Treatment for Anxiety
Online therapy for adults
in Wisconsin and 41 StatesAnxiety can look like relentless worry about everything, feeling constantly on edge, or being so afraid of judgment that you start avoiding the people and situations you actually want in your life. Treatment can help you stop feeling fearful, learn to manage anxiety and uncertainty, and start making your own choices again.
Don’t let anxiety rule your life.
Don’t Let Anxiety Call the Shots
Sometimes anxiety is sharp pangs of fear and heat in your chest or throat. Or maybe it’s the feeling that your heart is going to pound its way out of your body, or even waves of nausea. Other times it's restlessness, like being on edge and not quite being able to fully relax. It might arise from any little thing, with relentless worry about everything that’s hard to control. Anxiety might also rise up when meeting new people or having to perform in front of people.
Generally, anxiety and fear are normal and serve to protect us from danger. However, anxiety is defined in psychology as a response to the perception of danger. When a clinical anxiety disorder develops, the anxiety is out of proportion to the actual danger. In other words, there is a perception of danger even though you’re actually safe.
Through therapy, you can stop letting anxiety rule your life, learn to lessen the anxiety, and teach your brain that you're not in as much danger as you thought you were. Cognitive-behavioral therapy is an empirically-supported treatment to address these fears and learn to take back your life from anxiety’s control.
What Does Anxiety Look Like?
There are many different anxiety disorders, and I treat OCD and other anxiety disorders at Leap Counseling and Consultation. Here, we’ll specifically talk about Generalized Anxiety Disorder (GAD) and Social Anxiety Disorder.
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Social Anxiety
Social anxiety makes you constantly think about how other people see you. You might worry about being judged as awkward, boring, stupid, unlikeable, or just somehow wrong. That fear can show up when meeting new people, dating, speaking up, asking for help, eating in public, giving a presentation, or simply feeling like other people are watching you.
Social Anxiety Disorder symptoms can include:
fear of negative judgment or rejection
anxiety during social interactions or performance situations
avoiding social situations
worrying that you said or did something embarrassing
replaying interactions afterward
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Generalized Anxiety Disorder (GAD)
With GAD, worry seems to attach itself to almost anything: work, finances, health, relationships, family, or even everyday things like being late. The worry is persistent, difficult to control, and often comes with feeling restless, exhausted, irritable, tense, or unable to sleep.
Symptoms of GAD may include:
insomnia
difficulty with focus & concentration
overthinking things
over-preparing
procrastinating
avoiding things that might go badly
seeking reassurance
trying to plan for every possible outcome
How Can Anxiety Treatment Can Help?
Whether you experience feeling anxious in social situations, or just generally feel anxious most days, therapy can help.
Generally, when people try to avoid, control, push away, or get rid of anxiety, it ends up making the problem worse. With social anxiety disorder, safety behaviors and post-event rumination keep people from challenging their current negative thinking and perception of social situations as dangerous. They also tend to overestimate how terrible it would be if someone were to be mad at them, and they don’t let themselves learn that, although distressing, they can handle it.
In generalized anxiety disorder, over-preparing, perfecting, and even worrying itself tends to feed the anxiety. They end up telling themselves, through their own behavior, that these situations are truly dangerous. They may constantly feel like they narrowly escaped disaster through their actions - and never learn whether things would’ve been fine either way.
The Leap Counseling Approach to Anxiety Treatment
For both generalized anxiety disorder and social anxiety disorder, I use Cognitive-Behavioral Therapy (CBT), including Exposure Therapy. CBT looks at the relationship between your thoughts, emotions, and behaviors, and helps us target the patterns that are keeping you stuck. A big part of anxiety treatment is learning to reduce avoidance and safety behaviors while gradually facing the situations that anxiety tells you are dangerous.
I also incorporate Acceptance and Commitment Therapy (ACT), which focuses on learning to accept uncomfortable thoughts and emotions rather than trying to avoid or get rid of them. The goal isn’t to never feel anxious again. It’s to learn that you can handle anxiety and uncertainty, and still make choices based on what matters to you.
Why Do I Keep Replaying Things in My Head?Maybe you leave a conversation, meeting, or social event and start going over everything that happened. You might replay what you said, think about what you should have done differently, or wonder what the other person thought of you. Other times, your thoughts might jump ahead from one “what if” to another about what could happen next.
For people with social anxiety, this common occurrence is called post-event rumination, where you replay interactions and focus on the things you think went wrong. With generalized anxiety, the worry is more often focused on future events and all the different ways something might go badly.
Either way, all that thinking and worry leads you to avoid people, places, and situations. You may feel like you are trying to figure something out or prevent something from going wrong, but most of the time it just makes you feel worse.
Therapy can help you spend less time replaying the past or trying to prepare for every possible problem in the future.
Frequently Asked Questions About Anxiety Treatment
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Everyone worries about these things from time to time, especially when something concerning is happening (like a big surgery coming up). Worry becomes a problem when it’s excessive (worrying about health when there are no known health issues), it’s happening all the time, and it’s really hard to control or disengage from.
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OCD and anxiety disorders all have a lot of similarities and can look like each other. I wouldn’t expect you to be able to diagnose yourself. The good news is, you don’t have to know exactly what diagnosis fits you best in order to start therapy - part of my job is to thoroughly assess your symptoms and provide a diagnosis and / or my conceptualization of what you’re experiencing. I am specialized in treating anxiety disorders and OCD, so no matter which of those problems it is, I should be able to help you. If we ever discover it’s a different type of problem that I can’t help with, I will always do my best to offer appropriate referrals and point you in the right direction.
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Social Anxiety is a specific, diagnosable mental disorder, whereas shyness is more of a personality characteristic. Shyness is a broader term and describes someone as more socially reserved. It refers to being more inhibited in social situations, a tendency to feel self-conscious, and they might need time to warm up to people. Some people who describe themselves as shy may actually have social anxiety disorder, but a lot of people who are shy don’t necessarily have a clinical problem. Social anxiety is more of the clinical term, and shyness is a general tendency of how someone behaves in social situations. The distinction isn’t the most clear, even in research!
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In GAD, current research-based models suggest that worry is a form of avoidance. People with GAD often have difficulty tolerating uncertainty about future events and whether bad things might happen. When someone worries, thoughts typically jump around to all different possible situations. Rarely do they settle on one specific worst-case scenario and stay there. One theory is that worry keeps people from fully exposing themselves to what it might actually look like if things went wrong. So, exposures usually involve writing about a single worst-case scenario in which their fear came true. And they read the scenario until it starts to feel like just a story. With repetition, the emotional charge wanes, and people are able to move forward.
We might also do behavioral experiments to discover, for example, what happens if you don’t overprepare or if you make a typo in an email at work? This then allows them to see whether their assumptions have been accurate, and anxiety tends to decrease.
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I love getting creative with exposures for social anxiety.Typically we start small, and after that, we might try a lot of different things to target the client’s fears. Depending on the individual’s specific fears, exposure ideas might include:
Text a friend first
Ask a friend to hang out
Call a local business and ask about their hours
Drop a bunch of coins on the ground in a busy spot, pick them up
Order a Big Mac at a Burger King
Say something factually incorrect at a party
Eat in public
Make a typo in a presentation
Do a mock interview
Assertively tell someone “no” to a request
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In social anxiety disorder, the anxiety is focused on social situations only, whereas in GAD, there is anxiety about a host of different areas of life. People with social anxiety might experience some worry, but it is only in social situations. Also, post event rumination in social anxiety is focused on an event that already happened, while worry is focused on events in the future.
That being said, it is possible to have both social anxiety disorder and GAD. It is not uncommon for people to be diagnosed with more than one anxiety disorder.
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As the adage goes, what you resist, persists. By avoiding situations that cause anxiety, we are not able to challenge our fears about them. Our anxiety just ends up coming up with something new to be concerned with, and then we start avoiding that, too. So, the more we avoid, the more anxiety comes up with other things to be afraid of and to avoid, and we keep communicating to ourselves that the danger is real. After all, why would you avoid something that’s not dangerous? It strengthens the perception of danger, which strengthens our anxiety.
And, as we avoid, our world gets smaller and smaller, until our lives no longer feel like our own. It doesn’t have to be this way! By taking small steps every day, therapy can help lead you toward the life you want.
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It depends on the type of overthinking you’re experiencing. Overthinking might look like worry, or rumination, or overplanning, or even mental compulsions in OCD. The exact strategies might differ depending on which of these it is. But there are effective evidence-based strategies to address each one!
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Yes, it can. Using exposure therapy, challenging unhelpful thinking, and taking chances, you can learn that being judged is not actually the world-ending event that it 100% feels like it is. By making real changes, with the help of a trained therapist, you can learn to tolerate anxiety and face your fears.
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Research tells us that online therapy can be just as effective as in-person treatment. This is especially true when the therapy being used is cognitive-behavioral therapy (CBT), which is what I use.
Online Therapy for Anxiety in Wauwatosa, WI
You don’t have to let anxiety keep running your life. Therapy can help you break the cycle and start living the life you want to live. Leap Counseling and Consultation offers specialized treatment for social anxiety and generalized anxiety disorder.
Leap Counseling and Consultation is a Wisconsin-based solo therapy practice led by Dr. Johanna Wood, who specializes in OCD and anxiety disorders. Through personalized, evidence-based treatment, Dr. Wood helps clients develop effective tools to manage panic disorder and move forward with confidence. Meet one-on-one with an experienced Panic Disorder therapist in Wauwatosa.
Other Online Counseling Services at Leap Counseling in Wisconsin
Social Anxiety and Generalized Anxiety Disorder treatment aren’t the only therapy service offered at my Wisconsin-based online therapy practice. I understand you may have other concerns you would like to address. As a licensed online psychologist in Wisconsin and all PSYPACT states, I also provide therapy for OCD and other anxiety disorders such as agoraphobia, panic disorder, PTSD, insomnia, and phobias.
No matter where you’re starting, meaningful change is possible with compassionate, evidence-based care. Read my mental health blog to learn more about how therapy can help, and when you’re ready, reach out to schedule an appointment and take the next step toward feeling better.