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Bill, LCSW, Consultant, Expert Witness
Category: Mental Health
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Experience:  35 years treating individuals, couples, families with mental health and substance abuse prob's
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Hey ther I have anxiety disorder, can u open new chat

Customer Question

Hey ther I have anxiety disorder, can u open new chat
Submitted: 2 years ago.
Category: Mental Health
Expert:  Kate McCoy, M.Ed, NBCC, LPC replied 2 years ago.

Hi, are you looking for someone in particular or can I help you?

 

Kate

Customer: replied 2 years ago.
You can help, can you open one of those chat things
Expert:  Kate McCoy, M.Ed, NBCC, LPC replied 2 years ago.

I can't open a chat from the question and answer format, but we can talk this way as well. Do you want to let me know what is going on and how I can help?

 

Kate

Customer: replied 2 years ago.
Ok yeah I just have this panic and anxiety disorder and freak out over little things and stuff but I texted a girl today that I was hanging out with last night and we were drinking alot and I texted her and said "Dead" from like being tired and hungover and I started freaking out like maybe she thought I was threatening her and stuff but she texted me back with like a exhausted face and it seems ok, I shouldn't worry right?
Expert:  Kate McCoy, M.Ed, NBCC, LPC replied 2 years ago.

I wouldn't worry about that. For one, you did not make any threat at all. Just "dead" could mean anything. All someone has to do is clarify it with you. And two, even if she did take it seriously, she could just contact you to ask what you meant.

 

You may want to text her back and just say what you really meant, then add a short note saying just in case she misinterpreted it, then add a smile or some way to show her that you don't see this as serious.

 

Kate

Customer: replied 2 years ago.
Yeah I mean this was like an hour an half ago and after she texted back I said too many shots because we were doing shots of tequila and stuff but she hasn't responded but Im prettysure I'm just freaking out for nothing , I always do. I'm not gunna text her back because I kinda like her and don't wanna look desperate but everything seems fine and I'm sure if she took it another way she would ask. So I shouldny worry right
Expert:  Kate McCoy, M.Ed, NBCC, LPC replied 2 years ago.

I wouldn't worry. If you were both drinking, she probably attributes it to that anyway. But if she is concerned, I'm sure she will let you know. And as long as she has let it go, there is nothing to worry about. You handled it just fine.

 

Kate

Customer: replied 2 years ago.
Ok and also I always am stressed and have increased heart rate but no history of heart attacks and am young. I shouldn't worry about heart attack right because of my anxiety/panic disorder?
Expert:  Kate McCoy, M.Ed, NBCC, LPC replied 2 years ago.

As long as your doctor says you are healthy, there is no reason to worry. Anxiety often causes people to worry about their health. Worry about their own health is the number one reason people seek help from their doctors and the ER when they first deal with anxiety. Many people believe that they are having a heart attack when in reality they are only experiencing anxiety.

 

But once your doctor checks you out and you know you are healthy, then your physical symptoms are almost surely due to anxiety only and nothing else.

 

Kate

Customer: replied 2 years ago.
Hey there, one more thing, I asked another psychiatrist on here same thing and she agreed with you but can u read it to make sure it's accurate because she's new and had 0 accepts n her name is socialworkit
Expert:  Kate McCoy, M.Ed, NBCC, LPC replied 2 years ago.

Given that she does not yet have a history here on Just Answer, I don't know anything about her. But her answer seemed fine to me. What is important is if you felt it helped you.

 

Is there anything else I can help you with?

 

Kate

Kate McCoy, M.Ed, NBCC, LPC, Therapist
Category: Mental Health
Satisfied Customers: 5459
Experience: Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
Kate McCoy, M.Ed, NBCC, LPC and other Mental Health Specialists are ready to help you
Customer: replied 2 years ago.
hey there, i had one more question. as you know i have this anxiety/panic disorder and freak out over every little thing. but today i went to eat a restaraunt and got a weird feeling like i was unfamiliar with where i was and it just felt weird but i think its normal, but i feel fine now. it isnt health related righT? cause i always look for stuff to freak out about. also had a mild shortness of breath when i was panicing but am good now and was told that is symptom of anxiety/panic
Expert:  Kate McCoy, M.Ed, NBCC, LPC replied 2 years ago.

It doesn't sound health related. Those types of feelings are very normal when you have anxiety. It is the mind's way of distancing itself from your surroundings because you feel as if you are in danger. Just like after a trauma you feel out of touch and isolated, anxiety sends signals to your brain that there is danger so you "separate" from it emotionally and mentally.

.

Kate

Customer: replied 2 years ago.
also had a mild shortness of breath when i was panicing but am good now and was told by docs that is symptom of anxiety/panic, right?
Expert:  Kate McCoy, M.Ed, NBCC, LPC replied 2 years ago.

Yes, that is a symptom. And it is good that you were looked at first to be sure it was not a physical issue. Now that you have been cleared physically, it is most likely because of your anxiety. If that happens, try some of your relaxation techniques to calm yourself. That will help you breathe better.

.

I hope this has helped,

.

Kate

Customer: replied 2 years ago.
ok yeah i mean i been told by many docs on this website, not physically, that it is my anxiety and whenever im really panic it happens but its never been bad its always very mild. ill just relax now
Expert:  Kate McCoy, M.Ed, NBCC, LPC replied 2 years ago.

That is good! If you keep practicing the relaxation techniques, it will help.

.

Kate

Customer: replied 2 years ago.
yeah it happened like 1-2 more times only for like a matter of seconds and didnt bother me but am fine now--sorry my anxiety is acting up
Expert:  Kate McCoy, M.Ed, NBCC, LPC replied 2 years ago.
No problem! I'm glad to help you with it.
Customer: replied 2 years ago.
hello there, i need some help. i have panic/anxiety disorder and my head always looks for things to panic about. if i have slight heartburn i worry about heart attack or im afraid ill develop a disorder where i cant control my actions and try and hurt someone but i know i wouldnt. when im relaxed and i dont really get the thoughts as much so how do i get my heart to slow down and relax?
Expert:  Kate McCoy, M.Ed, NBCC, LPC replied 2 years ago.

Hello,

 

Fears about physical illness are common with anxiety. It is one of the main concerns when someone is anxious because it feels so out of control.

 

Anxiety is often about fear of losing control. Your mind searches for things to be fearful of and when you think of them, your body creates adrenaline because it thinks you are in danger. This causes the symptoms you feel.

 

If your doctor has cleared you and says you are in good health, then any fears you experience are probably only anxiety. To address how you feel, therapy is a good option. Therapy has been proven to be the best treatment. Your doctor can refer you to a therapist.

 

Self help is another good option. There are numerous books and resources to help you to find ways to feel better. Here are some resources to help you:

 

http://www.webmd.com/anxiety-panic/guide/mental-health-anxiety-disorders

 

http://psychcentral.com/disorders/anxiety/

 

http://www.helpguide.org/mental/anxiety_types_symptoms_treatment.htm

 

The Anxiety and Phobia Workbook by Edmund J. Bourne

 

The 10 Best-Ever Anxiety Management Techniques: Understanding How Your Brain Makes You Anxious and What You Can Do to Change It by Margaret Wehrenberg

 

Kate

 

May I please request that if you find the service I provided helpful at all that you rate me with three or more stars? Your rating is the only way I am reimbursed for my answer. Thank you so much!

Customer: replied 2 years ago.
ok even if i have thoughts off devloping a thing where i do something bad and cant control my actions--i still should remain relaxed right?
Expert:  Kate McCoy, M.Ed, NBCC, LPC replied 2 years ago.

Yes, relax as much as you can. Thoughts cannot hurt you and they cannot make you do something you do not want to.

.

Kate



If you're satisfied with my response, please rate me highly. Thanks!

Kate McCoy, M.Ed, NBCC, LPC, Therapist
Category: Mental Health
Satisfied Customers: 5459
Experience: Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
Kate McCoy, M.Ed, NBCC, LPC and other Mental Health Specialists are ready to help you
Customer: replied 2 years ago.

Wow, i think what you just said is going to help me tremendously "Thoughts cannot hurt you and they cannot make you do something you do not want to". I don't know why i never thought about that

Expert:  Kate McCoy, M.Ed, NBCC, LPC replied 2 years ago.

Good! I am glad I could help and that you are feeling better.

Kate

Customer: replied 2 years ago.
hello--i just had one extra question and will pay if i have to but its kind of a simple question. When you said the quote "Thoughts cannot hurt you and they cannot make you do something you do not want to", meaning theres no way i can develop something or have something where i cant control my actions? Because ive never had a problem with it just worry i will sometime
Customer: replied 2 years ago.
Relist: Other.
just one extra question
Expert:  Kate McCoy, M.Ed, NBCC, LPC replied 2 years ago.

No there is no way to develop something where you cannot control your actions. What you feel is just a symptom of anxiety.

Kate

Customer: replied 2 years ago.
one more quick question-- what about OCD? in which you feel you have to do something in order to somethign else. (must tap foot 3 times) whats difference between that and me?
Customer: replied 2 years ago.
Relist: Answer came too late.
Customer: replied 2 years ago.
Relist: Incomplete answer.
Expert:  Dr. Colby replied 2 years ago.
Hi, this is Dr. Colby.

Reading through the long conversation, it seems like you are suffering a variety of anxiety symptoms and that each time the previous expert assured you the symptoms were part of anxiety, you came up with another.

I generally agree with the previous expert, and there are some ways that I differ from her. If you would like me to continue to respond, please put my name at the start of your inquiry so I will know it is for me. Otherwise, I will leave it alone and let the previous expert continue to help you.

Note: It is after 10 pm, here, and I have to get some folks to bed, so I may not get back to you until the wee hours of the morning.
Customer: replied 2 years ago.
do you think its possible for me to develop somethign where i actually act? because i know i never would am just scared i will and never have took action just am always worrying about it and look for things to panic
Expert:  Dr. Colby replied 2 years ago.
The basis of Cognitive Behavioral Therapy, or CBT, is that what we think and how we think have a significant and formative impact upon what we do and how we feel. As corollaries, how and what we feel affects thought and behaviors, and how we act and what we do affects thoughts and feelings. CBT does not purport to treat certain types of problems, such as psychosis, where brain chemistry is sufficiently changed to change the person, and it also does not directly deal with problems where there have been substantive damage to certain areas of the brain, either pre- or post-natally.

Within the range of relatively normal brain functioning, people can engage in repetitive, compulsive behaviors. I do not know of situations where serial murder is included in this, nor "compulsive" armed robbery, etc. Psychopathy (not psychopathology), or the nature of being a Psychopath, apparently, from the research of Dr. Robert Hare an others, involves somewhat different brain functioning than normal; for this small percentage of the population, emotion is apparently not processed by the brain as it is for the rest of the population. And there are disorders, as well, in which action does not appear to involve either volition or the effect of internal behavioral controls.

However, anxiety is not typically experienced by persons suffering from Psychopathy, and it is also not generally experienced during behaviors caused by, for example, Temporal Lobe Epilepsy. Anxiety is generally connected with hyper-arousal of the sympathetic nervous system that has been labeled by the individual as anxiety. There is some research, such as by Dr. Albert Bandura and colleagues, that shows that how we label experiences has a great deal to do with how we act during and upon them. This is part of the scientific basis of CBT, namely, that how we label, how we self-speak, about what we are doing has significant impact upon what we do and how we do it.

So, the take-home message is that thoughts CAN affect and even direct behaviors. If they could not, then CBT and therapies like it, such as Dialectical Behavioral Therapy (DBT, developed by Dr. Marsha Linehan) would not work, and there is ample evidence in the experimental and clinical literatures that they often (not always) do.

What you describe appears to me to me to be a very different situation than thought-driven, or even impulse-driven, action. You appear, from your posts, to be constantly worrying about something, including worrying about worrying. What the previous and apparently other experts have suggested, i.e., staying relaxed and, even more, engaging in intentional and systematic relaxation practice, should impact these anxieties substantially.

There is also the possibility that your brain chemistry is such that just engaging in relaxation practice may not be enough. Therefore, again from the repeated questions you ask ... in effect, 'Could it be this, or that, or the other' ... no matter how often you are re-assured that everything will be okay, there is the possibility that your anxieties are driven by abnormal endocrine system functioning, or some other brain chemistry anomaly, that prevents the usual interventions from being sufficiently effective to provide you adequate relief.

To make sure this is not the situation, especially when CBT techniques do not seem to be enough, I always recommend to my patients that they have a thorough medical examination, including blood chemistry and urine panels, and, if something is not routine, to see a prescribing provider (I am not one) to explore pharmacologic intervention as well as CBT or other types of psychotherapeutic intervention.

Yep. I'm a psychologist, and I am also recommending that you have a full medical evaluation as well as that you see a prescribing provider who is not just a general practitioner, or PCP. From what you say, you sound functionally debilitated by these constant fears and worries, so much so that engaging in intentional cognitive and relaxation exercises simply may not be enough. As the old, Southern saying goes, "It's hard to remember that your object is to drain the swamp when you are up to your [lower middle rear body part] in alligators." Sometimes, getting some relief from the constant, nagging, debilitating worry can give you room and time to develop other skills such as the ones I and others have suggested.

I hope this lengthy response begins to answer some of your nagging questions. Can worry and fear lead to action? Yes, they can. Is it likely to be harmful or dangerous action? No, it is not. COULD it, though? Yes, it could, in extreme cases and extreme examples. It would be what we call an 'outlier', but it could happen. What can provide you relief? The tools we all have described as well as, perhaps in your case, some type of medication that can give you a little edge on getting more in control.

If this is enough of an answer, please credit me with some type of feedback using the buttons provided. If not, or even if so, you can continue the conversation with me (or with others) even after pushing the feedback button.

I wish you the best in overcoming this difficult and plaguing worry which appears to include even worrying that you are so worried.

Dr. Colby
Customer: replied 2 years ago.
ok so what you're saying is even when having these thoughts--anxiety never is really involved. Which i notice because when im relaxed about these thoughts it kind of goes away. Meaning its just there to keep me on edge and worry, worry, worry. It's not typical to develop something like that based on just worrying you will get it right? Thanks
Expert:  Dr. Colby replied 2 years ago.
Not quite. What I am suggesting is that there are several scenarios that could cause the physiological experiences you are having that you have labeled as anxiety. If I understand your follow-up question correctly (and I'm not sure I do), you are continuing to want to know what is the relationship between thoughts of various types and emotions of various types, including anxiety.

What we consciously experience as emotion is usually slightly down the physiological pike from some sort of somatically experienced event. For example, when faced with a hungrily tiger (or any other imminent danger), you might experience many things that your brain labels as emotions, but your sympathetic nervous system is active long before you apply the labels consciously. In the midst of survival mode, we do not usually wonder if we are anxious, if we are going to survive.

The thoughts you have may or may not directly involve anxiety, but anxiety, which is a label applied to a set of physiological experiences, can be one of them. One of my teachers, long ago, pointed out that the physiology of anxiety and the physiology of excitement (or of reaction to danger) are all about the same. So, were a person with anxiety to try relabeling the experience as excitement, and then search for what is exciting, it might be possible to get through it better. Labeling is, to some extent, a learned process.

Worry, worry, worry, as you put it, involves repeated enervation of the sympathetic nervous system, or SNS, which usually involves the generating of adrenalin, and that can become habit-forming, all by itself. You have certainly heard of the phrase, "adrenalin junkie." It refers to a person who constantly is trying to stay on the edge, and it is, ultimately, exhausting. You can do that with worry, too, because it, too, involves the SNS. The calming exercises earlier recommended by myself and others are aimed at enervating the parasympathetic nervous system, or PNS, which has characteristics that are the opposite of those of the SNS.

Thus, while rapid, shallow breathing is typical of the SNS, long, slow deep breathing is typical of the PNS. Since you cannot both rapid-shallow and long-slow-deep breathe at the same time, and since the characteristics of the SNS operate together, sort of "instant on" (you would want that if facing a hungry tiger), enervating the PNS with slow, deep breathing can rapidly shut down the SNS and, with that, much of the anxiety you experience sitting on the couch.

If you analyze all this carefully, you will see some holes, but this is generally how it works.

What my previous post suggested is that while all this may be true, there can be brain chemistry issues at work that are not a function of either SNS or PNS enervation (or that act parallel to them, in effect). If so, then the problems leading to the labeling of physiological experiences as anxiety might be at least somewhat beyond your volitional control. If so, then this is something a medical profession can help you with, both in terms of diagnosis and treatment.

Finally, in those situations (I suspect most situations) where there is a combination cause, chemistry plus past experience (i.e., learning) plus labeling, then perhaps a combination of pharmacology and cognitive therapy will be the best way to provide you the tools to control your experiences of anxiety, no matter what the causes.
Customer: replied 2 years ago.
but a big thing i notice is when im relaxed these thoughts go away, meaning there prob just there to make me panic? also its not likely for someone to develop a disorder where they cant control their actions by just worrying you will, right?
Expert:  Dr. Colby replied 2 years ago.
The way you have phrased your response suggests to me some continuing confusion. Thoughts do not come in order to make you panic, as though thoughts were a controlling factor. Panic can occur with or without troublesome thoughts. They can even occur when you are sleeping, and being asleep suggests that you are probably relaxed. The following link provides some information about this.

http://www.medicinenet.com/panic_disorder/page2.htm

"Possible" and "likely" are probabilistic terms. The research on causes of aggressive behavior has shown that extreme stress can generate aggressive behavior. "Can" is like "possible" but is not the same as "probable" or "likely." You appear to be worried that if you are worried, the worry will cause something else to occur. I cannot truthfully tell you that there is absolutely no risk that were you to become so distressed that you felt like you were "losing your mind with worry" that you would not, at some point, lash out at someone else. It would not make a very good affirmative defense in a criminal case, of course, because the tools and treatment options to control such worry are readily available. We have discussed them, here.

So, to use your language, it is "not likely" that you would "develop a disorder where [you] can't control [your] actions by just worrying you will." That is correct. Possible? Probably possible. Probable? Probably not probable.

In order to find out if your feelings of panic are just a function of worry, or of constant worry, or of having thoughts that are troublesome, you absolutely must rule out other possible causes of panic. The website I referred you to will raise the possibility of MANY causes of panic.

Please let me know through the feedback buttons if I have addressed your concerns adequately and/or provided you sufficient response to your questions.
Expert:  Dr. Colby replied 2 years ago.
I notice you have been silent for a while. If my responses have been helpful, please indicate this by pushing one of the feedback buttons on the question page. Of course, you may pick any level of feedback that you like; however, I will receive no credit for my work on this issue, with you, and my responses unless you indicate positive feedback at some level. If you are satisfied with my work, I would appreciate that level of feedback. If you are not, perhaps we could converse further.

Thanks.
Dr. Colby
Customer: replied 2 years ago.
yes sorry--i just know deep down i never would because i love my life and family too much, but my head wants me to think there is a way i will "snap" for no good reason when i know i never would. i just want to relax
Expert:  Dr. Colby replied 2 years ago.
Your latest response concerns me. You have now made specific reference to possible harm to yourself and/or your family. And you have stated that "your head" (you?) wants you (the split is concerning) to find a way to "snap" and cause physical harm to yourself or others.

At this point, I now strongly recommend that you be in personal, face-to-face contact with a mental health professional and begin to explore these fears and temptations. That person might be in the best position to guide you into more helpful directions.

Dr. Colby
Expert:  Dr. Colby replied 2 years ago.
Hi, this is Dr. Colby.

I do hope you will follow-up with a live therapist in order to begin to sort through these issues in person with a professional. More than anything, your worry appears to be very troubling to you, and a live person is the best resource for helping you sort these things out.

Best wishes to you,
Dr. Colby
Customer: replied 2 years ago.
I guess you don't really understand and are a psychologist instead of psychiatrist. I talked to psychiatrist online and said its just irrational thinking to make me panic because deep down I know I never would--i was starting to relax and feel better til i read your post
Customer: replied 2 years ago.
i didnt mean to sound rude or anything just upset that i was feeling good and then your post made me panic--can't i just relax because of what psychiatrist/psychotherapist told me?
Customer: replied 2 years ago.
i know i never would do the above and just worry about, please help me Dr. cant i relax?
Expert:  Dr. Colby replied 2 years ago.
I continue to be concerned that you are spending so much time going over and over and over these worries that you may be setting yourself up to make a decision that is not in your best interests. Since you already have an opinion you liked from a psychiatrist, it is curious to me that you keep hammering at the same issue, here, with others, never feeling satisfied with their answers.

I recommend a therapist as your best action, at this point. There, you can sort these issues out, face-to-face, and perhaps achieve a better resolution that you will by repeatedly posting, here.

After I post this, I will again opt out and give others the chance to respond, if they like. I wish you the best in your search for help.

Dr. Colby
Customer: replied 2 years ago.
Dr Colby-- please just understand i will be able to relax if you help me. The only reason im worrying now is you said i should be concercend. before that i was relaxed and not having those thoughts thats the only reason im panicing now. Those thoughts have started to go away
Customer: replied 2 years ago.
dr-- I am suffering and just need your help the only reason I'm panicking is because you said to be concerned b4 that I was relaxed and the thoughts went away. Doesnt it show it's just my anxiety?
Expert:  Bill replied 2 years ago.
Hello- Thank you for asking the question. I have over 30 years of experience working with individuals, couples and families & am happy to reply.

Take my advice and call a Psychiatrist to help you.
You will feel better. I think all who have tried to encourage you to seek help are on the same page.

Now it is up to you to call and make the appointment. Obsessing about this online and asking for more chat time is only making you more anxious.

Call the Doctor today.

Best, Bill
Customer: replied 2 years ago.
I have called and have an appt. tmrw-- i was relaxing fine untill Dr. Colby said it concerns him after i said i know i never would my mind just wants me to worry about it--cant i just relax because i said i know i never would?
Expert:  Bill replied 2 years ago.
That's great- I am glad you have an appointment.
I think you will feel much better and I know it is hard to just stop worrying. That is why you are getting help.
It takes courage and I am proud of you for following though.

I wish you the best at your appointment tomorrow.

Bill

I appreciate your positive rating as it is the only way I receive credit for my time

Thank you and have a great day!

Customer: replied 2 years ago.

ok thanks just one last thing--being a psychotherapist--do you think it sounds concerning or should i just relax because i know ill never do sometingh like that?

Expert:  Bill replied 2 years ago.
Just relax and you should be fine- Be a good patient and work with your Doctor and you will get the help you need to work through this.

I believe you can do it so push away from the computer and stay busy and keep your mind occupied on something else. Like, watching the Olympics, calling a friend or family etc.

BEst, Bill

PLEASE CLICK ACCEPT- I THINK I HAVE EARNED YOUR POSITIVE RATING.

Thanks, Bill
Bill, LCSW, Consultant, Expert Witness
Category: Mental Health
Satisfied Customers: 3705
Experience: 35 years treating individuals, couples, families with mental health and substance abuse prob's
Bill and other Mental Health Specialists are ready to help you

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