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Dr. Emily Ferrara, founder of Simplify Life Counseling + Coaching in Atlanta, discusses anxiety’s impact and the best treatment options.
What are anxiety’s primary causes and effects? How do you diagnose it?
The causes depend on the type because there’s a wide array, from general anxiety disorder to OCD and PTSD. Heredity accounts for about 30 percent of those experiencing the former, whereas with OCD it can be up to 50 percent. Regardless, science shows that when we live on edge for a long time, it’s harmful to our health, especially our brains.
I always use clinical criteria to initially assess a patient’s anxiety rating because the data drives the diagnosis—otherwise, it’s easy to misdiagnose. As an example, people will often think they have ADHD when it’s anxiety or report that they’re having a heart attack when it’s a panic attack.
Is our society more anxious than ever? If so, why?
Yes, but it’s nuanced. For one, we see a lot of young folks with social anxiety, which COVID amplified by necessitating being behind screens even more instead of being around others. But the bigger problem is not having the tools to manage it. That’s particularly challenging because it’s so easy today to get distracted rather than process your feelings.
In addition, people overly identify with anxiety; a lot of them will say “I am an anxious person” instead of “I have anxiety.” It becomes their name tag, a situation that’s only made worse if they self-diagnose through googling or using AI. As therapists, we work to emphasize instead that they are so much more than that. But I think that they get comfortable with such labels, which creates learned helplessness and can even lead to weaponizing mental health.
How can labels weaponize mental health?
Here’s one example. Many individuals, especially young ones, say “You triggered me” or “I was so triggered in class.” Trigger is a term that we use for extreme trauma, such as when a soldier comes home and goes into fight-or-flight mode because of fireworks. It’s not merely when you get frustrated.
What are the best ways to handle anxiety?
We normally only consider medication for more serious forms. Otherwise, we’ll work on helping individuals face it. For instance, if someone has a contamination phobia, we may have them touch doorknobs. With general anxiety, cognitive behavioral therapy, or CBT, is the most proven effective method. Through it, we try to change their thoughts, which changes their beliefs, which changes their actions.
Plus, CBT goes beyond our sessions: self-dependence is the goal, not to see a therapist forever. We’ll teach them strategies, such as logging their anxiety prompts, thoughts, and responses, that they can use in everyday life and, if need be, to lean on advocates like their parents or partner.
You believe that anxiety can be good. How so?
It’s not cancer—it’s something that naturally helps us by keeping us fully attuned, such as by making students feel nervous when taking a test, preventing them from getting distracted or being unable to recall as much.
People’s responses to anxiety are vital. If they can control it, they can use it to improve their performance. However, when it gets to be too much, they can freeze up and assume something bad is going to happen. Ultimately, that’s what the condition does: it causes us to overestimate negative outcomes and underestimate our ability to prevent or solve problems.
Overall, is there hope?
There’s more hope now than ever before. I was the three-year-old who was washing my hands obsessively and making family members wonder, “What is this?” In prior generations, people who had any kind of overt mental health problems were often put in institutions. Today, we’re able to explain anxiety and provide practical solutions for managing it.
