Growing Anxiety

"How much pain have cost us the evils which have never happened."

-Thomas Jefferson

I’ve been noticing a growing trend lately when I return calls or emails to potential new psychotherapy clients that they act both delighted and surprised to hear from me. Apparently, my field is becoming much like general construction contractors who have a poor reputation for never calling people back. I think that’s sad, and I keep being surprised myself to hear someone be so delighted that I extended the simple courtesy of replying to an email inquiry or returning a phone call.

I gained some perspective on this trend though yesterday when I read an article in the Wall Street Journal which described how much of a crisis the health care system is in America right now. Millions of people are now suffering new complications from previous COVID infections and suffering the consequences of having missed standard health screenings for a couple years now. There were also many incidents where patients were denied routine healthcare for things like heart conditions or diabetes as medical providers were simply overwhelmed to maintain routine preventative care while responding to the crisis levels of COVID. Along with this massive new number of advanced health complications is a skyrocketing number of mental health concerns with an unprecedented need for more licensed therapists vastly outpacing the availability of qualified providers.

Millions of people have lost loved ones included in the more than one million Americans who died from COVID in the past two years. There are many more millions now helping to care for others who have had complications or life changes from what are called the “long hauler” COVID complication symptoms which are still just beginning to reveal themselves. Alcohol and other drug use has spiked in the past two years and drug-overdose deaths broke all records in 2021 which again has that ripple effect of leaving many more grieving and mourning loved ones behind. Overall, it is a grim picture of the present state of physical and emotional health with a gloomy prediction of what might be expected in the future.

Before COVID, the general rate of people suffering from a mental health complication at any point in a given year was somewhere around twenty percent, or one in every five adults in need of mental health intervention. Anxiety and depression have traditionally been the most frequently reported mental health complications and both have increased by more than thirty percent just since COVID began in 2020. Imagine the impact then of a thirty percent demand on a system which was already impacted itself under the strain of COVID and you can imagine why people are suddenly so surprised or grateful to get a return call from a mental health provider.

Anxiety has been the number one issue I have been presented with and treated in my more than two decades of practice. Unfortunately, there is now more anxiety than ever before and for many people it has become truly debilitating. On it’s own, anxiety is a healthy and normal metabolic response to a perceived challenge or threat which helps us find motivation for things like completing projects, showing up to work on time, or rising to a new challenge. There is even such a thing as “performance anxiety” which can enhance how well we do in certain activities like delivering a speech, competing athletically, creating artistically, or performing theatrically.

For a growing number of people though, anxiety is evolving into a number of complicated conditions ranging from generalized anxiety to social anxiety or phobias and even panic attacks. A panic attack is a truly awful thing to experience which mirrors the symptoms of a heart attack very closely and sometimes even experienced emergency room personnel can initially mistake a panic attack for cardiac arrest.

When anxiety is left untreated or allowed to persist over time, our mental and even physical systems can exhaust and become vulnerable to depression. So, for all the growing number of depression complaints, a large number of those started out with prolonged anxiety. Clearly there is a big difference between “good stress” like performance anxiety, and debilitating stress like a panic attack.

More than any time in our recent history, it has become very important to guard and maintain our mental health and emotional wellness. Being proactive in taking times to rest and calm ourselves can help us be resistant to the complications of prolonged anxiety. There are a variety of self-help measures we can learn which can include simple breathing exercises, meditation techniques, and physical activities like walking, various forms of exercise, and stretching such as what’s involved in yoga.

Medication can be useful temporarily or in some cases long-term depending on what a prescribing physician recommends. Psychotherapy is of course a primary treatment to resolve anxiety or a proactive means to avoid further complication of anxiety or depression.

A particularly effective therapy for anxiety which is finally on the rise as more therapists get trained and certified is “EMDR” or Eye Movement Desensitization Reprocessing Therapy. EMDR is the therapy I have specialized in exclusively in my private practice for many years now. This is not a traditional talk therapy, and I would highly recommend anyone suffering from anxiety consider EMDR as a first mode of attack to combat and defeat anxiety permanently. In fact, if you’ve already experienced EMDR with me, I would encourage you to share this article with anyone you know who might benefit from the therapy because there are just too many people suffering right now.

Despite facilitating EMDR with close to 8,000 clients all over the globe in the past twenty years, I continue to be amazed at how powerful our own brains are in self-healing when EMDR is employed to facilitate normal brain processing in recovery. It’s also amazing to me to see what often emerges from past life events which can be complicating our present life and wellbeing.

I am encouraged that the EMDR Institute and the EMDR International Association have both recently endorsed the facilitation of EMDR virtually as it was an office-based practice until COVID forced many therapists to learn how to offer this ground-breaking intervention virtually. I’m also thankful to Better Help for recruiting me four years ago which pushed me ahead of the curve in figuring out how to facilitate EMDR virtually about two years prior to COVID making that ability a necessity.

There was a client I met on Better Help who lived on the opposite side of the world from me in a country I had to look up to figure out where it was located. The woman suffered from agoraphobia or social anxiety so acutely that she had been unable to leave her house for more than two years. I knew immediately I could help her if I could facilitate EMDR, but I had no idea how to make that happen through a video connection online.

I did a bit of research and creative thinking to come up with a crude attempt at EMDR facilitation virtually and I explained to the client I had never attempted this before, but I was somewhat confident it might help, and it would only take one appointment to find that out. The woman very eagerly agreed to try it and in just under an hour we had completed the session successfully.

I scheduled a standard reassessment appointment a week later and when the appointment came, I was amazed as the woman appeared on video with her husband, both with tears of joy to report she had left their house successfully! The woman and her husband described how she was able to go outside with no anxiety just a few days after the EMDR appointment. It was the first time she had experienced fresh air and sunshine in over two years, and I was very near tears myself in hearing their report and in realizing the potential for virtual EMDR.

I continued to refine the virtual facilitation of EMDR and eventually there were web-based platforms and tools developed which have assisted therapists like myself who have made the leap to facilitate virtual EMDR to not have to resort to the initial measures I did initially in getting started. When COVID emerged about two years later and I was told by my primary care doctor I could not leave my house, it was a natural transition to close my traditional office practice and to start facilitating EMDR virtually on both Better Help and through my private practice.

What surprised me further was hearing from my office-based clients who followed me virtually in reporting they actually preferred virtual service for reasons I would not have identified initially. They liked saving time traveling to my office which for some was more than thirty miles each way. They liked not being nervous they might see someone they knew in the lobby or coming and going from the office or parking lot. They liked not having to drive at night or in inclement weather. They liked not having to worry about spreading cold and flu or COVID germs, being in their own environment which they could control, and to feel comfortable being more casually dressed – sometimes way more casually dressed!

I thanked my office clients back then for all these great suggestions which I now list on my private practice website. I’ve also maintained my commitment I made to them at the time that even though I was comfortable with them showing up for appointments in their pajamas I would always be in my regular daytime clothes J

Overall, I can look back and see good things which have come out of the devastation of COVID. More people than ever are reaching out for mental health support which has helped many more people realize counseling or psychotherapy is not anything to stigmatize or feel embarrassed about. More therapists have started getting certified in EMDR and a few of those are figuring out it’s possible to offer this amazing intervention virtually. Virtual therapy and platforms like Better Help have expanded to make services available to many more people than ever before, and the diversity and scope of practice encountered has helped therapists like myself further hone or skills and continue to increase our effectiveness.

I believe this whole experience embodies the theme we should always employ when responding to trauma or tragedy or when having to navigate increasing stress and anxiety. We can find the resources we need to successfully overcome challenges, we can grow together, and we can encourage one another as we learn from our challenges, and we can find positive outcomes that are surely discovered eventually in any situation.

I hope you have a terrific week!