Many people with panic attacks develop a condition known as “agoraphobia,” which is best described as a fear of being out of the home or in places that are unfamiliar. One of the reasons that people with panic disorder may develop agoraphobia is because they start to avoid places where they feel like they might have a panic attack.
For example, if they have a couple of panic attacks while in the mall, they may stop going to malls. If they have it in a restaurant, they may stop going to restaurants. Over time, they become limited to very few places, and some people have a trauma response that makes them not want to leave their house at all.
But the problem is not just that people start to avoid places because they’re afraid they may have panic attacks. The problem is that they are often correct – if they did choose to go to a place that they feared, they would be very likely to have a panic attack. That is because panic attacks are self-fulfilling in a way that is caused by the symptoms of the attacks themselves.
How Panic Attacks Become Self-Fulfilling
Panic attacks are intensely physical anxiety events. When a person suffers from a panic attack, they often have rapid heartbeat, chest pains, light headedness, and a series of physical symptoms that can be so severe, they can be genuinely convinced that something is wrong with their health.
Because panic attacks are such overwhelming physical events, a symptom of persistent panic attacks is known as “self-monitoring.” People with panic attacks tend to pay attention to how their body feels at any given time in order to see if a panic attack is coming. If they start to feel the symptoms of a panic attack, it will often cause distress and anxiety – which then contributes to the attack.
In addition, people with panic disorder also develop what’s known as “hypersensitivity.” That means that they feel things stronger than other people do. While most people might not even notice a small pain or bit of discomfort, a person with panic attacks will not only notice it, but will feel it stronger. Both of these symptoms are also more likely the more anxious a person feels.
That is how panic attacks become self-fulfilling and reinforced. Let’s use the example of library.
Someone with panic attacks is worried they may have a panic attack at the library.
Because they’re worried, they’re a bit more anxious.
That anxiety causes them to experience a very mild sensation somewhere on their body.
Because of their hypersensitivity, the symptom feels worse than it otherwise might.
Because of their self-monitoring, they always notice it immediately.
That causes them to experience strong anxiety, worried a panic attack or worse is coming.
That anxiety triggers a panic attack.
Now their fear of going to the library is reinforced, and they may not go anymore.
This cycle can occur to anyone, even those without agoraphobia. Eventually, many people with untreated panic disorders will start to avoid places because of fears they may have an attack, or they may experience attacks more often because they have become self-fulling when they are out and about.
How Do You Stop the Self-Fulfilling Nature of Panic Attacks?
There are many ways to approach panic attacks and panic disorder, and you and your NYC therapist at Flourish Psychology will work to find the approach that makes the most sense for you. We may deploy treatments like cognitive behavioral therapy (CBT), rational emotive behavior therapy, gestalt therapy, positive psychology, and more.
CBT, specifically, is often used to treat panic disorder, and many of the treatment approaches are specifically about addressing these issues:
Monitoring your body for sensations.
Misinterpreting those sensations.
Avoidance behaviors.
Many psychologists have identified these issues as some of the main reasons that panic attacks keep recurring. So, your therapist will provide you with actions that you can take to address these issues. Some of them may be uncomfortable – for example, you may have to put yourself “at risk” for a panic attack again as you stop avoiding places that caused them.
Your therapist may even have you mimic some of the same symptoms that you’ve had before that have triggered panic attacks. For example, if you get dizzy with panic attacks, you may be asked to make yourself dizzy so that you can learn how to calm yourself when you experience those sensations.
The approach that we take will be based on your specific situation, but much of addressing panic attacks comes from breaking this self-fulfilling panic attack cycle.
Depression can happen to anyone. It is a condition that can occur gradually, as a response to life trauma or inability to cope with stresses. It can also occur suddenly, after a major loss or struggles at work or in a relationship. As therapists for depression in NYC, we know that there is no “type” of person that may struggle with depression.
Yet the data does show that lawyers experience depression more so than nearly any other profession. As many as 28% of lawyers show signs of depression – more than 1 in 4, a 400% increased risk compared to the general population – and many others experience work stress and anxiety that could lead to depression someday.
The data is clear: lawyers have a higher rate of depression than almost every other career. Understanding why this may occur is one of the first steps toward addressing it.
Risk Factors for Depression in Lawyers
Because depression can happen to anyone, there is not necessarily a single reason that attorneys may be more prone to depression, or a single cause that can be identified in order to address it. But there are many factors that are likely at play, and any combination of these can be a contributor.
Binary Success – One reason that lawyers can struggle with depression is because the career itself is based on binary success. You either win, or you lose, with rarely much middle ground in between. You’re constantly in competition with someone else, and – depending on your specialty – someone’s money, health, or life may be directly tied to you winning. Even the best lawyers lose cases, and that can hit people very hard.
Peer Competition – Similarly, many lawyers feel in constant competition with their peers. Not only is that true in the courtroom, where you are tasked with trying to “beat” someone as part of your role, but also those that are trying to grow their practice are in competition for clients and revenue. Those comparisons and that competition can lead to a considerable amount of stress.
Financial Concerns – Though not true of every specialty, most lawyers receive payment at seemly random times, going for months – or sometimes years – before getting paid for a case that you’ve been working on. That inconsistency means a lot of challenging times financially, navigating banks and debt to pay your staff before hoping that you receive payment on time.
Lack of Sleep – Sleep is critical to our mental health. Many lawyers struggle with sleep, either because they’re working too late at night or they are heavily focused on their cases and struggling with insomnia. No matter the cause, a lack of sleep makes people more prone to depression.
Lawyer Characteristics – The same strengths that draw people to the legal profession may also make them more prone to depression. For example, “perfectionism” is a common quality of those drawn to law, and perfectionism is considered a risk factor for depression. This would mean that there may be some self-selection involved in why lawyers experience depression.
These are only some of the many reasons that lawyers may be more prone to depression. Drug and alcohol abuse and relationship issues are also more common among lawyers, both of which also put people at greater risk of depression.
The Challenges of New York City
Lawyers all over the United States are going to be more likely to have depression based on that factors outlined above. But we are in NYC, and here in NYC, these same pressures are multiplied considerably. Manhattan and Brooklyn are home to some of the most “high powered” lawyers in the entire world, and that means that attorneys here face tough legal battles, bigger stakes, and even more pressure to compete and succeed in this environment.
Depression Therapists for Lawyers in NYC
Flourish Psychology has a team of carefully selected NYC therapists led by Dr. Sadi Fox. Our private practice recognizes your unique experience as an individual, and seeks to use the best possible treatments to support a recovery that is sustainable and actionable for your long term mental health. Contact Flourish Psychology today to schedule an appointment.
We hear many people say that “the mind and body are connected.” We often feel this in ways that are hard to describe but noticeable when we see it. There are some situations in which this link is incredibly apparent, such as the way that many of us feel “depressed” when we are sick with the flu, or the way we feel generally unwell when we feel sad or nervous.
But we’re still discovering ways that our bodies and minds are linked – often ways that we still do not fully understand, but can prove nonetheless. One such example is the way that over-developed and under-developed muscles, especially in the core and posterior chain, can lead to developing some fairly significant anxiety symptoms.
How Could Muscle Development Affect Anxiety?
We spend a lot of our time leaning forward. We slouch when we sit and watch TV. We slouch forward in the car. We slouch forward when working on our computers. Now, with smartphones, we even slouch forward when we walk and stand. We also do all of this while we exercise less and – even those that do go to the gym – tend to focus on the most visible muscles, such as the chest, the abs, and the biceps.
What’s happening to many of us is that some of our muscles are tightening and overdeveloping – often in the front of our bodies. On a physical level, this can cause all sorts of challenges, such as a hunchback and back pain as we age. If you feel like your lower back is often achy or your shoulders are frequently tense, that is an example of what these issues can cause.
Entire textbooks have been written about the ways that this affects our body – causing our muscles to not communicate properly, increasing stress on the nerves, and so on. But our focus here is on how these underdeveloped muscles can cause anxiety, and one of the many ways they do this is by causing dysfunctional breathing.
When your front muscles are tight and your back and core muscles – especially those on the back side of your body, like the glutes – are underdeveloped, it leads to poor posture and shorter, shallow, and less consistent breaths. These breathing pattern problems lead to a host of different issues, most notably, hyperventilation:
We breathe in too much oxygen.
We breathe carbon dioxide out too quickly before we have a chance to make more.
We *feel* like we are not getting enough oxygen, leading to attempts to draw in more.
We start to experience lightheadedness, rapid heartbeat, and other symptoms as our bodies need a certain carbon dioxide/oxygen balance to work efficiently.
If you’ve ever had a panic attack before, some of these symptoms will sound familiar. That is because hyperventilation is a key part of a large number of panic attack symptoms. Without the right oxygen balance, our bodies also become stressed.
What happens next?
When our bodies our stressed, we start to experience more anxiety and stress as well. Sometimes, this can lead to full-blown panic attacks. But even in those that are not prone to panic attacks, it can make us feel more stressed and anxious generally – even though we may not entirely understand why. When we’re faced with other types of stress and anxiety, they may also feel more severe, as our bodies are already starting from a more anxious baseline.
All of this because of posture and muscle strength.
Does This Mean a Gym Will Cure Anxiety?
We now know that our posture and our muscles are linked to issues like breathing and anxiety. But does this mean that all we need to do to reduce it is to go to the gym and work on our squats? Will strong glutes cure anxiety?
Typically, no. Once we have developed anxiety, poor breathing habits, and other mental health challenges, we often need professional support in order to learn to manage them effectively. Similarly, while we know that poor posture and poor muscle development can lead to anxiety and stress, we also know that anxiety and stress can lead to poor posture.
People with depression, for example, are far more likely to slouch their shoulders and hunch their back. This postural change ends up causing tighter muscles in the front of the body and weaker, stretched muscles in the back, leading to poor breathing habits. But in this situation, the depression came first. Exercising our muscles could theoretically help relieving some of the symptoms, but the depression would still be present.
Still, it’s important to recognize that our lives benefit from holistic healthier living. When we take care of our minds and our bodies, we are more likely to see an improvement in our quality of life.
Cognitive behavioral therapy, known as “CBT,” is considered the gold standard psychological treatment for several mental health conditions. CBT is especially effective for anxiety. At Flourish Psychology, we believe in creating a personalized approach to treating all mental health conditions, but for many of our patients, CBT is the best primary treatment choice.
But why is CBT so effective?
Benefits of CBT – What it is and Why it Works
CBT has been extensively researched by universities across the United States. It has been the primary therapy choice on the West Coast for decades. Other therapeutic modalities remained more popular in places like NYC and Brooklyn, like psychodynamic theory, but recently CBT has overtaken them as well as the top choice for most psychologists.
Cognitive behavioral therapy isn’t one specific approach, but rather many different strategies that are all related to addressing cognitions (thoughts) and behaviors. Guided by your therapist, you’ll use strategies that include:
Identifying behavioral patterns.
Challenging thought accuracy.
Creating goals and problem solving.
Activating emotionally healthier behaviors.
Learning relaxation techniques.
Within these are even more techniques and strategies, such as reducing “fortune telling” behavior, journaling, interventions for emotional reasoning, and more.
What makes these techniques so effective is that they are directly related to the thoughts and patterns commonly associated with all forms of anxiety, and they provide those solutions with other benefits that include:
Faster – While there is plenty of benefit to seeing a psychologist for ongoing treatment, CBT itself can provide faster results than almost any other studied form of psychology.
Goal Oriented – You and your anxiety therapist will be specifically trying to reach measurable goals, and will be able to see and track your progress along the way.
Present Focused – There is benefit to talking about your past and future. But when you need help now, what matters most is a present-focused approach, like CBT.
Anxiety itself affects the way people think and act in ways that contribute to even more anxiety. CBT addresses these directly and head on.
Above all else, CBT is evidence-based. This is a form of therapy that has stood up to rigorous psychological testing, so we can deliver CBT with confidence when we treat our patients here in NYC.
About CBT Therapy with the Brooklyn Therapists at Flourish
What matters is your recovery. CBT may be the gold standard, but maybe your specific treatment needs silver or platinum. Our goal is to talk to you to identify what approach makes the most sense for addressing your struggles and your needs.
But there is no denying that for anxiety CBT is one of the best ways to support our patients, and our therapists at Flourish Psychology can provide CBT in ways that encourage your recovery and help you move forward in your life. Learn more about Flourish by contacting our team today.
We often talk about the different symptoms of anxiety, from rapid heartbeat to sweating to tension and more. But anxiety affects your entire body, inside and out, and the longer you live with anxiety, the more you might start to notice more unusual symptoms that do not always fall under what we typically think about with mental health, but are still directly related to how you feel.
That is especially true of symptoms of the eye. Anxiety is known to cause a variety of eye problems. Both short term anxiety attacks and long term anxiety can lead to challenges related to sight, pain, and more. It’s not uncommon for the symptoms to appear even when you do not feel like you are struggling with anxiety in the moment.
How Does Anxiety Affect the Eyes?
Our eyes are surprisingly sensitive to change. Some of the effects of anxiety have a direct impact on the eyes through neurotransmitter changes in the brain. Others are related to the ways that anxiety affects the muscles surrounding the eyes. At any time, both during anxiety attacks and others, you may see eye symptoms of anxiety that include, but are not limited to:
Eye Pain – Your eyes themselves may feel pain for many reasons. Lack of sleep can cause your eyes to ache and hurt. During anxiety attacks, your pupils dilate, which may cause them to experience sharp pains if they take in more light than they need. Migraines, which can be triggered by stress/anxiety, can also lead to eye pain.
Headaches Around the Eye – Sometimes, it’s not the eye itself that hurts, but a soreness near or surrounding the eye. This can be caused by muscle tension, as any causes the muscles around the eye to contract. It can also be caused by a lack of sleep, which is especially common for those with anxiety.
Vision Problems – Anxiety doesn’t just cause pain. It can also lead to vision problems. These may include tunnel vision (which are common during anxiety attacks), blurry vision, twinkling in your vision, and a sensitivity to light. Vision issues can also lead to further eye pain, as your eyes may not know how to adjust to them, causing you to squint or experience eye strain.
Eye pain and discomfort are typically not the most problematic of anxiety symptoms, which is why not everyone even realizes it may be related to anxiety at all. But it’s important to realize that long-term stress and anxiety can touch almost every single part of your body, inside and out, and some of the strange or uncomfortable issues that you may be experiencing with your eyes, or with some other part of your body, may be directly related to the stress of living with long term anxiety.
Reduce Anxiety, Reduce Symptoms
Rarely is any symptom related to anxiety permanent. If you’re able to control your anxiety and stress, you should also be able to reduce your eye pain, eye headaches, and other issues that are related to that anxiety. Talk to Flourish Psychology today for anxiety treatment in NY, with services for anyone in the entire state.
There are some people that can talk to anyone. If someone is in a room with them, a friend or stranger, they can fearlessly walk up to that person and start a conversation, with no timidness or hesitation in their voice.
But not everyone is that social, and some people struggle to have conversations – especially with people they do not know. Often, these individuals are described as being “shy.” Sometimes, however, these individuals are struggling with social anxiety disorder, and their shyness is actually a form of moderate to severe anxiety that would benefit from treatment by a mental health professional.
Yet how do you know if it is shyness or social anxiety?
Shyness and Social Anxiety Similarities and Differences
Shyness and social anxiety share many common traits. Both make it harder to socialize with strangers or groups. Both can make it more difficult to have the relationships you want, or participate in some of the activities that you want to enjoy.
But there are key differences between the two, and most of them relate to the emotions, thoughts, and behaviors that occur during social situations.
Shy people can often motivate themselves to be social with only a little bit of self-talk.
Shy people may feel a little bit of anxiety, but it is fleeting and easy to manage.
Shy people often still go out and participate in social activities.
Shy people do not necessarily feel significant shame or embarrassment at being shy.
On the other hand:
Social anxiety tends to cause moderate to severe anxiety at the idea of being social.
Social anxiety comes with a lot of negative self-talk.
Social anxiety causes increasingly severe physical responses in social situations.
Social anxiety leads to many negative emotions and overthinking about the experience.
Social anxiety is difficult to overcome, and can get worse over time.
Social anxiety makes people avoid possibly enjoyable social situations.
A person that is shy may feel like they want to talk to someone but have a bit of a hard time speaking up. A person with social anxiety is often fearful about talking to that person, worried they’ll embarrass themselves, and may experience severe anxiety that prevents them from engaging with others.
Still, while the two are different, they are not entirely unrelated. Shyness can lead to someone developing social anxiety disorder if their shyness starts to negatively impact their life, and what we call “shyness” could be a form of mild, manageable social anxiety that has the potential to worsen depending on life experience. It may be a personality trait, but it may also be a form of social anxiety that is currently manageable, but could develop into worse symptoms over time.
Evaluating and Treating Your Social Anxiety
It is difficult to live with social anxiety. It is even more difficult to live with social anxiety here in Brooklyn and NYC, as our area is densely packed, brimming with events and social experiences, and often requires socialization in order to navigate the busyness of the city.
At Flourish Psychology, we believe that what matters most is helping you achieve your goals. Whether you have social anxiety or you’re just feeling shy and want a bit more self-confidence to be social, we want to be here to work with you, helping you achieve these goals and live your life the way you want to live. Contact us today to learn more.
Location: 300 Cadman Plaza West Floor 12 - Brooklyn, NY 11201
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