My general treatment plan for…..anxiety
When you refer a patient for anxiety, chances are that they are experiencing symptoms severe enough to cause at least interference in their everyday life. Many patients will note that they are having trouble sleeping, changes in appetite, a feeling of excessive stress, and excessive worry. Some will report irritability, difficulty working, and perhaps avoidance of things they feel worsen their anxiety. Some will report panic attacks of varying degrees of severity; in fact, some of these patients may have consulted you to rule out heart symptoms or other serious illness before concluding that their symptoms better match an anxiety diagnosis.
At their first visit in my office, as I do with every new patient, we spend some time getting a detailed immediate history and inventory of their symptoms, and what medical options have been explored so far. I also get a fairly detailed history of their childhood and life to date, including any events experienced as strongly negative or positive. I ask about extended family members who may have experienced either anxiety or depression, as well as any family history of substance abuse, with the idea that it may represent self-medicating for mood disorders.
Next we explore what they have already tried to lessen their symptoms, whether self-help or other therapies, and how successful or not those attempts have been. This gives me a lot of insight into what their general coping style preferences are, and what types of tools might be most successful.
I conceptualize anxiety treatment as helping patients to build and fill a toolbox of resources, beginning with simple techniques and adding as necessary until they feel that they are now coping with life with a minimum of anxiety. These tools might include breathing exercises, progressive muscle relaxation, imagery work and simple self-hypnosis, cognitive behavioral techniques, improvements to lifestyle habits like sleep, diet and exercise, and others.
I almost always work with anxiety patients “from the outside in”. By this I mean that we start with simple techniques, and if those solve the problem then treatment concludes. If roadblocks arise that point to deeper issues, then we work deeper to heal those issues. The patient decides how far they want to go with their treatment. It’s not uncommon for a patient to do some surface-level work, terminate treatment, and then decide to return later because they are now ready to explore deeper root causes. Naturally, if a patient comes to my office already primed to work on deeper issues (past abuse, trauma, etc) then we begin there. Even so, we are always focused from the first session on building and strengthening tools, so that they experience symptom relief as quickly and deeply as possible.
It is generally my policy to communicate regularly with a patient’s physician, whether you directly referred them or not. If I am not doing so, it means that the patient has declined to provide a release. Some patients feel very private about their therapy sessions, and if they are not comfortable providing a release, I don’t push them unless there is a pressing need to do so.
So that’s what I wrote to doctors …
If you are suffering from anxiety, please do call me. There are lots of ways to help cope with anxiety that do not involve the long-term use of medication. Sometimes all we need to do is work on some skills (see the “toolbox” paragraph above). Often there’s something that is causing it, either right now or that’s been brought up from the past. It usually doesn’t take long to figure out what it is (contrary to what you may have seen on TV). Then the next step is to change what can be changed in the present, and / or work on changing your reactions to it. If it’s a traumatic event from the past, I have some great techniques to help you heal from those events. The amount of improvement can be dramatic.
I hope this information helps you. If you or someone you know is suffering from anxiety, please call. As always, if I’m not the right person for you, my commitment is always to help you find the right person, whether in my office or in the Simi / Moorpark area.