Generalized anxiety: the Energizer Bunny of the brain

What is generalized anxiety? Generalized anxiety is a little bit different than most other anxiety experiences. Typically, anxiety is linked to particular items such as a traumatic event, panic attacks, obsessive thoughts, or even particular critters (I’m snake phobic). Generalized anxiety is anxiety about EVERYTHING! Hopefully the name it away, but generalized anxiety is the experience of constant, excessive, uncontrollable worry about pretty much everything in your life. These worries can range from worried about being on time to a meeting, saying the right thing on a first date, the health and safety of your loved ones, or even something as small as taking the right road to work. Now, we live in a society that tells us that worry is normal and that everyone has it….this is both true and untrue. Worry is a natural experience as is the subsequent anxiety we experience. However, for many individuals their level of worry is above and beyond the average level. When you can’t stop the worry, when your brain doesn’t let you sleep at night because it is consumed with worry thoughts, when you can’t concentrate, when you believe you will get fired because you made a small slip up during your presentation, when you call your partner 15 times in 4.5 minutes because you think they died on the way to the grocery store; this is the worry that is likely eating your life.

I’m noticing this level of worry come into my office more lately, which has me thinking about what various factors might increase someone’s worry from average to clinical levels. Increased demands at work might be the cause. Increased stress from our current political climate might play a role. Constant comparison between yourself and others might make you reflect on your life and believe things that ordinarily you might not. Generalized worry is constant and often feels very out of your control. It’s as if your mind is on a hamster wheel that is being run by the Energizer Bunny, it never stops. This type of worry can really take a toll on your body, mind, and life. You might notice yourself feeling more agitated throughout the day, irritable at your kids or partner, your shoulders and jaw may feel tense all the time, you might even feel like you’re going crazy.

Generalized worry is a really common experience, but it is one of those experiences that people often don’t talk about. Nearly 15 million people in the United States alone experience clinical levels of generalized worry and that is a low estimate! Generalized anxiety can start at any time in your life and can continue throughout your life. But it doesn’t always decrease your ability to live into your life. For some people who experience generalized anxiety, it’s actually motivating because if you’re anxious about getting tasks done you might actually finish them weeks in advance (I am one of these people). Orrrrrr you might notice yourself procrastinating assignments or tasks because the anxiety makes you believe that if you can’t do it perfect there’s no point to do it. General anxiety is chronic, but often untreated for many people. Worry is totally normal for many of us, but there comes a point when the worry doesn’t stop, where you can’t focus, where you feel exhausted, where you don’t enjoy your life anymore because of how much you worry. Fear not though! There is hope imbedded deep within that worry. Cognitive Behavioral treatments for generalized anxiety have been shown to be highly effective for reducing the frequency, intensity, and duration of worry-based thoughts (and this is without medications too!). There is life without all consuming anxiety and worry. There is a way to overcome that Energizer Bunny in your mind. For more information about generalized anxiety and treatments, please contact my office via phone or email. You can get your life back, let’s find your spark as we extinguish the flame of worry!

Men, Sex, and Anxiety

One of my favorite topics to talk about is anxiety. Another is sex. As someone who has spent a large portion of her career examining gender variables, these topics tend to overlap when talking about men and sexual performance. Anxiety does not discriminate based on any variable and for many individuals, when anxiety hits sex starts to plummet. Sex is an innate part of humanity, without it, the species could not continue. But as we have progressed as a species, so have our difficulties. Men who have difficulty functioning sexually are stigmatized, humiliated, and frequently report feeling inadequate. But what role does anxiety have on sex for men? Let’s dive in shall we!

According to Masters and Johnson, sexual response occurs on a particular cycle:

When we discuss sexual functioning issues in men, we are talking about something not working somewhere in this cycle. Now, different sexual problems happen at different points. For example, the most commonly known sexual difficulty in men is erectile disorder (aka erectile dysfunction). This is the inability to obtain and/or maintain an erection for the desired length of time. For most, they think that it is an organic issue that can be treated with a pill such as Viagra or Cialis. However, for more individuals than you may think, the cause of ED is not organic. Psychological effects can be a major cause of sexual issues, particularly in men. One of the major areas I am going to focus on here is anxiety.

Anxiety can look differently for different people, but ultimately it is a sense of arousal (not sexual) where your body cannot turn off it ingrained flight, fight, or freeze response. Your body is preparing you for something bad whether it be anxiety related to intrusive memories of combat, fear of going over bridges, shaking from a fear of panic, stress related to obsessive thoughts; anxiety makes your body turn on and not in the fun way. When your body is anxious, it is often difficult to focus and this includes sexual focusing. When a man is anxious he may notice his erection not emerging or deflating quicker than he’d like . He may be able to “keep it up,” but not be able to have an orgasm. For some, the anxiety makes their system go into overload and they may orgasm extremely quickly.

So why does anxiety cause these problems and why is it that once they start to happen more often, it’s harder to fix them? The penis is very sensitive, both literally and figuratively. Anxiety can make a man even more sensitive to everything around him both internally and externally. A major area of concern I see in practice is the impact of Posttraumatic Stress Disorder or PTSD on erections. While not often discussed, it has been found that individuals with PTSD are at significantly increased risk of having sexual problems. Why you may ask? One major area is the body. When someone is going through a trauma, their entire body system is activated. They are more sensitive to sights, sounds, smells, tastes, and physical sensations, so when they are trying to make sense of what is happening, their brain is creating a pairing that tells it “when X body system happens, Y bad thing will happen so be prepared.” Ready for this: when your body is sexually aroused, the exact same physiological system being activated is the one that was activated during trauma that created that pairing. So, when your body “turns on” for sex, it’s also “turning on” for trauma. No wonder someone with trauma has difficulty functioning sexually! Their body is preparing for another horrible thing to happen even though the actual situation is one of pleasure. The pairing effect often results in increased fear and anxiety, intrusive thoughts about the trauma, disconnection from the situation, and physical touching difficulties to name just a few. This is only one example of how anxiety can cause difficulties in someone’s sex life, but for men especially, there is another layer to the anxiety.

Societal pressures about sexual performance and expectations in men are staggering, but not often discussed. Men are typically told that being a man means certain things and one of those things is having a functional penis. There are horrible messages given to men that if they don’t have sex that makes them weird, a freak, broken, not a man, and so many other completely wrong labels. Not being able to have sex, masturbate, or feel aroused with anxiety is completely normal, but it is also one of the things that makes someone feel not just anxious, but depressed. If a major area of your identity is your ability to functioning sexually and that goes away, what does it say about you? For many men with anxiety and sexual problems, it does not just go away. If anything, the longer you wait to treat the anxiety, the harder (pardon the pun) treating the sexual problem is as well.

Anxiety is a tricky thing to treat by yourself as are sexual problems, but what we know about treatment is that treating one can impact the other. Finding a provider who can address these interconnected issues is key in your overall recovery. If you would like to know more about how to treat anxiety and sexual problems in men, feel free to give me a call at 702-587-1573 or an email at jnspsychology@gmail.com. Having anxiety does not make you a freak, having sexual problems does not make you any less of a man, and seeking out treatment does not mean you are weak. 

Exposure Therapy 101

Anxiety is defined as “a state of intense apprehension, uncertainty, and fear resulting from the anticipation of a threatening event or situation, often to a degree that normal physical and psychological functioning is disrupted” (American Heritage Medical, 2007, p. 38). While I’m a big fan of this technical definition, I think it’s safe to say to anyone who has ever experienced anxiety is that it just SUCKS! The way your body reacts to anxiety makes you legitimately feel like you’re dying. I remember my first panic attack so clearly that if I needed to create it for any reason that would definitely not be a problem (it involved a snake and, at that time, my anxiety towards those little beasts was near paralyzing). I didn’t know what I know now about treatment for anxiety, particularly about exposure-based treatments to resolve any anxiety or trauma disorder. Each year, Anxiety Disorders impact approximately 18% of 40 million adults in the United States (NIMH, 2013).

So, what is exposure therapy? Considered the gold standard treatment for anxiety disorders, exposure-based treatments focus on change by exposing an individual to their feared objects, activities, or situations in a safe environment to help reduce fear and decrease avoidance (APA Division 12, 2013). Below are so basic examples of what type of techniques are used in exposure-based treatment.

While exposure therapy seems scary at first glance, what we know about it is truly astonishing. Numerous research studies have revealed that positive treatment outcomes for Anxiety Disorders are maintained longer for individuals who have participated in Cognitive-Behavior Therapy and Behavior Therapy (exposure therapy; National Institute of Mental Health, 2013). But the real question people typically have is not “what is it?” but rather “how does it work?” Well, here’s how:

Over time, anxiety goes down the more frequently someone practices/engages in the activity that makes them anxious. Here are some examples of how you and your therapist can take this theory and put it into action:

While exposure therapy isn’t magic, sometimes it can feel like that. It can treat a variety of Anxiety and Trauma Disorders such as Social Anxiety, Panic Disorder, Obsessive-Compulsive Disorder, Specific Phobias, and Posttraumatic Stress Disorder (PTSD). I have seen individuals who have chronic anxiety (we’re talking 40+ years) go through exposure therapy and report no longer having anxiety, at all! I admit my bias when it comes to exposure therapy, but it truly is one of my favorite things to do in treatment because IT WORKS. Some examples of specific exposure treatments include:

If you experience anxiety, things can get better. It won’t always be pleasant and, at times, it downright hurts, but you can overcome your anxiety, you can take back your power, you can live a life without anxiety! To learn more about anxiety, trauma disorders, and treatment feel free to email me at jnspsychology@gmail.com or give me a call at 702-587-1573 to schedule an appointment.