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Anxiety is part of everyday life, and everyone experiences anxiety and fear from time to time. Mild worry, anxiety, and fear plays an important role in helping us prepare and deal effectively with challenging and threatening situations; they are all necessary responses in adapting to life. However, people with anxiety disorders experience anxiety with a greater frequency and intensity that interferes with daily life. Fortunately, anxiety disorders are treatable, and people can improve considerably from treatment by learning ways to cope effectively with their anxiety, worries and fears.

Anxiety disorders may include generalized anxiety disorder, social anxiety, specific phobias, panic disorder, obsessive compulsive disorder, post-traumatic stress disorder, acute stress disorder, substance-induced anxiety disorder, and anxiety due to medical disorders.

Generally, people with anxiety disorders experience distress along with disturbance in sleep, concentration, greater sensitivity to physiologic changes and problems in social interaction or job-related situations.

Although anxiety disorders differ in their symptoms and treatments, broadly speaking, anxiety may include some of the following: over-vigilance, apprehension, and excessive or irrational worry or fear which interferes with daily functioning. There is an excessive fear of losing control of oneself or of a situation. Physical symptoms may include restlessness, irritability, muscle tension, sleep disturbance, stomach pains, hot flashes, rapid heartbeat, etc.

Dr. Carlos Durana offers comprehensive programs for recovering from anxiety disorders in his individual counseling practice in Bethesda, Washington DC, and Reston. This program includes ways to help:

1)    Transform the “self-talk” or personal rationalizations that maintain and intensify anxiety and worry. These negative interpretations are based on faulty assumptions or distortions. For example, when we imagine the worst outcomes or “blow things out of proportion,” we tend to display an “attention bias” towards a perceived threat. So, if a person fears snakes, the brain becomes very vigilant to anything that resembles a snake – every stick then looks like a snake. Many types of therapy treat anxiety disorders, but the leading approach as shown by research is cognitive behavioral therapy (CBT). Dr. Durana uses this approach in his individual counseling work to help the client challenge the negative or irrational thoughts that contribute to the anxiety, and replace these with positive realistic and calming statements, in order to defuse a situation that creates a great deal of anxiety.

2)    Eliminate the habits or behaviors of avoiding situations and cues that trigger anxiety. Avoidance causes the world of the anxiety sufferer to shrink. The person will avoid getting on the plane, speaking in public, going outside the house, etc. These habits must change to be successful. In this treatment, exposure therapy gradually exposes you to the situation in a way that you gain an increasing sense of control over it. In therapy, you will learn mindfulness skills that help you step back, accept the fear and regain motivation to transform the fear (“I don’t like it, I am scared, but I can do it anyway, so I step up”). In counseling, the strategies are designed to gradually expose the client to increasing levels of discomfort so that the client moves from avoidance to, “I can handle more than I think I can,” to “I can handle it.” This method is a step-by-step process for overcoming your fears and achieving your goals.

3)    Learn to manage and reduce physiological symptoms associated with anxiety, and expand one’s ability to experience positive feelings and wellness. This includes learning relaxation and stress management skills, breathing and meditation techniques, and body awareness and body-centered psychotherapy skills. Dr. Durana encourages the use of moderate exercise, because it plays a key role in reducing physical symptoms. Lifestyle measures are also important; these may include nutrition information to balance blood sugar and energy, healthy sleep habits, and wellness coaching. For some individuals, medication may be used as an adjunct to individual therapy.

Therapy and counseling with Dr. Durana in Reston or Bethesda helps you to work on enhancing self-esteem and self-confidence, while teaching you assertiveness and relationship skills. For many, the comprehensive and integrative approach above helps to achieve personal success. For others, recovery from anxiety may also entail tackling questions of meaning, purpose, and spirituality.

Carlos Durana, Ph.D. practices counseling and therapy in Reston, VA, Washington, DC, and Bethesda, MD.

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