email      DrSooHoo@sequoiacounselingoc.com                                                    
phone     949.337.1034                 
mailing address   340 E. 1st St. #291, Tustin, CA 92781         
Sequoia Counseling & Wellness Services OC offers virtual teletherapy services for California Residents  

Anxiety Disorders and Treatment

Are you often worrying too much about future events and wish you could avoid them altogether?​
  • Do you find yourself sweating and having difficulty breathing when at parties and have to leave?
  • Are you so distracted by your worries that it is hard to focus on where you are or who you are with?
When we are stressed, our sympathetic nervous system (responsible for the “fight or flight” response) kicks into gear, producing adrenaline, cortisol, and other stress hormones. This survival instinct contributes to our cognitive, emotional, and behavioral responses. Depending on the intensity of the stressors and previous coping, we likely will experience anxiety symptoms. 

What does anxiety look like? ​

Symptoms of anxiety include:
  • Feeling out of control due to anxiety
  • Constant worry
  • Racing thoughts
  • Fatigue/Sleep problems/Lack of sleep
  • Lack of appetite
  • Panic, fear and uneasiness
  • Avoiding places, things or people
  • Tense muscles
  • Headaches
  • Stomach aches
  • Feeling agitated
  • Restlessness
  • Difficulty concentrating
  • Irritability
What I Treat: 
There are various anxiety disorders, each with its own unique characteristics and treatment options. I specialize in treating several types of anxiety disorders including:
  • Generalized Anxiety Disorder
  • Panic attacks and Panic Disorder
  • Social Anxiety Disorder
  • Phobias
  • Health Anxiety Disorder (Intense Illness Worry)
  • Anxiety Associated with Having or Managing a Specific Diagnosed Health Condition
  • Coping with Stressors Related to COVID-19
How Anxiety Develops and Is Maintained: 
When faced with a threatening situation, we experience anxiety symptoms. Our instinct is to avoid or leave this situation, resulting in immediate but short-lived relief of the anxiety symptoms. Subsequent encounters with the situation results in intensified anxiety symptoms and negative beliefs about one's ability to handle the situation. The cycle of avoidance and worsening anxiety repeat until there is a change. ​The image below is a visual representation of this cycle.
Treatment Options for Anxiety
​The longer you let anxiety go unchecked and without treatment the worse it can become over time. Take active steps to manage your symptoms as soon as possible. Here are the current treatment options: 

  • Cognitive Behavioral Therapy: CBT is a proven treatment strategy for anxiety disorders. It consists of identifying and changing unhelpful thoughts and/or applying new behaviors. The purpose is for the patient to have apply new skills that lessen their anxiety over time. For more on the research evidence for CBT and anxiety symptoms, click here.
    • Exposure Therapy: The therapist works with the patient to gradually face anxiety producing situations without avoidance. Over time, the fear experienced in the situation loses its power and goes away. Exposure therapy is particularly effective for the treatment of panic attacks, phobias, and generalized anxiety disorder. 
    • Relaxation Skills: Relaxation skills, a common component of CBT, comes in many forms. With consistent practice of relaxation skills, the patient is able to calm their nervous system and relax. Watch my video below for a quick demonstration of relaxation training.
 
  • Mindfulness Techniques: Mindfulness techniques are useful for general stress. These techniques train the patient how to redirect their mind away from anxious thoughts and remain present-focused.
​
  • Medication: Medications used to treat anxiety include antidepressants, benzodiazepines, and anxiolytics. Other medications, such as antihistamines, have also shown promise and I would recommend consulting with your doctor or psychiatrist to determine if medication is right for you. It is not uncommon to treat most anxiety disorders with an antidepressant. Realize that antidepressant medications are taken daily (as opposed to "as needed") until the anxiety disorder is resolved. In many cases, therapy is essential for anxiety treatment so that the patient can learn to change their responses when faced with specific stressor(s). In most cases I would not recommend using benzodiazepines as a routine medication in practice for a couple of reasons. One, they actually are psychologically and physiologically addictive. Two, they feed into the avoidance cycle discussed above, rather than correct it. The patient is then left with the original anxiety symptoms AND now has to also treat the dependence. Prematurely discontinuing medications and symptom relapses are common with antidepressants; consultation with your doctor is strongly recommended.  
What is therapy for anxiety like?
I like to start therapy by collecting symptom information from the patient so that we can better measure treatment improvements. From our conversations, I develop hypotheses as to how these problems came to be and how to best fix them. I offer a variety of skills and ideas on how to view the situation differently. The patient then practices these skills, providing feedback on their effectiveness. We continue to practice the skills as the patient's confidence builds. Therapy ends with a review of treatment progress, challenges, and ideas on how to handle challenges in the future. The duration of our weekly sessions will depend upon when the anxiety first developed and how the anxiety is impacting the patient's life. Some anxiety disorders can successfully be treated in as little as 8-10 visits. 
   If you have any questions or would like to schedule an appointment, call or send me a note. I look forward to hearing from
​you ! ​​
​          - Dr. Melissa Soo Hoo