The Silent Secrets

of  Anxiety


A generation’s struggle with the most common disorder in America.

By Simple Modern Therapy

Anxiety is part of our world, the same way stress, sadness, and happiness are, but the key is understanding how to cope with it, and how to keep it from becoming unhealthy. The National Institute for Mental Health (NIMH) says that over 40 million peoplein the US over the age of 18 suffer from some anxiety-related disorder, and those are just the people who have been diagnosed, or whose symptoms fit into a pre-described condition. Millions more go undiagnosed. Anxiety is the most frequent mental-health disorder in the US, affecting nearly one-third of both adolescents and adults, according to NIMH. However, unlike depression, with which it commonly occurs, anxiety is often seen as a less serious issue.

Put simply, anxiety is a sense of fear and apprehension that puts you on alert. Biologically, it’s meant to put us in a heightened sense of awareness so we’re prepared for potential threats. Unfortunately, when we start to feel excessive anxiety, or we live in a constant state of anxiety, we’re in trouble. Our bodies never turn off our fight-or-flight response, and we live with the physical and emotional effects of anxiety on a day to day basis, even when there’s no reason or cause for them.

If you’re having trouble dealing with it on your own, come see us. Rehna Schuyler is our in-house anxiety and stress expert. Give her a call, she’d love to see you.

Rehna Schuyler

Women, LGBTQ & Relationship Expert + LMFT


But wait, there’s more!

Stress Vs. Anxiety

(abridged text from LifeHacker’s “What Anxiety Does to Your Brain and What You Can Do About It” article)

On its face, anxiety can look like stress; but the reality isn’t so simple. Anxiety can arise as a result of stress, but stress can manifest in many other ways. Stressors can make a person sad, angry, worried, or (get this) anxious, while anxiety is specifically that feeling of fear, dread, and apprehension. You may never even know what’s causing your anxiety, or in some cases, it can manifest on its own, without any real “trigger” or cause. Stress is often caused by external influences, while anxiety is an internal response. That’s part of what makes anxiety intrinsically different than stress, and also what makes it so difficult to manage. Indeed, anxiety actually has an evolutionary purpose; it helps us detect and potentially avoid dangerous situations. We shouldn’t dismiss it entirely, just to make it a healthy, manageable part of our lives. Even if you don’t suffer from an anxiety-related disorder, you’ve likely had to deal with it and cope the best way you know how. Highly anxious people, though, have a high strung fight-or-flight response that perceives threats where there often aren’t any. The feeling of anxiety is part of your body’s stress response. Your fight-or-flight response is triggered, and your system is flooded with norephinephrine and cortisol. Both are designed to give you a boost to perception, reflexes, and speed in dangerous situations. They increase your heart rate, get more blood to your muscles, get more air into your lungs, and in general get you ready to deal with whatever threat is present. Your body turns its full attention to survival. Ideally, it all shuts down when the threat passes and your body goes back to normal.

About Young People

(abridged text from the New York Times’ – “Why Are More American Teenagers Than Ever Suffering From Severe Anxiety?)

Sometimes there are good reasons to feel anxious. For many teens and young adults, particularly those raised in abusive families or who live in neighborhoods bombarded by poverty and/or violence, anxiety is a rational reaction to unstable, dangerous circumstances. The contemporary political climate can also feel incredibly unsafe for the community of kids we serve. And yet addressing anxiety is low on the priority list in many economically disadvantaged communities. Kids who “act out” are often labeled defiant or aggressive, while those who keep to themselves — anxiety specialists call them “silent sufferers” (a term coined by Dr. Phyllis E. Carter) — are overlooked or simply mistaken for being shy.

Teenagers raised in more upper class communities might seemingly have less to feel anxious about. But Suniya Luthar, a professor of psychology at Arizona State University who has studied distress and resilience in both well-off and disadvantaged teenagers, has found that privileged youths are among the most emotionally distressed young people in America. “These kids are incredibly anxious and perfectionistic,” she says, but there is “contempt and scorn for the idea that kids who have it all might be hurting.”

For many of these young people, the biggest single stressor is that they “never get to the point where they can say, ‘I’ve done enough, and now I can stop,’ ” Luthar says. “There’s always one more activity, one more A.P. class, one more thing to do in order to get into a top college. Kids have a sense that they’re not measuring up. The pressure is relentless and getting worse.”

It’s tempting to blame helicopter parents with their own anxiety issues for that pressure (and therapists who work with teenagers sometimes do), but several anxiety experts pointed to an important shift in the last few years. “Teenagers used to tell me, ‘I just need to get my parents off my back,’ ” recalls Madeline Levine, a founder of Challenge Success, a Stanford University-affiliated nonprofit that works on school reform and student well-being. “Now so many students have internalized the anxiety. The kids at this point are driving themselves crazy.”

Though there are cultural differences in how this kind of anguish manifests, there’s considerable overlap among teenagers from different backgrounds. Many are anxious about school and how friends or teachers perceive them. Some obsess about family conflicts. Teenagers with OCD tend to worry excessively about what foods they should eat, diseases they might contract or whatever happens to be in the news that week. Stephanie Eken, a psychiatrist and the regional medical director for Rogers Behavioral Health, which runs several teenage-anxiety outpatient programs across the country and an inpatient program in Wisconsin, told me that in the last few years she has heard more kids than ever worry about terrorism. “They wonder about whether it’s safe to go to a movie theater,” she said.

When asked about other common sources of worry among highly anxious kids, Eken didn’t hesitate: social media. Anxious teenagers from all backgrounds are relentlessly comparing themselves with their peers, she said, and the results are almost uniformly distressing.

The Takeaway

Once you’ve recognized the effects of anxiety, it’s time to do something about it. You don’t have to just try to keep your head above water. There are plenty of tricks and techniques you can use to ease yourself out of an anxious state or defuse anxiety when you feel it rising. Here are some starting points:

Talk to a professional

Many of us deal with anxiety on a regular basis and just blow it off because we don’t want to be perceived as “neurotic,” but the truth is that more people suffer from anxiety disorders—or at least persistent anxiety—than you may realize. If you’re having trouble dealing with it on your own, come see us. Rehna Schuyler is our in house anxiety and teen issues expert. Schedule an appointment, she’d love to see you.

Try a “suggested visualization”

Simple Modern’s “suggested visualization” is a simple relaxation technique; it can also be used as a coping mechanism for stress! Here’s how it works: Imagine that you’re in the most relaxing environment that you can possibly think of, whether it’s at home in bed or on the beach in the tropics. Wherever you think you would be most relaxed, stop and really put yourself there. If you’re at the beach ask yourself how warm it is, and whether there are clouds in the sky. Are you alone? Is it quiet, or can you hear the ocean? The goal here isn’t just to paint a pretty, relaxing picture in your head, but also to get your brain working on those details—the more you do, the farther away your mind will be from whatever’s triggered your anxiety.

Music. Exercise. Meditation.

Relaxing music can take help take your mind off of your anxiety, or help you refocus after an anxious/awkward spell. Exercise is similar, but instead of just taking your mind away, it actually has a neurological benefit (as well as a physiological one). The endorphins released in our brains during exercise make us happier, and the feeling of accomplishment we get from regular activity can help curb anxiety. Meditation—especially guided meditation—can also help, since the entire point is to calm the mind and dismiss the errant thoughts that lead to anxiety and stress. Meditation can help you focus on your surroundings or be mindful of the present, instead of letting the background seep to the fore. There are great tools out there like Insight Timer, an app that offers thousands of free meditations and practices.

Comments to avoid.

If you are a parent and have a child who is dealing with anxiety, not knowing what to say may actually only intensify their fears. Fortunately, there are ways to be supportive that won’t cause more distress for your teen or adolescent. Here’s a quick list of five comments that you should learn to avoid:

(abridged text from the Center For Discovery and Scott Bea’s Cleveland Clinic research)


1. “Don’t sweat the small stuff.”

For someone with anxiety everything is “BIG stuff”, offer words of encouragement rather than a “cowboy up”.

The sad truth is that what you consider to be a little problem may not seem so small in someone else’s world. While you may be trying to insert a positive, upbeat message into a tense situation, you may be diminishing something that’s a much bigger deal to another person. You might remind your teen that they were able to handle this panic-producing moment in an earlier situation. This can help you validate their feelings, show them that you understand that the pain they are experiencing is real, and help them push beyond those overwhelming feelings.

2. “Calm down.”

Teens that are struggling with anxiety and panic disorders aren’t able to simply calm down instantly. The ability to immediately relax, on command, isn’t something even the most resilient adults can do, so it would certainly be even more difficult for someone that is suffering from an anxiety disorder. Even though you have good intentions, telling someone to calm down will probably have the opposite effect. If they were able to halt their anxiety, they would have already done it.

The right words aren’t always the answer. Keith Humphreys, a professor of psychiatry at Stanford, says (and this isn’t an exact quote) that even the bestest, most well-chosenest words don’t always work. Offering to do something non-threatening with your teen could be the best way to help alleviate the pain of their symptoms. Humphreys says activities like meditating, going for a walk outdoors, or working out may be more effective in the long run.

3. “Just do it.”

What makes for a fun, little shoe slogan can make your teen feel defensive and unsupported. When someone with anxiety is attempting to face their fears head on, giving them some “tough love” may not produce the effect you’re hoping for. Depending on the type of phobia or disorder your child may be dealing with, panic can strike them suddenly at anytime. Obviously if they could overcome this they would because it would be more pleasant — No one chooses to have anxiety.

Really the key is practicing empathy. Change pep-talk language to sentences like “that’s a terrible way to feel” or “I’m really sorry you’re feeling like this.” The paradox is, an empathetic phrase helps them calm down because they don’t feel like they have to fight for their anxiety. It shows some understanding.

4. “Don’t worry. Everything’s going to be fine.”

While this may sound supportive, teens struggling with anxiety won’t usually react to the comforting words in the way that you might hope. Telling someone who is dealing with anxiety that ‘everything is going to be alright’ won’t do much, because nobody is going to believe it. Reassurance sometimes can be a bad method. It can make your child feel better for 20 seconds and then doubt can creep in again.

Try to be encouraging, rather than resort to using standard blanket statements that may not offer any real value. Sometimes, if you allow your child to acknowledge their worry, it can be a big help. It’s important to understand that they can always accept the condition of the situation. Encouraging them that it’s okay to feel what they’re feeling can be a pretty good fix.

5. “I’m stressed out too!”

Perhaps you’re just trying trying to relate, or maybe you are actually stressed out. but this is similar to the failure of the “calm down” and “don’t sweat the small stuff” tactic. You may accidentally trivialize your child’s dilemma by creating a comparison. If you are stressed out, or suffering from an anxiety or panic disorder yourself, sharing your point of view with your kid can be dangerous. It’s important not to obsess with each other. If you have two people who are anxious, they can actually begin to feed off each other. If people have trouble controlling their own anxiety, try not to engage in that activity even if you think it might help.

Research has demonstrated that stress can be a contagious emotion. A recent study by the University of California San Francisco discovered that newborn babies can absorb negative feelings from their mothers. To encourage healthier thinking, the research suggests that changing the conversation instead of commiserating can be more uplifting.


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