It takes courage to ask for help.

The Marin Stress & Anxiety Center is here to help you on your journey to health and wellness.

We treat the following conditions:

• Chronic Stress
• Generalized Anxiety
• Social Anxiety
• Phobias
• Panic Attack/Panic Disorder
• Agoraphobia
• Obsessive-Compulsive Disorder
• Post-Traumatic Stress Disorder
• Depression

It is helpful to understand the difference.

Stress is the impact of a particular event (or stressor) in which the sympathetic (fight, flight, or freeze) nervous system is stimulated for a duration of time. There are good kinds of stress called eustress, like moderately strenuous exercise or the rush of excitement we may feel before speaking in a group. Distress is the kind of stress most often associated with the term “stress”. States of distress include a varying range of strain on the psychological, emotional, or physical wellbeing. States of distress could include getting into a minor car accident, working too many hours, or the rush of disabling fear we may feel before a big speech.

Our stress response is a normal adaptive mechanism to help us survive. In our modern world, it can leave us with a host of physical and psychological health issues that creates its own new problems.

Anxiety, which also stimulates the sympathetic nervous system, is more associated with incessant worry and fear about an imagined negative outcome. Common anxiety producing thoughts may include the fear of not being liked or accepted, something “bad” happening, or the fear of death itself. Anxiety can be a product of a stressful event or can be free floating in nature, with no specific trigger other than our own thoughts. Anxiety can trigger stress responses such as increased heart rate, shallow breathing, chest tightness, and muscular tension. Understanding the stress response is the first step to understanding how anxiety works. You can be stressed but not anxious. But you can’t be anxious and not stressed.

Anxiety can remain somewhat low grade for a long duration in some or can have dramatic spikes (i.e. panic attacks) in response to high stress or trauma.

The symptoms can be similar for both stress and anxiety. Whereas stress often dissipates when the life stressor passes, a diagnosis for an anxiety disorder requires the symptoms to be present for a minimum of six months. Treatment can look similar although anxiety can be tougher and longer to treat as its causes are less identifiable. Those who suffer from stress and anxiety can both benefit greatly from an integrative psychotherapy rooted in both mind and body-oriented interventions.

Chronic stress is when your stress response lasts longer than the specific stress triggers causing a long-lasting negative impact on your wellbeing. Chronic stress creates sleep, eating, and mood disturbances. It can cause or exacerbate heart, respiratory, and digestive conditions.

Chronic Stress is an epidemic in our modern-day life and leaves us susceptible to mental illness and substance abuse. Tools to manage stress have now become an integral part of living a balanced life of work, relationships, and family.

Many people who suffer from chronic anxiety for a minimum of at least six months often fall into this category.

This is a grouping of symptoms that include restlessness, irritability, muscle tension, sleeping issues, difficulty concentrating, and being easily fatigued. This grouping, on the other hand, does not include panic attacks, phobias, or obsessions.

Generalized Anxiety Disorder is identified in situations where there is significant distress or dysfunction in at least two areas of life, including finances, work, school, relationships, or health.

It is common for there to be a presence of “basic fears” such as: the fears of failure, losing control, rejection, not being able to cope, and death.

This condition is often triggered or exacerbated by stressful life circumstances.

We all have felt nervous and awkward in social situations at one time or another, leaving us feeling a little anxious to make social contact.

Social anxiety is a more extreme version of this where you may develop avoidant behaviors to evade the fears that arise in ordinary social situations.

You may be greatly concerned with the fear of being judged, embarrassed, or humiliated. It may be associated with one on one interactions, group dynamics, or even public speaking.

Other examples of social anxiety may include the fear of crowds, test taking, using public restrooms, or choking on food in public. A formal diagnosis of social phobia may be given if the avoidant behaviors interferes with work or social activities, important relationships, or if there is significant distress.

An adult may understand the fear is unreasonable but may not be able to overcome it without treatment.

Some common phobias include:

• Fear of animals
• Fear of heights
• Fear of doctors
• Fear of airplanes
• Fear of bridges or tunnels
• Fear of illness
• Fear of loud sounds
• Fear of elevators

A panic attack is identified by a sudden episode of acute apprehension or intense fear that occurs without any apparent cause.

The intensity of the panic often lasts for no more than a few minutes but may return in short bursts for a period up to a couple hours.

Panic disorder includes having 2 or more panic attacks and at least one month of persistent concern about having another, after an initial attack. This apprehension about future attacks is what often characterizes panic disorder.

Symptoms of panic may include (minimum of 4 qualifies a full blown panic attack):

• Sweating
• Shaking or trembling
• Dizziness or feeling faint
• Shortness of breath or choking
• Accelerated heart rate or pounding heart
• Nausea
• Numbness or tingling in hands or feet
• Chest pain or tightness
• Hot or cold flshes
• Fear of losing control or “going crazy”
• Fear of dying

It is normal for agoraphobia to start after a few episodes of panic attacks in public. This can lead to a pervasive sense of anxiety through all aspects of one’s life.

Moderate to severe agoraphobia will have a strong impact on the normal work, social, and relational aspects of life.

Obsessions and compulsions are traits that most of us have to one degree or another. What makes this condition problematic is the extent to which it disrupts the functioning of one’s life.

Obsessions are recurring ideas, thoughts, images, and impulses that may seem senseless yet remain intrusive to one’s mind. These might include fears of not locking your door, leaving your lights on, or even impulses for violence. These thoughts or images are usually unrelated to real problems one might be experiencing.

Compulsions are rituals or behaviors that you perform to dispel the anxiety brought up by obsessions. Some common categories for compulsions are washing, checking, and counting.

In the case of obsessions and compulsions, you can know that the thought or act is unreasonable yet still feel powerless to it. There may be a significant amount of anxiety, shame, or even depression as a result.

The essence of PTSD is the development of disturbing and potentially disabling psychological symptoms following a traumatic event. Aside from veterans from where this condition was first denoted, it is also prevalent in victims (or families of victims) of natural disasters, violent crimes, and traumatic accidents of all kinds.

The correct diagnosis is dependent on the duration of symptoms. Symptoms of less than one month after the traumatic event are given a diagnosis of acute stress disorder. With symptoms enduring longer than one month, the diagnosis is changed to PTSD.

The most common symptoms of acute stress or post-traumatic stress are:

• Nightmares related to the event
• Strong, life-like flashbacks
• An avoidance of thoughts or feeling associated with the event
• Repetitive and distressing thoughts about the event
• Loss of interest in activities that used to bring pleasure
• Emotional numbness
• Avoiding activities or situation associated with the trauma
• Dissociation or detachment from sense of one’s body
• Detachment or estrangement from others
• Insomnia
• Difficulty concentrating
• Irritability or outbursts of anger

Depression is often a result of having inadequate strategies in dealing with the normal stressors we encounter in life. It ordinarily follows a time of extraordinary stress and can hinder our capacity to effectively function in our personal and professional lives. It can be entangled with bouts of anxiety or stand alone as its own condition.

Depression is indicated by a marked disturbance in mood, sleep, appetite, ability to concentrate, or experience pleasure. Depression can strongly impact our sense of self- worth, ambition, sexual desire, or even lead to suicidal thoughts.

Symptoms lasting consistently for more than two weeks that are markedly different than the person’s normal mood is often given the diagnosis of Major Depression Disorder although there are many other factors that might impact the exact diagnosis.

It is clear that this is quite common and treatable through proven clinical interventions.

My psychotherapy services are designed to meet you where you are and help you develop tools to manage life with confidence again. I specialize in working one on one with adults, teens, and parents.