Thousand Oaks Clients with Anxiety: Is what you have really anxiety?

Many clients come to me and say they struggle with anxiety, but in my five years of clinical work, I’ve seen many different presentations, some not just anxiety. I found it crucial to differentiate these instances to help my clients clarify what it is that they are really struggling with. Truth is, we can never fully help our issues without first knowing what they are.

At Tide and Shore Therapy, I offer anxiety therapy in Thousand Oaks for clients that struggle with generalized or specific anxieties. If you have specific phobias or generalized concerns, you’ve come to the right place. I’ve worked with many folks in individual and group settings that are anxious. I’ve also facilitated a women’s anxiety group in my career. As a woman with anxiety myself, I am not only an expert clinically but have also navigated through coping as a person.

Anxiety: What is it?

The DSM-V has detailed diagnostic criteria for anxiety. There are several diagnoses in the cluster, including Generalized Anxiety Disorder (GAD), Panic Disorder, Social Anxiety Disorder, Specific Phobia, Separation Anxiety Disorder, Agoraphobia, and Anxiety Disorder-Unspecified. What sets anxiety apart is that it is marked by fears or worries, often future-focused and not explained by other diagnoses. My clients have reported fears related to specific situations or places, as well as more generalized worries. These symptoms need to persist for at least 6 months to meet the diagnostic criteria.

When it’s not just Anxiety: Differential Diagnoses

I often noticed that my clients report they struggle with anxiety, but their situations are better explained by other diagnoses. Let me break down a few of these situations, and let’s see if yours fits in any one of these categories to determine what the focus of treatment really should be.

Obsessive-Compulsive Loops: Perhaps Obsessive-Compulsive Disorder (OCD)

Let me just say: this is the most commonly misdiagnosed group in my experience. These clients come to me with complaints that are more obsessive-compulsive, typically sounding something like, “I can’t stop thinking about this. I have to continue checking, researching, fixing, and I do this multiple times a day.” For instance, if a client is worried about her home security and needs to check 3 times before leaving every time she departs, she is more likely to report having anxiety about unlocked doors/windows instead of focusing on the obsessions, home security, and compulsions, checking repeatedly. 

OCD has a loop that builds anxiety into the system. Obsession creates anxiety, and it will continue building until the compulsion is done, and we receive our dopamine relief by executing the fix. Without anxiety tied to obsessive thinking, we have no fuel for compulsion. And without compulsion’s reinforcement, the obsession will not have a foundation to continue. So yes, the client is much more likely to notice that they are anxious, but they may not have noticed the loop that locks them in endless repetitions. 

Substance Use: Fuels Anxiety

Sometimes I have a client that reports generalized anxiety, but upon interview, discloses that they use substances consistently and habitually. I empathize with this group, since the stigma associated with substance use commonly causes shame and secrecy. Let’s say a client enjoys around 3 glasses of wine daily and reports that they experience anxiety throughout the day. A seasoned clinician will be aware that alcohol, when not delivered continuously (hopefully not), will cause a client’s general sense of anxiety to heighten as dopamine/endorphins/serotonin ebb and flow. In this case, exclusively discussing stressors is unlikely to help the client address a big portion of their real struggles.

Life Transitions: Perhaps Adjustment Disorder

This group is not always anxious throughout their lives: their struggles are tied to changes in their circumstances. For instance, a client moves to a new job, and she becomes highly sensitive to her bosses’ and coworkers’ opinions, worrying about presentations and job performances. This client may fit the criteria of adjustment disorder better if their struggles are specific to the new job and do not persist for more than 6 months. If they still have recurring worries past 6 months, they may then fit another diagnosis depending on presenting symptoms.

Anxiety Therapy in Thousand Oaks: High-functioning Area with Clients Interested in Research

Thousand Oaks is a community with many smart folks, at least that’s what I noticed! Many of my clients enjoy a good psychology podcast, a self-help book, and a therapist that is knowledgeable. The fact you are here speaks volumes. I hope this blog article helps you better understand what you are actually going through and can seek professional help based on the correct information.

Individual Support

Anxiety makes life seem more difficult, but it could also be the beginning of tremendous growth. In the end, we always grow from pain, not from pleasure. 

If you’re seeking anxiety therapy in Thousand Oaks, I invite you to reach out. You are my ideal client, and I understand your struggles. Let’s work together to help you evolve and grow into your most grounded, confident self!

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Kaidi Liu, LMFT
Tide and Shore Therapy – Therapist for Anxiety in Thousand Oaks