Anxiety Keeping You Awake At Night? Try These 5 Things

Is anxiety keeping you awake? It’s not uncommon for those who experience anxiety to feel the effects at night. Sometimes we toss and turn, filled with worries that keep us from falling asleep. Other times we may wake up anxious in the night, and have a hard time getting back to sleep. 

If this sounds familiar, here are 5 things that can help keep an anxiety attack from keeping you awake. If your anxiety is impacting your life, it may be time to talk to someone about it. Brightside Health can help.

Start with a free assessment today.

Do some deep breathing

If you can’t get to sleep because anxiety is keeping you awake, deep breathing can be a great way to calm your body and your mind. There are a number of reasons that this works. 

First, deep breathing increases the oxygen flow in your body. That can stimulate the parasympathetic nervous system, which promotes a state of calmness. 

Secondly, a deep breathing routine can give your brain something to focus on that isn’t the thing (of things) making you feel anxious. This can be especially true if you breathe in a rhythm dictated by counting. Here’s one of our favorite examples: “Breathe in for a count of four seconds, hold for a count of four, then exhale for a count of six.”

Consider how counting alone might help your brain to let go of some of the anxiety–and now combine that with the benefits of the increased oxygen. It’s easy to see how deep breathing might help!

Get out of bed

Sometimes, anxiety about not sleeping keeps you awake. This may be particularly true if you are already exhausted and have a big day coming up. As you lie there worrying about worry and feeling anxious about whether you can get to sleep, stay asleep, or even wake up in time, this can trigger an anxiety attack of its own. 

Instead of getting caught in that trap, experts suggest getting out of bed. Johns Hopkins’ Luis F. Buenaver says that staying in bed when you are feeling anxious “will lead your brain and body to associate your bed with wakefulness instead of with sleep. It can be difficult leaving a warm, comfortable bed after waking up in the middle of the night. But think of this step as an investment in better sleep—if not tonight then tomorrow night and in the future.”

When you get up due to anxiety in the night, do something relaxing, like reading a book or meditating. Don’t worry about how many hours of sleep you are getting, or practicalities like paying the bills. The key here is to change what you are doing and help your thoughts stop racing.

Try the 3-3-3 Rule

If those racing thoughts and anxiety are still keeping you awake, try the 3-3-3 rule. This is a widely practiced technique for grounding and helping to relieve anxiety. It goes like this:

• Start by finding 3 things you see. 
• Then locate 3 things you hear. 
• Then pick 3 parts of your body and move them while appreciating the sensation of motion that this creates.

Too often, anxiety (and insomnia) are tied to things that are not in your control, and to things that aren’t necessarily in the room with you in the middle of the night. You may be worried about school, or work, or money, but none of those are things that you need to deal with when you are trying to fall asleep.

The 3-3-3 rule helps you to be present and mindful of what is actually there at that moment. Focusing on things you can actually see, hear, and feel can help your brain let go of the abstract thighs that it’s worried about.

Change your nighttime routine

For some people, the anxiety that keeps them awake is carried over from poor sleep hygiene. Many people scroll social media, watch TV, do homework, or play video games until bedtime, and then find themselves surprised that anxiety keeps them awake. But it’s no surprise at all. 

All of the things listed above stimulate our brains. And a stimulated brain is an active brain. This can cause anxiety that can keep you awake. 

Stimulants like coffee or nicotine can also cause your mind to stay “on” long after you’d like to put it to bed. So as we’ve suggested elsewhere on our blog, it’s a good idea to let your brain wind down. “Avoid screens and phones for at least 30 minutes before bed. Do relaxing activities like reading an enjoyable book, listening to relaxing music, or just taking some time to sit and chat with your partner, family members, or roommates.”

See a professional about your anxiety

If your anxiety keeps you awake often, you may be experiencing a generalized anxiety disorder. The key symptoms of a generalized anxiety disorder include:

• Excessive anxiety and worry about not just one, but many issues, individuals, or events
• Difficulty in controlling the feelings of worry, often without control in shifting from one topic to another

One of the most common symptoms that individuals experience are sleep problems. You may have difficulty falling or staying asleep. The worries and fears that you experience may keep you from getting a good night’s sleep.

While we can all benefit from relaxation techniques and healthy sleep habits, those with an anxiety disorder should see a mental health professional. Often, with therapy and, when necessary, medication, we can help you get your rest.

Want to speak 1:1 with an expert about your anxiety & depression?

Start with a free assessment

The post Help! My anxiety is keeping me awake appeared first on Brightside.

Social Anxiety Disorder & Tips for Coping With It

If you experience an intense, persistent fear of being observed and judged by others in social situations, you may be experiencing social anxiety disorder. And you aren’t alone: research suggests that about 12% of Americans suffer from social anxiety disorder at some point in their lifetime.

This is a complex mental health condition, but there are a number of things you can do to help yourself to get over social anxiety and feel more comfortable and confident in social interactions. Remember that only a mental health provider can accurately diagnose anxiety disorder. If you think what we’ve described sounds like you, take our free assessment today.

So let’s take a closer look at what social anxiety is and what you can do about it.

What is Social Anxiety Disorder?

Social anxiety disorder is a common and treatable mental health condition. As we explain on our website, “People with social anxiety disorder often expect the worst possible consequences from a negative experience during a social situation, and avoid doing things or speaking to people out of fear of embarrassment.”

The DSM-V-TR says that a diagnosis of Social anxiety disorder requires:

1. “Marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others.”
2. “The individual fears that he or she will act in a way or show anxiety symptoms that will be negatively evaluated (i.e., will be humiliating or embarrassing; will lead to rejection or offend others).”
3. “The social situations almost always provoke fear or anxiety.”
4. “The social situations are avoided or endured with intense fear or anxiety.”
5. “The fear or anxiety is out of proportion to the actual threat posed by the social situation and to the sociocultural context.”
6. “Cause “clinically significant distress”
7. “And be persistent (lasting 6 months or more).

Most simply, someone with social anxiety disorder will generally feel that they can’t get rid of social anxiety.

What are the symptoms of Social Anxiety Disorder?

Key symptoms of social anxiety disorder include:

• Fear of situations in which you may be judged by others
• Worrying about embarrassing or humiliating yourself, even in front of complete strangers
• Anxiety in anticipation of a feared activity or event

There are a number of physical symptoms which may include:

1. Blushing
2. Sweating
3. Upset stomach
4. Dizziness
5. Trembling
6. Having a shaky or soft spoken voice when in a social situation

People with social anxiety disorder often expect the worst possible consequences from a negative experience during a social situation, and avoid doing things or speaking to people out of fear of embarrassment.

Tips to overcome social anxiety

In many cases, a person can learn to overcome their anxiety. It may be challenging, and it may require specialized social anxiety disorder treatment with a mental health provider (we’ll discuss this more in a moment). Here are some things you can do right away if you experience social anxiety, or if you suspect you may have social anxiety disorder.

Challenging Your Thoughts

There are a number of useful thought challenges you can use to help you feel less anxious. One of these involves actively challenging your anxious thoughts. That fear of being judged can be really pervasive, so ask yourself: What are others doing to show they don’t approve of you? How do you really know what others are thinking? What is your evidence?

Breathing Techniques

To calm down in a hurry, try a breathing or relaxation technique. Inhale slowly and deeply through your nose, and exhale slowly through your mouth. Think of your chest like a big balloon and fill it as full as you possibly can. Then let the air out as slowly as you are able.

Positive Self-Talk

If you are feeling anxious in a social situation, take a moment to remind yourself how strong you are. Keep in mind that you have been in similar situations before, and come out just fine. Try commenting on something you about yourself when you look in the mirror, such as your hair or your sweater. Positive self-talk may feel awkward at first, but it can be very helpful in boosting your self-confidence and quitting those negative thoughts.

Grounding Techniques

Grounding techniques can be great for calming anxiety in social situations. One of our favorites is to find

• 5 things you can see
• 4 things you can hear
• 3 things you can touch and feel
• 2 things you can smell
• 1 (safe) thing you can taste

If you are feeling the signs and symptoms of social anxiety disorder, take a moment to understand the world that’s actually around you. It may not be so scary after all.

Support Network

Having a support system of friends or family members who understand and support you, and who know that you feel anxious in social interactions, can be a big help. Reflect on who you feel comfortable with. Who can you ask for support?

Treatment

Once a diagnosis has been established, social anxiety disorder can generally be treated with therapy, medication, or both. Talk with your provider about the best treatment option for you. We tend to avoid the things that make us anxious, and this makes anxiety worse in the long run. In treatment, you learn to safely and effectively engage in the very things that make you anxious. This approach is highly effective and backed by science.

With social anxiety, it means creating a hierarchy of anxiety-provoking social situations that you gradually experience while practicing coping skills to manage anxiety from becoming overwhelming.

Situational Exposure

Exposure therapy is a therapy technique that helps people confront their fears. It can take many forms, including situational exposure — confronting anxiety by volunteering to speak at a company meeting, for instance. Exposure therapy is used to treat a range of mental health problems and can be done under the guidance of a trained mental health professional. People can also practice being assertive by asking for special toppings at a restaurant or a special cut at the grocery store or help in a library. It’s just about getting in lots of reps of social interaction so you can practice various responses to how conversations naturally flow.

The Bottom Line

The most important thing about social anxiety disorder is that it doesn’t have to stop you from reaching your full potential. With treatment, you can overcome your symptoms. Brightside Health is here to help you to reclaim your life.

Want to speak 1:1 with an expert about your anxiety & depression?

Start with a free assessment

The post All About Social Anxiety Disorder appeared first on Brightside.

Whether you experience anxiety or have been diagnosed with an anxiety disorder, you may be wondering: Is it possible to have multiple anxiety disorders?

Yes, it is possible. We’ll explore multiple anxiety disorders later in this post, but first, let’s talk about what anxiety is and isn’t. 

What is anxiety?

Anxiety is a feeling of fear, dread, or uneasiness. It might cause you to sweat, feel restless, or experience a rapid heartbeat. It’s important to know that anxiety is a natural reaction to stress—if it is temporary.

As the National Alliance on Mental Illness (NAMI) states:

We all experience anxiety. For example, speaking in front of a group can make us anxious, but that anxiety also motivates us to prepare and practice. Driving in heavy traffic is another common source of anxiety, but it helps keep us alert and cautious to avoid accidents. However, when feelings of intense fear and distress become overwhelming and prevent us from doing everyday activities, an anxiety disorder may be the cause.

If your anxiety doesn’t go away, or gets worse, then you may be experiencing an anxiety disorder. According to Cleveland Clinic, an anxiety disorder happens when:

• Anxiety interferes with your ability to function.
• You often overreact when something triggers your emotions.
• You feel you can’t control your responses to situations.

Other symptoms of anxiety disorders include those mentioned in our blog:

• Excessive worry 
• Unable to control panic
• Restlessness
• Easily fatigued
• Difficulty concentrating or overthinking
• Irritability
• Muscle tension
• Sleep difficulties

If you are experiencing these symptoms, it is possible you might have an anxiety disorder. Consider reaching out to a mental health professional so you can get the support you need and the care you deserve. 

Types of anxiety disorders

There are 6 types of anxiety disorders, all with their own distinct symptoms. 

Generalized anxiety disorder

Generalized anxiety disorder involves symptoms that include chronic worrying that makes it hard to focus or complete everyday tasks. This can be exhausting and lead to physical symptoms like stomachaches or headaches. 

Panic disorder

With panic disorder, a person may experience panic attacks without warning and sudden feelings of terror. They might feel dizzy or short of breath. Women are twice as likely to be affected as men. 

Social anxiety disorder

Social anxiety is more than being shy. Individuals with social anxiety disorder may have serious fears about social interaction because they worry about being humiliated. They may also have panic attacks with forced interactions. 

Phobias such as agoraphobia or specific phobias

While we all might avoid situations or things that make us uncomfortable, people with phobia(s) often work especially hard to avoid their sources of fear. Whether it’s open or crowded spaces (agoraphobia), spiders (arachnophobia), heights (acrophobia), enclosed spaces (claustrophobia), or another phobia, individuals with phobia may have a strong reaction of fear when they’re in a situation, or even when they anticipate being in the situation, that involves their trigger.

Separation anxiety disorder

Separation anxiety disorder can affect children, and occasionally teenagers and adults. It involves excessive worry and distress about being away from loved ones or away from home. There may be physical symptoms like headaches or stomachaches. Mayo Clinic says, “Separation anxiety disorder may be associated with panic disorder and panic attacks—repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes.” 

Selective mutism

Selective mutism typically begins in children under five and involves an inability to talk or communicate in certain situations. With selective mutism, a person may be able to speak easily at home and not be able to at school. 

Multiple anxiety disorders: diagnosis and treatment

As you may have noticed above, there are some overlapping symptoms between these anxiety disorders—such as physical aches and panic attacks. Besides these overlapping symptoms, it is possible for a person to have distinct symptoms of multiple co-occurring anxiety disorders. 

If you think you might have an anxiety disorder, know that you’re not alone. There is support available that can help you get back to feeling like you again. A mental health practitioner can provide you with a comprehensive diagnosis based on your symptoms, concerns, and history. They will consider whether you may be experiencing one or multiple mental health conditions and help you with a personalized treatment plan.

Though it’s not an anxiety disorder, it’s quite common for people with anxiety to also experience depression—nearly 50% of those diagnosed with depression are also diagnosed with anxiety. One research study found that “Patients with multiple anxiety disorders had a much higher rate of depression than did those with only one anxiety disorder: 88 percent compared with 56 percent, respectively.” 

Fortunately, the treatment approach remains the same regardless of the number of conditions as therapy, medication, or both in combination are the gold standard approach for these concerns.

Treatment for multiple anxiety disorders

Whether you are experiencing one anxiety disorder or multiple co-occurring disorders, treatments generally work on the same principles to help you feel better. Within 12 weeks, 86% of Brightside members feel better and 71% achieve remission of their symptoms altogether. 

For psychiatric services, your psychiatric provider will recommend the right medication for you using our PrecisionRx technology. By analyzing data points, we can determine the most effective treatment tailored to your needs. Your medication can be delivered to you monthly, or picked up at a local pharmacy.

For therapy, your therapist will work with you 1:1. We offer evidence-based therapy with virtual therapy sessions, interactive lessons with practice and reflection, and tools to help you track your progress. If you have an anxiety disorder or multiple anxiety disorders, your treatment may include:

• Coping skills: Your therapist can help you learn and practice coping skills to relieve your symptoms. These may include breathing, reframing, and mindfulness techniques.
• Exposure with response prevention: This can help you approach rather than avoid sources of anxiety, with skills in your toolkit that help you cope and build distress tolerance. Over time, avoiding sources of anxiety can often make symptoms worse, so using coping skills while you engage in the stressful situation until the anxiety dissipates will help you to learn to manage the anxiety connected to the situation. 

If you’d like to talk with a mental health professional to get support for anxiety or another concern, get started with a free assessment today. Appointments are available in as little as 24 hours.

The post Can a person have multiple anxiety disorders? appeared first on Brightside.

Social media isn’t inherently bad—there are many benefits of social media, from staying connected to advocating for important social causes to maintaining relationships with important people in your life. However, ignoring the potential negative impacts of social media prevents us from finding ways to cope with social media stress.

Let’s take a look at how social media impacts mental health.

Before we begin, we want to remind you that if you are experiencing anxiety or stress, talking with a mental health practitioner can be a huge help. Brightside Health is available to you.

Start with a free assessment

Social media and mental health

Spending time scrolling Facebook, Instagram, and other social media platforms is a popular way to pass time. These platforms can be good ways to stay in touch with others and to stay up to date on the latest news.

Harvard’s McLean Hospital says, “Social media has a reinforcing nature. Using it activates the brain’s reward center by releasing dopamine, a “feel-good chemical” linked to pleasurable activities such as sex, food, and social interaction. The platforms are designed to be addictive and are associated with anxiety, depression, and even physical ailments.”

Many studies have shown that social media contributes to stress and anxiety among users. A series of recent papers have shown that social media is connected to depression and anxiety, particularly in young people, but it’s vital to know that nobody is immune to having these reactions.

Some of the aspects that can contribute to social media stress are:

• FOMO (Fear of Missing Out)
• False or unfair comparisons
• An inundation of filtered news (“doomscrolling”)
• Abuse from others 

Concerns about social media: comparisons

Many people feel compelled to compare themselves to others in their social media feeds.

What we often forget, is that social media can only give us a glimpse into the lives of those around us, and will only reflect the news and attitudes that we have selected to receive. This can cause problems in terms of perception and comparisons. 

Many who spend a lot of time on social media apps overlook the fact that most of what they see there is surface-level information. Think of this like looking at a duck swimming on a lake. Above the water, that duck is calm and serene, but under the water, its feet are paddling frantically. If you forget that those feet are also part of the duck, you may believe that a duck is only calm and serene.

Social media is the same way. The content that gets posted on social media is deliberately selected and then edited and altered to portray a purposeful image of who we are to the world. This might not reflect the nuance of real life at all. It can be so tempting to compare our own lives to what we see on social media sites, but that comparison is entirely unfair. 

Social media will always be an unfair comparison because we can only see others’ serene and peaceful floating on top of the water, while we can only know our own feet furiously and frantically paddling under the surface. We never get unfiltered feedback about how we are perceived by others. We need to remember that we are comparing the entire continuum of our own experience to other people’s hand-selected highlight reel. 

This comparison can also lead to a fear of missing out (FOMO). We might feel jealous, lonely, or left out if we aren’t living the exciting lives we see on social media. We don’t see the costs of those exciting lives; we don’t see the fear and the loneliness that others may be feeling or what they might be going through. It is always an unfair comparison between our inner experiences and others’ outer experiences.

These comparisons and FOMO reactions can cause users to feel depressed that their lives don’t stack up. The impacts of social media on areas of concern like body image, relationships, and communication have been well documented.

In this way, social media may exacerbate your experience of anxiety and depression disorders. 

Concerns about social media: abuse

We often say things online we wouldn’t say in person. Many people who spend time on social media overshare personal information, leaving them vulnerable. This is particularly problematic because social media is remote and somewhat anonymous.

Distance can lead to a disinhibiting effect that can lead to bullying and other problems. People may say something very cruel or hurtful without worrying about the consequences—they may use the anonymity of social media to be abusive. 

These abuses might range from microaggressions to full-fledged cyberbullying. A Pew Research study found that “59% of U.S. teens have been bullied or harassed online, and a similar share says it’s a major problem for people their age.” It should come as no surprise that abuse on social media can cause stress and anxiety.

Potential benefits of social media 

Again, we want to stress that social media can be a very good thing in the lives of many people. Just a handful of the potential advantages include: 

• Establishing and maintaining relationships
• Raising awareness about social issues or areas of personal interest
• Raising funds for important causes  
• Providing a larger pool for social support and social connection 
• Democratization of information sharing

A research study from Harvard expands on this:

We know that having a strong social network is associated with positive mental health and well-being. Routine social media use may compensate for diminishing face-to-face social interactions in people’s busy lives. Social media may provide individuals with a platform that overcomes barriers of distance and time, allowing them to connect and reconnect with others and thereby expand and strengthen their in-person networks and interactions. Indeed, there is some empirical evidence supporting this.

Tips for healthy social media use

Instead of cutting social media from your life, it’s most important to understand how social media may help alleviate or contribute to symptoms of depression and anxiety.

Here are some tips for using social media that can help you avoid social media stress:

• Pay attention to how social media makes you feel. Try to be mindful of when it’s helping you connect with others versus when it’s causing you distress. 
• Track your screen time. Take breaks and hold yourself accountable to change if you notice your screen time gets out of hand. (You can also ask a friend or someone you live with to help out here.)
• Turn off notifications. When your phone lights up with a notification, it’s hard to avoid picking it up. Turning off notifications that aren’t important can help you cut down social media time. 
• When you feel the need to check social media, consider trying a mindfulness app instead. This might not feel easy at first, but if you pause and think about why you’re about to open social media (Are you avoiding a difficult emotion? Are you simply bored?), you might choose a mindfulness app to fulfill that need instead. 
• Talk to a mental health professional. Licensed therapists can help you with goals and give you tips for coping with difficult emotions. If you’re feeling down, anxious, or stressed, know that support is available. We all need help sometimes. 

If you are experiencing stress and anxiety, get started with Brightside. 

Start with a free assessment

The post Can social media cause anxiety and stress? appeared first on Brightside.

Trauma falls into the latter category and can impact families across generations. This type of impact is known as generational trauma (you may also hear intergenerational trauma or transgenerational trauma). 

What exactly is generational trauma?

Generational trauma is trauma, or the effects of trauma, that are passed on and experienced by more than one person. It can be nuanced, complex, and indirectly addressed. People experiencing generational trauma describe picking up on these implied lessons as they observe their family members struggling to overcome systemic barriers in their lives.

Dr. Steven Lucero, associate director of therapy at Brightside Health, emphasizes this. “It’s important to know that generational trauma is a systemic issue, not an individual one,” he says. “Generational trauma isn’t an explicit lesson taught by a parent to a child. It’s interwoven more subtly into how families interact with one another and with the outside world.” 

For example, a parent that was in a car accident that led to the loss of their sibling may act emotionally distant as they observed negative reactions from their family whenever they brought up the pain associated with that loss. If they never healed or dealt with the trauma, their children may deal with their emotions in a similar way as the family reinforces avoidance of such an emotionally fraught topic. When a traumatic experience does occur again in the future, they may try to cope with denying or minimizing the situation.

Researchers have been studying the effects of generational trauma and how to treat it for decades. Here are some examples of intergenerational trauma: 

• In one 1988 study, published in The Canadian Journal of Psychiatry, grandchildren of Holocaust survivors were found to be 300% overrepresented in psychiatric care referrals. 
• Research in Neuropsychopharmacology found that the effects of parental stress can be directly transmitted to offspring during pregnancy or during early postnatal care of newborns.
• A study published in the Canadian Journal of Occupational Therapy in 2020 found that the occupational lives of second-generation Ilankai Tamil and Vietnamese refugees were heavily influenced by generational trauma: Sociohistorical, cultural, and familial contexts influenced the way second-generation refugees view what they can and should do.

Who is susceptible to generational trauma?

All of us are susceptible to generational trauma but there are certain groups that are more at risk. This includes families who have experienced:

• Systematic exploitation 
• Racism 
• Oppression
• Poverty
• Abuse
• Violence

Marginalized groups such as BIPOC and those with lower socioeconomic status may experience more prominent generational trauma, because of the consistent and ongoing problems their families have had to face over time.

In some cases, generational trauma is due to a collective historical trauma—such as refugees and Holocaust survivors—and other times, it is not—such as a family dealing with domestic violence or abuse.

Understanding the symptoms of generational trauma

Many times, people experiencing generational trauma may not explicitly be aware it’s happening or even talk about it. That’s why it’s important to know the symptoms and how generational trauma presents. 

Remember, generational trauma is a systemic issue. This means that the person who experienced the trauma coped with their emotions in a specific way and developed a trauma response that helped them manage their lives while they were going through that trauma. They may not have had the help they needed to cope in a healthy way with oppression, violence, or abuse, because the coping strategies that help us survive a situation are often not the same skills that will help us cope over the long-term.

As a result, behavior, adaptive to the initial trauma, is passed down across generations. Sometimes, this is referred to as survival mode. The American Psychological Association explains this further:

Trauma psychologist Elena Cherepanov, PhD, of Cambridge College in Boston, has been examining how survivors’ initial reactions to an event may affect future generations—a topic outlined in her upcoming book, tentatively titled “Understanding the Transgenerational Legacy of Totalitarian Regimes: Paradoxes of Survivorship.” Living under such difficult, oppressive circumstances, she surmises, can lead parents to formulate fear-based “survival messages” that they pass on to their children and grandchildren—ideas like “Don’t ask for help—it’s dangerous.” While the messages may have initially helped people stay alive, in the present they are often irrelevant and may even increase people’s interpersonal vulnerability. Fear of personal disclosure and not trusting mental health care providers, for example, “is exactly why it is so hard for trauma survivors to seek and accept support,” says Cherepanov, who is comparing these messages in Russian and American samples.

So, what are some of the signs of generational trauma? They can include:

• Anxiety 
• Depression 
• Insomnia 
• Panic attacks 
• Hypervigilance (excessive attention to the possibility of danger)
• Mood dysregulation (trouble managing emotional responses)

Healthline also mentions these symptoms:

• A sense of a shortened future
• A sensitive fight-or-flight response
• Issues with self-esteem and self-confidence 

You may be experiencing signs of generational trauma that aren’t listed here, such as behavior patterns or reactions that do not fit the demands of the situation that prompted them. Talking about them with a therapist can help you process them and start treatment.

Treatment for generational trauma: Take care of yourself

Whether you’re experiencing personal trauma or intergenerational trauma, there are treatments available that can help you heal. You don’t have to go through it alone.

At Brightside Health, we offer evidence-based therapy and precision psychiatry virtually—from the comfort of home. 

Get started with a free assessment 

While generational trauma isn’t formally encoded in The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, it is widely known among mental health professionals that trauma influences our daily lives. There are many strategies and coping skills that can help you process and heal. 

Given the subtlety of intergenerational trauma, treatment can often be more nuanced or longer-lasting than with other presenting concerns. Stay on track with your treatment plan with Brightside’s tools, check-ins, and reminders.

The post What is generational trauma and how long can it last? appeared first on Brightside.

Technically, “relationship anxiety” is not a recognized mental health condition listed within the DSM-5. It may, however, be a sign of another anxiety disorder, such as generalized anxiety disorder, social anxiety, or another condition (we’ll come back to this later).

It’s still okay to use the phrase “relationship anxiety” though, as what you are feeling is very real and worth examining. And if it’s causing you distress, which we’ll examine below, it’s something worth talking to a mental health professional about.

What is relationship anxiety?

Relationship anxiety (RA) is a feeling of spiraling worry, which leads an individual to seek constant comfort and reassurance from their partner. At first, this can feel reinforcing and validating, but it can quickly become problematic as it begins to dominate all interactions in the relationship. 

Eventually, any expression of vulnerability will become a topic fraught with trust issues, which causes both partners to question the amount of mutual trust in the relationship. This causes the reassurance-seeking behavior to feel like a lack of trust to a partner, which leads to more reassurance-seeking and therefore confirmation that the partner lacks trust. It’s a vicious cycle.

Signs and symptoms of relationship anxiety

If you’re concerned you may have a tendency towards relationship anxiety, look for the following signs:

• Fear of intimacy
• Clinging behavior
• Reassurance-seeking
• Frequent worry about the relationship
• Mistrust
• Anger
• Detachment

It’s not uncommon for relationship anxiety to cause one partner to project their worries onto the other partner’s behaviors. 

Some amount of relationship anxiety is normal, even in a healthy relationship. But if the anxiety is disrupting your relationship, it may be time for couples therapy or other assistance.

Get started with a free assessment.

Causes of relationship anxiety

Dealing with relationship anxiety often entails seeking and addressing the underlying cause. The anxiety may be influenced by any number of life circumstances, including:

• Previous relationship experiences
• Attachment issues
• Poor communication
• Money problems
• Frequent arguments
• Incompatibility

Sometimes therapy for relationship anxiety uncovers low self-esteem, confidence problems, past trauma, or family problems—all of which can cause someone to experience heightened anxiety. Other times it’s simply negative thoughts that create feelings of jealousy or anger.

Tips for overcoming relationship anxiety

It can be helpful to establish boundaries to clarify what level of reassurance-seeking is okay. For example, you and your partner should talk about how you both feel about knowing a partner’s plans when they go out with friends, and how many and what types of questions are ok to ask afterward. You should also discuss at what point the questioning begins to feel invasive or critical.

Keep in mind that there’s no “right” amount of question-asking and reassurance-seeking in a relationship. It’s vital that the couple finds the balance that works most effectively for them.

Getting over relationship anxiety also requires the partner that seeks out excessive amounts of reassurance to develop distress tolerance skills. This way, they can be aware of triggering thoughts, emotions, or situations that lead to them seeking out reassurance in the first place. 

Then, they’ll need to identify methods that allow them to fulfill that need in more effective ways that don’t drive their partner away. This sometimes means they’ll have to experience periods of discomfort, as they adjust to not knowing as many details about what their significant other is doing.

There are times, however, when relationship anxiety is a sign of another form of anxiety. In this case, professional help is strongly recommended.

Get started with a free assessment.

Other forms of anxiety

Some amount of anxiety is normal and actually helpful. If we didn’t feel any anxiety, after all, we wouldn’t feel motivated to perform at our best. 

The anxiety performance curve indicates that there’s an optimum amount of anxiety to experience. With too little anxiety, we don’t adequately prepare and invest in the things that really matter to us. While too much can impair our functioning, so we don’t do as well as we would have otherwise.

Most types of anxiety share some similar characteristics:

• Thoughts: ruminating worry about how things could go wrong
• Feelings: specifically of being overwhelmed and fearful
• Physical sensations: increase in heart rate, knotting in your stomach, or the urge to simply “run” from the current situation

With that in mind, you should be on the lookout for signs of an anxiety disorder, because if these signs appear, it’s best to see a mental health professional as soon as you are able. Signs of an anxiety disorder include:

• Excessive worry for more days than not, for 6 months or more
• Inability to control the worry
• Restlessness
• Easily fatigued
• Difficulty concentrating
• Overthinking
• Irritability
• Muscle tension
• Sleep difficulties
• Clinically-significant impairment across multiple areas of life

Anxiety disorders can not be due to another disorder, medical condition, or substance abuse—as those are separate issues with resulting side effects. 

You’ll need to talk to a mental health professional to get a diagnosis, but there are many types of anxiety disorders, including:

• Generalized anxiety disorder
• Social anxiety disorder
• Separation anxiety disorder
• Selective mutism
• Specific phobia
• Panic disorder
• Agoraphobia (can apply to any of these)

Can anxiety disorders be treated?

Of course. The great news about anxiety disorders, including relationship anxiety, is that they can often be successfully treated. So if you are feeling anxious, and especially if you are experiencing any of the symptoms that fall on the lists above, reach out to talk to someone. 

Start with a Free Assessment

The post Relationship anxiety: what it is & how to overcome it appeared first on Brightside.

It’s perfectly normal to feel anxious sometimes. In fact, some feelings of anxiety can actually be healthy. 

Feeling nervous and anxious before a job interview, or experiencing some anxious fear before a competitive race can help you better prepare for those events. Often the feeling of anxiety that people experience before public speaking is adrenaline fueling the systems that need support.

As Psychology Today’s Loren Soelro, Ph.D., puts it, “situational anxiety if it’s proportionate to the circumstances in which it arises, can have quite a positive impact.”

Where problems arise is when anxious moments, or even anxious days, turn into weeks or months. If anxiety becomes so severe that it disrupts daily life, feels uncontrollable, or overwhelming, you may be experiencing an anxiety disorder. 

How do I know if I have an anxiety disorder?

As we said above, not all anxiety is a sign of an anxiety disorder. Anxiety disorders are complex mental health conditions. 

Here are the main symptoms of anxiety:

• Excessive worry 
• Unable to control panic
• Restlessness
• Easily fatigued
• Difficulty concentrating or overthinking
• Irritability
• Muscle tension
• Sleep difficulties

To be diagnosed with an anxiety disorder, the anxiety has to cause you significant impairment across multiple areas of life and the negative consequences of the anxiety are not due to another disorder, medical condition, or substance abuse.

What does anxiety feel like?

While the experience of anxiety varies from person to person, the most common signs are:

• Thoughts: Ruminating worry (sometimes irrational) about how things could and will likely go wrong
• Feelings: Near-constant state of being overwhelmed and fearful
• Physical sensations: Quickly beating heart, knotting in your stomach, or an urge to get out of the current situation

Different people experience anxiety in different ways. 

Some feel crushing panic attacks that last for a period of time, while others may experience a nearly constant feeling of intense fear or all-consuming dread. Some may feel anxious in social situations, and others may find that being in a social environment actually reduces their anxiety and makes them feel safer.

Types of anxiety disorders

There are several types of anxiety disorders, and each has distinct symptoms. 

According to the National Institute of Mental Health, these specific anxiety disorders include:

1. Generalized anxiety disorder
2. Panic disorder
3. Social anxiety disorder
4. Phobias such as agoraphobia or specific phobias
5. Separation anxiety disorder
6. Selective mutism

And, although they are now considered separate from anxiety disorders, obsessive-compulsive Disorder (OCD) and post-traumatic stress disorder (PTSD) also often have a major anxiety component and can require medical treatment or therapy.

Can anxiety be cured?

Remember, some anxiety is normal to experience. If we didn’t feel any anxiety, we would not be able to perform our best. 

The anxiety performance curve indicates that there is an optimum amount of anxiety to experience. With too little anxiety, we don’t adequately prepare and invest in the things that really matter to us. Too much anxiety impairs our functioning so we don’t do as well as we would have otherwise.

But if your anxiety begins to interfere with your ability to do the things you enjoy doing, then it’s no longer healthy. Though “cure” is not the right word, you should seek treatment for anxiety as you can learn to reduce how much your anxiety symptoms negatively impact your life and learn about key coping mechanisms to help you through life.

It’s a good idea to speak to a professional counselor when your anxiety:

• Begins to cause significant impairment across a variety of life domains
• Negatively impacts your job performance, sleeping, eating, or daily routines
• Prevents you from meeting new people or attempting to do the things that you might like doing
• Keeps you at home because you worry about what might happen in interactions with others

If you are experiencing any of these things, know that you are not alone. Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults age 18 and older (or 19.1% of the population.)

Does treatment for anxiety work?

Research literature is abundantly clear that anxiety is one of the most treatable mental health disorders when the individual follows through on treatment suggestions. Generally, treatment for anxiety consists of therapy, medication, or both.

The best available evidence indicates that combining therapy with medication is the best way to treat anxiety, with or without other mental health conditions. 

• Therapy can “give you the structure and support to help get through difficult issues, including space to reflect, process challenges, and build skills.” 
• Medication can help make the most acutely problematic parts of anxiety feel more manageable.

Another thing to note is that it’s often the case that anxiety symptoms overlap with symptoms from other conditions. In fact, it is estimated that 60% of people with anxiety also suffer from depression, and vice versa. 

Because of this, mental health providers will often treat clusters of symptoms. According to Brightside Chief Medical Officer Dr. Mimi Winsberg: 

Distinguishing depression from anxiety can be difficult, and it is not uncommon for them to coexist in the same individual at the same time. There is some overlay in symptoms between the two diagnostic entities, and prolonged anxiety or stress can lead to a sense of helplessness and then despair. Additionally, depression can present with anxious features. In these cases, it is important for the provider to try to understand which came first (the chicken or the egg so to speak).

If you think you may have an anxiety disorder, help may be closer than you think. 

At Brightside, we treat anxiety-related disorders like: 

1. Generalized anxiety disorder
2. Obsessive-compulsive disorder (OCD)
3. Panic disorder
4. Post-traumatic stress disorder (PTSD) 
5. Social anxiety disorder
6. Phobia such as agoraphobia

We are able to offer medication, therapy, or both from expert providers, and, what’s more? Your treatment can be provided in the comfort of your own home. 

Start with a judgment-free, cost-free assessment

The post How to know if you have an anxiety disorder appeared first on Brightside.

This Mental Health Awareness Month, we’ve been thinking a lot about mental health in youth. In the United States, the state of mental health in children and young adults has reached a level that some researchers believe to be a crisis. 

Harvard’s Claire McCarthy, MD writes:

In the fall of 2021, the American Academy of Pediatrics, along with the American Academy of Child and Adolescent Psychiatry and the Children’s Hospital Association, declared a national emergency in child and adolescent mental health. 

They called for increased funding for mental health resources, as well as other actions, including more integration of mental health care into schools and primary care, more community-based systems to connect people to mental health programs, strategies to increase the number of mental health providers, and ensuring that there is insurance coverage of mental health care.

Because mental health among youth is such an urgent topic, we would like to look at why mental health awareness is so important for young people. 

What does mental health awareness mean?

Before we go too much further, let’s define “mental health awareness.” To us, mental health awareness involves fostering an understanding of:

• What it means to have good mental health
• The stigmas that exist about mental illness
• How many people experience mental health challenges
• The potential dangers of not treating mental health conditions
• The barriers to treatment that many individuals face

Every May, we join other mental healthcare organizations and providers to renew our commitment to promote awareness. And, as we have explained in our blog, to advocate for those who need us and to provide support to all who live with mental health conditions.

Why is mental health awareness in youth so important? 

Simply put, there is not enough attention being paid to mental health in children and adolescents. According to the National Alliance on Mental Illness in 2020:

• Statistically, only “50.6% of U.S. youth aged 6-17 with a mental health disorder received treatment.”
• Among adolescents (12–17 years), “1 in 6 experienced a major depressive episode (MDE).”
• “3 million had serious thoughts of suicide.”

Statistically speaking, as a society, we are not talking enough about mental health in youth; we are not listening enough when there’s a problem, and we are not helping enough youth get the treatment they need. 

One of the best ways that we can begin to address these deficiencies is to promote awareness. Here are a few ways you can do this today.

Talk to youth about mental illness

If you were ever a child, you may recall that often the most frightening thing was the unknown. It can be terrifying when you feel bad but don’t understand why. Mental illness, and mental health in general, needs to be discussed in order to make it less scary for those who experience it.

The National Institute of Mental Health says that “An estimated 31.9% of adolescents had an anxiety disorder.” That’s roughly a third of the population. If these children simply understood that others experience anxiety as well, they may understand that they are not the only ones experiencing anxiety. If the other two-thirds of children also knew that their friends sometimes experience anxiety, then they are better suited to offer help.

Help them identify the signs of a problem

Talking more about mental health will also teach children, teens, and young adults the warning signs that often occur when someone may be on the verge of experiencing a crisis. Learning about these warning signs gives youth the chance to recognize these signs and take action if a friend exhibits them or if they themselves start to display them.

Of course, reviewing warning signs and symptoms will also help parents, teachers, and others. 

There is ample evidence that suicide prevention often starts with someone paying attention.  Claire McCarthy, MD says, “So pay attention, and take what you see seriously. If your child is showing signs of anxiety or depression, call your doctor. Don’t put it off.”

Help young people understand and overcome stigmas about mental health

It is common for youth (and adults) to be embarrassed by mental health challenges. Much of this embarrassment is caused by the stigma that mental health is somehow less important than physical health. Findings published in the academic journal BMC Psychiatry show that:

• “Young people, including adolescents and young adults aged 10–24 years, are at a critical period in the prevention and treatment of mental health disorders.”
• “Public stigma universally prevents people who experience mental health problems (i.e. symptoms that are not sufficient to warrant a diagnosis of a mental disorder) and those with mental disorders from seeking counseling and treatment.”
• “Educational interventions to reduce the stigma associated with mental health may improve help-seeking behaviors by avoiding the use of psychiatric labels that are not commonly understood…”

In other words, reducing stigma and normalizing mental health challenges increases the willingness to seek treatment in the future.

Help young people get the treatment they need

Perhaps the best way to promote youth mental health awareness is to help kids in need access mental health services. Children’s mental health, according to Youth.Gov, can change over time.

With the developmental changes and challenges that youth face normally, especially in adolescence, many experience transitional phases of mood and behavioral changes. Youth and their families can successfully navigate the challenges that come from experiencing a mental health disorder. Those with more persistent mental health challenges usually do very well with treatment, peer and professional support and services, and a family and social support network.

You can help Brightside Health promote awareness of youth mental health this month and every month. If you are experiencing mental health concerns, we want to help. Brightside Health treats people ages 18 and over and you get started with a free assessment. You can also:

• Text HOME to 741-741 to connect with a Crisis Text Line counselor.
• Call The 988 Suicide & Crisis Lifeline at 1.800.273.8255.
• Visit the National Alliance on Mental Illness website for additional resources. 

You can use the lifeline services mentioned above for yourself, or talk to someone for advice if you are concerned for a loved one. You are not alone.

The post Why is mental health awareness in youth so important? appeared first on Brightside.

If your doctor has already diagnosed your chest pain as being anxiety-related, the good news is that there are some things you can do, even while the chest pain is happening, to remedy the anxiety and relieve your chest pain.

Before we look at some home remedies for anxiety, let’s take a look at anxiety-caused chest pain so you can better understand it, and see how to recognize its symptoms. 

What are the symptoms of anxiety-related chest pain?

Chest pain is a sign that should be taken seriously and evaluated. When in doubt, seeking medical attention is always recommended. However, in many cases, anxiety-related chest pain can be treated at home.

Part of what makes it complicated, and sometimes hard to identify as being caused by anxiety, is that, anxiety-related chest pain can be a bit different for everyone who experiences it. As we explain in our blog, “It can sometimes be difficult to know whether your symptoms are being caused by your anxiety, or if they are being caused by another medical problem altogether.” 

Healthline goes on to list the ways that anxiety-caused chest pain is described by those who experience it. These descriptions include:

• Sharp, shooting pain
• Persistent chest aching
• An unusual muscle twitch or spasm in your chest
• Burning, numbness, or a dull ache
• Stabbing pressure
• Chest tension or tightness

And, to reiterate what we said above, a particular challenge of anxiety-related chest pain is that it has the ability to induce more anxiety. Chest pain can be alarming and worrying since it feels like something terrible may be happening — and this isn’t likely to reduce whatever anxiety you may be feeling. But it can also help to know that:

• “An estimated 25 to 50 percent of patients who come to the emergency department with low-risk chest pain (chest pain not related to a heart attack) experience moderate to severe anxiety,” according to Healthline.
• “Chest pain is present in between about 20% to 70% of panic attacks,” according to News-Medical.Net.

This means that anxiety-related chest pain is pretty common. It also means that there are likely home remedies for anxiety that will help your chest pain.

Home remedies for anxiety-related chest pain

One of the best home remedies for chest pain is to control the anxiety that’s causing it. So let’s step back from chest pain and talk more generally about home remedies for anxiety attacks. 

Practice deep breathing

One of the first things you may try when experiencing anxiety is to slow and deepen your breathing. An anxiety attack, also known as a panic attack, can cause you to breathe shallowly and more quickly than usual. As Medical News Today explains, “Rapid breathing can lead to low carbon dioxide levels in the blood, causing lightheadedness and tingling in the extremities.” This may cause you to feel chest pain. On our blog, we provide a few thoughts on calming anxiety. Here is an example of a deep breathing exercise that may help:

Whereas breathing from your chest results in shallow breaths that may increase anxiety, breathing with the focus on your belly may help you take deeper breaths. It can help to place one hand on your heart and the other hand on your belly during breathing exercises so that you can more easily notice whether your chest or your belly is rising and falling with each breath.

Mindfulness exercises 

After you are done slowing your breathing, or even while you are doing so, you may try any number of mindfulness exercises. If you are new to this idea, here are a couple of at-home techniques that may remedy your anxiety:

Take stock of the situation

It can often help to step back and observe what you are feeling. Sit with your emotions to see if you can figure out what may be causing you to feel anxious. Try not to judge your thoughts or feelings—accept them as they are.

Picture a place you love

Another widely accepted mindfulness technique that may help you remedy your anxiety at home is to try to picture a place that makes you happy while slowing and deepening your breath. This could be somewhere you’ve visited or somewhere you’d like to visit. Think about the details clearly: What color is the grass? Is there water? Is it warm or cool? What does it smell like? What sounds can you hear there? This can help calm you down.

Engage your five senses

A popular method for reducing anxiety is the 5-4-3-2-1 exercise. Look around you and focus on:

• 5 things you can see
• 4 things you feel 
• 3 things you hear
• 2 things you smell 
• 1 thing you taste 

This technique can help ground you in the present moment.

Be proactive about your physical health

While this may not help in the middle of an anxiety episode, being proactive about your physical health is a great home remedy for stress and anxiety. Take good care of your body. Drink lots of water. Maintain your personal hygiene. Get regular exercise and eat as healthy as you can. If you’re a caregiver, remember to take care of yourself too. 

See a mental health provider

If you need support for relieving chest pain caused by anxiety, try talking with a mental health provider. They are licensed professionals who will be able to recommend more ways to help you feel better. 

At Brightside, you can get a personalized treatment plan online and start feeling like yourself again with medication, therapy, or both.

Take our free assessment today.

The post How to relieve anxiety-caused chest pain appeared first on Brightside.

If you experience symptoms of anxiety, such as restlessness, near-constant worrying, or trouble controlling worry or panic, it’s a good idea to talk to a mental health provider. At Brightside Health, expert providers can put together a personalized treatment plan that includes therapy, medication, or both to help you get back to feeling like you again.

What causes anxiety? 

If you experience symptoms of anxiety or know someone who does, you may be wondering about the cause of anxiety. Anxiety disorders are caused by many factors, including brain chemistry, personality, life events, and genetics. 

While you may commonly hear the word anxiety, there are actually several types of anxiety disorders:

• Generalized anxiety disorder (GAD)
• Panic disorder
• Post-traumatic stress disorder (PTSD)
• Acute stress disorder
• Social anxiety
• Phobia
• Obsessive-compulsive disorder (OCD)

Anxiety symptoms can come in many forms and often, many overlap with depression. In fact, it’s estimated that 60% of people with anxiety also experience depression.

Depression symptoms & anxiety symptoms

What the research says: How anxiety works in the brain

Considering that brain chemistry is one of the factors that influence anxiety’s development, let’s take a look at research that studies both the brain and anxiety. 

• Research published in the National Library of Medicine states that anxiety develops because of “brain circuits that regulate the emotional response to potentially threatening stimuli.” Just like our ancestors perceived a threatening animal and chose to fight or flee, our brains sometimes create the same response in our bodies even when threats aren’t there.

The review continues, “The expression of anxiety involves a coordinated activity of numerous brain pathways involving different neurotransmitters, all of which interact.” Examples of these neurotransmitters, the brain’s chemical messengers, include serotonin and GABA. Serotonin helps stabilize mood while GABA is involved in decreasing your nervous system’s activity. 

• A Stanford University School of Medicine study found differences between the amygdala patterns in people with generalized anxiety disorder compared to those without the mental health condition. The amygdala is the brain’s center for emotions and motivation. They found that those with GAD had muddled lines of communication from their amygdala and less connection to the region of the brain responsible for determining the importance of things. They concluded, “This could mean that people with the disorder have a harder time discerning truly worrisome situations from mild annoyances.”
• One study involving fMRI brain scans of people who recently experienced a traumatic event found differences in brain activity related to mental health symptoms. Participants with brain activity categorized as reactive/disinhibited (high activity related to both a threat and reward) had more symptoms of both PTSD and anxiety over the six-month follow-up period compared to people with different brain activity.

While experts are still exploring exactly how the brain and anxiety are linked, the studies above emphasize the clear connection between the two. When talking about the cause of anxiety, it’s also important to discuss the other factors that influence anxiety, including personality, life events, and genetics.

Other anxiety factors

• Personality
  • Have you ever wondered how your personality affects your mental health? Studies have found that personality traits, such as NEM and behavioral inhibition, can affect our emotional responses and how we cope with stress. In particular, NEM, which relates to your likelihood to experience and express negative emotions, was correlated with emotional distress such as stress and anxiety.
  • Two additional studies further discuss the implications of personality and anxiety in terms of behavioral inhibition—a personality characteristic in which one shows stress or nervousness in new situations or avoids them altogether. One study published in the Journal of the American Academy of Child and Adolescent Psychiatry found:
  • Participants who continued to show behavioral inhibition in childhood were more likely to experience worry dysregulation in adolescence (age 15), which in turn predicted elevated anxiety during the early months of the COVID-19 pandemic when the participants were in young adulthood (around age 18).
  • The second study also found that behavioral inhibition, this time in infants, predicted personality and was linked to mental health conditions years later in adulthood.
• Life events
  • Events in your life, as well as your response to them, can impact your mental health. As noted in the brain and anxiety research mentioned above, trauma can impact one’s susceptibility to an anxiety disorder. Additionally, other stressful life events can too—one study measured adolescents’ responses to difficult events such as parents’ divorce, loss of a family member, hospitalization, and more.
  • They found that stressful events can lead to repetitive thinking (called rumination) as well as increased attention to your body and mind’s signs of anxiety (called anxiety sensitivity). As the study says, “Both rumination and anxiety sensitivity are established risk factors for the development of anxiety. As such, it is likely that similar environmental events (i.e., stressors) may trigger the development of each of these types of self-focused thought.”
• Genetics
  • Is anxiety hereditary? It can be. Generalized anxiety disorder is thought to be about 30% heritable and anxiety disorders as a whole have a 26% heredity lifetime rate. This means about a quarter of your risk for anxiety is genetic—however, your environment, personality, physical health, and life events are important factors too.

The bottom line: Treatment for anxiety 

There are many factors that can cause anxiety—and often, it’s the combination of a few of them that leads to an anxiety disorder.

The good news is that anxiety responds well to treatment, which can include therapy, medication, self-care, and lifestyle changes. If you have symptoms of anxiety, it’s important to talk to a mental health provider so you can get the care you deserve to live your life fully. 

At Brightside, therapists and psychiatric providers can diagnose you and recommend a personalized treatment plan so you can feel better sooner and stay that way longer. Within 12 weeks, 86% of Brightside members feel better and 71% achieve remission.

 Start with a free assessment

The post Anxiety and the brain: How do they relate? appeared first on Brightside.