You may have heard about anxiety or panic attacks, but may not fully know what it means to suffer from anxiety. If you find yourself having troubling or worrisome thoughts more often than not, it's likely you are experiencing anxiety. Not everyone who struggles with anxiety is completely aware of it. In fact, a person who has experienced anxiety for most of his or her life may think it's "normal" to feel the way they do. Anxiety can include continual criticism of oneself with the belief that one is inferior to those around him or her. Some types of anxiety include social anxiety, which involves being so afraid of not being accepted in social situations that a person often avoids social settings altogether. Other anxieties can be more phobia-related, such as fear of certain things or situations, but to such an extreme that it impedes a person from living a healthy life or pursuing certain opportunities because of the fear. For example, a person who is so fearful of bridges that he cannot travel in certain areas where he would have to drive across a bridge, and therefore does not apply for a job he really wants, because the only route to the company would require him to drive across a bridge.

Another anxiety-related struggle involves Panic Disorder. This occurs when a person has frequent panic attacks, which can involve anything from heart palpitations and shortness of breath, to shakiness and even dizziness and feeling as if one might faint. Panic attacks can sometimes be accompanied by particular thoughts that trigger the attack, but not always. Many people describe panic attacks as feeling like a heart attack, because many of the symptoms are similar. People also frequently describe panic attacks to feel like they are going to "lose control" of their bodies or minds.

There are therapeutic interventions that can be very helpful for anxiety and panic. One of these techniques is the use of Cognitive Behavioral Therapy. This type of therapy involves modification of one's thoughts from exaggerated fears or beliefs that are unlikely true, to more accurate thinking.

If you struggle with depression, then you may know how hard it is some days just to get out of bed, let alone function in a way that allows you to be productive or to withstand being around other people. Many people struggle with depression, yet they feel compelled to "plaster on a smile" and go through the day as if nothing is wrong. Often, people have stated to me that they don't want to bring those down around them, or they don't want other people to view them as less of a person because of their struggle. Despite people's ability to continue working and meeting other responsibilities that are placed on them, they may suffer in silence with these feelings.

Sometimes, people are unaware that they are struggling with depression, they just feel that something is "off." They might feel more tired than usual, or have difficulty concentrating. Sometimes physical pain even accompanies these symptoms. Another common sign of depression is loss of interest in hobbies, social activities, or anything else that the person previously enjoyed. Depression can also affect sleep, either by making it difficult for someone to sleep, or by causing them to feel like sleeping more than usual.

There are several ways to manage depression. Cognitive Behavioral Therapy can be helpful, as well as finding ways to incorporate small behavioral changes into a person's life that will enable them to find meaning and purpose again, as well as change brain chemistry by releasing dopamine and endorphins (through things such as exercise and other physical activities). Medication can also be a helpful alternative for managing depression, as it assists the brain in the transmission and absorption of the chemicals needed to balance emotions.

A large percent of the population has experienced at least one traumatic event. There are multiple types of trauma. I've had people tell me they thought PTSD was something with which only veterans or first responders struggle. While it is true that veterans, active military personnel and first responders can suffer from Post-Traumatic Stress based on things that have happened to them in their respective lines of duty, civilians can suffer from PTSD as well. Some traumatic events that can cause Post Traumatic Stress Disorder are situations such as abuse, sexual assault or other physical violence, car accidents, natural disasters or any other situation in which a person intensely fears for his or her safety.

The actual definition of Post-Traumatic Stress Disorder is "a normal reaction to abnormal circumstances." There are actually a couple of types of civilian related trauma. There is a single incident trauma, in which a person experiences one traumatic event, such as a car accident for example. There is also Complex PTSD, which can occur when someone experiences multiple life or safety-threatening events, or when the trauma has been ongoing, such as childhood abuse or an abusive relationship. This type of trauma tends to impact a person more strongly and can take more time to heal.

You might ask, "Can PTSD be cured?" The short answer to that is no. The reason for this is that you can't remove a person's memory of the trauma, and therefore there is no way to guarantee you can remove the possibility they will respond to a trigger that reminds them of the trauma. The longer answer, however, is that while there is no "cure" for PTSD, there is substantial relief for the symptoms it causes. There are several therapeutic methods that are known to provide healing for symptoms created from post-traumatic stress. One is Cognitive Processing Therapy, in which clients are asked to identify the meanings they might have subconsciously assigned to a traumatic event or events. Once these meanings are discovered, the goal is to work on creating new, perhaps more accurate meanings that will allow the perspective of the client to change in a way that helps them process the traumatic event in a more healthy way.

Another type of therapy for post-traumatic stress is called EMDR, or Eye Movement Desensitization and Reprocessing.

Everyone experiences changes in life, but many people don't realize that changes, even positive ones, can sometimes disrupt the balance of emotional health. This occurs because sometimes changes include loss of some kind or introduce new stress into a person's life. For example, many would associate getting a new job and moving to an exciting new city, a positive life event. This, however, may be accompanied by loss of being near loved ones, feelings of missing their previous home, among other things. Sometimes, people have a hard time understanding why they may feel sad when things are going well for them in this instance. The reason for the sadness is the grief for some of the things they are losing. This generally changes with time, but it can be helpful to have someone with whom to process the confusing emotions, as well as discovering healthy coping skills for these emotions.

There are, of course, more difficult life changes that occur for many people as well, such as divorce, loss of employment or development of chronic illnesses. These changes can feel scary, and too often, people feel isolated in their circumstances and emotional difficulties because they may be facing these life transitions alone or with minimal support. It can be beneficial to reach out to a mental health provider for assistance in coping with difficult emotions that understandably come with these changes.

If you are going through a difficult period in your relationship, where either you feel you are unable to communicate well with one another, or your perspectives are different from each other’s, it can be beneficial to talk to a third party to work through miscommunications.

“What can I expect from couple’s counseling?” You may ask. One important thing to expect is that your therapist should not side with one person. Couple’s sessions are supposed to be beneficial for both parties in that both people can feel respected and heard. The therapist may point out when one person might be misinterpreting information or may have unrealistic expectations, but this should be pointed out in a way that is respectful to each party. Sometimes, simply having a neutral party present to “reframe” information in a way that it might be interpreted differently can be helpful, as often in intimate relationships people hear each other through a veil of intense emotions and therefore information can be skewed to some degree.

Another important piece of information is that couple’s counseling does not have to happen only when there is a significant problem. Many couples choose to work on communication before it becomes an issue, so that they can plan ahead on how to handle disagreements or stress in the relationship.

Some couples who are choosing to end a relationship come to counseling as well, so that they can transition out of the relationship in a healthy way for each person. In this instance, a couple is not necessarily trying to salvage the relationship, but they are trying to process difficult emotions that come with the break-up as well as find possible closure.

There are multiple situations in which people seek couple’s counseling, including communication difficulties, trust issues, infidelity, life transitions, child-rearing, and defining roles within the relationship, to name a few.

Grief is known to most people as something one experiences after a death or other major loss. While this is accurate, there is more than one type of grief. Grief can also occur with life changes, such as change in jobs or moving to another city. Grief is essentially an experience that can occur with a loss of any kind. There is also Complicated Grief, which occurs when one suffers a significant loss which also may have circumstances surrounding it that make it more difficult to get through the stages of grief in a healthy way. Complicated grief may be more intense and last longer than natural grief. It may manifest into depression if it goes untreated. Examples of losses that can lead to complicated grief might include losing a loved one to suicide or other sudden, unexpected loss.

Another thing to note about grief is that there is no particular timeline of when grief is supposed to "end". The amount of time spent in the grief process varies for each person. There is also not a particular order in which people go through the stages of grief or how they handle grief. Everyone has their own way of reacting to grieving.

Grief therapy typically involves processing the stages of grief and receiving validation of the emotions you are experiencing. If you feel stuck in the process, getting help from your therapist in figuring out the reason you are having difficulty moving forward and working to find solutions to continue making progress in healing can be helpful.

Cognitive Behavioral Therapy, sometimes known as CBT, is a type of therapeutic technique which involves working on changing thought patterns or behaviors that lead to difficulties. It is a solution-focused approach as well as being fairly short-term, as it is something that one can begin practicing right away, and it is highly-effective. Cognitive Behavioral Therapy does involve a collaborative effort between the therapist and client. The therapist will ask questions that allow a client to formulate new ways of thinking about distressing events. The client is usually able, with the help of the therapist, to come to more accurate conclusions about the things that are bothering him or her rather than relying on emotions alone to direct the thoughts. The therapist may assign “homework” which may simply be worksheets to aid the client in changing thought patterns. One of the great things about Cognitive Behavioral Therapy is that it is simple for clients to employ, and with practice, it can become a natural technique for someone to use during times of emotional distress.

The best description is taken from the founder of EMDR, Francine Shapiro, Ph.D., on her website for EMDR Institute, Inc.

“EMDR (Eye Movement Desensitization and Reprocessing) is a psychotherapy that enables people to heal from the symptoms and emotional distress that are the result of disturbing life experiences. Repeated studies show that by using EMDR therapy people can experience the benefits of psychotherapy that once took years to make a difference. It is widely assumed that severe emotional pain requires a long time to heal. EMDR therapy shows that the mind can in fact heal from psychological trauma much as the body recovers from physical trauma. When you cut your hand, your body works to close the wound. If a foreign object or repeated injury irritates the wound, it festers and causes pain. Once the block is removed, healing resumes. EMDR therapy demonstrates that a similar sequence of events occurs with mental processes. The brain’s information processing system naturally moves toward mental health. If the system is blocked or imbalanced by the impact of a disturbing event, the emotional wound festers and can cause intense suffering. Once the block is removed, healing resumes. Using the detailed protocols and procedures learned in EMDR therapy training sessions, clinicians help clients activate their natural healing processes.

More than 30 positive controlled outcome studies have been done on EMDR therapy. Some of the studies show that 84%-90% of single-trauma victims no longer have post-traumatic stress disorder after only three 90-minute sessions. Another study, funded by the HMO Kaiser Permanente, found that 100% of the single-trauma victims and 77% of multiple trauma victims no longer were diagnosed with PTSD after only six 50-minute sessions. In another study, 77% of combat veterans were free of PTSD in 12 sessions. There has been so much research on EMDR therapy that it is now recognized as an effective form of treatment for trauma and other disturbing experiences by organizations such as the American Psychiatric Association, the World Health Organization and the Department of Defense. Given the worldwide recognition as an effective treatment of trauma, you can easily see how EMDR therapy would be effective in treating the “everyday” memories that are the reason people have low self-esteem, feelings of powerlessness, and all the myriad problems that bring them in for therapy. Over 100,000 clinicians throughout the world use the therapy. Millions of people have been treated successfully over the past 25 years.

EMDR therapy is an eight-phase treatment. Eye movements (or other bilateral stimulation) are used during one part of the session. After the clinician has determined which memory to target first, he asks the client to hold different aspects of that event or thought in mind and to use his eyes to track the therapist’s hand as it moves back and forth across the client’s field of vision. As this happens, for reasons believed by a Harvard researcher to be connected with the biological mechanisms involved in Rapid Eye Movement (REM) sleep, internal associations arise and the clients begin to process the memory and disturbing feelings. In successful EMDR therapy, the meaning of painful events is transformed on an emotional level. For instance, a rape victim shifts from feeling horror and self-disgust to holding the firm belief that, “I survived it and I am strong.” Unlike talk therapy, the insights clients gain in EMDR therapy result not so much from clinician interpretation, but from the client’s own accelerated intellectual and emotional processes. The net effect is that clients conclude EMDR therapy feeling empowered by the very experiences that once debased them. Their wounds have not just closed, they have transformed. As a natural outcome of the EMDR therapeutic process, the clients’ thoughts, feelings and behavior are all robust indicators of emotional health and resolution—all without speaking in detail or doing homework used in other therapies.”