Instruction:
Sometimes, I'm fine and can go out or meet people, but other days, my heart races and words physically cannot come out of my mouth. I've always thought it was normal and I was just nervous, but the other day, it took me almost 30 minutes of sitting in my car to find the courage to enter Target by myself.

Response:
It is possible that you could have or be developing an anxiety disorder. There isn't really enough information provided here to suggest a particular disorder, but it might be worth meeting with a counselor or therapist to do a formal assessment. Some of the questions they might ask could be what other kinds of physical symptoms you experience, how frequently these physical symptoms happen, what's going on for you when they tend to happen, and how frequently/intensely you find yourself worrying in general. Anxiety itself is a really natural thing - it's just when it starts interfering with your ability to "do life" the way you want that we start to consider potential disorders. It might be that for the most part, the anxiety you feel is normal and you simply have some triggers that intensify it more than usual. Working on your own or with the support of a counselor/therapist to both address those triggers at the root and also to develop ways of managing the actual anxiety symptoms. This two-fold approach can be really helpful for not letting anxiety keep you from engaging in life the way you'd like.


Instruction:
Sometimes, I'm fine and can go out or meet people, but other days, my heart races and words physically cannot come out of my mouth. I've always thought it was normal and I was just nervous, but the other day, it took me almost 30 minutes of sitting in my car to find the courage to enter Target by myself.

Response:
These types of symptoms can be very disruptive to life!  Anxiety often presents in two key ways:  1) physical symptoms such as: racing heart rate, sweaty palms, dry mouth, shaking or trembling or nausea - often these physical sypmtoms are categorized as a Panic Attack.  2) mentally anxiety presents itself as worry.  Worry that spirals out of control, worry that dirsupts your life and concentration.  Worry that keeps from being present in your life.  Anxiety when it begins to spiral out of control either with disruptive mental or physical symptoms, needs to be addressed formally.  I urge you to see a counselor and/or a psychiatrist soon to begin to address these issues.  Good Luck, Sitka Stueve, LSCSW


Instruction:
Sometimes, I'm fine and can go out or meet people, but other days, my heart races and words physically cannot come out of my mouth. I've always thought it was normal and I was just nervous, but the other day, it took me almost 30 minutes of sitting in my car to find the courage to enter Target by myself.

Response:
Feelings of anxiety can be scary and sometimes we're not aware of the triggers that lead up to moments of anxiety, i. e., heart racing, sweaty palms, sweating, shortness of breath. It's important to realize that in moments of anxiety our body & mind are experiencing a reaction from our primal or reptilian brain that is signaling the flight or fight response within us, which kicks the hypothalamus into action flooding our body with chemicals, like adrenaline or cortisol.  So, one way to work with anxiety is to find out what the triggers are that lead to anxiety, such as fear, stress. negative thought patterns, not enough food or sleep. Keeping a daily journal can help you track the patterns and triggers and once you identify the triggers you can ameliorate them by learning new skills & techniques and by reducing stress and getting enough sleep. One quick way to reduce anxiety is by taking deeper breathes, sometimes this is called belly breathing. When you breath in make sure your belly rises and expands and as you breath out the belly deflates. Many of us do shallow breathing up in our chest which does not allow for a full breath, and getting a full breath is so important as a tool to help relax us in times of stress & anxiety .


Instruction:
Sometimes, I'm fine and can go out or meet people, but other days, my heart races and words physically cannot come out of my mouth. I've always thought it was normal and I was just nervous, but the other day, it took me almost 30 minutes of sitting in my car to find the courage to enter Target by myself.

Response:
I would suggest keeping a log of those days when you are having a hard time. Items to write would be what were you doing before you felt this way, did you eat and what, what time of day is it, how much sleep did you get that night, etc... This can help you identify any triggers. Further assessment can be made by a health care professional. It does sound like you are experiencing some symptoms of anxiety.


Instruction:
Sometimes, I'm fine and can go out or meet people, but other days, my heart races and words physically cannot come out of my mouth. I've always thought it was normal and I was just nervous, but the other day, it took me almost 30 minutes of sitting in my car to find the courage to enter Target by myself.

Response:
Yes, it seems like you may have a type of anxiety: but considering that it is intermittent, it may be a good idea to talk to a therapist and explore what triggers the anxiety.  Different types of anxiety are caused by different scenarios, memories, or stressors.   Once you identify what triggers the anxiety, you may be able to identify the coping mechanism that will help you handle your symptoms.¿Tengo algún tipo de ansiedad?A veces estoy bien, puedo salir a reunirme con personas, pero otros días, mi corazón se acelera y las palabras no salen de mi boca.   Siempre pensé que era normal y que solo estaba nervioso, pero el otro día, me tomo casi 30 minutos encontrar el valor para salir del carro y entrar a Target.Si parece que tienes un tipo de ansiedad, y considerando que es intermitente, puede ser útil hablar con un consejero para explorar su causa.   Hay diferentes tupos de ansiedad que son causados por diferentes estímulos, memorias y escenarios. Ya que logres identificar que causa tu ansiedad, entonces podrás aprender mecanismos de defensa que te ayuden a controlar la ansiedad.


Instruction:
Sometimes, I'm fine and can go out or meet people, but other days, my heart races and words physically cannot come out of my mouth. I've always thought it was normal and I was just nervous, but the other day, it took me almost 30 minutes of sitting in my car to find the courage to enter Target by myself.

Response:
Though I don't know for sure, it sounds like anxiety to me. I think it would be helpful if you work with a therapist who specializes in anxiety disorders.


Instruction:
Sometimes, I'm fine and can go out or meet people, but other days, my heart races and words physically cannot come out of my mouth. I've always thought it was normal and I was just nervous, but the other day, it took me almost 30 minutes of sitting in my car to find the courage to enter Target by myself.

Response:
Your, sitting in your car for 30 minutes, story sounds so sad and frustrating.Yes, you're describing classic symptoms of anxiety.Anxiety itself is the indirect result of repeatedly being in positions of feeling helpless or frightened.Are you able to recall from your growing up years of feeling insecure?You may not have felt loved and nurtured as much as you needed.Some people develop anxiety from missing enough love.  They feel lacking in ability to take care of themselves, similar to the lack of being sufficiently taken care of when younger.Try understanding if you felt neglected emotionally.If "yes", then start the slow process of emotionally rewarding and acknowledging yourself.Progress will be slow.Eventually you'll stabilize the way you feel toward yourself.This will gradually result in decreased anxiety.


Instruction:
Sometimes, I'm fine and can go out or meet people, but other days, my heart races and words physically cannot come out of my mouth. I've always thought it was normal and I was just nervous, but the other day, it took me almost 30 minutes of sitting in my car to find the courage to enter Target by myself.

Response:
First, be aware that each end every one of us has anxiety at some point. That certainly seems to fit what you're describing here, but that doesn't mean you have an anxiety disorder, necessarily. That's where there is a difference. Anyone who has a hard time with public speaking or feels uncomfortable in large crowds, for example, is experiencing anxiety.It sounds like it would be helpful to look at the differences between the days when you are more comfortable on the days that you are not. If you notice your anxiety is keeping you from doing things that you need or want to do, it may be helpful to talk with and mental health professional.I wonder also whether your appetite and sleeping patterns are the same or similar to how they were before you experienced this anxiety, when your anxiety started, and whether you feel more comfortable when someone you trust is there with you.If you have an idea of times or situations in which you feel anxious, consider carrying a small smooth rock or another object that makes you feel calm and centered. Perhaps you can keep it in your pocket and remember specific comfortable times while you have it in your hand.


Instruction:
A lot of times, I avoid situations where I am to meet new people because I have a fear of embarrassing myself. I often avoid large groups of people, like parties, because I think they all constantly judge me.

Response:
Hello, and thank you for your question. First, I want you to know that you are certainly not alone on this issue. Everyone, at some point in time, has a fear of public embarrassment. But for many people, this fear can become so awful that it begins to have a real negative impact on their quality of life.  They will try to avoid any situation that they even THINK will cause them embarrassment or anxiety. Escaping a possible embarrassing moment by avoiding or isolating may cause some relief at first, but then many times the avoidance will eventually lead to loneliness, isolation, and even despair. By avoiding, we can also miss out on things that make us feel alive and bring enjoyment. There are many self-help books that offer advice on this issue. You can do an internet search, and I recommend reading the reviews of the book. That is  great way to find out if others have found the book helpful. Another option is to seek a counselor to help you with this fear. I would recommend a counselor who specializes in helping people who have anxiety or social anxiety. Acceptance and Commitment Therapy is  a good choice for helping with anxiety, but there are many others. The truth is that anxiety and fear of embarrassing ourselves is not something that any of us will ever "get over", but we can learn to respond to those feelings differently. A colleague may offer some other advice, as well.. Be wellRobin Landwehr, DBH, LPC, NCC


Instruction:
A lot of times, I avoid situations where I am to meet new people because I have a fear of embarrassing myself. I often avoid large groups of people, like parties, because I think they all constantly judge me.

Response:
Why not accept and tolerate that you naturally are a shy person who doesn't like large groups?This is not necessarily something to get over if it is part of who you are.People have the capacity to judge others regardless of whether the group is large or small.If you aren't afraid of being judged in small groups then study the factors which allow you to feel safe in small groups. Possibly you can generalize your findings to large group venues.If you try the and aren't successful, then likely you simply aren't naturally someone who cares for large group settings.Not everything a person doesn't like is a symptom of something is wrong w the person!


Instruction:
My partner lives in Canada while I live in the US. We visit each other, but we go months in between visits. I have anxiety, and I'm always anxious about him cheating or still having feelings for an ex that he dated for three years. He doesn't understand my anxiety. How do I stop myself from worrying so much?

Response:
Would you worry less if you and your partner had a plan as to when you will be together as a couple?Long distance relationships are not for everybody.   Some people need the daily or frequent interaction to feel secure.The question is not so much how to deal with anxiety that your partner is cheating on you than whether your own emotional and relationship requirements are satisfied with a long distance relationship.Anyway, cheating has nothing to do with distance since married people cheat while living together for years under the same roof!


Instruction:
I just about fall asleep then I can't help but sit up and walk around.

Response:
Maybe you are afraid to let go of your problems for a few hours.Although you didn't write this, usually what keeps people awake or prevents them from falling asleep are worries about certain situations in their lives.If this describes you then. maybe talk with yourself to convince you that you are entitled to a good night's sleep.Really we all are and feeling rested from the day and life's tensions will better you to handle whatever the particular matters are.Also, maybe you will be more enthusiastic to go to bed if you have a comfy mattress and nice pillows!  Make your bed an inviting place because this will tempt you to enjoy relaxing enough to go to sleep!


Instruction:
I have severe anxiety and have tried everything. Everything makes it worst.The only thing that helps is my emotional support animal.

Response:
Sorry to read of your suffering.Is it actually permitted that people are able to take support animals to school?I see your point of the animal helping you.  I just also see the point that some people have allergies to animal hair or dander, or may feel distracted by an animal in the classroom.You may end up feeling worse, if when you bring your support animal to school, that it disturbs people or interferes with the routines of the class.For your anxiety, I suggest some loving kindness toward yourself.  Be patient with yourself and that you have anxiety.  If you're able to accept that some situations create great discomfort for you, maybe you'll tolerate these difficult situation.Embrace your anxiety as part of you, basically, rather than trying to banish it, which because it actually is part of you, is impossible to achieve.In a way, I'm suggesting you become your own "support animal".  Love yourself, be kind to yourself, and see if you feel a little less stressed in school.


Instruction:
I'm just an extremely paranoid person. I constantly feel as though I am in some sort of danger, like as though I live in a horror movie with no resolution. It worsens at night. It gets to the point I'm scared in my own home more so than anything. I have no access to the help I need so I'm desperate.

Response:
One approach is to be more accepting of yourself as someone who has fears.It is much easier to manage a problem when you're not fighting yourself for having a problem.Once you are willing to accept this quality within yourself you may start to feel a little more relaxed about handling the fears when they arise.One answer is to examine the facts about the fears.   Ask yourself fact based questions as to how you would handle the worse case scenario of your fears.Feeling prepared, whether or not the circumstance is highly unlikely to happen, may increase your peace of mind with living the great fears within your mind.


Instruction:
I don't know if I'm normal. I'm really scared to touch a girl. I'm a young adult and a virgin. My fiancée and I want to have sex soon, and this might mess everything up because she wants a baby soon as well.

Response:
Your question is a good one!The best way to decrease the fear would be to talk with your fiancee about it.   Eventually she'll find out, and better to talk about it when there is less pressure than to be in the midst of a situation which frightens you.Also, she may feel similar to you, who knows?Discussing a topic which relates directly to your relationship is a good way to increase emotional intimacy.  And emotional intimacy has a lot to do with feeling at ease with physical intimacy.


Instruction:
I don't understand why this is happening. Why do I feel this way?

Response:
The short answer I could give is that we don't know why it's happening. The longer answer could come from deeper exploration as to your fears, or anxieties, that you experience maybe just thinking of going outside. But any sort of exploration about this almost HAS to begin with an agreement within you (and all of your feelings), that's it's not something to be ashamed of. If we are ashamed of any of our behaviors, then we lose the ability to sit with them and see where they are coming from. This could be something that can be worked through in therapy, and specifically with a therapist who specializes in anxiety and more specifically, agoraphobia.


Instruction:
I don't understand why this is happening. Why do I feel this way?

Response:
The first step to answer your question is to reflect on what is going on in your life overall.  If you're in the midst of severe stress, whether within your relationship or effort to establish a relationship, upheaval in family dynamics, some type of significant loss like a job or someone with whom you feel closely attached, then you may simply be creating the solitude which is necessary to better understand and absorb the meaning of these changes.I assume you mean you are by yourself when you are indoors.What you write sounds like you're not happy with this recent urge rather than that you and someone or others are having great and fun times together.One way to encourage yourself to go back outdoors is to connect w a friend or search for an interest within you to develop.This way with either of these, you'd feel a little bit of motivation to join and get more involved with either of these.


Instruction:
I am a peaceful person, but I often find myself having thoughts about killing people. Eventhough I like the thoughts at the time, they make me cry. Why do I feel like this?

Response:
Maybe because you have great emotional pain stored inside you of which you are not aware exists.Sometimes people who feel greatly hurt by others or who feel unloved by others, imagine if they do the opposite of love, which is to kill, that they will get the recognition and acknowledgement from others which they wish would come to them in a loving way.This is my theory, it is not necessarily a definitive description of your inner dynamic.Most important is to keep an open mind to self-discovery on your feelings, including the ones which are uneasy, such as killing, to consider.


Instruction:
I am a peaceful person, but I often find myself having thoughts about killing people. Eventhough I like the thoughts at the time, they make me cry. Why do I feel like this?

Response:
Hello, and thank you for your question. Clearly this is something that has you very concerned. Sometimes thoughts are just thoughts, and they are pretty harmless. Many people have thoughts of killing someone, but they would never actually do it. They really don't even want to do it, they are just having a thought. Other times, thoughts are a sign of something more serious, and we should receive help when they start to worry us. I would recommend meeting with a counselor to discuss these thoughts. It is usually a safe environment where you can get advice with little judgement. Now, If you begin to start thinking about killing someone specific and making a plan to do it in reality- you should call for help immediately. By help, I mean 9-11, or a family member or friend. You would want to get help before doing something to harm yourself and others. Again, none of this is to judge, but rather to encourage you to get the help you're seeking. Either way, when we become concerned about some aspect of our behavior, seeking counseling is usually a good choice. Be well, Robin J. Landwehr, DBH, LPCC, NCC


Instruction:
I shake and have panic attacks.

Response:
One way to understand panic attacks is as a sign of feeling insecure or lacking confidence in a certain area or characteristic of yourself.The insecurity can sometimes feel overwhelming and this starts the sense of panic. One way to build your sense of security within yourself is to have a simple life and a slow paced life.   When there are many activities or involvements to pay attention, then it is easy to not give full attention to all of them.  This may trigger a sense of insecurity since in fact you may not have had sufficient time to study and know your own opinion about all of what your life is immersed in.A simpler life of fewer activities allows more time to know and understand your own inner feelings and reactions.To know more about yourself may help build your confidence and security in your ability to know and live what goes on in your life!


Instruction:
I shake and have panic attacks.

Response:
One of the first things I would suggest is to see if you can keep track of what is leading you to feel anxious. If you shake all the time, consider talking with your primary care physician. Sometimes that can be a hormonal imbalance or another chemical imbalance (such as thyroid).One of the most difficult things about anxiety is that having anxiety (particularly panic attacks) can lead to anxiety about having more panic attacks. Also remember that panic attacks are typically part of your brain's protective response to what it considers to be some sort of threat. You may have heard of the fight or flight response. When you have an anxiety attack, your body is preparing you to react to something that isn't actually a threat, so it's almost as if you're fight or flight response is overactive. Here is an image that may be helpful: http://psychology.tools/fight-or-flight-response.htmlThere are many different things you can do. You can practice breathing, mindfulness, meditation, or yoga techniques. If you decide to try some breathing techniques, try breathing in for a count of five, holding for a count of five, breathing out for a count of five, and repeating five times.Also remember that it is easier to learn these techniques when you're not having a panic attack. At that point, it can be really difficult to use methods to not panic. Also remember that panic attacks typically last 5 to 10 minutes. Using techniques to slow your breathing or become focused on the room around you is probably most helpful when you first start to feel anxious.Here are some other techniques that may help to decrease anxiety: http://psychcentral.com/lib/9-ways-to-reduce-anxiety-right-here-right-now/As you figure out what is leading up to your anxiety, also consider asking yourself what is making that certain issue a big concern for you. Another important question could be when you have felt that way before.


Instruction:
I haven't been feeling like myself lately. I've been upset for no reason and feeling anxious. I'm feeling burnt out. What can help me feel better?

Response:
Does it help to put a name to the experience you are having? Where you first said, "I've been upset for no reason and feeling anxious," you then say that you are "feeling burnt out," which gives a little more context to what may have once felt like "no reason." Perhaps you are feeling burnt out! That is a big deal, and please try not to take it lightly! When we get burnt out, I have found that it's from one of two things: either we are not doing what we want, or we are doing too much (either of something we want or something we don't, doesn't really matter once we get into doing too much.)If either of those rings true for your experience, try as much as possible to sit with the experience and get a better sense of where the burn out is coming from. I wrote about burnout for a newsletter and it is on my website. I don't want to do shameless promotion, but I thought it could also add to helping you: https://davidkleintherapy.com/my-experiences-with-burnout/I hope that you can also see that it's not an abnormal experience.


Instruction:
I haven't been feeling like myself lately. I've been upset for no reason and feeling anxious. I'm feeling burnt out. What can help me feel better?

Response:
There's no such possibility that you're upset for "no reason"!The reason is not obvious, not that you are feeling upset in response to nothing at all.What can help you feel better is to be kind and gentle with yourself because this sort of approach will more likely relax your mood and mindset enough for the tension and anxiety you feel, to dissipate somewhat.Try to understand whether certain situations or interactions remind you or feel similar to ones which distressed you before.This may be the reason for your anxiety.It is good news that you know the difference between your usual sense of yourself and that you've been away from this feeling.Give yourself a little credit for understanding yourself.   Giving credit adds confidence and confidence will help you find the reasons and new ways to handle your anxiety.


Instruction:
I have a fear of something and I want to face that fear to overcome it, but I don't know how. What can I do?

Response:
Fears are not that difficult to deal with, first you need to train yourself to relax using some relaxation strategy, once you are able to employ that in your daily life, you then need to start facing your fear, for instance I'll use an example of a man who has a fear of driving over a bridge. We would build a hierarchy of fears, that is a list of fears ranging from least to most, for example the man may want to start by looking at a picture of a bridge while employing his relation technique, then he may want to see a real bridge from a distance while employing that same relaxation technique, then moving closer to the bridge, then maybe standing on a bridge, all the while moving closer to his fear while relaxing, until you come to most fearful proposition which is crossing that bridge, or you can also engage in flooding which is for example, if you were scared of an elevator, go into an elevator until you are not panicking anymore, in the movie Batman Begins, Bruce Wayne who has a great fear of bats, goes into this cave and allows himself to be surrounded by bats until he is no longer fearful of them. Secondly, look at your fears, do they even need to be worked on, some fears are healthy, for example if i was a therapist in New York City and someone came to me and said "I'm scared of snakes", I would probably say that is OK because there are very little snakes left in ManhattanHope that helps C


Instruction:
I have a fear of something and I want to face that fear to overcome it, but I don't know how. What can I do?

Response:
Your fear may have deeper roots within your sense of who you are, than you realize.   Fears are sometimes irrational so that logic doesn't get rid of them.Think about whether you felt secure and confident as a child.  Also, did any major bad events happen to you with other people or situations when you were growing up?Often these overwhelming situations of childhood stay with us as fears of situations in our adult lives.  If the root of the problem w the fear is from long ago, then probably a therapist who can ask you questions which help you remember upsetting childhood circumstances, may help you to dissolve the current fear.Another possibility is CBT, cognitive behavior therapy which teaches people short term mantras to do something which is safe, say being a passenger in a commercial airplane, which feels frightening to a person.CBT is short term and results are limited to specific fears.  It is a much quicker approach than self-understanding.


Instruction:
I have a fear of something and I want to face that fear to overcome it, but I don't know how. What can I do?

Response:
Fear is a part of life. In fact, our five main emotions are joy, fear, sadness, shame, and anger. We tend to spend a lot of time and energy running away from or trying to get rid of most of those emotions and the more we do that, the more we set ourselves up for failure and disappointment. As a result of viewing our human emotions as "bad" or "wrong," we often get caught up in a trap of thinking we have to overcome them or get rid of them before we can do what matters to us. In reality, you can do what is important to you while having your fears! My question for you is, what would you do if this fear was completely gone? What behaviors would you have if you were the ideal you? What skills, knowledge, or personal qualities would you develop? What kind of relationships would you have?I imagine your fear has kept you from achieving those goals because your mind tells you you can't do it until the fear is gone. I challenge you to do the following exercise:What is a goal you would like to achieve? Example: I would like to change careersWhat actions are necessary to complete this goal? Example: see a career counselor to determine my ideal career, go back to school/get a certification, network with others in my desired industryWhat thoughts, feelings, or urges might get in my way? Example: thoughts of "What if I fail? I'm not smart enough. I can't do it. I'm too busy to put energy into this." Feelings of fear, shame, excitement. Urges to distract myself through drinking or watch tv instead of taking action.It would be helpful to remind myself that: example: It is natural to have these thoughts, feelings, and urges but I can take action anyway. I deserve to have a fulfilling life.The smallest and easiest step I can take now: example: research career counselors in my area and write down their phone numbersThe time, day and date that I will take that first step, is: example: Tonight at 7pm At least think through these answers but it is most beneficial to write them down. I hope this helps!


Instruction:
I have a fear of something and I want to face that fear to overcome it, but I don't know how. What can I do?

Response:
This answer could be very different depending on the fear, the degree of it, and what it connects to.I wonder the following:On a scale of 1 to 10, how upset, anxious, or scared to you get when you think about overcoming this? If it's more than a 5/10, I would definitely recommend talking with a therapist in your area.A lot of fears that we have come from something that at one time was self-protective and important. Do you know where your fear started? If you think it is still protecting you or helping you in some way, talk with someone (like a therapist) about it.If it is something that you know is irrational (for example, fear of being hurt by static cling from winter clothing), is there some part of that that you are not afraid of?I really encourage you to consider whether your fear has a lot of emotions connected to it or if it ties from something in your past that was very emotional for you at the time. If it does, consider working with a therapist to establish emotional safety before taking away the fear or anxiety that may actually be helpful to you.Also, the fact that you notice that you are afraid of something and you don't want to be afraid of it anymore is a big step in the forward direction.


Instruction:
I have a fear of something and I want to face that fear to overcome it, but I don't know how. What can I do?

Response:
Biologically, fear is designed to protect us from harm. Fear is not always a bad thing, and in fact can be quite healthy and appropriate depending on the situation. A phobia, however, is different. You used the term "fear" rather than "phobia". A phobia is an irrational fear - meaning it is not rational for you to fear that thing. If your situation is a phobia, exposure therapy can help. This consists of gradually exposing yourself a little at a time to the thing you are afraid of. Some people with phobias find that the irrational fear interferes with their life and they do need to overcome it. Someone who is afraid to drive over bridges may go to great lengths to avoid routes that have bridges. People who are afraid of elevators may always use the stairs instead, which may not always be feasible. If overcoming a phobia will improve the quality of your life, then by all means, seek professional help to overcome it.Everyone has fears, or things that make them nervous. Public speaking, asking a person out, fear of failure. Examine what your fear is and try to determine the reason for the fear. When you can get to the root cause of the fear, you can deal with that issue. A lot of times, it is a self-esteem issue. You may be able to peel back the layers of the fear and find out what's causing it and deal with the real issue. Some fears are caused by trauma. Someone with PTSD is going to have an exaggerated fear response and will find themselves being kicked into "fight or flight" mode over things that someone without the trauma experience wouldn't notice or react to. In cases like this, exposure therapy would be the wrong approach and could actually make things worse. If there is a possibility that a past trauma is the cause of your fear, I strongly urge you to seek a therapist - not just any therapist, but one who is trained to work with trauma and abuse victims.


Instruction:
I have a fear of something and I want to face that fear to overcome it, but I don't know how. What can I do?

Response:
Hello, and thank you for your question. Overcoming fears is something that everyone struggles with at one time or another. Sometimes we come across something that scares us, we push through it and suddenly we aren't afraid anymore. But sometimes it can seem like our fears just take over and we cannot overcome them. There are some options:1. You can go to a counselor and receive some type of treatment. What kind of treatment would depend on the type of fears you are experiencing. For example, if you have a general phobia about something, they may use various techniques to help you manage it.  2. There are different websites and even some self-help books that you can use to try to overcome your fears. When it comes to overcoming certain fears or phobias, exposure therapy well-studied and proven to work. A therapist would help you with this, but some websites give instructions for how to do it yourself. I am not sure how well it works when you try it by yourself, but here is a link to a website that does offer some tools. http://psychology.tools/anxiety.htmlSome colleagues may offer you some other types of advice. Be well.Robin J. Landwehr, DBH, LPCC, NCC


Instruction:
I don't remember when the voices in my head started, but I remember Hearing them when I was little.    I know it's not normal to hear voices that aren't your own. I fight the voices and I want them to stop. They've been here so long and I want them gone. How can I make the voices stop?

Response:
How is your life going overall?Since you hear voices since you were young I wonder whether you mean the thoughts each of us has about what to do, our opinions, including self-criticism and praise.I try to understand how severe a problem these voices are if you've managed to get to a point in life of awareness about the voices.Usually when mental health people hear about voices the immediate thought is you need drugs bc you are psychotic.Since this is going on for a number of years, I wonder if the problem is something different.


Instruction:
I don't remember when the voices in my head started, but I remember Hearing them when I was little.    I know it's not normal to hear voices that aren't your own. I fight the voices and I want them to stop. They've been here so long and I want them gone. How can I make the voices stop?

Response:
You are right. It is not normal to hear voices that aren't your own but the fact is some people do. In my experience, medication seem to help. It is also important to understand when you hear voices the most - meaning it is important to understand what the triggers are. It is also important to understand when the voices are the least - meaning what helps you deal with the voices better. My clients have reported that their triggers are being in social gathering or around strangers or for some even the TV. Trying to identify your triggers is helpful for some people. Clients have also reported that listening to music, watching TV, being with friend or family helps them deal with their voices. Every individual is different and you need to figure out what works for you and what triggers your voices. My suggestion is to see a therapist / health care provider and then go from there.I hope this helps.


Instruction:
I don't remember when the voices in my head started, but I remember Hearing them when I was little.    I know it's not normal to hear voices that aren't your own. I fight the voices and I want them to stop. They've been here so long and I want them gone. How can I make the voices stop?

Response:
First, let me express my support and compassion for what you're going through. Hearing voices can be incredibly difficult and can feel like you can't get a moment's peace, even in the privacy of your own mind. And not everyone will necessarily understand what you're dealing with, so I imagine you may also be feeling isolated or somehow different. Atta girl/boy on reaching out for help! Many people find benefit to taking medications, such as risperdal, seroquel, and so on. These should be prescribed by a nurse practitioner or psychiatrist -- I do not recommend a primary care doctor venture into this area, as a general rule. Discuss the options thoroughly and insist on a good rapport with your prescriber, if you decide to go this route. Some people are having results with a talk-therapist to develop coping strategies. There is a new and somewhat less conventional approach to challenging voices with a professional to assist you, rather than to suppress the voices, which medication will do. There is peer-run organization and a general approach that attempts to live with voices in a different way.  You can read about it in Living With Voices by Marius Romme. I have heard interviews but have not read the book(s) and can't speak to its efficacy. No matter what steps you decide to try, managing your stress, sleep, exercise, healthy food is essential -- in other words, just the daily care and feeding of yourself should be included in all of your efforts and bears surprising benefits to your brain and emotional health. Best wishes to you,Karen Keys, LMHC, CASAC


Instruction:
I don't remember when the voices in my head started, but I remember Hearing them when I was little.    I know it's not normal to hear voices that aren't your own. I fight the voices and I want them to stop. They've been here so long and I want them gone. How can I make the voices stop?

Response:
This isn't something you can do on your own. If you haven't already, you need to see a medical doctor ASAP to rule out medical causes for this. Many diseases, illnesses, and conditions can cause hallucinations. In the elderly, sometimes it's something as simple as a urinary tract infection. Some medicines may have that side effect as well.However, you say you've been hearing them since you were little. I have no idea how old you are now, but something that has been going on for many years does lead me to think it could be a type of schizophrenia. A psychiatrist could diagnose that after taking a complete look at your history, medical history, etc. There are medications that they can put you on that will help. One thing that I find encouraging is that you recognize you're hearing voices. This means you are not so far into a delusion as to believe it is real. A lot of people that hear or see things that aren't there are not able to have the awareness that these things are not real. They fully believe what they're hearing/seeing. It's completely real to them. Because you have the awareness that you do, I feel this is a very good sign that with treatment you can live a normal life (assuming you are not already receiving treatment for it. If you are and are still hearing the voices, please know that medications often need to be changed and adjusted, and the voices may never completely go away but medicines certainly help dull them a lot. Always talk to your doctor when it seems your symptoms are getting worse so that they can make the necessary medication adjustments for you).If at any time the voices are telling you to do something, please go to an ER as this is an emergency. Sometimes people hear voices telling them to harm themselves, harm someone else, or do other things that are against the law. Do not try to deal with something like that on your own. There are people who can help.


Instruction:
I've hit my head on walls and floors ever since I was young. I sometimes still do it but I don't exactly know why,    I have anxiety and I had a rough childhood but now I'll start to hit my head and sometimes not realize it but I don't know how to stop or even why I'm doing it.    How can I help myself to change my behavior?

Response:
Give yourself a lot of empathy and care for having had a rough childhood and realizing that life can be better than how you were treated when growing up.Be patient with yourself too bc lasting change takes time. Alternatives to hitting your head require constant gentle reminders to do these new behaviors, or if you've discovered a satisfying alternative in one moment, time is required for you to repeat this alternative until it feels natural.Anxiety usually means someone did not feel well understood growing up and was rushed to comply with the wishes of others who were a regular part of their lives.Anxiety lessens as the person starts to know and accept their wishes and needs as valid.  Allow yourself to learn who you truly are in the spirit of accepting whatever you discover about yourself.The behaviors will naturally change with your new understanding and self acceptance.Good luck and enjoy this self discovery project!


Instruction:
I've hit my head on walls and floors ever since I was young. I sometimes still do it but I don't exactly know why,    I have anxiety and I had a rough childhood but now I'll start to hit my head and sometimes not realize it but I don't know how to stop or even why I'm doing it.    How can I help myself to change my behavior?

Response:
Hello. I have to wonder from a behavioral perspective if what you are doing is useful for you. In other words, does it serve a purpose in some way when you find yourself doing it. Yes, this could well be an expression of anxiety, or maybe some type of coping skill you have developed over the years to deal with stressful situations. Yet it sounds like you have developed a sort of knee-jerk behavioral conditioning that causes you to do this behavior during specific (or perhaps even non-specific) circumstances. Do you think it is a self-soothing behavior? Do you feel good after you have done it? The behavior itself is likely causing some form of slow physical damage, so I would recommend you have yourself checked by a doctor, to rule out any injury. If none exists, this obviously doesn't excuse the behavior, it just says that for the moment luck is on your side.When we do any behavior of any kind, it is good to ask if what we are doing has merit or value. Is the behavior helping us to solve our problem, or is it merely creating yet another problem by doing the behavior in the first place. In the same way that a person might drink excessively because they are stressed and need to cope with some unresolved issue, when they are done drinking the original problem will still likely be there, but now they are intoxicated. No closer to solving the issue. When we deal with things like anxiety or depression, we need to do things that work on dealing with the symptoms, but also get to the root issue that created those feelings and find effective solutions. So the things we do to cope with life events need to not be ones that cause us harm, but rather support us as we move forward and work to deal with what life throws at us.Sometimes seeking support from a friend or a counselor is a good idea. Being given the opportunity to express your feelings about what is going on around you and getting feedback and insight from others is much more effective than actions of self-harm, wouldn't you agree? So I would encourage you to find a counselor or a trusted friend who can help you find positive behaviors you can take to deal with your feelings, as you also work to find the answers to the day to day issues of living a life filled with promise and opportunity.Reach out if you need help...there will likely be a hand there waiting for you.


Instruction:
I've hit my head on walls and floors ever since I was young. I sometimes still do it but I don't exactly know why,    I have anxiety and I had a rough childhood but now I'll start to hit my head and sometimes not realize it but I don't know how to stop or even why I'm doing it.    How can I help myself to change my behavior?

Response:
The best way to handle anxiety of this level is with a combination of appropriate medication given to you by a medical doctor, and therapy to help you understand the thoughts, feelings, and behaviors that are causing the anxiety. This is not something that anyone should just “white knuckle” and try to get through on their own with no help. Cognitive Behavioral Therapy is a technique that has been proven helpful for depression and anxiety. This takes a therapist trained in CBT. You will learn to recognize when and why you perform the behavior of hitting your head, help you deal with the underlying cause of this, and replace the behavior with a more positive behavior. You'll learn coping skills.You mention having a rough childhood. Anyone who has experienced trauma like this, especially long-term ongoing trauma from abuse of any kind, definitely does not need "exposure therapy", which is what is recommended for phobias. You need a therapist trained specifically in trauma informed therapy.You are on the right path by recognizing there is an issue and what it is. Good luck with your healing journey!


Instruction:
I have several issues that I need to work through. However, I am afraid of and do not trust therapists after a horrible experience. I'm dealing with grief and guilt over losing my sons due to drug use. I have a very complicated traumatic relationship issue that is causing me severe anxiety and fear.

Response:
I am sorry that you had this experience. Therapy should be a healthy positive experience off g growth. You have the right to look for certain high qualities in a therapist and finding the right one. Each therapist is bound by a code of ethics and clients should have high expectations. You are trusting them to guide, support and help you achieve the absolute best outcome and success. You should never be or feel judged, and you should feel comfortable and feel as though your therapy process is moving along with YOUR GOALS IN MIND. Speaking as a therapist, I encourage my clients to always let me know how they feel, even if they disagree with me, they also have the right to inform me if something I'm doing simply is not working for them, communication is critical in maintaining a healthy therapeutic alliance/ therapeutic relationship. I'm able to offer ways of thinking and strategies to my clients they may not have thought of. Its important to listen to my clients. It's also critical for clients to feel they can share in a environment that feels safe, non judgmental and confidential.Remember, you are the driver in your healing process, you should be the one in control because you know what your life struggles are. Speaking as a therapist, I'm here to guide my clients toward achieving their goals, encouraging and empowering my clients in what is meaningful to them to achieve. You should feel comfortable speaking your thoughts, my advice would look one who open hearing toy feel, even it's regarding them a therapist. That they are open to feedback.With all of that being said, it will take time to trust again but remember, ask questions and communicate with the next therapist  share  your experience and how it made you feel and that trust and being spoken  in a respectful , non judgemental and non condnscending way is critical for you. Be honest clearly state your expectations from start.  I offer free 50 minute first sessions for clients. The reason. I do this is because I feel that clients deserve opportunity observe the environment, ask me questions and have the opportunity to determine their level of comfort and decide if it's a good fit. Other therapists sometimes offer the similar, try finding one willing to offer a  consultation as that could give you the opportunity to feel things out and set forth expectations.The article below is an excellent article about what to look for in a therapist. It is worth your time reading because you are WORTH FINDING THE BEST HELP AVAILABLE! This article was written based on both evidence from research and clinical experience. I would strongly encourage anyone searching for help to read this and even use it as your guide. I hope this was helpful.https://www.psychologytoday.com/blog/insight-therapy/201603/10-ways-spot-good-therapistLaura Cassity, LMSW, LMAC


Instruction:
Why am I so afraid of it? I don't understand.

Response:
Your fear is somewhat reasonable.  No one wants to be raped and I imagine everyone is afraid of what being raped would feel like.Do you mean that this fear is on your mind more often than you would like?If this is the case, then try understanding the reason behind your fear.Is it because you personally know or know of someone who was raped?  One general direction of what would help is to regain confidence in your decisions of keeping yourself safe.  The more you trust yourself to avoid social situations with lots of drinking, isolated physical surroundings, and being in isolated locations with someone with whom you're not very familiar, probably your fear will decrease.The other general direction to understand is if in your family history, people have been violated severely, either emotionally, mentally, or physically.In families in which people have suffered severe violations of themselves, often the emotional patterning of expecting to be hurt by others, plants itself very deeply and transmits to the younger generation.Its possible then, that you are suffering from fears established in other family members who have not yet been able to fully understand and accept their own suffering.The good news is that individual therapy, with a credentialed and licensed therapist, is ideal for a safe place to open and clear this type of emotional burden.


Instruction:
Why am I so afraid of it? I don't understand.

Response:
Why are you afraid of rape? Because it is a problem in the United States! The National Sexual Violence Resource Center reports that one in five women (0r 20%) will be raped (http://www.nsvrc.org/sites/default/files/publications_nsvrc_factsheet_media-packet_statistics-about-sexual-violence_0.pdf) and that 80% of women know their assailant. Given these statistics, it is perfectly logical to be afraid. However, there are things you can do to reduce the risk of rape, such as being aware of your surroundings, and limiting the use of drugs or alcohol.The Enhanced Access, Knowledge, Act program for college-aged women has been shown to reduce the risk of rape by more than 50%. (http://www.blueprintsprograms.com/factsheet/eaaa-enhanced-assess-acknowledge-act-sexual-assault-resistance-education) You may want to see if a program like this is available in your area. Another great app for when you need to walk somewhere alone, is the Companion App (http://www.companionapp.io). Friends or family can track your progress from one point to another via the GPS in your phone.In addition, talking with a counselor about your fears would also be a good idea. Sometimes fears are rational and reasonable. Sometimes they are over-reactions and unreasonable. When then are over-reactions and unreasonable, they can have a negative impact on your life. In this case, a counselor could help you understand why your fears are unreasonable, and how you can stop them from negatively impacting your life.


Instruction:
I have attention-deficit/hyperactivity disorder, posttraumatic stress disorder, anxiety, anger, and memory problems. I can't work. I have no income. I'm on medicine, but I feel worthless. I want to be normal.

Response:
I am so sorry to hear that you are struggling.  It sounds like you've had a traumatic experience that has impacted your life in many ways.  Without knowing much about your history, I wonder if the trauma you suffered has lead to the anxiety, anger, and memory problems you are dealing with, in addition to PTSD.  I would encourage you to look for a trauma therapist who offers a sliding scale or pro bono services.  There may also be community mental health services in your area that offer free therapy if you are eligible for grant.


Instruction:
I never feel like myself. I can’t even think straight anymore. I start stuttering and I can’t remember anything. I always get nervous and usually talk myself down but recently end up fighting with, what feels like, someone else. I don’t know why I feel this way, but I hate it.

Response:
Hi Houston, Okay, something's definitely going on, right? My gut is to start with your family physician, because you have some physical symptoms. While it seems anxiety is a likely problem here, your doctor will hopefully know your history and can help you decide if you need some medical tests or some therapy. Without knowing more, that's all I can say at this point. Best of luck.


Instruction:
I never feel like myself. I can’t even think straight anymore. I start stuttering and I can’t remember anything. I always get nervous and usually talk myself down but recently end up fighting with, what feels like, someone else. I don’t know why I feel this way, but I hate it.

Response:
What you are describing sounds like it may be a form of dissociation. Dissociation is our mind's way of disconnecting us from aspects of our experience in an attempt to protect us in overwhelming situations. It also sounds like you are noticing anxiety in certain situations. In working with a competent therapist, you may be able to gain insight into these experiences, learn skills for coping with anxiety and reconnecting with yourself, and alleviate these symptoms over time.


Instruction:
I never feel like myself. I can’t even think straight anymore. I start stuttering and I can’t remember anything. I always get nervous and usually talk myself down but recently end up fighting with, what feels like, someone else. I don’t know why I feel this way, but I hate it.

Response:
Hello,I am wondering if you might be experiencing some form of dissociation.  People who dissociate might feel like the world around them is unreal and unfamiliar, or that they are not really in their bodies and that they are observing themselves from outside of their bodies.  Dissociation can also mean that there are parts of you that have "split off" and sometimes parts are can feel like they are at odds with each other or are locked in conflict.  Sometimes dissociation happens after someone experiences a trauma.  Therapy can help you to understand what is going on and help you to integrate your experiences and ultimately heal.I am a therapist in Houston who specializes in dissociation.  On my website I have information specific to dissociation that might be helpful to you. Sarah


Instruction:
I had to put a restraining order against my ex-fiancé. He was served last night. He was mentally and verbally abusive towards me. I thought it was my nerves, but every time I stand up, I get sick. If I sit and rock, I'm fine.

Response:
Hello, and thank you for your question. You may be right, your physical symptoms of getting sick to your stomach may very well be your nerves or anxiety. That is totally normal and understandable given your circumstances. Another thing that is not unusual is that you feel better when you sit and rock. That is actually a fairly common way that many people comfort themselves in times of high stress. If you are concerned that there is an actual physical illness causing these symptoms, you may want to visit your primary care provider. They may tell you that they don't see anything physically wrong with you, and at that point you may want to visit a counselor about the symptoms and your relationship experience. A visit with a counselor may be a good idea either way. I work as a counselor in primary care, and I promise you that many people have very real physical symptoms when they have gone through abuse. Unexplainable stomach and headaches are very common. Sometimes, with counseling, those physical symptoms actually stop. Be well, and I hope you feel better soon.Robin J. Landwehr, DBH, LPCC, NCC


Instruction:
I've been dealing with this for years. My mom thinks I'm overly emotional and refuses to offer any help, like therapy or seeing a doctor. She's seen me when I'm having a panic attack and just said I was faking for attention or that I'm a hypochondriac. I just want to get better.

Response:
I don't know how old you are, but in Pennsylvania, if you are over 14, you can have therapy without your parents' consent. If you are young enough to use their insurance, that could be complicated, but depending on the state, there may be ways to work around that as well. If transportation is a problem, call a local mental health agency and see if they can connect you with assistance.In the meantime, try searching for a phone helpline in the county where you live. They may be able to help you figure out where you can get help.Another idea is that if you are in school, your guidance counselor may be able to provide links to where you can go for help. He or she may also be able to give you more specific ideas to help with your panic attacks.I know you said your mom refuses to offer help, which included seeing a doctor, but I wonder if she trusts the doctors that is your primary care physician (also called a family doctor) who you see when you have a minor medical ailment that may need medication. That doctor may be able to help you as well.Some of the information here may be helpful to you because it explains some of what anxiety is and there are some quizzes there that may give you information to discuss with a doctor or therapist when you get connected with one. http://www.webmd.com/anxiety-panic/guide/mental-health-anxiety-disorders This may give you other information to speak with your mom about. Remember that I'm not asking you to actually diagnose yourself with one of these things, but just offering some basic information that may help you be able to talk about what is going on.If you are having a panic attack or having a moment of anxiety, try focusing on different things in the room around you. It may help to shift your focus briefly outside of what you are feeling and that may lessen the feeling a bit. Also remember that sometimes anxiety leads to more anxiety about having a panic attack in the future. Remember that they usually and after a few minutes.It would also be helpful for you to keep track of what leads up to your anxiety.Best wishes to you and keep trying until you get connected to someone.


Instruction:
I've been dealing with this for years. My mom thinks I'm overly emotional and refuses to offer any help, like therapy or seeing a doctor. She's seen me when I'm having a panic attack and just said I was faking for attention or that I'm a hypochondriac. I just want to get better.

Response:
How old are you?Are you old enough in your State to have therapy without your mother's consent?Your mom's attitude toward you may be one significant reason on why you feels so much tension in the first place.Don't let her opinions and beliefs get in the way of what you know about yourself.Are you in school and does that school have a guidance counselor?Would you talk with that person about your difficult getting your mom to retain helping services for you?Keep looking for local resources which will support you either directly or indirectly by advocating for your right to receive mental health care.


Instruction:
I’ve been on 0.5 mg of Xanax twice a day for the past month. It hasn't been helping me at all, but when I take 1 mg during a big anxiety attack, it calms me down. I was wondering how I can ask my psychologist to up the dose to 1 mg twice a day without her thinking I'm abusing them. I just have very big anxiety attacks. Should I stay on the 0.5mg and deal with the attacks or should I ask to up the dose? I'm afraid she will take me off them and put me on something else.

Response:
Do you think you're abusing xanax?It is a highly addictive drug so maybe one reason you feel compelled to take more is bc you already are addicted.Drugs don't do anything helpful in solving life's problems.   Once the effect wears off, the stressful situation is once again waiting for you to address it.Think over your reason for not directly asking your psychologist about upping your dose.Also, do you ever talk about your life problems with this psychologist or only your need for drugs?    The more gradual path to a better life is to not need drugs in the first place. This consists of your willingness to face the matters that are creating such terrible feelings inside you.


Instruction:
I’ve been on 0.5 mg of Xanax twice a day for the past month. It hasn't been helping me at all, but when I take 1 mg during a big anxiety attack, it calms me down. I was wondering how I can ask my psychologist to up the dose to 1 mg twice a day without her thinking I'm abusing them. I just have very big anxiety attacks. Should I stay on the 0.5mg and deal with the attacks or should I ask to up the dose? I'm afraid she will take me off them and put me on something else.

Response:
Staying on the lower dose may give you more room to learn strategies for coping with your anxiety.  Medications are so helpful, and needed at times, but it's also important to have a variety of tools you use to manage your responses to stress.  If you are not already seeing a therapist, consider finding one who can help you learn some effective strategies, like replacing self-defeating thoughts with ones that work better for you, or mindfulness, relaxation, or other tools to keep your anxiety in the manageable range!


Instruction:
I’ve been on 0.5 mg of Xanax twice a day for the past month. It hasn't been helping me at all, but when I take 1 mg during a big anxiety attack, it calms me down. I was wondering how I can ask my psychologist to up the dose to 1 mg twice a day without her thinking I'm abusing them. I just have very big anxiety attacks. Should I stay on the 0.5mg and deal with the attacks or should I ask to up the dose? I'm afraid she will take me off them and put me on something else.

Response:
In general, Xanax is very short-acting. You mentioned that you are afraid that your medical provider will take you off of the Xanax and put you on something else. If the Xanax is not working well for you, I wonder if something else may work better. What is your reasoning there? Also, sometimes there are medications that you can take in addition to Xanax.In addition to talking with your medical provider about changing the medication, try to track your levels of anxiety on a scale of 1 to 10 throughout the day so you can get a pattern of what is happening. Also consider writing down what is happening before you have anxiety attacks. This may help your medical provider know what medication may be helpful to you or what changes could be made.As far as how to discuss this with your medical provider, I would suggest mentioning the symptom changes you are having (anxiety attacks that are not helped with 0.5mg of Xanax) and ask what they would suggest that might help. If your medical provider suggests taking you off of the Xanax, I would recommend talking about the reasons why you would prefer to stay on the Xanax and what your concerns are about coming off of it. You could also ask whether anything could be combined with Xanax.There are also many other anxiety medications. I have seen lots of people that take more than one medication to lessen anxiety that they are having.I would also consider talking with a therapist (unless the person who is prescribing a medication is also doing therapy with you). Getting more information about your anxiety and how it is affecting you may be greatly helpful to you.


Instruction:
I’ve been on 0.5 mg of Xanax twice a day for the past month. It hasn't been helping me at all, but when I take 1 mg during a big anxiety attack, it calms me down. I was wondering how I can ask my psychologist to up the dose to 1 mg twice a day without her thinking I'm abusing them. I just have very big anxiety attacks. Should I stay on the 0.5mg and deal with the attacks or should I ask to up the dose? I'm afraid she will take me off them and put me on something else.

Response:
Hello, and thank you for your question. While counselors work closely with medical providers, and sometimes have discussions about medications with people, we rarely make recommendations about how much or what type of medication a person should be taking. This is because prescribing and advising on medication is out of our scope of practice. The only exception would be if a counselor is also a physician, nurse practitioner, physician's assistant, etc. Having said that, I certainly understand that anxiety is a real serious problem that many folks struggle with. If you are currently not in therapy to help you with these panic attacks, you should consider it. Medications can be helpful for anxiety, and medications like Xanax may help for immediate relief, but they do nothing to deal with the root of anxiety and may not help with anxiety long-term. Therapists who have experience in exposure therapies would be good people to start with. Exposure therapy has good outcomes for people with anxiety disorders and panic attacks. If you are interested in speaking with your provider about the Xanax, I think explaining it the way you did on here is just fine. The provider will then decide if they feel comfortable increasing your medication. Please remember that medical providers are not trying to give people a hard time. Medications like Xanax really are highly addictive. The more you take, the more you may feel you need. The more often you may feel you need to use it. Depending on the frequency and amount of use, some people suffer serious withdrawal symptoms when they do not take the medication. It is a good idea to talk to medical provider about all of those things so that you can partner on right course of action to manage this anxiety. I certainly hope that you get some relief.... I know anxiety is awful.Robin J. Landwehr, DBH, LPC, NCC


Instruction:
I am so terrified of having sex anymore because I have been told over and over that sex is dangerous even though me and my partner used both forms of protection. My partner is not happy about this and simply wants more sex, and honestly, I want to give that to her.

Response:
I would suggest possibly talking with a physician about all the different types of protection. They may be able to help you to know about all of the options that are available.It sounds like your partner is open to understanding your concerns. Perhaps until you have the chance to speak with someone about the effectiveness of different contraception and forms of protection, are either of you open to other forms of engaging in sexual intimacy (without penetration, but with use of vibrators, toys designed for sexual interactions, etc.)?


Instruction:
I am so terrified of having sex anymore because I have been told over and over that sex is dangerous even though me and my partner used both forms of protection. My partner is not happy about this and simply wants more sex, and honestly, I want to give that to her.

Response:
I am wondering who is telling you that sex is dangerous.  Is this medical advice, or is this someone’s
opinion trying to scare you from having sex?
And if so, how old are you? Is it ok to have sex, do you want to have
sex?  It sounds like you want to make
your partner happy, and that you are taking care of protecting yourself and
your partner, but maybe you are forgetting to consider what do you really want.  Having sexual relations is a very personal decision;
you and your partner have to consent.  It
is also important to talk about the possible consequences and being responsible
for them as well.  But sex should be something
that you enjoy, not that you should be fearful of.  A therapist can help you to process those
negative thoughts and feelings that may impair you from enjoying your sexual
life. ¿Cómo puedo superar mi miedo de un
embarazo no deseado y poder tener sexo otra vez?Estoy
aterrorizado de tener sexo porque me han dicho una y otra vez que el sexo es
peligroso, inclusive cuando yo y mi pareja usamos dos métodos de protección.  Mi pareja no está contenta y simplemente
quiere más sexo, y honestamente, yo quiero darle lo que ella quiere.Me pregunto quién
te está diciendo que el sexo es peligroso.
¿Esto es aviso medico, o es alguien intentando asustarte para que no
tengas relaciones?  ¿Y si es así, que
edad tienes?  ¿Es apropiado que tengas
sexo a tu edad?  ¿Quieres tener sexo? Me
parece que estas enfocado en hacer feliz a tu pareja, y te estás protegiendo y protegiéndola,
pero tal vez están olvidando analizar que tu quieres realmente.  Recuerda que tener una relación sexual es una
decisión personal, en la que tú y tu pareja deben de estar de acuerdo.   También es importante hablar de las posibles
consecuencias de tener relaciones, como un embarazo, y discutir sus opciones e
intenciones, si eso ocurriera.  Ya que
han tenido comunicación al respecto, el sexo debe ser algo que disfruten,  no que temen.
Un terapista te puede ayudar a procesar esos pensamientos negativos y
los sentimientos que te pudieran impedir disfrutar de tu vida sexual.


Instruction:
I am so terrified of having sex anymore because I have been told over and over that sex is dangerous even though me and my partner used both forms of protection. My partner is not happy about this and simply wants more sex, and honestly, I want to give that to her.

Response:
Maybe you'll feel less fear by understanding that whoever told you sex was dangerous, was wrong.If this message came from your upbringing, then it may a deeply embedded belief.Since the belief itself instructs to avoid risk, and overturning this belief requires taking the risk to believe the logic that reasonable safe sex measures are adequate protection, give yourself time to absorb this new understanding.Talk w your partner about your psychological difficulty bc their patience will help you.


Instruction:
I am so terrified of having sex anymore because I have been told over and over that sex is dangerous even though me and my partner used both forms of protection. My partner is not happy about this and simply wants more sex, and honestly, I want to give that to her.

Response:
Alot of our choices have to do with what we have been taught and partly our fear of trusting ourselves to do what is right. There is so much more going on within you than you realize. We can help you bring it to the surface. Please contact us when you can and in whatever way you can to discuss what's going on with you.


Instruction:
I was in a car accident and totaled my car. I gave up my job of nine years to pursue school full-time to better myself. I failed a class, and my boyfriend that I live with thinks I’m stupid and wants to break up with me. I have nowhere to go, and I feel like I’m losing everything.

Response:
When we feel overwhelmed by life situations, it is important to understand where the feeling is coming from.  Once we understand the source, it is important to normalize the situations that got us there and find balance in our lives.First, car accidents are common, and since they are accidents they are not a reflection of us.   When we have an accident we feel anxious, worried, and may have some trauma after the accidents.  If you have been experiencing anxiety since the car accident, talk to your doctor or therapist about it.  Second, a lot of people fail classes, tasks, deadlines, etc. but they don’t give up on their goal.  We have to remember that failing is part of the learning process, and having the courage to try again is what gives us determination and character.  Remind yourself what motivated you to leave your job, and the courage and determination that took to do so, then channel that energy back into school.  Third, when we have problems in our relationships, is helpful to look for ways to improve communication, discuss our concerns and how we want to resolve them, but it may be that the relationship needs to end if there isn’t enough interest in one of the parts or if there’s verbal or emotional abuse.  Consider talking to your boyfriend and set some boundaries regarding appropriate communication.At all times:  focus on being kind to yourself and improving your self-esteem: increase self-care activities, do more things that you enjoy, meditate in what gives you peace and make an effort to have more of that in your life.   At the end, you are the one in control of your life, and you determine who you become.¿Qué puedo hacer cuando siento que mi vida está fuera de control?Estuve en un accidente de auto, y fue pérdida total.  Deje mi trabajo de 9 años para completar un grado a tiempo completo.  Falle una clase, y mi novio piensa que soy estúpida, el quiere dejarme.  No tengo a donde ir y siento que lo estoy perdiendo todo.Cuando nos sentimos agobiados es importante reconocer donde estamos parados y entender de donde vienen esas emociones.  Ya que entendemos la fuente de agobio, es importante normalizar las situaciones que lo causaron, y volver a encontrar el balance en nuestra vida.Primero, los accidentes de auto son comunes, y por ser accidentes no son un reflejo de nosotros o nuestras destrezas.  Cuando experimentamos accidentes no s sentimos ansiosos, preocupados, y puede que experimentemos algún trauma.  Si sientes ansiedad, extrema preocupación habla con tu doctor o terapista al respecto.  Segundo, muchas personas fallan clases, tareas, fechas de entrega, pero no se rinden.  Tenemos que recordar que fallar es parte del proceso de aprendizaje, y tener el valor de intentarlo de nuevo, es lo que nos da determinación y carácter.   Recuerda que te impulsó a dejar tu trabajo y canaliza esa energía en la escuela.  Tercero,  cuando tenemos problemas en las relaciones, es importante comunicar nuestras preocupaciones y diferencias, pero puede ser que la relación termine si no hay interés mutuo o si hay algún tipo de abuso.   Considera hablar con tu novio y establecer límites respecto a la comunicación apropiada.En todo momento: enfócate en cuidarte a ti misma y mejorar tu autoestima, aumenta las actividades que te ayudan a sentirte bien, medita sobre lo que te paz y pasa más tiempo practicando esas actividades.


Instruction:
It's especially bad at night time. I am scared of sleeping alone.

Response:
Being able to know you feel anxiety and write about it, is the first step to addressing and handling it!Generally, anxiety is deep fear of not being able to handle what comes up in life.  Somehow the person was insufficiently nurtured and so felt  insecure when very young.Usually the person had to fend on at least a psychological and emotional level for themselves before reaching an age when doing so would have been reasonable.Their inner feeling of overwhelmed from when very young, hasn't faced the reality that the grown person is now capable, even if this takes some practice. Try asking yourself what you are afraid of and theorize how you would handle these situations as a grown person.Also, sometimes anxiety comes from feeling lonely.  This loneliness is reminiscent of the loneliness that the grown person now, felt when being left to take care of situations as a child which were too difficult and complex for any child to address.


Instruction:
I am on the track and softball team. My school is small, so I play all four sports it offers. I feel obligated to do track because I'm not a horrible runner, and my dad wants me to. The catch is is that the days before a track meet and the morning of, I get sick and cry.

Response:
Does anyone notice that you get sick and cry on track meet days?Have you told anyone?From what you write, as much as you would like to please your school and dad, something within you doesn't quite want to fully follow through.Step one in life always is to know what you want and what your limits are.   It already is difficult to avoid listening to your body.Try understanding what is difficult in telling your father that you'd like doing as he wishes, only are not able to do so because you are emotionally and physically distraught on the days you have track.After finishing the season for this year with your school's track team, then expect to concentrate on taking care of your own need to not do track.Hopefully your father will understand and care about your problem.   If he does not and track is more important than your well being, then you have a different problem entirely.


Instruction:
I am on the track and softball team. My school is small, so I play all four sports it offers. I feel obligated to do track because I'm not a horrible runner, and my dad wants me to. The catch is is that the days before a track meet and the morning of, I get sick and cry.

Response:
It sounds like you are no longer committed to track emotionally.  It can be hard to talk to your dad about this, but he may think you love track and may not know you are getting so upset the days of meets.  An idea would be to first write a letter to your dad to see what feelings come out and then preparing to speak with him.  I think he will appreciate your honesty and maybe this conversation will bring you relief and also time to find something you really will enjoy.


Instruction:
I'm socially awkward. I've always want to be popular. I've had the opportunity to be popular, but every time I get i,t I'm too scared. All I have to do is talk the popular people. They're really nice to me, but I'm too scared of change. I really want to work up the courage to lose my fear.

Response:
Change can be uncomfortable, but sometimes those uncomfortable moments are the opportunity for us to be the person we feel we really are.  It sounds like you like to spend the time in your head anticipating the worst, why not be in the present and encourage yourself that you can talk to people and it will be okay.  By telling yourself it will not be okay, or that it will go wrong you are hurting your confidence to do what you want.  Give yourself some credit for being awesome and tell yourself you can build new friendships...it may be the motivation you need to move past this fear.


Instruction:
I often get the feeling that I'm being watched, like video cameras are hidden wherever I am, even at home. I feel like people can see all that I do and are reading my thoughts. Things I read or hear on the radio seem to be about (or meant for) me, and people are talking about me when they whisper.

Response:
It sounds like you are feeling pretty overwhelmed with worry about being continuously monitored, with no privacy even in your own mind, and as if people are constantly saying things about you in whispers on in the media. It's hard to say from a post online what is at the root of this experience, but you may be able to get insight into that, as well as develop ways of coping with the distress of feeling this way, with the help of a good therapist. There is no pill or technique that can guarantee that this experience will go away, though it might, however, there are things that you can do so that you can understand it better and so that it does not have such an impact on your ability to lead a satisfy life.


Instruction:
I have a bad habit of thinking and worrying about what others may think of me. I really want to stop it and enjoy things.

Response:
Thinking about what others think of us is a natural tendency. Human beings are social creatures and rely on feedback from the outside world of people, places, and things to let us know more about ourselves. We also have an inner voice, dialogue, conscience, etc. that helps us to determine the path for us. Often, when someone is worried about the external feedback, and focuses on this as the sole source of information, it can create a dependency that can become problematic. Balance is key to so many things in life. Your own voice is powerful and has strength to provide you the enjoyment you seek. Don't discount it and rely only on the voices of others.


Instruction:
I feel really uncomfortable when I have people's attention. It makes me not want to talk in public or answer questions in class. Can I get over this social anxiety?

Response:
you can learn lots of skills/techniques to feel more confident in what you need to do that will decrease your anxious response for sure! :) And  you can also learn how to work with your personality that may not like the attention. You may find that "talking" to others through the internet is more comfortable and you are great at it, or that you love one on one talking but aren't really made for group talking. There is a place in this world for you either way! Public speaking skills can be practiced in speech class, or toastmaster group, they will give you practice in a safe environment where the cool kids or cutest boy aren't ready to laugh at you.  What topics are you interested in and what groups can you do a little speaking up? Maybe in your small group at church try and raise you hand to share your opinion, or maybe your Girl Scout troop? Look around for a peer and one adult who you like to hear speak out, ask them to share with you 2 things that help them feel comfortable speaking in public. Check out some Ted Talks and see how they share in groups. Social anxiety is a difficult concern and picking apart what is your awesome personality and what needs skill building and mindfulness/anxiety  help are important steps. Good luck!


Instruction:
I feel really uncomfortable when I have people's attention. It makes me not want to talk in public or answer questions in class. Can I get over this social anxiety?

Response:
Since anxiety usually about anticipating a bad result, or fear of being judged negatively, as though having failed some sort of test, consider what would give you the feeling of anticipating a good result from talking to an audience?Maybe, for example, if you prepared and rehearsed your talk more than what you typically would, you'd feel more secure in speaking  in front of an audience.Once you sort through your particular reason as to the source of your discomfort, it may feel more manageable.Yes, social anxiety can change.  You may naturally prefer smaller groups than an audience.And, it is possible to decrease anxiety in what may always be somewhat uncomfortable for you.


Instruction:
I have been having a lot of nightmares where I am being killed in different ways. I either wake up in a panic or just crying and sweating. It has made me terrified of falling asleep and is now affecting my daily life too. Can I make the nightmares stop?

Response:
Hello, and thank you for your question. Sleep problems, including insomnia and even the nightmares that you are writing about, are really common for people and so many people suffer from them. Here are a few things to consider or to try: 1. Have you changed or started taking any new medication lately? Medications can certainly affect your sleep and some can even cause vivid or frightening dreams. If you are taking a new medication, talk to your provider about the nightmares, this may be the cause. 2. Stress can certainly increase our difficulty with sleep and can also begin to affect our dream states. The dreams may not make much sense, but then again even good dreams don't always make much sense. Ask yourself, do I have any new or renewed stressors in my life? Work, school, relationships, health.... all of these areas and many more are places where stress can hide out. If this is the case, talk with your provider or consider seeing a counselor who may be able to help. 3. Something to consider is that once we start to have anxiety or stress about something, we can begin to obsess about it. My guess is that going to bed for sleep is no longer a pleasant thing for you. Your stress and fear of what may happen when you sleep could start way before you actually go to bed. This could increase your chances of having another bad dream. Try relaxation techniques before going to bed. If you have YouTube, you can pull up "Guided Meditation for Sleep" exercises to help you relax. There are many different ones to choose from. You may also want to try deep breathing.4. There are self-help ideas for managing bad nightmares. If you Google search "Nightmare Rescripting" or "Nightmare Exposure" you may find some ideas and instructions on how to manage dreams. I hope these ideas help. Be well... Robin J. Landwehr, DBH, LPC, NCC


Instruction:
My boyfriend and I have been dating for almost a year. We go to different schools, and we don't see each other that often. I just feel very paranoid that there's someone else or that he could be hiding something from me.

Response:
Have you spoken to him about your fears? Perhaps you can explain this feeling to him and let him know what might lead to feeling more secure.  Also, it is important to trust your intuition!  Perhaps there are good reasons to feel concerned. It may not be paranoia - it may be based in reality!


Instruction:
My boyfriend and I have been dating for almost a year. We go to different schools, and we don't see each other that often. I just feel very paranoid that there's someone else or that he could be hiding something from me.

Response:
Paranoid is a mental disorder word.  That is a strong word I think to use in this situation.  Honestly the bottom like is either you don't trust him for some reason or you are insecure with yourself.  Which is it?  Do some soul searching to help you figure which one it is.   Work on either discussing why you don't trust him and work on building that trust ....or why you feel you are not good enough and work on that.


Instruction:
I'm concerned about my boyfriend. I suffer from anxiety, but I always have this feeling he wants to hurt me because he told me he was interested in BDSM intercourse. We haven't tried it, but I've had this feeling he always wants to.

Response:
Hello! Thank you for your question. There are few things
that people find more personal than their sexual relationships. When we feel
connected to our partner, sex can be best thing since sliced bread. However, if
we feel disconnected in some way, sex can feel degrading and even painful.
I don’t know the specifics about your relationship or how
comfortable you are in talking to your boyfriend, but this is one of those
situations where communicating your fears is a good idea. The only exception to
that would be if you believe he is actually a threat to you in some way. If you
believe that, then you should do whatever you think is safe. It sounds like
there is a part of you that is already afraid of him, and if that is the case
then remaining safe is your top priority.
Assuming you are able to share with him your feelings,
telling him what you are and are not interested in sexually is very appropriate
and sexually healthy. Sex is something that is supposed to be enjoyable for
all parties. All parties should feel respected and able to say “no” to
absolutely anything they are not comfortable with.
I call the respectful agreement between sexual partners, “sex
trust.” Sex Trust means your partner respects your boundaries. It means they
won’t degrade you sexually with hurtful words, forced sex, or forcing or
coercing sex in ways someone is not interested in having.  Your personal safety and mental well-being is
what is most important.
Now, if there is a part of you that is curious about BDSM
and may be interested in participating in it, there are many websites that you
can explore to learn information. I will warn you, some websites and articles
are better or worse than others, but you may at least feel more informed.
Many people engage in BDSM and have happy relationships, but
again, it completely depends on what each person in the relationship wants. It is
also important to know that BDSM is not just one thing and people practice it
differently based on comfort. If it is something you are uncomfortable with,
then you shouldn’t feel obligated to do it.

I hope this was helpful. Be well.

Robin J. Landwehr, DBH, LPC, NCC


Instruction:
I get so much anxiety, and I don’t know why. I feel like I can’t do anything by myself because I’m scared of the outcomes.

Response:
This is a very common question in my practice. Panic attacks typically emerge from an underlying issue (ex. Depression, low self-esteem, fears). To decrease your anxiety symptoms it’s recommended to seek treatment with a therapist who specializes in working with anxiety disorders and most importantly one with whom you feel comfortable with.In my practice I educate clients about their anxiety and discuss building a framework with helpful tools for decreasing anxiety:1. Starting a daily mindfulness practice. For example: listening to guided meditation; engaging in deep breathing exercises; yoga practice; or other positive calming activities.2. Understand your negative and positive thoughts. Many times we tend to focus on the potential for bad things to happen. Increase positive self-talk when feeling down or when anxious. For example: "I don't need to worry, I am calm and relaxed". 3. Exposure to fearful or anxious situations. This can be accomplished under the care of a mental health professional. Many times we shy away from things that make us feel uncomfortable or insecure. This may led to an increase in isolating behaviors resulting in difficulty in performing things we were once able to do. For example: leaving the house; presenting in front of others; going to social events; and having conversations with people. However, the more we expose ourselves and practice the use of our positive coping skills (ex. deep breathing) the chances of anxiety will decrease. I hope this was helpful. Keep in mind, a therapist can help with guiding you through self relaxation and improvement.


Instruction:
I get so much anxiety, and I don’t know why. I feel like I can’t do anything by myself because I’m scared of the outcomes.

Response:
The other two post answers to your question are very good and I don't feel the need to repeat what has already been said quite well, but I will offer one other option I have been able to utilize quite successfully with those dealing with panic attacks.  Chain analysis is a fantastic way for your to map out the situation starting with the prompting event, the chain of events ((links) that lead up to the behavior - in this case a panic attack, and then what the consequences were.  See the illustration below:This is very useful in that it lays everything out for you to see so that it becomes possible to alter one of the links leading up to the unwanted behavior (panic attack), allows you to come up with strategies for similar situations (prompting events) and allows you to understand how you are reinforcing the behavior when it does occur (consequences).  Finally - it would also allow you to identify any particular vulnerabilities, such as not enough sleep, poor nutrition, trauma history or having a cold the time it occurred.  Working with someone who utilizes a behavioral approach, such as DBT or behavioral analysis, you can find solutions that replace one of the links and therefore breaks the chain of events.


Instruction:
I get so much anxiety, and I don’t know why. I feel like I can’t do anything by myself because I’m scared of the outcomes.

Response:
Anxiety is simply your system communicating to you that you are in danger. The issue that I see in most of my clients is that they try to reason with this anxiety. You do not reason with sensory states in the body. If your system tells your in danger (your stomache feels like it is knots, your heart is beating out of your chest,) validate by just being present with it. Take your breath to it. Breath in and out of that space. Say ok, I am in danger. I always tell my clients, "a crying baby wants to be held, not told to shut up." Listen to your system, validate it like you do a child and see what happens.


Instruction:
I get so much anxiety, and I don’t know why. I feel like I can’t do anything by myself because I’m scared of the outcomes.

Response:
The are two ways that such anxiety can be dealt with. One is an attempt to replace maladaptive thinking by examining the distorted thinking and resetting the fight-or-flight response with more reasonable, accurate ones. As an example "I'm scared of spiders." But if you change the thinking from being scared to "I'm bigger than the spider," it allows the mind to reach a calmer state of mind. Mindfulness-based therapy can also help  focus on the bodily sensations that arise when you feel anxious. Instead of avoiding or withdrawing from these feelings, remain present and fully experience the symptoms of anxiety. Instead of avoiding distressing thoughts, open up to them in an effort to realize and acknowledge that they are not literally true.Although it may seem counter-intuitive, fully realizing the experience of anxiety enables the release of over identification with negative thoughts. You can practice responding to disruptive thoughts, and letting these thoughts go.By remaining present in the body, you'll learn that the anxiety being experienced is merely a reaction to perceived threats. By positively responding to threatening events instead of being reactive you can overcome an erroneous fight-or-flight response.


Instruction:
I started dating my fiancé two years ago. My first cousin is married to my fiancé’s sister. There has always been a communication issue between my uncle and aunt and my cousin and his wife. My uncle goes to my mom instead of talking to my cousin, and it upsets my mom.

Response:
Based on the information provided, this is an issue with boundaries.   Sounds like your uncle goes to your mom and possibly your mother takes the issues to you.  I do not like to assume so I will direct you to information regarding families dealing with enmeshment and triangulation.  Enmeshment is the concept of diffused boundaries in families and other personal relationships.  Triangulation is two individuals relaying information to a third party what cannot be said directly to each other.  From someone who has dealt with both these issues on a personal level, being informed about family dynamics is beneficial and can help you develop healthy boundaries for yourself within your family structure.  You may need assistance with developing healthy boundaries.  Although it is possible, it is not easy to change the way you have been operating for any extended amount of time.  Hope this help!


Instruction:
I started dating my fiancé two years ago. My first cousin is married to my fiancé’s sister. There has always been a communication issue between my uncle and aunt and my cousin and his wife. My uncle goes to my mom instead of talking to my cousin, and it upsets my mom.

Response:
When you're upset about something, the first question you can ask yourself is "Whose problem is this?" It is amazing how many problems will disappear right at that point, because you realize the problem isn't even yours. You can't fix everything in your family. You are starting a new family of your own, and it's time to create a protective bubble around your family unit that keeps other people's issues away. I tell myself "Not my pig, not my farm, not my problem." When you stop trying to take care of other people's problems, they are more likely to step up and deal with it themselves. :)


Instruction:
Whenever I have to speak in public or be in big crowds, I freak out. I get light-headed, sweaty, and I have trouble breathing.

Response:
Basically, your response is the fight, flight or freeze reaction
which is hard wired into the human nervous system, specifically, the autonomic nervous system (called the autonomic response).  This system
is responsible for regulating the heart, digestion, respiratory rate
as well as other aspects which match the symptoms you describe.  It is largely an unconscious function, but
with training it can be managed such as a public speaking course in which you
prepare and even have some exposure to smaller experiences to help you prepare
and cope for larger presentations.  One of the greatest applications of
addressing this response is the NASA program which exposes the astronauts to situations
they will encounter while in space which will trigger the response so that when
it does happen (not if but when) that they are able to move through the
challenge with success.  You can learn
more about his by going to TED Talks “What I learned about going blind in space” It is
a truly inspiring look at what you are experiencing as well as how to deal with
it.
With that being said, finding a program
like a Dale Carnegie Public Speaking program can help.  Working with a counselor who can help you
utilize visualization of an upcoming speech has been shown to help and you can
always talk to your doctor to see what options might be available there as
well. Good luck!


Instruction:
Whenever I have to speak in public or be in big crowds, I freak out. I get light-headed, sweaty, and I have trouble breathing.

Response:
As you do it more, it should get better or at less with less anxiety.  Anxiety is normal for most when speaking in public.  I hear this from even the best of facilitators who have been doing it for years.  I even experienced that when I first became a counselor and had to lead classes.  I asked myself why were I so anxious?  I admit at that time I didn't have confidence in myself.  The more I prepared and practiced, the more my confidence level increased.  Yours will too...