can help to understand its origins and target them at the source.Something to know is that the presence of anxiety does not mean you are in any danger, no matter how much your body is elevated.  Anxiety is just our body's way of letting us know something is off, though it often exaggerates the response because it doesn't always operate from a place of logic.  Triggers could be as small as a word, smell, time of day, or really anything.  Triggers can also be physical sensations inside our bodies.  Though panic attacks are very scary and feel incredibly uncomfortable, they will not kill you.What message might your body be sending you via panic attacks?  Is there any area of your life you could step away from at all to give yourself some relief?  If you pay attention to when panic attacks happen, that could clue you into what is setting off that false alarm.Some apps that are really great for relaxation and use breathing techniques are Calm, Headspace, PanicShield, etc.  Try some out and see which ones really fit for your needs.  Breathing is a great tool because you always have it right there with you and it's something you can control when it feels like your body is out of control.


Input: How can I be less stressed out?

Instruction: I shake and have panic attacks.

Output: One way to understand panic attacks is as a sign of feeling insecure or lacking confidence in a certain area or characteristic of yourself.The insecurity can sometimes feel overwhelming and this starts the sense of panic. One way to build your sense of security within yourself is to have a simple life and a slow paced life.   When there are many activities or involvements to pay attention, then it is easy to not give full attention to all of them.  This may trigger a sense of insecurity since in fact you may not have had sufficient time to study and know your own opinion about all of what your life is immersed in.A simpler life of fewer activities allows more time to know and understand your own inner feelings and reactions.To know more about yourself may help build your confidence and security in your ability to know and live what goes on in your life!


Input: How can I be less stressed out?

Instruction: I shake and have panic attacks.

Output: One of the first things I would suggest is to see if you can keep track of what is leading you to feel anxious. If you shake all the time, consider talking with your primary care physician. Sometimes that can be a hormonal imbalance or another chemical imbalance (such as thyroid).One of the most difficult things about anxiety is that having anxiety (particularly panic attacks) can lead to anxiety about having more panic attacks. Also remember that panic attacks are typically part of your brain's protective response to what it considers to be some sort of threat. You may have heard of the fight or flight response. When you have an anxiety attack, your body is preparing you to react to something that isn't actually a threat, so it's almost as if you're fight or flight response is overactive. Here is an image that may be helpful: http://psychology.tools/fight-or-flight-response.htmlThere are many different things you can do. You can practice breathing, mindfulness, meditation, or yoga techniques. If you decide to try some breathing techniques, try breathing in for a count of five, holding for a count of five, breathing out for a count of five, and repeating five times.Also remember that it is easier to learn these techniques when you're not having a panic attack. At that point, it can be really difficult to use methods to not panic. Also remember that panic attacks typically last 5 to 10 minutes. Using techniques to slow your breathing or become focused on the room around you is probably most helpful when you first start to feel anxious.Here are some other techniques that may help to decrease anxiety: http://psychcentral.com/lib/9-ways-to-reduce-anxiety-right-here-right-now/As you figure out what is leading up to your anxiety, also consider asking yourself what is making that certain issue a big concern for you. Another important question could be when you have felt that way before.


Input: When I'm around children I get this intense feeling of paranoia and fear

Instruction: I'm a male in my early 20s. Lately, my paranoia about being around kids is causing me too breathe heavy and sweat a lot. I then start to act weird because I'm trying to fight my paranoia. This leads to people starring at me because they don't know that I'm suffering from panic attacks and paranoia. They just notice me acting scared around kids and they think I'm a threat because of it.    I'm not a pervert or predator. I would never hurt a kid. I like kids and don't know why I'm so scared to be around them.    I don't understand why I feel like this. Am I a bad person? How do I make this stop?

Output: Your very concern about your response to being around children shows that you aren't a bad person--it actually speaks to that you care. Panic attacks are really scary and not easy to deal with.  I wonder what you mean by paranoia--does this mean you are worried about your body's response when you are around kids?  Do you worry about their behavior?  Or does paranoia for you mean that you are worried about other people's judgments of you because of panicking?  If what you are saying is that you are trying to fight off the anxious feelings you have, it could intensify your symptoms because emotions want to be acknowledged.  One way to help manage through that is via deep breathing.  You can check out some videos on youtube that you vibe with and the nice thing about practicing this is it's very easy to do in public without people noticing.I'm also curious about more of the details of what your experience is like.  Are there certain age ranges or behaviors that trigger your anxiety?  Figuring out the specifics of what sparks that response in your body will give you some basic insight into why you are feeling that way and what types of situations to prepare yourself for.  You can do this by paying attention to what happened right before you started feeling anxious.If you are looking for more personalized ways of working through your anxiety, a counselor can help personalize treatment for you.  There are a lot of telehealth counselors available right now at lower rates due to the COVID issue as well.Overall message here is there's so much you can do and your anxiety means nothing bad about you!


Input: When I'm around children I get this intense feeling of paranoia and fear

Instruction: I'm a male in my early 20s. Lately, my paranoia about being around kids is causing me too breathe heavy and sweat a lot. I then start to act weird because I'm trying to fight my paranoia. This leads to people starring at me because they don't know that I'm suffering from panic attacks and paranoia. They just notice me acting scared around kids and they think I'm a threat because of it.    I'm not a pervert or predator. I would never hurt a kid. I like kids and don't know why I'm so scared to be around them.    I don't understand why I feel like this. Am I a bad person? How do I make this stop?

Output: In our practice, many people we see have unwanted thoughts of doing harm to children - physically or sexually. As you said, these are intrusive and unwanted thoughts - not genuine desires to harm them. This is a form of OCD we often call Harm or Pedophilic OCD. What you are describing here as "paranoia" sounds similar to this, and is so demoralizing because you are dealing both with the distress of these unwanted thoughts and feelings, as well as the fear and uncertainty about your own character as a good person.If this is really what is going on (further assessment by the right professional would determine this), the current gold standard approach to addressing OCD is Exposure with Response Prevention - in this case, confronting the feared situations, thoughts or images on purpose, rather than avoiding them, until they lose the fear and shame associated with them.


Input: When I'm around children I get this intense feeling of paranoia and fear

Instruction: I'm a male in my early 20s. Lately, my paranoia about being around kids is causing me too breathe heavy and sweat a lot. I then start to act weird because I'm trying to fight my paranoia. This leads to people starring at me because they don't know that I'm suffering from panic attacks and paranoia. They just notice me acting scared around kids and they think I'm a threat because of it.    I'm not a pervert or predator. I would never hurt a kid. I like kids and don't know why I'm so scared to be around them.    I don't understand why I feel like this. Am I a bad person? How do I make this stop?

Output: Your question is written in a very sincere tone.   This, together with the fact of searching for self-understanding, sound more like someone who is unsure and puzzled, not someone who is "bad".What was your own childhood like?The sensations you describe feeling sometimes occur in people who are reminded of very deep hurts from during their own childhood.Is it possible what you're feeling is from being reminded of great distress you lived through when you were at a similar age as the kids around whom you feel this sudden and great paranoia and fear?


Input: Why do I find pleasure in thinking about killing?

Instruction: I am a peaceful person, but I often find myself having thoughts about killing people. Eventhough I like the thoughts at the time, they make me cry. Why do I feel like this?

Output: Let me point a couple things out to you.  These thoughts obviously go against your core values, otherwise they wouldn't upset you!  Having thoughts about killing people bugs you, and that's a GOOD sign.  You are also concerned enough to reach out on this chat forum.  That tells me you have put some time into worrying about these thoughts and what they mean.There's absolutely nothing wrong with a thought.  We all have extreme thoughts in life because our brains are built to wander.  Unless you are acting on these thoughts, they are not dangerous.  It's important to note that having a thought doesn't mean you are that thought.  It's pretty easy to assume that our thoughts are who we are, but that couldn't be less true.  If we were our thoughts, we'd be so many different things at once it'd be unimaginable!Something I wonder is if these thoughts feel intrusive to you.  Even if you enjoy them, do they seem to show up without invitation?  When a thought is intrusive in nature, it can often make someone feel as if it is uncontrollable and holds more weight than less intrusive thoughts.  It is also interesting that you mention finding pleasure in thinking about killing in the sense that it's definitely giving you some psychological relief in the moment.  From that, I have two thoughts: 1) could it mean you are trying to cope with something socially upsetting to you via these types of thoughts? and 2) I'm wondering if there is any repressed anger in your life.  You mention being a peaceful person.  Are you usually the peacemaker in your social world?  Do you feel as if people take advantage of you or that you don't have a voice?  Those situations can breed anger and resentment. If you don't allow yourself to feel or express anger, the brain will find a way to do it for you and it's not weird or strange that it would want to send out thoughts that clearly get your attention!Another thing you could try is tracking when the thoughts come up.  Keeping a log can help shed light on what may be triggering them and what their purpose may seem to be.Wishing you all the best!


Input: Why do I find pleasure in thinking about killing?

Instruction: I am a peaceful person, but I often find myself having thoughts about killing people. Eventhough I like the thoughts at the time, they make me cry. Why do I feel like this?

Output: Maybe because you have great emotional pain stored inside you of which you are not aware exists.Sometimes people who feel greatly hurt by others or who feel unloved by others, imagine if they do the opposite of love, which is to kill, that they will get the recognition and acknowledgement from others which they wish would come to them in a loving way.This is my theory, it is not necessarily a definitive description of your inner dynamic.Most important is to keep an open mind to self-discovery on your feelings, including the ones which are uneasy, such as killing, to consider.


Input: Why do I find pleasure in thinking about killing?

Instruction: I am a peaceful person, but I often find myself having thoughts about killing people. Eventhough I like the thoughts at the time, they make me cry. Why do I feel like this?

Output: Hello, and thank you for your question. Clearly this is something that has you very concerned. Sometimes thoughts are just thoughts, and they are pretty harmless. Many people have thoughts of killing someone, but they would never actually do it. They really don't even want to do it, they are just having a thought. Other times, thoughts are a sign of something more serious, and we should receive help when they start to worry us. I would recommend meeting with a counselor to discuss these thoughts. It is usually a safe environment where you can get advice with little judgement. Now, If you begin to start thinking about killing someone specific and making a plan to do it in reality- you should call for help immediately. By help, I mean 9-11, or a family member or friend. You would want to get help before doing something to harm yourself and others. Again, none of this is to judge, but rather to encourage you to get the help you're seeking. Either way, when we become concerned about some aspect of our behavior, seeking counseling is usually a good choice. Be well, Robin J. Landwehr, DBH, LPCC, NCC


Input: I don't want to keep going back and forth between my parents' houses

Instruction: I'm 17 and I'm sick and tired of going back and forth. I'd like to stay at my mother's house. This problem has really affected me. I've had anxiety attacks and suicidal thoughts and self-harm in the past.    Currently I'm going through anxiety and my thearapist is not available. How do I handle this?

Output: Sounds like a lot is going on right now at such a young age. I'd start with discussing with mom your concerns and ideal situation. I'm unsure what prevents you from staying there, but whoever you are staying with, it should be brought to their attention. In regards to your anxiety attacks, deep breathing is always a benefits. I have a link you can use to help to do this online if you are interested. In addition, finding ways you usually cope with anxiety and what's worked before can help and if it isn't, exploring new way to calm you down can be beneficial. This is something you can speak with your therapist about going forward when they are available.In regards to feeling suicidal: I would call suicide prevention hotline (You can google them) if you truly feel the ideation is getting worse. They are professional agents who can speak with you about your ideation and help you through the process. Hope this helps.


Input: I don't want to keep going back and forth between my parents' houses

Instruction: I'm 17 and I'm sick and tired of going back and forth. I'd like to stay at my mother's house. This problem has really affected me. I've had anxiety attacks and suicidal thoughts and self-harm in the past.    Currently I'm going through anxiety and my thearapist is not available. How do I handle this?

Output: That's a really tough situation and it can feel like you have no control as a teen.  Have you checked your state's laws?  In some states, you can choose which parent you live with as long as you are above a certain age.  How comfortable do you feel about talking to your mom about staying there?  Maybe there's a way she can help advocate for you? Or support you in the ways you need?Try to remember that although it may feel like this is your life forever, you only have less than a year until you can make those kinds of decisions for yourself.  When your therapist becomes available again, it may help to come up with a plan to make it through the time you do have left.  That can include things that help calm you, things that help you survive your dad's house if you have to go, friends you may be comfortable confiding in, etc. If you are feeling like you need more emotional support, you can text HOPE to 741741 (the Hopeline)--they are a great resource that doesn't require too much privacy if you are around other people.


Input: I don't want to keep going back and forth between my parents' houses

Instruction: I'm 17 and I'm sick and tired of going back and forth. I'd like to stay at my mother's house. This problem has really affected me. I've had anxiety attacks and suicidal thoughts and self-harm in the past.    Currently I'm going through anxiety and my thearapist is not available. How do I handle this?

Output: At age 17, I think you are old enough to decide which parent you want to stay with full-time. I would gently and lovingly tell your father that you've decided to stay with your mother. You can offer to visit him regularly, if you'd like. Parents often have a hard time letting go and, especially in divorce situations, your dad might feel as though he's "lost the battle" if you go live with your mom. He might also feel he's lost you. If your dad is unrelenting and the situation unbearable, you can ask a judge to modify the custody agreement.


Input: I don't want to keep going back and forth between my parents' houses

Instruction: I'm 17 and I'm sick and tired of going back and forth. I'd like to stay at my mother's house. This problem has really affected me. I've had anxiety attacks and suicidal thoughts and self-harm in the past.    Currently I'm going through anxiety and my thearapist is not available. How do I handle this?

Output: OK first things first. We have to think of your safety and take care of those thoughts of hurting yourself.Yes, this is a major problem for you and can cause anxiety and depression. You have the right to be sick and tired. Kids often are pawns in this marital problems that their parents have. I'm sorry that this is happening to you.I am not sure of your rights in the state you live in but as far as I know you as a 17 year old you have the right to stay where you want. So your'e going through an anxiety episode and your therapist is not available.  If I'm the therapist we would have already set up a plan so that if you are in this situation you would know what to do. In the worst case scenario you would be able to contact me.But I would have given you several exercises to help reduce your anxiety.Staying with your mom should be your choice. I know you probably don't want to hurt anyone's feelings but there are ways to ease the tension. Maybe with your permission and their agreement, we all could meet together for a session or two to ease your tensions and get over and through this hassle.


Input: I don't want to keep going back and forth between my parents' houses

Instruction: I'm 17 and I'm sick and tired of going back and forth. I'd like to stay at my mother's house. This problem has really affected me. I've had anxiety attacks and suicidal thoughts and self-harm in the past.    Currently I'm going through anxiety and my thearapist is not available. How do I handle this?

Output: Have you told either of your parents that the current house rotation of where you stay, bothers you?Since each parent has an interest to be together with you, I imagine that to some degree, each cares how you feel.If these conversations are not getting your problem solved, then maybe your therapist can have a family session with your parents together and depending on the outcome, with you and each parent.


Input: I don't want to keep going back and forth between my parents' houses

Instruction: I'm 17 and I'm sick and tired of going back and forth. I'd like to stay at my mother's house. This problem has really affected me. I've had anxiety attacks and suicidal thoughts and self-harm in the past.    Currently I'm going through anxiety and my thearapist is not available. How do I handle this?

Output: I am so sorry to hear you are going through this. Divorce can be so disruptive in a child's life.I'd really need a lot more information about your situation before I'd feel comfortable offering any advice or suggestions. There are so many variables, and not knowing the whole story, any advice could possibly make your situation worse.I do see some positives, though. One, you say you have a therapist. That's great! I hope you're able to talk to them about this soon. Still, they can't give you legal advice, and a lot of this situation may be dictated by the law. What your therapist can help with, though, is dealing with whatever situation you have to follow by law. If you can't change the situation, you at least need to learn how to cope with it better. Two, you're 17. When you're 18, you're legally an adult and will not be bound by any custody rules or visitation plans in place. Honestly, teenagers usually have a lot of say with the courts in custody arrangements. Since you didn't specify more on the situation, I have no idea what your specific situation is. Were your parents ever married? Are they separated or divorced? Was there ever a court hearing for custody? Not all couples have an official court order arrangement. All families are different, too. Was there abuse between your parents? Towards you by one of them? Does either of them have addiction issues, major health or mental health issues, or anything like that? You mentioned that you want to live with your mom, but didn't say why. Are you afraid to tell your dad you want to stay with your mom? Is mom the lenient and fun parent while dad is the more strict one, or is there something else going on? This isn't a decision that should be placed entirely on you, and it also isn't a decision that anyone else needs to make on your behalf without your input. But advice on what to do needs to come from the people who know more about your situation so they can help recommend the best thing for you. Whatever you do, hang in there! 18 will be here before you know it. Focus on that. Freedom. College. Plan for your future that YOU control, and focus on making it the best it can be. Do not let the anxiety and depression cloud your thoughts and make you do something irreversible.