Problems We Treat
Social Anxiety Disorder
Panic attacks are common in all anxiety disorders and in the general public (33% of people have had a panic attack in the past year). However, those who suffer from panic disorder have persistent fear of having a panic attack in a situation in which they cannot escape or get help. A panic attack is defined as the emergence of four or more physiological sensations (e.g., heart race, dizziness, light-headedness, stomach distress) peaking in intensity within 10 minutes. Those with panic disorder typically fear one of four catastrophic outcomes resulting from panic: “I am going to lose control of myself,” “I am going to die,” “I am going to go crazy,” and “I am going to embarrass myself.” Often, people with Panic Disorder tend to avoid situations that might elicit a panic attack (called agoraphobia). Examples of avoided situations: locations (airplanes, traffic, large open spaces); foods (caffeine, sugar, alcohol); emotions (excitement, anger, anxiety); and activities (exercise, sex). Further, people with panic disorder tend to use benzodiazepines (e.g., Xanax, Ativan) to control the onset of and recovery from panic sensations.
Generalized Anxiety Disorder (GAD) Chronic Worry
Individuals with GAD experience excessive worry during more than 30% of the day. The chronic worry creates significant anxiety and physiological sensations (e.g., stomach distress, muscle tension, fatigue, irritability). Individuals with GAD typically worry about topics that are concerns shared by most people but have difficulty “turning off a worry” and often “spiral” to imagining the worst-case scenario. Individuals with GAD often experience sleep difficulties secondary to the physical sensations brought on by worry. In general, most individuals with GAD have trouble trying new experiences (travel; recreational activities) as they have difficulty tolerating the uncertainty. GAD in children presents in a similar way, however, they may not be as aware of the worries as they are of physical problems brought on by worry (e.g., stomachaches).
Animal Type (e.g., dogs, cats, spiders, insects, rats, birds, and snakes) Natural Environment Type (e.g., heights, storms, and water) Blood-Injection-Injury Type (e.g., seeing blood, receiving a blood test or injection, watching medical procedures) Situational Type (e.g., driving, flying, elevators, and enclosed places) Other Type (e.g., choking or vomiting, loud noises, or fears of costumed characters).
Obsessive Compulsive Disorder (OCD)
contamination (e.g., HIV/AIDS, dirt/germs, or not-just-right feeling) harm to loved ones/self symmetry/order and exactness unwanted religious or sexual thoughts excessive doubting not-just-right-feeling about numerous (or single) thoughts, objects, emotions, or body sensations hand washing or excessive cleaning excessive checking arranging or ordering praying or mental compulsions like replacing a bad thought with a good thought mentally reviewing situations repeating (e.g., erasing, re-ordering or adjusting, re-reading) Accumulating a large quantity of possessions typically seen by others as useless and not valuable. Individuals who hoard exhibit great difficulty discarding items. Common reasons include attachment or sentimentality, facilitating memories, emotional comfort, and responsibility not to waste. The saving and acquiring behaviors interfere with the use of the space (e.g., can not cook in the kitchen or accommodate a guest in spare bedroom). The individual experiences life-interfering distress or impairment.
Post Traumatic Stress Disorder (PTSD)
re-experiencing the trauma (i.e., flashbacks, nightmares, recurrent intrusive thoughts) hyperarousal (i.e., feeling jumpy or easily startled, difficulty sleeping and restlessness, irritability, difficulty concentrating, and hypervigilance or feeling on guard) avoidance (i.e., avoiding places, people, events, or objects that remind a person of his or her trauma, emotional numbness, loss of interest in previously-enjoyed activities, difficulty remembering important aspects of the trauma, feeling cut-off from people)
Body Dysmorphic Disorder (BDD)
People with BDD suffer from the obsession that a part of their body is defective, deformed, or flawed. All parts of the body are susceptible, but common sites include hair, skin, nose, and legs. Clients with BDD engage in a number of “safety behaviors” to relieve their distress including body camouflaging with make-up or extra clothes, excessive mirror checks, reassurance seeking from loved ones, research on how to correct the perceived defect, avoidance of social/public gatherings and, in extreme cases, surgery. Clients suffering from BDD can experience significant life interference on every level (e.g., financial, emotional, social, and occupational). Although BDD affects a percentage of the population similar to other anxiety disorders (1-2%), it’s not a widely recognized condition.
Major Depressive Disorder (MDD)
Individuals with MDD experience either loss of interest in pleasurable activities and/or persistent sadness for at least two weeks. Approximately 13% of U.S. adults report that they experienced a major depressive episode at some point in their lives. Typical symptoms of MDD include fatigue, concentration difficulties, feelings of hopelessness, thoughts of death or dying, and changes in appetite and sleep patterns. However, individuals with MDD can endorse numerous additional symptoms including anxiety, physical pain, and extreme social sensitivity. It is common to develop depression secondary to a severe anxiety disorder. Common symptoms of depression seen in children are irritability/aggression, social withdrawal, low self-esteem, and poor school performance.