Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States. Anxiety disorders cost the U.S. more than $42 billion a year, almost one-third of the country’s $148 billion total mental health bill.  More than $22.84 billion of those costs are associated with the repeated use of health care services.  People tend to seek relief for anxiety symptoms that are often confused as medical illnesses.  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 that includes genetics, personality, and life events.  However, not all anxiety is unhealthy or necessarily problematic.  Occasional anxiety is a normal part of life. You might feel anxious when faced with a problem at work, before taking a test, or when facing an important decision.  This type of anxiety is a natural response to life’s demands and challenges.  Anxiety is the body’s attempt to mobilize our internal resources to meet these demands and challenges.  Anxiety Disorders however involve more than temporary worry or fear. For a person with an anxiety disorder, the anxiety does not quickly go away and can worsen over time. Anxiety is considered problematic when it begins to regularly interfere with daily activities, job or school performance or relationships.

Anxiety Disorders

There are several types of anxiety disorders. Some common examples include Generalized Anxiety Disorder, Panic Disorder, Social Anxiety Disorder and Simple Phobias.

People with Generalized Anxiety Disorder tend to experience recurrent worry about a great variety of stressors which may change often.  Symptoms include restlessness, difficulty concentrating, irritability, muscle tension, difficulty controlling your worry and sleep problems-such as difficulty falling asleep or staying asleep.

Panic Disorder is characterized by recurrent unexpected panic attacks, which are sudden and repeated attacks of intense fear.  These attacks may include heart palpitations,accelerated heart rate, sweating, trembling, shortness of breath, feeling smothered or choking and feelings of impending doom.  People who suffer from Panic Disorder also tend to have recurrent worries about future panic attacks. Those who suffer from Panic Disorder may often avoid places where panic attacks have occurred in the past and may often isolate.

Social Anxiety Disorder or Social Phobia is characterized by a severe fear of social situations where an individual fears being embarrassed, judged, or rejected.  Individuals who suffer from Social Anxiety Disorder feel highly self-conscious and often avoid public settings where there are other people. Many may feel flush, begin sweating or tremble when around other people.  They may feeling nauseous or sick to their stomach when other people are around as well.

Simple Phobias are a persistent, irrational fear of an object or situation coupled with a strong urge to avoid that object or situation.  The person with a specific phobia will react with significant anxiety when they face the fearful stimuli. Simple phobias can include a fear of animals, insects or even heights.  However, any object or situation can be at the center of a phobia.

Treatment

Anxiety disorders are typically treated with psychotherapy, medications or both.

Psychotherapy or counseling is “talk therapy.”  These treatment services may be in individual or group format.  Talk therapy focuses upon examining a person’s experiences with anxiety, identifying underlying causes and creating solutions to overcome one’s anxiety.

The most common therapy approach for Anxiety Disorders is a combination of Cognitive-Behavioral Therapy, Graded Exposure Therapy and Medications.

Cognitive-Behavioral Therapy (CBT) focuses upon identifying underlying thoughts and beliefs that are associated with the anxious feelings that are experienced.  Anxiety tends to be associated with an underlying fear about a particular situation, object or circumstance.  Once these underlying fearful thoughts are identified, therapy then focuses on challenging the accuracy and rationality of these thoughts.  Most Anxiety Disorders are based upon unrealistic or irrational fears.  Overcoming an Anxiety Disorder occurs when a person is able to change the thoughts and beliefs that are creating their anxiety.  CBT is typically brief with significant improvement in 12 to 20 treatment sessions.  CBT is a highly effective short-term treatment with research finding that over 60% will experience significant improvement.

Graded Exposure Therapy is another highly effective treatment approach for anxiety.  Graded Exposure Therapy consists of identifying the specific triggering situation, object or circumstance associated with the individual’s anxiety.  Once this is identified, what is feared is broken down into smaller, lesser intimidating or fearful steps.  The individual then faces each step in a slow, but progressive manner until they report no longer experiencing anxiety at that step.  Anxiety is overcome when the individual has successfully completed all of the prescribed steps of their Graded Exposure plan.

Medications are often prescribed to assist in treating Anxiety Disorders.  However, medications are used to manage anxiety symptoms-not cure the Anxiety Disorder.  There are several types of medications available to treat anxiety.  Medication regimens used to treat Anxiety Disorders must be prescribed by a medical professional such as a Physician or a Psychiatrist.  One should take care when using certain types of medications since many have a high addictive potential if used over a long period of time.  Medications can be a helpful addition to the treatment of anxiety, but research has shown that the most effective course of treatment is Psychotherapy and Cognitive-Behavioral Therapy.  Up to 50% of people who use medication experience some symptom relief.  Reduction of symptoms is generally moderate with the average improvement rate between 20% and 40%.

If you feel that you are suffering from an Anxiety Disorder, feel free to contact The Chrysalis Center to schedule an assessment with one of our licensed staff.

Bariatric surgery can help psychological and emotional problems.  There is well documented evidence of gains in positive self esteem, sense of taking control of one’s life, energy and vitality.   Anyone who has struggled with obesity is aware of its negative impact on the quality of life over time.  These include difficulties arise in social situations due to discrimination, shame and poor self confidence.  Depression, anxiety and even complete withdrawal from social circles are commonly reported.    Unfortunately losing weight doesn’t always translate into an immediate reversal of social anxiety nor of depression.

Some of the most common post bariatric surgery problems include:

• A lingering perception of being obese even after losing weight and falling within normal BMI ranges. Years of convincing oneself that they do not look good does not go away in just a few months.
• Relationships may be affected after bariatric surgery. Most individuals experience an increase in self-confidence.  Good relationships may become stronger while bad relationships may deteriorate further. As the person experiences greater self-confidence and enjoys their new body image, they may improve their sex life. This may strengthen an intimate bond with their significant other.  Those trapped in unhealthy relationships may find the strength to leave or push for changes.
• Prior to bariatric surgery, individual may have eaten to help cope with negative emotions, to celebrate or just to enjoy the flavors of foods.   Foods high in fats and sugars are often “go to” foods for emotional eaters.  Post surgery, that will no longer be possible. As a result, some patients may feel deprived or resentful, particularly when cravings or hunger returns.  The journey to finding the right combination of foods that satisfy often can be eased by the assistance of a qualified bariatric dietitian
• Some individuals, in not being able to cope with the change in diet, may develop other addictions to fill the void that food once did. There is an increased risk for abuse of alcohol that all bariatric patients should be aware of.
• Extra skin after bariatric surgery can be upsetting or depressing. While this is a normal result of weight loss, it can also derail the patient’s journey.

While you will experience challenges after bariatric surgery, there are ways to cope with your changing lifestyle. First, family and friends are important in helping you lose the weight. When family and friends are part of your weight loss solution, you create an intimate group with whom you can brainstorm answers to your problems.

It is also important to attend support groups on a regular basis. You will learn about tips and tricks to lose weight, other people’s experiences and learn what others have done in your position. Support groups have been proven to be a very effective tool in losing weight and keeping the weight off as well as avoiding many psychological issues.

In the end every significant change can affect us. Undergoing bariatric surgery requires a great deal of dedication to your health and diet.  It also opens the door to opportunities for social connectedness,  new interests and passions.  Make sure to take advantage of all the resources and opportunities available to you.

Hypnosis is popularly understood as a form of entertainment—stage hypnotists use focused attention combined with suggestions to have the willing act in often embarrassing ways to excite and amuse audiences.  If you have ever attended or witnessed a stage hypnosis act, you may have made certain assumptions, had skeptical questions, or perhaps even walked away scratching your head at what you had just experienced.  Common inquiries of those who have been on stage may include “What did it feel like?  Were you really hypnotized?  Do you remember anything?”.  Skeptics may search for clues that the entire performance was a fallacy and make comments such as “I saw you crack a smile” or “That wasn’t real”.  Still others may leave feeling mesmerized, ironically a term named after an early contributor to hypnosis, Franz Anton Mesmer.  Regardless of observer response, the fact remains that individuals participating in stage hypnosis perform according to the suggestions given by the hypnotist.  Stage hypnosis demonstrates the power of the mind to create change.

In fact, hypnosis is scientifically verified as an effective technique that can promote human change.  In a treatment setting it is used for issues such as anxiety or stress reduction, improving motivation and confidence, addressing fears and phobias, resolving grief and loss, changing habits, and increasing self-esteem. With hypnosis, we can create desired changes in behavior and encourage mental and physical well-being.  http://www.apa.org/topics/hypnosis/media.aspx

So what does hypnosis look like in therapy?  There are often myths to debunk that have emerged from theatrical depictions or misunderstandings.  The truth is that most people enter a trance state on a daily basis- think about the sensation of losing track of yourself while driving, watching television, or brushing your teeth.  There is no mystical loss of consciousness, giving over control to a hypnotist, or getting stuck in a hypnotic state.  A hypnotist cannot force somebody to do something against their moral code or will.  Even those participating in a stage event do so willingly with the expectation they are going to act silly.  Hypnosis is not sleep; the person being hypnotized is under full control of himself/herself.

Hypnosis in therapy guides clients into a naturally-occurring, wonderful relaxed state where one is much more able focus than in the normal waking state.  After inducing a trance, a hypnotherapist may then use imagery, relaxation, or processing depending on the goals of the client.  As an integrated tool in therapy sessions, the therapist and client work together to explore the subconscious mind.  People usually emerge feeling relaxed and energized.

Hypnosis is not a substitute for therapy!  It is an intervention used by a trained hypnotherapist who is also a licensed professional.  Throughout history and across contexts, hypnotic strategies have been employed by famous therapists including Sigmund Freud, Alfred Adler, Carl Jung, and Carl Rogers as effective tools to help people reach their goals and promote emotional, cognitive, and behavioral change. http://www.historyofhypnosis.org/.  In the words of Milton Erikson, “You use hypnosis not as a cure but as a means of establishing a favorable climate in which to learn”.

If you are considering using hypnosis to help you reach your treatment goals, take steps to ensure that you are working with a qualified provider who has been trained in the use and limitations of clinical hypnosis.  http://connecthypnotherapy.com/10-questions-to-ask-your-potential-hypnotherapist

“When you have exhausted all possibilities, remember this: you haven’t” –Thomas Edison

Leanne Christian is a Licensed Professional Counselor.  She became a Certified Hypnotherapist by the National Guild of Hypnotists in September 2015.  She uses Hypnotherapy in conjunction with other evidenced-based interventions to help her clients reach their treatment goals.