Our treatment approach to anxiety disorders

What Is an Anxiety Disorder?

Anxiety itself is a normal and adaptive human experience. It's the nervous system doing its job, alerting us to potential threat and preparing us to respond. Anxiety can become maladaptive when that system gets stuck in the on position, firing in situations that aren't dangerous or at a level that far exceeds what the situation calls for.

The DSM-5 outlines several distinct anxiety disorders, each with their own presentation. The most common include:

Generalized Anxiety Disorder (GAD) involves excessive, difficult-to-control worry about a wide range of everyday topics including work, health, relationships, and finances. To meet the criteria, worry is present more days than not for at least six months and is accompanied by at least three of the following: restlessness or feeling keyed up or on edge, being easily fatigued, difficulty concentrating, irritability, muscle tension, and sleep disturbance.

Social Anxiety Disorder is characterized by marked fear or anxiety about social situations in which a person might be scrutinized by others. Social Anxiety Disorder centers around thoughts that we will act in a way that will be negatively evaluated, humiliated, or rejected, and the anxiety is out of proportion to the actual threat posed by the situation.

Panic Disorder involves recurrent unexpected panic attacks, which are abrupt surges of intense fear or discomfort and include symptoms like racing heart, shortness of breath, chest tightness, dizziness, numbness or tingling, and a fear of losing control or dying. People with panic disorder often develop persistent worry about future attacks and change their behavior to avoid them.

Specific Phobias are intense fears or anxieties about a specific object or situation, such as heights, flying, needles, or certain animals, that is out of proportion to the actual danger and leads to avoidance.

Agoraphobia is the fear and avoidance of situations where escape might be difficult or help unavailable if panic or other distressing symptoms occur, such as being in crowds, using public transportation, or being outside the home alone.

With all anxiety disorders, the physiological response causes significant distress or impairment in daily life, and it's not something we’re able to manage through effort or reasoning alone.

The Common Coping Mechanism: Avoidance

Anxiety can be described in many ways: a constant sense of dread, a racing mind, a body that feels perpetually braced for something bad to happen. Many individuals feel it physically, in the chest, stomach, shoulders, or jaw. Anxiety can also result in mental exhaustion or burn out, with lower capacity to handle daily tasks.

Avoidance feels like relief in the short term, but over time it reinforces itself and makes the anxiety bigger. That cycle is one of the larger factors that drives us to seek outside help.

Avoidance takes many forms. In interpersonal relationships it looks like not bringing up something that's bothering us because the conversation feels too risky. It might look like saying yes when we mean no, because disappointing someone feels intolerable. It can look like staying in dynamics that don't feel good because the uncertainty of what comes after feels worse than the discomfort of staying put.

If our nervous system has learned that conflict means danger and disapproval means rejection, and that those things might mean losing the relationship, asserting a need or saying no stops being an option. Avoidance becomes a way of managing our fear, and it works just enough in the short term to keep the pattern going.

Over time though, consistently overriding our own needs to keep the peace tends to produce its own kind of anxiety. The resentment builds quietly. The sense of self gets harder to locate and relationships feel like something to manage. And the original fear, that honesty or boundaries will cost us something important, never gets tested, which means it never gets the chance to be disproven.

How We Approach Anxiety Treatment

Part of the work we do to treat anxiety is building understanding about where avoidance has been showing up in life and what it has been protecting us from. The foundation of everything we do at Denver Therapy Collective is Person-Centered care and the work is collaborative. We work from an Existential framework alongside the Person-Centered approach, which means we're also interested in the deeper questions that tend to inform anxiety. Anxiety often has something to say about identity, belonging, uncertainty and fear.

For clients whose anxiety has been present for a long time and has been resistant to other approaches, we also offer Ketamine-Assisted Psychotherapy. KAP can be particularly useful for anxiety that has become entrenched, creating a window of neurological flexibility that makes it possible to approach longstanding fears and patterns with more openness than usual. The preparation and integration work surrounding a medicine session is grounded in the same Person-Centered values that guide everything else we do.

As Colorado continues to expand access to psilocybin services, this is another option we are preparing to offer for clients who have not found sufficient relief through more traditional approaches. Psilocybin-Assisted Therapy has shown early promise for anxiety, particularly anxiety connected to existential concerns, identity, and end-of-life distress.

A Note on Minority Clients and Anxiety

For LGBTQIA+ and BIPOC clients, anxiety often carries an additional layer that deserves to be named directly. Minority stress is a documented contributor to anxiety symptoms that compounds with other aspects of identity.

At Denver Therapy Collective we follow your lead on language and how you describe yourself and we understand that anxiety is often a rational response to genuinely unsafe circumstances, and not something entirely pathological.

Getting Started

If you're in Colorado and you've been wondering whether therapy for anxiety might help, we'd be glad to talk. Evening and weekend appointments are available, we accept insurance, and sliding scale rates are offered for those who need them. Reach out here to get started, or email us at info@denvertherapycollective.org.