This is my problem. I give people my entire friendship, which everyone knows I’m a pretty awesome friend. I always have everyone’s back and always want everyone else to be happy. Even though I know these people don’t care about me like I do them, it physically and emotionally hurts to know that there’s nothing I can do. I think it is a part of my mental health issues. I see a counselor for the first time next week, but I want some input from other people who have felt this. I honestly think I seek the approval of everyone around me. When I was little, no matter how good my grads were, my parents were focused on my trouble maker brother. My dad got temporary custody of him when he got expelled from our school and all I wanted when I was in school was to live with my dad. I was upset because he wouldn’t fight for me and at my mom because she wouldn’t listen to me. She didn’t know that I cried all the time or barely had friends or got picked on in school. I remember when “popular girls” told me I could be popular if I stop being friends with this other girl that had freckles and curly red hair. They thought she was uglier than me. She never talked to me again and I still wasn’t popular, so then I was friendless. This was 3rd grade. I finally had a friend in 6-7th grade, but I had to move before I started 8th. Then I went to an even bigger school full of rich kids. I was a poor weirdo that wore clothes from Walmart and thrift shops while literally everyone I went to school with had fancy clothes and money to do things. When I started working at 15 I was able to buy myself a car. I got a 1993 Dodge Dakota, you know, the kind of car that had 2 keys: one for the ignition and one for the doors. My best friends dad bought her a 3 year old Ford Focus. It’s not that I wanted to have fancy things, because believe me, I am grateful that when I graduated and got pregnant that I knew how to take care of myself while there are still people I went to school with that don’t know how to do their taxes. I was more upset that it hindered me from having an enjoyable childhood because all of my friends would go out every weekend to a movie or sledding. I didn’t get to go very often and when I did I felt like the odd one out. I didn’t have a cool nick name or someone to pick me as their partner in every class. My dog was who I talked to most because even my best friend didn’t and still to this day doesn’t know what it was like to feel so alone for so much of your life. Here I am 8 years after graduating and I’m still struggling to seek approval from everyone. My friends, the people who let me think we were friends and pretend to care but then you hear what they say when you’re not there and I’m too old for this shit. I am not going to fight for friends.
Now that being said, making myself remember that I shouldn’t seek their approval is a whole other story. Someone tell me I’m not as alone as I think I am!
© Peggy Stewart
Published: July 2011
With her head hung low
and nowhere to go,
she can’t explain
this mysterious pain.
It comes on so fast.
How long will it last?
Her heart is just pounding; her head starts to spin.
Please go away; she does not want you in.
She’s uncontrollably crying.
It feels like she’s dying.
Her body is trembling; her hands start to shake.
She feels so helpless with this horrible ache.
Someone, please help her; make this go away.
She can’t stand to feel this way one more day.
Someone, please help her; she’s down on her knees.
She’s scared and helpless and hopes no one sees.
With her head hung low,
not knowing where to go,
she tries to explain
this mysterious pain.
There are two types of treatments that have been shown in numerous research studies to reduce the symptoms of anxiety disorders: (a) certain types of medications, and (b) a certain type of psychological treatment called cognitive-behavioral therapy (or “CBT” for short). This page briefly reviews the pros and cons of each type of treatment, and then focuses on CBT, which is our specialty at the ASDC.
Medications for Anxiety: Pros and Cons
The major classes of medication that have been well-researched and shown to be effective in reducing anxiety disorder symptoms are the selective serotonin reuptake inhibitors (SSRIs; e.g., Paxil), tricyclic antidepressants (e.g., Anafranil), Monoamine Oxidase Inhibitors (MAOIs; e.g., Nardil), and benzodiazepines (e.g., Klonopin).
The advantages of using medications to treat anxiety disorders include:
- They are often effective– up to 50% of people who use these medicines experience at least some symptom relief.
- They are easy to obtain– a physician (often a psychiatrist) prescribes them, and the medicine is widely available.
- They are easy to use– the pill does all of the work inside your body.
The disadvantages of using medication for anxiety include:
- Not everyone responds well– 50% of people who take these medicines do not respond.
- Symptom reduction is generally moderate– the average improvement rate is between 20% and 40%.
- Side effects are common– although they are generally mild and can be managed fairly well.
- You must remain on the medication over the long-term– usually, symptoms return if the medication is stopped.
CBT for Anxiety: Pros and Cons
CBT is a set of psychological treatment techniques that view the patient/client as an active participant in his or her own treatment. It is seen as beneficial if the patient understands exactly what is involved in treatment, and the ideas behind why these particular treatment techniques are used. The techniques used in CBT have been tested in hundreds of studies with thousands of people who suffer from anxiety problems. The results of these studies show that CBT is often very effective in reducing anxiety and related problems. A full description of CBT appears further below.
The advantages of CBT for treating anxiety include:
- It is a highly effective short-term treatment– research indicates that over 60% of those who undergo CBT experience substantial improvements in anxiety symptoms.
- It is the best long-term treatment– CBT teaches you skills that no one can ever take away from you.
- CBT is brief– typically, significant improvement is obtained in 12 to 20 treatment sessions.
The disadvantages of CBT include:
- It is hard work– CBT requires you to learn and practice new skills that can be challenging.
- It requires you to face your fears– one component of most CBT interventions includes gradually confronting the situations that provoke anxiety. This means you are likely to experience anxiety as a “side effect” of treatment.
- It is difficult to find therapists with expertise– relatively few psychotherapists have the training and experience to qualify them as experts in CBT.
What can you expect if you undergo CBT for an anxiety problem…
CBT is based on the idea that anxiety problems involve maladaptive patterns of thinking and behavior. Thinking patterns in anxiety usually include the tendency to overestimate the probability and severity of negative outcomes. This type of thinking leads to feelings of anxiety. Behavioral patterns in anxiety disorders include avoidance, compulsive rituals, and other anxiety-reduction strategies (“safety behaviors”). These behaviors serve as an escape from anxious situations, yet they also prevent the person from finding out that these situations are not nearly as dangerous as they had thought. Therefore, the person gets stuck performing the maladaptive behaviors which maintain their fears. In CBT, the person learns new ways of thinking and behaving in situations which create anxiety so that he or she can realize that such situations are not dangerous.
The first step in CBT involves getting a thorough history of the person’s life experiences and psychological functioning, and then assessing whether a medical or psychiatric consult is necessary. A medical consult is often helpful to rule out possible physical/medical causes for anxiety symptoms, and a psychiatric consult, though arranged only occasionally, is especially important for persons who are so impaired by their anxiety symptoms that they may not be able to utilize therapy effectively unless assisted by medication.
Next, the person learns about the nature and experience of anxiety and of his or her particular problem with anxiety. This includes learning how to better observe, record, and report anxiety-related triggers, thoughts, feelings, and behaviors. All of this helps the therapist gain a clearer understanding of the person’s specific anxiety problems. The better we understand the specific way an anxiety disorder is experienced by a patient, the better able we are to design an effective cognitive-behavioral intervention. A “road map” of the person’s symptoms is then devised; along with a treatment plan that specifies the specific thinking and behavioral habits to be modified through therapy, and which techniques will be used.
Cognitive Restructuring is a technique for identifying and challenging maladaptive thinking styles that fuel anxiety. In essence, one learns to ask, “What am I saying to myself about this situation that is making me feel so anxious?” Once these thoughts are identified, the person learns how to critically analyze the validity of these thoughts, and develop a replacement set of thoughts based on a more rational (evidence-based) appraisal of the situation. Unlike the power of positive thinking– which essentially focuses on having a person tell him or herself, “Everything will be OK“– cognitive restructuring is based on the power of critical or logical thinking. As with all skills developed in CBT, cognitive restructuring is learned in the treatment sessions and practiced by the patient on his or her own.
The next stage in CBT is usually one or more variations of therapeutic exposure during which the person practices facing his or her fears. Therapeutic exposure (as opposed to everyday exposure that some people have) is carried out carefully and under the guidance of a therapist. It is usually gradual, meaning that exposure begins with facing easier situations, working up to more challenging ones. The person also practices self-supervised exposure tasks between treatment sessions.
Although exposure therapy seems difficult, when armed with a full understanding of the problem and cognitive restructuring techniques, the person is well-prepared to face these fears. By developing a hierarchy, or list of fears, the patient challenges him or herself only a little at a time, beginning with the least challenging fears, and building up strength and self- confidence, moving upwards, to more feared situations. Finally, long-term maintenance of gains, relapse prevention, and “lapse response protocols,” or the ways in which to deal with symptoms which may re-emerge, are reviewed.
As you can see by the procedure described above, the focus of treatment is on the reduction and even elimination of anxiety symptoms. However, in addition, throughout therapy, additional issues are often addressed. If the initial assessment reveals specific trauma or issues related to family history, these issues may be incorporated into the CBT. Comorbid conditions may exist as problems separate but often related to the anxiety condition, most commonly depression and/or substance abuse. These and other comorbid conditions can also be addressed in treatment as needed. Issues around self- esteem and interpersonal functioning almost always are addressed as part of treatment. The development of, and/or improvement in, the support systems outside of therapy is promoted. Finally, the respect, support, and encouragement in the therapy relationship itself is crucial to the success of treatment.
You can learn more about CBT from the Association for Behavioral and Cognitive Therapy
Did You Know?
- Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States age 18 and older, or 18.1% of the population every year.
- Anxiety disorders are highly treatable, yet only 36.9% of those suffering receive treatment.
- People with an anxiety disorder are three to five times more likely to go to the doctor and six times more likely to be hospitalized for psychiatric disorders than those who do not suffer from anxiety disorders.
- Anxiety disorders develop from a complex set of risk factors, including genetics, brain chemistry, personality, and life events.
It’s not uncommon for someone with an anxiety disorder to also suffer from depression or vice versa. Nearly one-half of those diagnosed with depression are also diagnosed with an anxiety disorder.
I have suffered from both anxiety and depression for at least the last 7 years. I believe it began before that but my first diagnosis was in 2012. Since then, I have tried almost everything to help relieve my anxiety. Here are my top 10 favorites:
10. Candles/insence/essential oil diffuser. Sometimes just the smell of something you love (for me- rain) can put you in a better mood and help you feel more relaxed.
9. Baths with a bath bomb or scented epsom salt. Warm baths are proven to help relax, and it has helped me on many occasions, especially when muscle pain is working against you.
8. Walking! Getting a little bit of exercise is good for everyone. It can also help you sleep better at night, especially when done shortly before getting ready for bed.
7. Music therapy. A good scream-o song or hardcore rap can help you get out the emotions you feel weigh heavy on you.
6. Along with music- dancing. Someone commented on one of my posts about dancing it out. I have learned this from Grey’s Anatomy, and also use this technique as often as I can.
5. Painting/drawing/coloring. Focusing on a project keeps my brain on one thing. I feel more in control of my life when I can focus.
4. Playing with pets or children. I don’t know if everyone feels this, but sometimes my cat knows when I’m feeling off or sick, and my children try to help me so much. They always make me feel better!
3. Talking to a good friend. Having someone to let everything out on is really important. Not only do you feel you have support, but you actually start to feel stronger for having someone on your side like that.
2. Binging your favorite show! I post often about my love for certain shows. Again, my anxiety makes it hard for my brain to focus and concentrate on one thing at a time.
- My favorite; joining a group on Facebook or blogs of people who have the same issues as you. Realizing how many people suffer along with you can change your entire mindset.
Please like/comment/share/follow!!!!! Thank you all.
I feel each one of these. How about you guys?
The pain I am feeling from my sciatic nerve is sooooo bad. Like a 45000000 on a scale of 1 to 10. I haven’t felt good the last few days. I am taking a lot of medications to help everything. I am exhausted. I hope everyone is doing well!
Hey everyone! I wanted to post today not only because it is a holiday but because I have a lot of family I like to remember on this day whether they served or not. My grandpa served (RIP), my uncle Danny (RIP) as well.
Thank you from the bottom of my heart to every single soul that has served/wanted to serve but couldn’t.
I hope everyone has a great relaxing day with or without family.