Much of the way the general population conceptualises mental health issues such as depression or anxiety is through the medical model and pharmaceutical lens. This particular model tends to approach anxiety by looking at the problem removed from the person’s context. In other words, depression or anxiety is seen as separate from the person and as something happening to them. So, from a medical standpoint, you then treat the anxiety with medication, ignoring the context of the person’s life, relationships, and coping skills. The goal thus becomes to address the anxiety through medication, as though it is a virus or external thing attacking the person.
However, there are many problems and limitations with this approach.
Firstly, you may know people who are taking Selective Serotonin Reuptake Inhibitors (SSRIs) and other serious brain drugs to address their anxiety or depression. These medications often take a long time to have an effect and can lead to serious side effects. Moreover, they frequently need to be modified and adjusted due to the potential loss of efficacy over time, which may necessitate higher dosages. And while people may feel a bit better while on them, if the real underlying issue isn’t resolved, the person needs to stay on the medication.
And as mentioned, another problem with the medical/pharmaceutical model is that it doesn’t look at the context of an individual’s life. It fails to take into account the influence of relationships, problem-solving strategies, and the undesirable choices a person is facing that may be contributing to their anxiety or depression. Often, when we take a step back and look at the person’s life, relationships, choices and challenges they confront, we can start to see how anxiety may develop.
Mental health counselling takes another, more holistic, model to look at mental health issues, such as depression or anxiety. It is more like a quantum physics approach to issues. The mental health issue, whether it is called depression or anxiety, is not some external thing attacking the person that must be eliminated. Instead, it is seen as a symptom or outcome of how a person’s creative system consciously, but more often unconsciously, chooses to deal with the relationships and choices in their life.
When people seek counselling for anxiety or depression, they often believe that this misery is happening to him or her. However, mental health professionals see the client as (unconsciously) choosing the misery s/he is feeling as their best attempt to solve their current relationship or life dilemma. So, I would say the person is depressing or “anxietying” (an active verb). The good news is this also means the person can do something about this so that they can stop “anxietying” and start “happying”.
Now, most people reading this would say, “I’m not CHOOSING to be depressed or anxious, I don’t want this.” I would agree that it is something you don’t want, and it is not necessarily anything that you are CONSCIOUSLY choosing. However, it is a total behaviour emanating from your control system and you are choosing it. The great news is that once you figure out what you want, you can choose differently.
Total Behaviour
All people can do from birth to death is to behave. All behaviour is purposeful to meet our needs to the best of our ability at the time we are choosing. All behaviour is total behaviour and includes thinking, doing, feeling, and physiology.
Anxiety is a normal response that all people have and is a total behaviour that affects your thinking, doing, feeling, and physiology. In fact, without it, we would be dead. For example, if you are crossing a street and see a bus coming and you have no anxiety, you might stare at the bus as it proceeds to run you over. So, anxiety helps us stay alive – it is looking out for threats to our well-being. Kept in check, it is a good thing to have.
Unfortunately, for some people, anxiety starts to become a solution to everyday living. People with anxiety are plagued by physiological symptoms of shortness of breath, racing heart, sweaty palms, general discomfort, and a constant sense of doom or something bad happening. Their thinking is focused on the future and all the horrible things that might happen. Their behaviours include panicking, pacing, and worrying and they feel anxious, out of control, and overwhelmed.
So, if you step back, you can see how anxiety is a total behaviour that affects all the components of people:
- Thinking: Many anxious people are thinking about the future and catastrophising worse case scenarios and all sorts of horrible things that can go wrong
- Behaviour: Anxious people can be seen reading, planning, researching, fretting, pacing, calling and talking to people non-stop about the issue over and over again
- Feeling: They will have a constant feeling of unease, worry, doom, and of something bad happening
- Physiology: They will often feel a “pit in their stomach”, be sick to their stomach, have a headache or muscle tension or body aches as though their body is geared up for a fight
So anxietying is a total behaviour. It is not something that you just feel or think or do. But rather, your whole being revolves around this state in an attempt to solve a problem. One of the challenges for people is that by the time the “anxietying” becomes overwhelming and has so much physiology, the total behaviour can become very distracting and creates problems for the person.
It is at this point that people often seek help. If they go to a psychiatrist to treat the symptoms of “anxietying”, they will be given medication. However, if a person sought help from a mental health professional, addressing anxiety will encompass looking at what is going on in the person’s life and relationship. The counselling session for anxiety with our therapist in Singapore will see the anxiety as a symptom to the REAL issue, not the problem itself. We basically start the session with the understanding that anxiety started out as a solution for the person, but then the solution created its own set of issues.
The mental health counsellor would find out what the person is trying to solve and help them find more effective, healthy ways to deal with the issue at hand. This will involve understanding the challenges the person is really facing, the quality of their relationships, and the skills they need to choose more effectively. A psychiatrist or medical doctor will just write a prescription to treat the symptoms of anxiety, but it will not target the thinking, behaviours, or choices of the person’s problems.
Signs & Symptoms of Anxiety
Anxiety disorders, encompassing a range of mental health conditions, have the potential to significantly impact an individual’s daily life, resulting in an overwhelming sense of unease, apprehension, and distress. And anxiety often manifests itself through a range of distinct physical and psychological symptoms, each indicating the presence of this complex mental health challenge. By identifying these unique markers, individuals can gain a clearer understanding of their experiences and seek appropriate support. Here are some key signs that could indicate the presence of anxiety:
1. Physiological Responses
Anxiety disorders can trigger a spectrum of physiological responses that manifest as heightened sweating, trembling, sensations of nausea, and disorienting dizziness. Experiencing an increased heart rate or shortness of breath can also be indicative of heightened anxiety levels. These physical sensations often accompany the overwhelming sense of unease that anxiety brings.
2. Chest Pain and Tightness
Anxiety can lead to sensations of chest discomfort and tightness, sometimes resembling the symptoms of heart-related issues. This sensation can exacerbate anxiety further.
3. Panic Attacks with Cardiac-Like Symptoms
Panic attacks triggered by anxiety may mirror the symptoms of heart attacks or strokes, causing intense fear and physical reactions that feel life-threatening. These episodes often entail a surge in heart rate, rapid breathing, and an overwhelming sense of impending doom.
4. Gastrointestinal Distress & Disturbance
Anxiety often leads to feelings of nausea, the sensation of wanting to vomit, and even dry retching, all of which contribute to the overall sense of unease. It can also contribute to gastrointestinal issues like gastric reflux, irritable bowel syndrome (IBS), stomachaches, and ulcers.
5. Physical Tremors and Tingling
Sweaty palms, trembling hands, body shakes, and tingling sensations in various parts of the body can be indicative of heightened anxiety levels.
6. Impaired Concentration and Mental Paralysis
Anxiety can interfere with cognitive functions, causing difficulty in focusing, mental numbness, and even moments of feeling mentally paralysed.
7. Specific Phobias
Anxiety can trigger specific fears or phobias, such as an intense fear of crowded places, public presentations, and germs.
8. Fear of Judgement
Anxiety often leads to a constant worry about what others think, resulting in a persistent fear of being judged negatively.
9. Dizziness and Loss of Control
Feelings of dizziness, a loss of control, and even the fear of blacking out or fainting can be linked to anxiety.
10. Need for Micro-Management
A tendency to be excessively cautious or the compulsion to micro-manage situations can stem from anxiety-driven behaviours.
11. Feelings of Helplessness and Hopelessness
Anxiety can contribute to a pervasive sense of helplessness and hopelessness, making it challenging to envision a brighter future.
12. Heightened Irritability
Anxiety can contribute to increased irritability and difficulty in managing emotional responses. Individuals may become more prone to irritability, frustration, or anger, often as a result of their ongoing anxiety. It can also lead to restlessness and an inability to stay still, driven by a heightened state of nervousness.
13. Overwhelming Emotions
Feeling overwhelmed and breaking down in tears without a clear trigger can be a manifestation of anxiety’s emotional toll. Those grappling with anxiety disorders can often find themselves caught in a cycle of incessant and disproportionate worry about various aspects of their lives, such as work-related performance, academic responsibilities, personal relationships, financial stability, and overall well-being.
14. Sleep Disturbances
Anxiety can interfere with sleep, leading to poor sleep quality, night sweats, and difficulties falling and staying asleep.
15. Avoidance Behaviour
Individuals contending with anxiety frequently engage in avoidance behaviours, steering clear of situations, environments, or activities that evoke intense feelings of anxiety. These may include evading social interactions or shying away from crowded places.
Different Types of Anxiety Disorders
Anxiety disorders encompass a range of distinct conditions, each characterised by its unique set of symptoms, triggers, and effects on daily life. Understanding these different types of anxiety disorders is crucial for individuals seeking insight into their own experiences and those of their loved ones.
Here are various forms of anxiety disorders, each with its own distinctive features:
1. Panic Disorder
This anxiety disorder manifests as recurrent panic attacks occurring unexpectedly. These attacks bring about symptoms such as sweating, chest pains, elevated heart rate, and sensations resembling a heart attack or choking. The emergence of overwhelming dread and the onset of excessive apprehension regarding the possibility of experiencing another panic attack can also trigger altered behaviour patterns that profoundly disrupt your everyday life.
2. Specific Phobias
Specific phobias involve an intense fear of a particular object or situation, like heights or seeing blood or snakes. Encountering these objects or situations can often trigger a fear response akin to the symptoms of a panic attack. As such, people experiencing specific phobias may freeze up, tremble severely, and even experience an increased heart rate when confronted with their phobias.
3. Generalised Anxiety Disorder (GAD)
GAD is characterised by excessive and persistent worries about several everyday matters, lasting for months. Therefore, making decisions and committing to choices can be particularly challenging for them. This overwhelming concern often presents itself alongside indications including a persistent sense of unease, heightened susceptibility to fatigue, irritability, muscle tenseness, and disruptions in sleep patterns.
4. Obsessive-Compulsive Disorder (OCD)
People with OCD are plagued by intrusive, distressing thoughts or images, leading to repetitive behaviours or rituals performed to alleviate the anxiety caused by these obsessions. They recognise that their actions are irrational yet struggle to control or stop them. Examples include compulsive hand washing to prevent infections.
5. Post-Traumatic Stress Disorder (PTSD)
Individuals who have experienced extreme traumatic events such as abuse or natural disasters may develop PTSD. This disorder leads to excessive vigilance, flashbacks of the traumatic event, perceiving threats in everyday situations, outbursts of anger, and sleep disturbances.
It’s important to note that these descriptions provide a basic overview of each anxiety disorder. Symptoms and experiences can vary widely among individuals, and professional evaluation is essential for accurate diagnosis and tailored treatment.
Purpose of Anxiety and Where It Goes Wrong
All of us have a creative system. Our brain is very creative and tries to solve problems for us. It never does anything to hurt us. But sometimes, our brain is a little like a Genie. If you have seen TV shows, Genies grant you a wish, but they are a bit literal. For example, if you say, “Genie, give me all the money in the world”. The Genie grants you this wish by dropping literally all the money in the world on you and killing you.
For many people, anxiety stems from a deep-seated belief that they are not competent or capable of handling what life may throw at them. This may not even be a conscious belief. People with chronic or severe anxiety can be extremely successful professionally or personally, but they often believe it’s because of their worry or anxiety-type solutions that they choose that make them successful.
As mentioned, one purpose of anxiety is to rev-up a person’s fight or flight mode for survival. Anxious people are constantly worrying about what might happen in the future. They play out all the potential worse case scenarios of what might happen.
Why do they do this? So that they can build plans and back-ups to the catastrophe that might occur. Now, lots of people do this and it’s not always a bad thing. However, people with anxiety do it compulsively or to a point that makes them unhappy and fearful that they won’t be able to handle some unexpected, unplanned event or disaster. They believe that by focusing and planning for all the possible worse case scenarios, they’ll be protected or safe.
“Anxietying” people become paralysed to do anything or go anywhere, due to the worry that something may happen that they didn’t plan for. This false belief that to be safe, you must anticipate every horrible thing is false and traps the person. At one point in their life, it was helpful, but now it has gotten out of hand.
For some, anxiety is to distract them from the unpleasant realities of their life. This may be an unsatisfying or dying marriage, a difficult child to parent, ageing or ailing parents, financial difficulties, work problems or health issues. By becoming so anxious and focused on the future, it allows us to avoid issues in the present. However, the solution, while effective at distracting us, also creates present day problems. The more you stop paying attention to the present, where you can affect change, the more likely you are to create future problems that are REAL worries.
Counselling for anxiety can help people look at where in the person’s life they really feel out of control and create plans to develop an internal sense of safety and security. We do not have control of the outside world, but we do have control over our ability to respond — and counsellors in Singapore can help you through your anxiety.
Other Reasons Why Anxiety Happens
Anxiety disorders stem from a complex interplay of factors involving biological, genetic, environmental, and psychological elements. Understanding these contributing factors can shed light on why anxiety happens and how it can be effectively managed.
Biological Underpinnings
Within the brain’s intricate network, neurotransmitters serve as messengers, orchestrating emotions. Serotonin and dopamine, pivotal neurotransmitters, orchestrate our emotional balance. However, if their equilibrium falters, anxiety and depression may ensue. In addition, Gamma-aminobutyric acid (GABA) is a neurotransmitter that slows nerve signals in the brain, curbing anxiety. When GABA activity drops, anxiety can surge, overwhelming your thoughts and feelings. Think of GABA as a calming conductor, quieting the brain’s inner turmoil. Anxious disarray can occur when GABA’s balance is disturbed by genetics, stress, or other factors.
Genetic Predisposition
Family history can serve as a significant indicator of susceptibility to anxiety disorders. A lineage with a prevalence of similar cases can increase an individual’s likelihood of experiencing such conditions.
Early Life Experiences
Upbringing and exposure to traumatic or stressful situations during formative years can contribute to the emergence of anxiety later in life. Early adversities may sensitise individuals to react more strongly to stressors, fostering an environment conducive to anxiety disorders.
Triggers and Stressors
Anxiety symptoms can also be prompted by triggers—specific events or circumstances that activate the onset of anxiety in those susceptible to such disorders. While triggers vary between individuals, they may include life-altering situations like the loss of a loved one, marital separation, or career transitions. Social situations, health concerns, and substance use can further catalyse anxiety symptoms. The intricate relationship between triggers and anxiety underscores the importance of identifying and managing these stressors in the treatment process.
Environmental Factors
The environment in which a person lives can also contribute to the development of anxiety disorders. Elements such as exposure to loud noises, family composition, crowded spaces, or highly demanding work environments can contribute to heightened anxiety levels.
When Should You Consider Going for Counselling for Anxiety
Embarking on anxiety counselling in Singapore is beneficial when emotions feel overwhelming and daily life becomes challenging. If anxiety disrupts your well-being, relationships, or activities, seeking professional support is wise. Whether facing persistent worries, panic attacks, or avoidance behaviours, timely counselling empowers you to manage anxiety’s impact.
Some Treatment Options to Address Anxiety
When addressing anxiety, several treatment methods are available, each catering to individual needs.
1. Anxiety Therapy
This is a pivotal approach, employing psychotherapy to identify underlying triggers and provide essential coping strategies.
Two main techniques within anxiety therapy are:
- Cognitive-Behavioural Therapy (CBT): This method focuses on recognising and altering negative thoughts and their triggers, leading to more constructive responses to distress.
- Exposure Therapy: Designed to tackle avoidance-based fears, exposure therapy involves gradual, controlled confrontations with anxiety-inducing situations to reduce avoidance tendencies.
2. Medication
This can complement therapy, especially for severe cases. Antidepressants can be considered, while other medications can be prescribed to offer short-term relief, but these may require dosage adjustments over time.
Navigating treatment choices hinges on individual circumstances, severity of symptoms, and preferences. As such, it is important to not only go for counselling to address the anxiety but also collaborate with mental health professionals to tailor an effective plan, leveraging the synergy of therapy and, if needed, medication to regain control over anxiety’s grip on your life.
Schedule a Counselling Session for Anxiety in Singapore
At All in the Family Counselling (Singapore), we believe that counselling for anxiety can help people face their present-day issues and figure out how to solve them. Avoiding issues in the short term is helpful, but it also creates long-term problems.
If you need help to figure out what your anxiety is all about and how you can get better, contact us to learn more about how counselling with our professional mental health therapist can help you. Through an initial consultation, we’ll help you frame the goals and outcomes of therapy and what that would look like to achieve it.
About All in the Family Counselling
All in the Family Counselling, led by the experienced therapist Ms. Tammy Fontana, is dedicated to providing anxiety counselling services in Singapore. Be it for anxiety counselling or individual counselling services, Ms. Tammy Fontana brings her knowledge and expertise to the field of mental health, particularly in addressing anxiety concerns.
Ms. Fontana is a qualified professional with a background in psychology and counselling. With years of experience, she has successfully guided individuals towards managing and overcoming anxiety-related challenges. Her empathetic approach, combined with her understanding of anxiety’s intricacies, enables her to create a safe and supportive environment for clients seeking relief.
Her qualifications, commitment, and genuine care for her clients make her a trusted figure in anxiety counselling. With a focus on personalised care, Ms. Fontana and her team at All in the Family Counselling offer compassionate guidance and evidence-based strategies to help individuals navigate their journey towards improved mental well-being.
For more information about Ms. Fontana and the expertise she brings to anxiety counselling, visit our About Us page.
Frequently Asked Questions About Counselling for Anxiety in Singapore
What is the connection between anxiety and depression?
Anxiety and depression often share a complex relationship, frequently coexisting and intertwining. While they are distinct disorders, they can manifest together, amplifying each other’s symptoms. Both conditions share common emotional features, such as persistent negative thoughts, low mood, and reduced interest in activities. Understanding this connection is crucial for proper diagnosis and effective treatment.
How many anxiety counselling sessions do I need?
The number of anxiety counselling sessions needed varies based on individual circumstances. Some individuals find relief after a few sessions, while others may benefit from more extended support. Our experienced therapists collaborate with you to determine a suitable plan tailored to your needs, ensuring progress throughout your journey towards well-being.
When should I go for counselling for anxiety?
Consider seeking anxiety counselling if you experience persistent worry, fear, or overwhelming anxiety that interferes with your daily life. If you find it challenging to manage symptoms on your own, or if anxiety disrupts your relationships and functioning, professional counselling can provide guidance and strategies to cope effectively.
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