Experiencing feelings of isolation, panicking about the scarcity of resources, and fearing for one’s health can be overwhelming during this time of uncertainty. Due to the threat of Coronavirus, we are being forced to alter the way we interact with colleagues, friends, and family, shifting our work and social schedules. Meetings and gatherings have been postponed or outright canceled. Many people are spending much more time in their own homes. This leaves a gap. We are, at our core, inherently social, and loneliness can be as overwhelming as any other trauma.
We need connection, and we can feel when it’s missing.
Working from home is fast becoming a best practice for minimizing the potential spread of COVID-19 within the workplace. However, such a drastic change to your daily routine, coupled with the constant news cycle updates, can put a strain on your mental health.
Rather than waiting to see a therapist “until things calm down,” it is worth exploring an emerging alternative to coming into a therapist’s office – Telehealth.
Teletherapy helps you maintain mental health
For years, telehealth (or teletherapy) has improved access to care for clients with mobility challenges and for those who live too far to travel to their preferred therapist. Now, teletherapy is becoming increasingly relevant as the number of remote workers, or people working from home, is surging.
Teletherapy reduces travel time to and from your therapist’s office, which makes it more convenient for the working professional. It also offers the benefit of being in a comfortable and familiar environment, which can often be helpful for self-expression and reflection.
HIPAA Compliant Teletherapy Offers Security
Some are reluctant to try teletherapy because they feel that something would be missing from a face to face interaction. With a clear camera and high quality internet connection, we find that, in practice, clients get just as much out of remote therapy as in-person. Others may be concerned about privacy. If this is a concern, make sure your therapist is using a HIPAA Compliant service, like Spruce Health or SimplePractice, that offers a secure connection. This way your data is protected.
If you are feeling overwhelmed by COVID-19, give me a call. I am a psychologist, and I can help you learn coping skills that will give you peace of mind during this challenging time. I also offer teletherapy sessions using a HIPAA compliant system.
Crystal Clements, PhD
I help people overcome depression and anxiety and experience empowerment in their daily lives.
Anxiety can be overwhelming. Though we all feel stress, anxiety disorders can cause a person to become agitated, restless, or excessively worried over something others may see as small. Anxiety can come in many forms, whether it’s
Feeling your heart pound and palms sweat
Negative self-talk
Avoiding social situations
Difficulty sleeping and calming down
Racing thoughts and difficulty concentrating
You may not know whether what you are feeling is typical stress, or signs of an anxiety disorder, and that feeling of not knowing brings its own discomfort and additional stress.
When we don’t know, we google.
And when we google, we can find that there are many types of anxiety, as well as other disorders in which anxiety plays a part. If you weren’t feeling anxious before, you may feel even more anxious as you flip through online pages of diagnosis after diagnosis. There are some online anxiety tests, and they can be helpful as a starting place to help learn more about anxiety, and to see whether it may be helpful for you to seek professional help. However, online tests have limits.
You’re probably feeling more anxious than normal when you read through a list of symptoms or diagnoses, and that may impact how you answer the questions. Secondly, sometimes the way things are written is not clear. For example, these quiz questions often ask about how often a symptom occurs without providing context – how often is “often” or “sometimes”? Lastly, even if an online quiz can tell you with 100% certainty that you have an anxiety disorder, it may not be able to link you to treatment with a quality mental health professional, nor provide treatment recommendations that are tailored to best fit you.
Pros of Taking an Online Anxiety Test
Learn basic information about anxiety.
Get a starting point to understand your own emotions
First easy step toward deeper self understanding
Free, or low cost.
Cons of Taking an Online Anxiety Test
Possible misdiagnosis
General, often not validated (accurate) questions
Not able to recommend appropriate treatment
Difficulty understanding results
Incomplete, limited results or insights
Knowing yourself is a key part of understanding how to take care of yourself, but figuring yourself out can be a complicated and uncomfortable process. I’ll explain a few ways to get started on your own, as well as ways we can help.
Take an anxiety quiz or read an article online
Though they have their limits, those online anxiety tests can help us start to learn the lingo around anxiety and start to get some ideas about ourselves. There’s a lot of them out there, so I would begin with any that come from any reputable clinics or universities. For example, here’s a page from Mayo Clinic on common signs of anxiety, or an article from Harvard on the difference between stress and anxiety. In terms of quizzes, this quiz from Mindspot gets around the “how often” problem by providing more concrete terms, which may help you be more exact about your symptoms. I also like this one from ADDitude, which provides more detail about what each of these symptoms means.
Start a Journal
Often our thoughts and feelings happen so fast that we have a hard time organizing them. Journaling is a great way to slow down our minds and put our complex thoughts, feelings, and patterns out on to paper. It doesn’t have to follow a standard format. For some people, just simple bullet points with their thoughts and feelings about a situation can be helpful to start to see patterns. Find a format that works for you and work to integrate it into your regular routine. This can also help you see if your anxiety tends to happen in any kind of pattern, as well as help you answer those pesky “often” and “sometimes” questions with more accuracy. When you write, reflect by asking yourself:
When did I start feeling this way?
What events today contributed to how I’m feeling now?
What feelings do these words communicate?
How much do these feelings affect my well-being, on a scale from 1-10?
Consider psychological testing
At Here Counseling, we provide quality psychological testing that can help you better understand what makes you tick. Psychological testing is a professional service that uses empirically validated measures to draw conclusions about your emotions and behaviors.
Our professionals will explore with you your concerns about anxiety, design a set of tests tailored to your needs, and provide personalized and concrete recommendations to help you with your anxiety. These tests can provide so much more than a quick online quiz, as we conduct a thorough interview to see patterns in your anxiety or in your history, look at other personality traits that may contribute to anxiety or be sources of strength to help you combat anxiety, and check for any other concerns that could be linked to anxiety. Let’s understand how psychological testing works.
Initial interview. A psychologist will ask you about the questions you want answered about yourself. These can range from questions about a specific diagnosis, such as ADHD or Bipolar II, to questions about your personality and relationship patterns.
Testing. You’ll come back in for a few hours of testing in which the psychologist will help you complete hand-picked, curated measures that together create a cohesive picture of your functioning.
Report writing. The psychologist writes a report with significant findings from the measures and draws conclusions in order to clearly shed light on the testing question.
Feedback session. The psychologist will sit down and explain the results of the test, and also recommend next steps for accommodation or treatment.
Having a professional working with you to give you accurate and helpful information has the potential to transform your life and move you closer toward your goals. It takes the pressure off of you to figure out the problem, so that you can take the right steps forward toward healing, health, and wholeness. Reach out today, we’re here to help.
Ashley Holcomb
Ashley provides psychotherapy and testing in our downtown Los Angeles office.
Panic attacks can be frightening and overwhelming. Many people worry about what’s happening to them, and they don’t know what to do to make it stop. We’re going to take you step by step through everything you need to know about anxiety, panic attacks, and some simple steps you can take (even today) to start resolving a panic attack.
What is a panic attack?
A panic attack is a sudden, painful collection of anxiety symptoms. Panic attacks often involve extreme tightness in your chest, a fast heartbeat, rapid breathing, and intense fear. Many people mistake panic attacks for heart attacks. Most panic attacks last for 15-60 minutes. After the intense period of anxiety, the pain decreases, and people usually feel exhausted from the heightened state of arousal.
Panic attacks can be debilitating. Many people who experience panic attacks often worry about going out with friends, to work, social situations, or the grocery store. They worry they’ll have a panic attack in public and won’t be able to control their anxiety.
What Do Panic Attacks Feel Like?
Panic attacks come on quite quickly and can be extremely overwhelming. Here’s how people often describe their panic attacks:
I’m afraid. During a panic attack, you will likely experience debilitating fear or sheer terror.
I feel physically shaken. Panic attacks cause a variety of physical symptoms, including chest pain or discomfort, lightheadedness, or nausea.
I feel like I’m dying. Many people who have panic attacks describe feeling as though they are dying.
I can’t think straight. In the grip of a panic attack, you might have trouble making decisions or remembering simple things.
I’m afraid I’m going to have a panic attack in public. Many people who experience panic attacks often will avoid public spaces for fear that they’ll have an attack in public.
How Anxiety works in your body
Before we can understand panic attacks, we need to understand how your body is built to handle anxiety. Anxiety is not a bad or destructive feeling. In fact, anxiety is the body’s natural and helpful response to a threat in the environment. Anxiety is like a fire alarm that signals your body is feeling unsafe. The anxiety response follows a normal rising and falling path, like a river. Let’s take a look at what happens in your body when you feel anxiety, and how your body calms itself and returns to normal.
When your body senses a threat in the environment, your amygdala —the fear center of your brain—sends a signal down your spinal cord to your heart to increase its speed and tension. Your body then prepares to fight or run away, as if your life depended on it.
Your mind scans your body and notices there’s tension in your heart and muscles. It recognizes your tension as a response to something scary, and —if it’s not a life-threatening threat—begins to soothe itself.
Like a river, your mind flows down a familiar track for how to soothe anxiety. Depending on how you deal with anxiety, you might take a deep breath, remind yourself of your value, cry, tell yourself that it’s going to be okay, or ask for help. These skills are acquired by having care-givers who consistently respond with empathy and soothing to our anxiety. Essentially, those experiences created the river, the way we know how to sooth ourselves when we’re anxious.
While you soothe yourself, your vagus nerve stimulates your heart, slowing it down, releasing tension, and helping you feel open and collected again.
Part of the soothing process is that you’re able to recognize why you were anxious. Because you feel calm, you’re able sense of your life and learn about what you’re needing.
How Panic Attacks Work in your Body
With a panic attack, the above anxiety “river” gets short-circuited. Let’s take a look at what happens during a panic attack.
Similar to the anxiety response, the first signal of a panic attack is from your amygdala. Your body senses a threatin the environment and sends a signal down your spinal cord to increase your heart rate and prepare to fight or run away.
Your body then senses your tension in your heart. In a panic attack, you don’t recognize this tension as normal or helpful. Instead of soothing anxiety, the signal is ignored. The fire alarm is dismissed, not paid attention to. We often ignore the signal by working harder, by scrolling social media, by busying ourselves.
Because the anxiety isn’t soothed, it continues to build inside until a breaking moment: the threat overwhelms the coping strategies. If our normal anxiety response is a river, then a panic attack is like a dam that, after holding back too much water, breaks.
It’s hard for the body to remain in a panic state for long. After the period of intense breathing, heart racing, and fear, the body will naturally calm itself down usually after 15-30 minutes, though occasionally it can take an hour or more.
Often the original cause of anxiety is forgotten, due to the overwhelming experience of panic.
Where Do Panic Attacks Come From?
We’ve explored how panic attacks happen in the body, and it can also be helpful to know why you experience them. First of all, I recognize the limitations of a blog article to tell you – a specific and unique person – why you experience panic attacks. However, after treating many people in Downtown Los Angeles with panic attacks, here are some common themes I see in my practice. Panic attacks are often the result of:
Ignoring stress. This is a common theme for people who suffer from recurring panic attacks. When they experience anxiety, they don’t pay attention to the feeling. Instead, they feel they’re being “weak” or “complaining”, or they feel guilty for needing to slow down at work. Instead of soothing their stress, they ignore it. They’re afraid to slow down or to take time for themselves to listen to the anxious feeling. Often when a person experiences a full panic attack, it’s after days, if not weeks, of suppressing (pushing down or avoiding) clear signs of being overwhelmed. While this strategy can work short term, your body needs a way to actually calm down and soothe itself.
Not getting help. Self-care is sometimes a dirty word. We can feel selfish or guilty: “Other people don’t need to slow down! Other people don’t take a day off when they’re overwhelmed! I don’t think I deserve to have a day off or to have time to myself.” It can be hard – especially in a culture that expects a lot of us. It’s sometimes difficult to see how well your body and mind can function when you have permission and space to take a breath in, to soothe yourself.
How To Conquer Panic Attacks
The first step in conquering panic attacks: you can’t stop the panic attack. Now I know that doesn’t sound great. However, there’s a different and better way to help. Returning to that “river” versus “dam” analogy, when the dam breaks, all we can do is allow the feelings to be there. Here’s what you can do, step-by-step:
Set a timer
Most panic attacks last 15-60 minutes. While this experience is painful and sometimes scary, it can help to know that there is an end to the pain. Your body takes a while to calm back down from this experience.
Accept the experience and allow it to pass naturally
Take a deep breath in through your nose, and out through your mouth, slowly. Allow your belly to fill with air when you breath in. Picture a place you feel safe. Allow the bodily feelings to pass naturally, knowing it’ll be over soon.
Once the panic attack is done, relax
You’ll feel exhausted after the panic attack. Don’t feel any pressure to get up and go. Let your body recover – act as if you’ve just completed a marathon. Drink some tea, put on white noise, eat something healthy.
Take stock of the last week or two
Ask your self what was different this past week. What things in your life have added to your level of stress or responsibility? What other, smaller signals was your body giving you about your level of stress before the panic attack?
Learn to soothe anxiety
Conquering panic means learning to listen to the smaller anxiety signals your body gives you early on. It means practicing soothing, finding that easy flowing river that helps you move through anxiety, rather than dam it up. That’s what we do. We help anxious professionals in Downtown Los Angeles overcome anxiety and live their best lives.
Managing a Panic Attack Worksheet
Want these questions in an easy to use free downloadable worksheet? This worksheet will help you take steps forward in dealing with anxiety. You’ll also get access to all our worksheets in Here Counseling’s Resource Library!
Reducing stress at work is both simpler and harder than it seems at first glance. As a psychologist who specializes in anxiety and works in Downtown Los Angeles, I want to give you a few tips to reduce your stress at work… and be more productive.
Meet Ian. Ian just accepted a new job at a law firm in Downtown Los Angeles. Ian’s excited, and willing to put in whatever work is required to prove his value as a lawyer. The first 2 weeks go well, and while he’s tired, he also gets a bit excited when he gets an email from a client on a weekend – he doesn’t mind replying, after all, it seems to be expected of people at his firm.
But 2 months into his new job, Ian is exhausted. The things that he loves are less exciting. He used to go on hikes on the weekends, but now he needs to be around his phone in case a client calls. He wishes he could couch in at the end of the day and not check email, but he feels an implicit pressure to answer emails immediately, even late at night. Now he isn’t sleeping well, he’s not enjoying things he used to, and he is having trouble calming down.
How do you know if you’re stressed?
Have you ever felt like Ian? Each of us comes up against tasks, whether in our professional or personal lives, that feel too overwhelming. Our anxiety or overwhelm is often a signal that we’re “red-lining”, that our brains are taking in too much information to regulate effectively. While stress is a normal experience, it becomes problematic when the body can’t calm back down. This inability to regulate anxiety is what constitutes workplace stress and overwhelm. As a way to manage the stress, often we work harder. Here’s a list of common behaviors people engage in when they experience chronic stress at work:
Taking on more projects, despite busy schedule
Checking work email during personal times or breaks
Working or responding to email during weekends
Social expectation to match work load or habits of others
Giving unrealistic deadlines for finishing projects
How many of these behaviors do you struggle with? Often they co-occur – people stressed at work do all of these to a varying degree as a way to reduce their anxiety. The trouble is, working harder to avoid stress doesn’t work – it seems to entrench the person in the same exhausting and stressful pattern. The more you respond to your anxiety by working harder, the faster the train goes, and the more difficult it is to get off. There’s a different way to manage stress: caring for yourself and setting boundaries.
Caring for yourself increases, not limits, your productivity
It’s true. The only way to escape stress is to slow down. And when we escape stress, we actually free ourselves up to work in a more productive way… a way that’s actually backed by neuroscience.
How can this be? We usually think of “self care” or “setting boundaries” as something warm and fuzzy. Something that’s for “me” at the expense of work or other obligations. Yet there’s more going on here. Think about it this way: You wouldn’t drive your car without changing the oil, or getting regular maintenance, especially when the warning lights come on. Caring for your car isn’t simply about making the car feel good, it’s about the reality that a car has a very finite ability to push itself without receiving the care it needs to continue functioning.
Just like a car’s warning lights, when we don’t listen to our overwhelm, we increase our chances of getting sick, suffer from lack of focus and lower energy. You know the feeling, don’t you? I’m sure you’re familiar with how well your body performs on a task when you’ve had good, peaceful rest. The opposite is true when we don’t listen. We start to break down, effecting our mind and body’s performance in all areas.
There’s a few common things our bodies feel when they’re trying to get us to slow down and take care:
Lack of energy
Lack of focus
Irritability at work
Inability to be present in personal life and relationships
Overeating
Undereating
Lack of restful sleep
When we don’t listen to these signs, it’s impossible to avoid the cost of overwhelm. The only way to move past these things isn’t more caffeine, or a fresher cold-pressed juice. There’s 2 ways to reduce your stress at work, the short way and the long way. I think you’ll find both apply to most situations of stress at work.
How to reduce stress at work: The Short Way
Your brain is made to swing like a pendulum between two primary modes: active and passive processing. Active processing is when your mind is actively working on a task. Your brain receives, processes, and acts on information it receives from its environment. Passive processing is what your brain does when it doesn’t have a task to do. Rather than turning “off”, your mind actively sorts through all the connections made during active processing, pruning them back and retaining the important details.
If we don’t ever give ourselves room to pull back from a stimulus, our minds struggle to find new ways of approaching a problem and to stay focused on what’s important. When we never pull back from our task, we slowly lose energy, and approach tasks repetitively. Doesn’t sound like the smartest way to work, does it? Here’s some quick things you can do to allow that pendulum to swing back toward passive processing, so you can regain energy.
TURN OFF EMAIL NOTIFICATIONS.
This is a quick win. You want to protect the time you spend away from your desk, so you can allow your mind to enter passive processing. Turn off email notifications on your phone. In fact, you can experiment with taking email off your phone, that way you’re only checking it when YOU decide to. Take Gmail off your phone, see what it feels like for 24 hours.
WALK.
Put down your phone, and take a walk in the middle of your work day. Maybe that means going out to lunch without your phone, or parking farther away from work so you need to walk. This is an easy way to give your mind space to passively process. Notice the energy you have when you return to your desk.
NEGOTIATE REALISTIC DEADLINES.
You might consider, just as an easy rule to start with, to extend your deadlines for projects by 25%. Most of us have a future bias concerning time, meaning we overestimate the free time we’ll have in the future. Account for this extending your expected time to complete a project. If you finish it early, you’ll have another win. Plus, you’ll be setting a different expectation for others about how available you are.
SET APPOINTMENTS.
Instead of jumping on the phone immediately with a client or colleague, give them appointment slots they can apply for.
“BUT! I can’t do those things!” Let’s think about this. There are some very real things that seem to inhibit you from following this list. You operate within a powerful culture of ceaseless work, constant availability, instant access. I’m very aware that I’m directly pushing back against that.
But let’s think about what happens if you don’t make these changes. There is an unavoidable cost to being constantly available. You’ll likely spend at least 50% of your waking hours at your job during your adult life. And these costs add up. It will be difficult to actually get off on weekends and holidays to enjoy your life. Maybe you can already feel the costs. You feel the exhaustion, the burnout, the “why did I get into this job?” feeling. So what is it worth to you to slow down? Is it worth possibly disappointing your co-workers? Or losing a client? Or having to find a different job?
Slowing down won’t just make you happier, it’ll help you work better too.
How to reduce stress at work: The Long Way
One very common voice that pops up, even as we consider letting go of being constantly available, is “I don’t want to”. The truth is, many of us, for many reasons, don’t want to make these changes. It’s not that we can’t, it’s that we won’t. The mind is like that – sometimes very divided and at-war with itself. We don’t just have a foot on the break pedal, there’s another foot on the accelerator that likes the speed.
Let’s take a look at some of the common reasons people like the speed of the Stress Train:
I enjoy feeling overwhelmed
“People pay attention to me when I’m busy”
“I’m only valuable when I’m busy, I feel good about myself when I accomplish a lot”
“I feel powerful when I’m busy and stressed”
“I’ve always had to do everything for myself, at least I have control over my life”
If I slow down I’m afraid worse things will happen
“People won’t understand my need to slow down, they’ll look down on me”
“People will be angry with me if I don’t meet expectations”
“I’m afraid I’ll be discarded if I don’t produce the value I feel is expected of me”
Now I realize often there are real expectations we’re up against. Our job may require a certain amount of hours or deadlines. Yet if we’re not careful, the employer can unknowingly collude with the parts of us that WANT to pick up speed, pressing two feet down on the accelerator. Only when we’re self-aware can we notice this happening and slow down. Slowing down means being willing to negotiate, to encounter conflict, and even disappoint someone.
So I challenge you today to slow down and care for yourself, no matter how difficult that might seem. Set a realistic boundary, even knowing it might invite a difficult conversation. A more productive and happier life is on the other side.
Connor McClenahan, PsyD
I help lawyers and other professionals overcome difficult emotional and relational patterns through psychotherapy.
