Tag Archive | anxiety


There is a lot written about anxiety and its symptoms. In my work, I notice few more indicators or symptoms that occurred often together with the anxiety. I decided to list them below. It doesn’t mean that you will have all the symptoms but it can help knowing that it’s not so uncommon to experience the following:

»I will die, go crazy or have heart attack« this is an obsessive thought that is common with anxiety. With time you will realize that nothing serious will happen while having panic attack but this thoughts will still pop up in your head. It is hard to get rid of them. It is very common that you have more than one intrusive thought. For example, »Will I have panic attack again?” or “How will I come through the day?” or “I am not strong enough«. Even if you proved yourself other vice time and time again you will still have this thoughts that comes to your mind.

Unusual or long persistent pain can cause fear that something is seriously wrong in people with anxiety.

“Unknown food or medication”
Thoughts that something bad will happened when we swallow unknown medication or eat new food are common.

Sensation when heart beads faster during sport can resemble panic attack. Which can begin real panic attack. Consequently many people with anxiety may avoid Sport.

In my work I have notice that ¼ of people with anxiety have fear of swallowing. Usually they have previous experiences with asthma or their throat becomes dry and tightens during panic attack.

“No escape”
Fear that you can’t escape form situation, feelings or place can cause enormous distress and anxiety.

“Smell, sight or sound sensitivity”
During panic attack many people have very sensitive sight, hearing or smell. It can even deepen their unpleasant feelings while experiencing the attack.

“Vivid imagination”
Persistent negative thoughts connected to us or significant other. For example, we are crossing the road and we imagine how we will get hit by the car. Imagination can get very detailed. I also notice that people with vivid imagination often report to me about fear of the dark.


*the article is based on my private practice observations

Anxiety is often a reason why people knock on my door. It is also the subject that I am most drawn to. That’s why I would like to write a short article based on my work experiences about dealing with anxiety.

In short, I approached anxiety in two levels:

  1. Dealing with symptoms: In the Internet era, people educate themselves about panic attacks and how to ease symptoms. Consequently this level is the most accessible for self-help. Cognitive-behavioral psychotherapy is mainly focused on this level. Many people come to psychotherapy equipped with the knowledge and exercises how to help themselves with panic attacks. But why do those people still come to therapy? I believe focus in this level is not enough for the long term anxiety relief. In my practice, I focus 80% of my time on second level:
  2. Deeper approach: Psychotherapeutic relationship offers safe, understanding, trusting environment which is especially important for people with anxiety. For them, knowing that they have safe place, whit expert who they can trust, play enormous role. I notice that people with anxiety often keep their fears and worries to them self, they are overly consider with other people’s emotions and are on the mission not to hurt others, their true content is locked inside them which one day explode into panic.
    In time, the therapeutic relationship is safe enough for all the hidden content to come to light, having somebody to talk about it, relieves the burden that is kept inside and coses stress. Often we are so used to carrying a burden that we don’t realize how anxious our mind and body are feeling.

What (not) to expect in therapy

A lot of people believe that there is some kind of recipe for panic attacks solution. And they expect to get it from therapist. There is not just one anxiety, I see different kinds of it, some overwhelming others »just« as symptom form some other mental disorder. Therapy needs to get to its core and there is no recipe for that.

I don’t believe that you can cure anxiety response 100%. Let’s not forget that no matter how unpleasant it is, it is still a normal human response. The only difference it is that by people with anxiety, the centers for danger are triggered where there is no actual life threatening situation. The difference after therapy is that less things are causing us stress. Before it was stressful to go to the grocery store, now it would be stressful when having an accident. That’s a normal body/mind response.


In this article I will summarized the work of Elaine N. Aron, Ph.D. book, The Highly Sensitive Person. In her psychotherapy practice she worked with HSP for decays and come to an interesting conclusions.

In connection to anxiety: HSP often treats his high arousal as anxiety. He got false messages form the environment that unpleasantness he is experiencing (due to high arousal) is actually fear. Consequently when they get aroused (annoyed, tired…) that automatically triggers fear.

Twenty percent of the population is born with HSP, 30% of them are extrovert and it effects women and men equally. The author distinguish between two subtypes:

First one is calm, quiet and satisfied quickly the other is slightly contradictory, for example he is curious but careful, cheeky but scared, he gets bored very quickly but at the same time, he is quickly overstimulated.

Hypersensitive nervous system
HSP have a hypersensitive nervous system. Exposed to the same amount of stimulus, they tend to absorb more and consequently they get aroused faster. Also they process everything very deeply and get easily overwhelmed.

They pick up the stimulus form the environment that many others would normally overlook. Some people call that good intuition. Their delicate sense make them a good writers, historians, philosophers, judges, artists, researchers, theologians, therapist, teachers, conscious parents and citizens.

Main characteristic of HSP Person:

  • Creative (unusual imagination), very empathic people.
  • They tend to have more vivid dreams and nightmares then others. Even if they didn’t have any traumatic experience it is not unusual for them to fear the dark. No wonder many of them have trouble sleeping.
  • They feel hunger very strongly.
  • They have hart time making decisions, especially because they are being more aware of consequences, wanting to make right by everyone and paying great attention to details.
  • If they had many negative experiences in life, they are more prone to anxiety or depression. HSP children can get criticized for their sensitivity, often the environment doesn’t know how to react to it. That’s why many of them feel like there is something wrong with them. In the environment that is in tune in with their sensitivity, they flourish to a confident person, viewing their sensitivity as a gift.
  • They react to criticism more intense than others which can result in avoiding criticism all together, by trying to please other people and putting others first.
  • They have lower pain tolerance. They feel changes in their body more profoundly, that’s why they are having trouble to brush the painful sensation off their mind.
  • They tend to be more sensitive to violence in the movies and real life. Due to their great imagination, they can vividly imagine what it would be like. The images can linger with them for weeks or even years.

Are you a HSP? Find out in these questioner: http://hsperson.com/


People working in busy environment or dynamic cities like London, New York, Singapore, Zurich, Frankfurt, where is no shortage of qualified therapists, often choose online therapy due to its convenience and flexibility. The comfort of having the therapy in your office and not being forced to travel to therapist office often weigh towards online psychotherapy.

Skype therapy has also turned out to be a great option for people whose part of their job is to travel. Regular therapy sessions are important part of progress in psychotherapy. Skipping them because of frequent business trips can become a problem at some point. Online treatment offers time and geographic flexibility which you can’t expect form face-to-face therapy.


Adjustment to a new environment

Cultural shock is a part of experience when you move abroad. Moving can be a stressful. You can never really prepare for the changes that you are going to face. Even if you are moving to a similar cultural background there will be some bumps along the road. If you are new to the language, this can only deepen the feelings of loneliness, isolation and stress.

People forced to move when their spouse is transferred to a foreign country, with no job and limited support, may have an especially hard time.

Sometimes cultural shock doesn’t hit us right away. We can be in a so called “honeymoon phase”. When person gets used to new environment and novelty become less exciting, the shock can check up with us.

Having problems living abroad

Being a human means that we will have rough times. We can develop or face serious troubles anytime in our life time, no matter where we live. If we happen to be in a foreign country, this can cause us even greater distress. Not having access to a therapist that is not only able to understand our language, but also our cultural background, can be discouraging. Online therapy helps in this cases. In my experience, it is a great option for people living abroad.


Online psychotherapy is suitable for people who due to temporary or permanent reasons can’t go out of their (safe) environment.

Temporary obstacles
In this category I am including temporary situations that require people to stay at home. Here we can talk about different kind of physical injuries that needs longer period of time to heal as well as risk pregnancies and Postpartum (postnatal) depression and/or anxiety and/or obsessive compulsive disorder. In the last case, due to a newborn baby, it is often easier for the new mother to be able to have therapy from home. In my personal experience, I also do therapy where the baby can be next to a mother if she doesn’t have babysitter or wants to have baby near her.

More permanent obstacles
In this category I am including social phobia, agoraphobia, anxiety disorder that leaves us with a bitter taste to go to the places where we experienced panic attacked and also other physical challenges that cost us difficulties to visit therapy face to face. Although the first disorders are not permanent per se, it often feels like they are to the person who is experiencing it. You don’t see the end of it. Isolation can become an issue for some when dealing with emotional difficulties and online treatment can help tremendously in that cases.


Types of anxiety Description
Panic disorder Panic attack feels like sudden attacks of terror which normally peaks within 10 minutes, but some symptoms may linger much longer. Attack can occur at stressful times or it isn’t connected to any particular situation. Many people have just one panic attack. In this case we can’t talk about panic disorder.
Common symptoms: pounding heart, sweating, weakness, faintness, dizziness, flush or feel chilled, tingle or numb hands, nausea, chest pain, smothering sensations, sense of unreality, fear of another panic attack, fear of dying, fear of losing your mind.
Panic attacks can limited us, especially if we don’t seek treatment before it develops into agoraphobia. Good news is that panic disorder is one of the most treatable of all the anxiety types.
Agoraphobia About one in three people with panic disorder develops agoraphobia. It is an outcome of repeated panic attacks. It happens when we avoid different situations because we have intense worry of attacks. We can define agoraphobia in two different ways. One is fear of going outside or to unfamiliar places. Other is fear that there is no escape. Early treatment of panic disorder can often prevent agoraphobia.
Generalized anxiety disorder (GAD)


GAD is diagnosed when a person worries excessively about a variety of everyday problems for at least 6 months (health, money, family, work issues). If person worry just about one thing, we can’t talk about GAD.
Physical symptoms: fatigue, headaches, muscle tension or aches, difficulty swallowing, trembling, twitching, irritability, sweating, nausea, lightheadedness, frequent visits to the bathroom, feeling out of breath, hot flashes, difficulty concentrating, insomnia.
Specific phobia Intense fear of something that poses little or no actual threat (closed-in places, heights, escalators, tunnels, highway, water, flying, dogs, blood etc.). Even though people realize that fear is ungrounded, they can have panic attack or anxiety when facing or thinking of facing the situation.
Separation anxiety disorder (SAD) SAD is normal life stage and occur with 7 months, reach its peak between 10 and 18 months and usually disappear when the child is 3 years old. Parents have trouble with bedtime and time of separation (clinging, crying, anxiety). If parents help his child deal with the anxiety constructively, child outgrowth this phase.
If anxiety is unresolved its’ continue to adulthood. Around 7% adults have it. In compared to medications counseling is usually considered the best treatment method.
To be diagnosed with SAD, one must have at least 3 following symptoms: experiencing great stress when you separate form home or love (trusted) one; worry to lose love (trusted) one or sth. bad will happen to them; don’t want to go from home because of the fear of separation; don’t want to be alone or without love (trusted) one; nightmares about separation; trouble sleeping when not being near love (trusted) one.
Social anxiety disorder= Social phobia is a great fear in one or more social situations. They can worry for days or weeks before and after social situations. They are afraid of embarrass themselves, being watching or/and judge. As a result, they choose to isolate themselves from society. They often self-medicate with drugs, alcohol, food. More than 66% have other mental disorder (commonly depression or anxiety)
Physical symptoms can occur: blushing, excess sweating, trembling, palpitations, nausea, panic attacks, diarrhea.


With a new baby in the house some worries are expected. Especially if it is our first born. But what if worries are persistent and with little base ground? Probably you already heart about postpartum depression, but what about postpartum anxiety? According to Germany University of Heidelberg, 11% of mothers developed postpartum anxiety, while 6% developed postpartum depression. Overall this affects 1 out of every 7 women. Unfortunately, postpartum anxiety and depression often occurs together. Read personal story about that HERE.

What are the symptoms that shouldn’t be overlooked?

If you had a baby within the last 12 months and are experiencing some of these symptoms for at least 2 weeks or longer you might have postpartum anxiety. Anxiety can also appear during the pregnancy.

• Having trouble quieting your mind. You are worrying all the time. You feel like something horrible will happen.
• You are unable to relax. You feel tense and on edge. You feel that you have to do something all the time.
• Disturbing thoughts which can vary from “harming your baby” to “not being a fit mother”.
• Physical symptoms like stomach cramps, headaches, shakiness, nausea, panic attacks.
• Disturbances of sleep and/or appetite.
• Feeling that something is off with you.

Seeking help is important

In the culture where motherhood is represented as something joyful it is hart to seek help when you are experiencing postpartum anxiety (or depression or obsessive compulsive disorder). Never the less, you are not alone.
It is very important to seek help sooner than later even with mild symptoms of postpartum anxiety. Left untreated, can interfere with your ability to bond with your child. Many moms find it helpful to talk to psychotherapist. It is important to have someone who acknowledge your panic, gives you support and strategies to deal with anxiety. Use of medication is also possible, even if you are nursing. This is determine on a case-by-case basis.

Could I predict it?

Knowledge about postpartum anxiety can help to catch the disorder in early stages which make treatment easier. If you have family member with (postpartum) anxiety or previous history of anxiety you have greater possibility to develop postpartum anxiety.
But that can happen to every mother, no matter the history. There might be a physiological explanations for mood disorders during and after birth. During that time our body goes through drastic hormonal changes. Which makes pregnancy a particularly vulnerable time for conditions such as depression and anxiety.

Read some personal stories and wisdom’s on following links here and here.

You are not alone! Encouraging video from other moms