Navigating more complex peer relationships, academic demands and identity issues can be daunting. Managing the multitude of changes that occur during adolescence can lead to anxiety as concerns about the future and conflicts about independence emerge. Fortunately, psychotherapy can help teenagers cope more effectively with difficult emotions and increase self-confidence. The Cognitive Behavioral Therapy and Mindfulness techniques I use are evidenced based and highly effective for anxiety and depression issues.
The following are areas I treat for anxiety.
Anxiety Issues
Chronic Worry: Do you worry excessively about the future, academics, or relationships?
Anxiety and worry is normal for everyone to experience throughout their lifetime. However, many adolescents may have chronic anxiety about every day events. This is often referred to as generalized anxiety disorder. The adolescent with chronic worry may find that after one anxiety issue subsides, another issue shortly emerges. This anxiety may be connected to upcoming events such as tests, athletic performance, peer relationships or concerns about the past. Worries about personal health or the health of others may also be concerns adults may find themselves preoccupied with. The anxiety and worry adolescents experience is often based on beliefs that the worst-case scenario is going to occur. Self-talk statements such as “I am going to fail” and “I will be rejected” are examples of the thoughts that can lead to chronic worry.
Other symptoms of chronic worry and generalized anxiety may be irritability, poor concentration, difficulty sleeping, restlessness or psychomotor agitation (ex: leg shaking, pacing). Often anxiety can impact performance in school and relationships.
How I can help with chronic worry?
I help adolescents develop skills to minimize catastrophic thinking. Rather than jumping to the worst-case scenario my clients learn skills to think in a more balanced and rational fashion. I also utilize mindfulness skills to help adolescents learn how to detach from anxiety thoughts pertaining to worry. I teach relaxation skills to help reduce irritability or psychomotor agitation that adolescents may experience when anxious. Through exploration adolescents will understand social factors that may have made them more prone to anxiety, and how their anxiety impacts social and personal relationships.
Social Anxiety
Do you feel extremely anxious when interacting with others in social situations?
During adolescence concerns about what other’s think and increased self-consciousness is typically normative. When adolescents experience excessive anxiety in social situations they may have a social anxiety disorder. Common thoughts adolescents may have in social situations leading to anxiety, may range from beliefs that they are awkward, unlikable, or boring. They also may fear that their anxiety will be noticed by others. Adolescents with social anxiety may avoid events and school activities all together. Conversely, they may go to social events and be reserved and minimize contact with others. Social anxiety may emerge from underlying self-esteem issues. The adolescent who does not feel positive about himself may feel that others will experience them in a negative fashion. Social anxiety can impact academic performance, classroom participation, concentration and peer relationships.
How I can help with Social Anxiety?
I utilize CBT skills to help adolescents perceive social situations more realistically. Specifically regarding their perceptions and assumptions about how they are perceived. I utilize mindfulness skills to improve social competence and attention skills that can be implemented when interacting with others. This increases confidence and social aptitude. I also use exposure techniques to help clients confront anxiety and become more habituated to anxiety provoking situations. Through exploratory therapy underlying self-esteem issues that may contribute to anxiety are identified. This insight can support self-esteem and self-efficacy.
Obsessive Thoughts
Do you or someone you care about have unpleasant and unwanted thoughts that create intense anxiety and make you feel bad about yourself?
Many teens have unpleasant thoughts that stick in their head like a broken record. These thoughts are unwanted and can be very disturbing. They may be related to sexual issues or aggressive impulses. These thoughts may be extremely dissonant with one’s morals and sense of self. The person suffering with obsessive thoughts may question why these thoughts are occurring and think they are a bad person. It is important to note that this is not the case and that the following unpleasant symptoms typically reflect an obsessive compulsive disorder which can be treated.
How I can help with Obsessive Thoughts
Mindfulness and acceptance skills can be extremely helpful in letting go of obsessive thoughts. My clients learn how to detach from intrusive thoughts and let go of them which helps minimize distress. By learning how to flow with thoughts, rumination (repetitive thoughts) is greatly minimized. Exposure techniques and providing clients with psycho-education about the neurological underpinnings of OCD is also extremely helpful in mitigating symptoms. With skills, knowledge and a compassionate environment, OCD symptoms can be managed and reduced.
Panic Attacks
Do you or someone you care for have intense episodes of anxiety where you feel like you are dizzy, have a racing heart and think you are going crazy?
Panic Attacks can be extremely unpleasant and can co-exist with many other anxiety issues. Signs of panic attacks include racing heart, feeling faint or dizzy, tingling in hands, chest pain, difficulty breathing, and sweating. People who have panic attacks may feel as though they are losing control, going crazy or even dying. Panic attacks are often perpetuated because once they are experienced there is great fear about having another one. This fear about having anxiety actually can elicit panic attacks. Additionally, people who have panic attacks often avoid places where they fear it will happen again. This can greatly impair one’s ability to function. Additionally, avoidance of anxiety provoking situations prevents learning and perpetuates the problem. Fortunately, panic attacks are not life threatening and dissipate in time.
How I can Help with Panic Attacks
I teach my clients relaxation techniques that they can implement while having panic attacks to return to their baseline functioning. Providing knowledge regarding why panic attacks occur and the physiological explanations of the symptoms can reduce the fear of having panic attacks and improve the capacity to manage them. Mindfulness techniques and acceptance are also extremely useful in coping with anticipatory anxiety regarding panic attacks and in reducing the intensity of panic attacks. Exposure techniques can also help people become habituated to panic attacks and reduce emotional reactivity and anxiety. Facing and surviving the fears of panic attacks is the best way of learning to live with them.
Test Anxiety & Performance
Do you or someone you care for have poor study habits, poor concentration and anxiety when studying or while taking exams? Do you find you forget material during tests that you recall after?
How I can Help
Depression, anxiety, or learning issues such as Attention Deficit Disorder can contribute to poor test preparation and lead to test anxiety. I work with students on altering negative thought patterns that contribute to procrastination and impact motivation. I teach students mindfulness skills to mitigate anxiety, depression and enhance concentration both when students are studying and taking a test. I also work with students on mnemonic devices to increase memory retention, which helps students feel more confident and less anxious regarding their performance. Planning and time management skills are taught to help students manage feelings of being overwhelmed by assignments.
Carolyn Ehrlich LCSW, CGP, Counseling Tribeca, specializes in Relationship Counseling NYC. In Couples Therapy Tribeca I help increase your self awareness and help you gain more insight into your inner life. We’ll work together so you can get more out of every day and meet any challenge life throws at you.