How to Recognize, Treat, and Live With Anxiety

The Story

Anxiety isn’t “just in your head.” Like taking your temperature, we all need to check in to make sure we’re feeling mentally well, not just physically well. Especially in the middle of a global pandemic, your mental health may be taking a hit.

You're telling me. 

Anxiety disorders are the most common mental illnesses, affecting 40 million people over age 18 in the US. Less than half of people with anxiety disorders receive treatment. We’re here to break down how to differentiate between them, how to seek treatment, and resources for working through anxiety in your day-to-day. 

RECOGNIZING ANXIETY

What are the symptoms of anxiety?They aren’t one-size-fits all. Generalized anxiety disorder, or GAD, affects more than 6 million US adults. It’s characterized by symptoms that may include excessive worry, worst-case scenario fixations, indecisiveness, trouble focusing, and trouble sleeping. 

OK I’ve experienced those, do I have an anxiety disorder?

Maybe. But worry and anxiety are often confused. Worry is pretty much an unavoidable part of being alive, while GAD should be treated. Worry is only one symptom of anxiety. A few more differences: worry is usually experienced in the head while anxiety is felt in the body. Worry is specific (e.g. nervous about catching the train) while anxiety is general (e.g. anxious about traveling). Worry often leads to problem solving while anxiety does not. Worry is temporary, anxiety is persistent. Worry doesn’t have a long-term effect on your life or wellbeing, while anxiety very much does.GAD is only one of many anxiety disorders that should be identified and treated. Here are some others, their symptoms, and then ways to seek treatment.

• Obsessive Compulsive Disorder (OCD)...This one is marked by frequent unwanted thoughts (aka obsessions) and repetitive behaviors (aka compulsions). OCD can take the form of hand washing, cleaning, or counting, all done in the hopes that obsessive thoughts go away. Spoiler: they don’t, unless the disorder is treated. 

• Panic disorder...Marked by episodes of intense fear paired with physical symptoms like chest pain, shortness of breath, and dizziness—all of which are called panic attacks.  

• Post-Traumatic Stress Disorder (PTSD)...This can develop after a terrifying event (including assaults, natural disasters, car accidents, military combat) in which physical harm occurred or was threatened. Symptoms may include distressing flashbacks, intrusive thoughts, difficulty sleeping, and avoiding certain places or people. 

• Social Phobia or Social Anxiety Disorder...This one is characterized by excessive self-consciousness and fear of being judged in everyday social situations. This can be limited to a particular type of situation, like public speaking, or can be so generalized that it makes it difficult for someone to ever be around other people.

GETTING TREATMENT  

While it’s helpful to know about different types of anxiety, you should not self-diagnose. WebMD rabbit holes are not your friend. Get treatment from a doctor who’s trained to help.

Which type of therapy is best for me?

You may gravitate towards a certain type of therapy based on your symptoms, or simply your preferences. Here are some of the most common types of treatments:

• Psychodynamic therapy...The one that looks in the rearview. This type of therapy focuses on digging into past events and behaviors to get to the root of current issues. It’s usually long-term, lasting from several months to several years.

• Cognitive behavioral therapy…The one that focuses on your thoughts. CBT is all about your current thought patterns and finding practical solutions to deal with them. It’s usually shorter term than psychodynamic therapy. 

• Group therapy...The one with the built-in support system. One or more psychologists lead a group of around five to fifteen people, often focused on a specific issue like social anxiety, depression, or substance abuse. 

These therapies are all effective for treating anxiety and depression. Psychodynamic therapy can be more effective for long-term problems rooted in past behavior, like relationship issues, while CBT can be most effective for treating conditions like insomnia. Group therapy is useful for those looking for a lot of feedback and a community—it’s also usually cheaper.

Does insurance cover this?

Fingers crossed. If you’re looking for a mental health professional and have insurance, start on your provider’s site. The law requires most insurance plans—including employer-sponsored plans and coverage purchased under the Affordable Care Act—to treat mental health like physical health coverage. That means an insurance company can’t charge a $50 copay to visit a psychologist if it only charges a $20 copay to visit a surgeon. 

But my therapist won’t accept my insurance, even though I have mental health coverage. Why not?

First off, you’re not alone. Many mental health professionals choose not to accept insurance. Therapists can charge more independently—especially since many insurance companies haven’t increased the reimbursement rate for mental health professionals in years, despite the rising costs of running a practice. Check to see if your plan accepts out-of-network providers. If it does, you’ll have to complete an insurance claim form and submit it along with the invoice for your treatment to get reimbursed. Can I pay for this with my HSA or FSA account?

It depends. Reminder: health savings accounts (HSAs) and flexible savings accounts (FSAs) are savings accounts specifically for your health insurance plans. You can contribute pre-tax dollars to them and save and pay for things like pricey deductibles, co-pays, prescriptions...and mental health coverage. Psychologist or psychiatrist treatment are eligible as FSA or HSA expenses, though certain therapies—like marriage counseling—are not, unless it’s for an explicit medical purpose. Prescriptions for mental health and treatments for issues like substance abuse are eligible. In order to receive the green light, you may have to first meet with your Primary Care Physician and get a Letter of Medical Necessity. 

DAILY COPING TACTICS

If you can’t afford to see a professional or want strategies for coping in-between sessions, there are tips and free resources out there to get started. Here are some of our favorites: Tips: 

• 54321 Method...A mindfulness tool that grounds you in the present. First, identify five things you can see. Then, four things you can hear, three things you can feel, two things you can smell, and one thing you can taste. This helps shift your attention to your surroundings and away from the intrusive thoughts in your head. 

• 3x30 Plan...Exercise at least three times a week for at least 30 minutes. This can mean walking, yoga, dancing, taking a virtual class. 30 minutes is one Friends episode. And exercise will be there for you (when the anxious rain starts to pour). 

• Breathe...You’ve heard this one before. Our stress guide gives you some breathing and relaxation tactics for managing stress (which can be a trigger for anxiety). 

• Schedule “worry time”...Take 15-30 minutes a day to identify what’s making you anxious and write it down. Because the first step is recognition and the second step may be starting a very sad handwritten book.

Apps and Websites: 

• Frame Therapy...This mental health platform offers free digital discussions on everything from racial trauma to coping with heartbreak, dealing with anxiety from layoffs, and more. It also helps match you with therapists within your budget. 

• Sanvello...An app that uses techniques based on Cognitive Behavioral Therapy to manage stress and anxiety. It includes things like daily mood tracking, meditations, and an engaged community—plus, it syncs with your Apple Health app. 

• National Alliance on Mental Health (NAMI)...A hub for all things mental health—including personal stories, educational guides, and insurance info. 

• Breathe2Relax....Because “breathe in, breathe out” is easier said than done. This app, created by the National Center for Telehealth, guides users through breathing exercises to help manage anxiety levels. 

• Happy Not Perfect...A mindfulness app and site with a range of meditations for specific issues, plus tips for sleeping better and easing anxiety.

Podcasts: 

• No Feeling is Final…The host, Honor Eastly, explores her journey with anxiety and depression. Her personal experience helps equip listeners with tools for dealing with mental health on a daily basis. 

• Terrible, Thanks for Asking…Host Nora McInerny lost both her husband and father to cancer and had a miscarriage within several weeks in 2014. Here, she explores the ways grief and anxiety have affected her life, and how she and others respond to the dreaded “how are you?” question. 

• Ten Percent Happier…Host Dan Harris, an ABC newscaster, had a panic attack live on GMA. Now his podcast and bestselling book by the same title explore Panic Disorder and anxiety, and all the changes he’s made to take control of them in his own life. 

• The Calmer You…Anxiety expert and hypnotherapist Chloe Brotheridge (and her soothing voice) dishes out solutions for achieving a more confident and calmer self. 

• Anxiety Slayer...Provides interviews with mental health professionals and actionable tips for managing anxiety.

theSkimm

Mental health stigmas are real, but so are treatments. Anxiety does not mean weakness. Anxiety does not mean indulgence. Anxiety means you’re human—and learning to manage the condition and live your life.