Anxiety Management

Anxiety Management

We all feel overwhelmed sometimes—but if anxiety or stress is making it hard to enjoy life, sleep well, or keep up with day-to-day stuff, it might be time to talk to someone.

At Bloom Psychology, we help you understand what's fueling your anxiety and give you real tools to feel more grounded, calm, and in control. Whether it's racing thoughts, a tight chest, or the constant "what ifs," we're here to help you breathe easier—literally and emotionally.

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§What is Anxiety?

Anxiety is your body's natural response to stress—a feeling of fear or apprehension about what's to come. While everyone experiences anxiety occasionally, an anxiety disorder involves excessive worry that interferes with daily activities, relationships, and quality of life.

Unlike normal worry that comes and goes, clinical anxiety is persistent, often irrational, and can be overwhelming. It affects approximately 40 million adults in the United States, making it the most common mental health condition in the country.

Common Anxiety Symptoms

Mental/Emotional Symptoms:

Excessive, uncontrollable worry about everyday things

Racing thoughts that won't slow down

Catastrophic thinking ("what if" scenarios)

Difficulty concentrating or mind going blank

Irritability and restlessness

Sense of impending doom or danger

Difficulty making decisions

Fear of losing control or "going crazy"

Feeling on edge or keyed up constantly

Physical Symptoms:

Rapid heartbeat or pounding heart

Shortness of breath or feeling like you can't breathe

Chest tightness or pain

Sweating, trembling, or shaking

Dizziness or lightheadedness

Nausea or stomach problems

Muscle tension (especially shoulders, neck, jaw)

Headaches or migraines

Fatigue despite adequate rest

Sleep disturbances (difficulty falling or staying asleep)

Behavioral Symptoms:

Avoiding situations that trigger anxiety

Difficulty completing tasks due to worry

Procrastination from fear of failure

Seeking constant reassurance from others

Perfectionism and over-preparation

Social withdrawal or isolation

Compulsive behaviors (checking, counting, organizing)

§Types of Anxiety Disorders We Treat

Generalized Anxiety Disorder (GAD)

Persistent, excessive worry about various aspects of life—work, health, family, finances—even when there's little reason for concern. The worry is difficult to control and often shifts from one concern to another.

Panic Disorder

Recurrent, unexpected panic attacks—sudden surges of intense fear accompanied by physical symptoms like racing heart, sweating, and feelings of impending doom. Many people develop fear of having future panic attacks, leading to avoidance behaviors.

Social Anxiety Disorder

Intense fear of social situations where you might be judged, embarrassed, or scrutinized by others. This goes beyond shyness and can severely limit work, school, and relationship opportunities.

Phobias

Intense, irrational fear of specific objects or situations (heights, flying, needles, animals, enclosed spaces). The fear is disproportionate to actual danger and leads to avoidance that interferes with daily life.

Health Anxiety (Hypochondria)

Excessive worry about having or developing a serious illness, despite medical reassurance. Frequent doctor visits, excessive health-related research, and constant body checking are common.

Performance Anxiety

Fear of being judged during performance situations like public speaking, test-taking, athletic competition, or work presentations. Physical symptoms can interfere with actual performance, creating a self-fulfilling prophecy.

§Understanding the Anxiety Cycle

Anxiety perpetuates itself through a predictable cycle:

1. Trigger: Something (real or imagined) activates worry 2. Anxious Thoughts: "What if something bad happens?" "I can't handle this" 3. Physical Symptoms: Heart races, breathing quickens, muscles tense 4. Behavioral Response: Avoidance or safety behaviors that provide temporary relief 5. Reinforcement: Avoidance confirms the perceived threat, strengthening anxiety for next time

Effective anxiety treatment interrupts this cycle at multiple points, teaching you that:

Anxiety sensations, while uncomfortable, are not dangerous

Avoidance increases anxiety long-term

You can tolerate discomfort and uncertainty

Catastrophic predictions rarely come true

§Evidence-Based Treatment Approaches

Cognitive Behavioral Therapy (CBT)

The gold standard for anxiety treatment, CBT focuses on the connection between thoughts, feelings, and behaviors.

Cognitive Restructuring:

Identify anxiety-provoking thought patterns

Examine evidence for and against worried thoughts

Challenge catastrophic thinking with realistic alternatives

Practice balanced, helpful thinking patterns

Behavioral Techniques:

Gradual exposure to feared situations

Response prevention (resisting avoidance and safety behaviors)

Behavioral experiments to test anxious predictions

Activity scheduling to combat avoidance

Skills You'll Learn:

Thought records to track and challenge anxious thinking

Anxiety hierarchy creation (fear ladder)

Exposure exercises tailored to your specific fears

Relapse prevention strategies

Acceptance and Commitment Therapy (ACT)

Rather than trying to eliminate anxiety, ACT teaches you to change your relationship with anxious thoughts and feelings.

Core ACT Principles:

Acceptance: Allow anxiety to exist without fighting it

Defusion: See thoughts as mental events, not facts

Present Moment: Ground yourself in "here and now" vs worrying about future

Self-as-Context: You are not your anxiety

Values: Identify what matters most to you

Committed Action: Take steps toward valued life despite anxiety

Mindfulness-Based Approaches

Mindfulness teaches you to observe anxious thoughts and sensations without judgment or reactivity.

Mindfulness Practices:

Body scan meditation to notice physical anxiety

Breath awareness to calm the nervous system

Observing thoughts like clouds passing

Present-moment awareness exercises

Non-judgmental acceptance of internal experiences

Exposure Therapy

For phobias, panic disorder, and avoidance behaviors, exposure therapy is highly effective.

How Exposure Works:

Create hierarchy of feared situations (least to most anxiety-provoking)

Start with manageable exposures

Stay in situation until anxiety naturally decreases (habituation)

Repeat exposures until fear diminishes

Progress up the hierarchy at your pace

Types of Exposure:

In vivo: Real-life exposure (e.g., actually flying)

Imaginal: Visualizing feared scenarios

Interoceptive: Inducing feared physical sensations (e.g., rapid heartbeat)

Virtual reality: Simulated exposure for certain phobias

§Physical Symptom Management

Since anxiety creates intense physical symptoms, we teach you somatic regulation techniques:

Breathing Exercises

Box Breathing: Inhale 4, hold 4, exhale 4, hold 4

Diaphragmatic Breathing: Deep belly breaths to activate parasympathetic nervous system

4-7-8 Breathing: Inhale 4, hold 7, exhale 8

Paced Breathing: Slow, rhythmic breaths at 5-6 per minute

Progressive Muscle Relaxation (PMR)

Systematically tense and release muscle groups to reduce physical tension and increase body awareness.

Grounding Techniques

5-4-3-2-1 Method: Name 5 things you see, 4 you touch, 3 you hear, 2 you smell, 1 you taste

Cold water: Splash face or hold ice cubes

Physical anchoring: Press feet into floor, notice where body contacts chair

Sensory focus: Texture, temperature, weight of object in hand

Vagus Nerve Stimulation

Humming, singing, or gargling

Cold exposure (ice on face, cold shower)

Deep, slow breathing

Gentle neck and jaw stretches

§Lifestyle Factors in Anxiety Management

While not treatments alone, these significantly impact anxiety levels:

Sleep

Anxiety and sleep have bidirectional relationship

Aim for 7-9 hours nightly

Consistent sleep/wake times

Limit screen time before bed

Create calming bedtime routine

Exercise

Aerobic exercise reduces anxiety as effectively as some medications

20-30 minutes most days

Activities you enjoy (walking, dancing, swimming)

Yoga combines movement with breathwork

Nutrition

Limit caffeine (can mimic anxiety symptoms)

Reduce alcohol (depressant that worsens anxiety long-term)

Regular meals to stabilize blood sugar

Omega-3 fatty acids support brain health

Adequate hydration

Social Connection

Isolation worsens anxiety

Regular contact with supportive people

Share feelings rather than hiding them

Join support groups or community activities

§Anxiety and Medication

For moderate to severe anxiety, medication can be an important part of treatment.

Common Anxiety Medications

SSRIs/SNRIs (First-line):

Sertraline (Zoloft), Escitalopram (Lexapro), Venlafaxine (Effexor)

Take daily, effects build over 4-6 weeks

Address underlying anxiety, not just symptoms

Can be used long-term safely

Benzodiazepines (Short-term):

Alprazolam (Xanax), Lorazepam (Ativan), Clonazepam (Klonopin)

Fast-acting (30-60 minutes)

For acute anxiety episodes or panic attacks

Risk of dependence with long-term use

Best used temporarily while therapy takes effect

Buspirone:

Non-addictive anti-anxiety medication

Takes 2-4 weeks to work

Alternative for those who can't take SSRIs

Beta-blockers:

Propranolol for performance anxiety

Blocks physical symptoms (rapid heart, trembling)

Taken as-needed before anxiety-provoking events

Therapy + Medication: Best Outcomes

Research shows combining therapy with medication yields better results than either alone. Therapy teaches skills you keep forever, while medication provides symptom relief to engage more fully in treatment.

We coordinate with your primary care doctor or psychiatrist to ensure safe, effective medication management alongside therapy.

§What to Expect in Anxiety Therapy

First Session (Assessment)

Comprehensive anxiety symptom evaluation

Identify specific triggers and feared situations

Assess impact on work, relationships, daily functioning

Review medical history and previous treatments

Discuss treatment goals and preferences

Begin initial anxiety management techniques

Ongoing Sessions (Weekly or Bi-weekly)

Practice cognitive restructuring

Gradual exposure exercises

Mindfulness and acceptance skills

Physical symptom management

Homework assignments to reinforce learning

Regular progress monitoring

Treatment Duration

Many people see significant symptom reduction within 12-16 weeks of CBT. However, severity of anxiety, consistency with homework, and life stressors affect timeline. Some continue occasional "maintenance" sessions to sustain progress.

§Why Choose Bloom Psychology for Anxiety Treatment

Specialized Anxiety Expertise

Dr. Jana Rundle has extensive training in evidence-based anxiety treatments including CBT, ACT, and exposure therapy. Unlike general therapists, we understand the neurobiology of anxiety and use proven techniques that create lasting change.

Personalized Treatment Plans

No two people experience anxiety the same way. We tailor treatment to:

Your specific anxiety type (GAD, panic, social, phobias)

Your triggers and symptom patterns

Your lifestyle and constraints

Your treatment preferences and goals

Flexible Therapy Options

Telehealth Anxiety Therapy: Secure video sessions from anywhere in Texas, ideal for those with social anxiety or transportation challenges.

In-Office Care: Our North Austin office provides a calm, private environment designed to help you feel safe exploring anxiety.

Skills You Can Use Forever

Unlike medication alone, therapy teaches you tools you'll have for life. When anxiety returns during stressful periods, you'll know exactly how to manage it.

Austin's Anxiety Specialists

Serving North Austin, Round Rock, Cedar Park, Georgetown, Pflugerville, Lakeway, and all of Texas via telehealth.

Unlike general therapists, we understand the neurobiology of anxiety and use proven techniques that create lasting change.

Your Path to Calm

1

Comprehensive Assessment

Identify your anxiety triggers, physical symptoms, thought patterns, and the impact on your daily functioning.

2

Personalized Treatment Plan

Develop a tailored approach combining cognitive techniques, mindfulness practices, and physiological regulation strategies.

3

Skills Integration

Learn to seamlessly incorporate anxiety management tools into your daily life, gradually building confidence in challenging situations.

Key Benefits

Symptom Reduction

Decrease the frequency and intensity of anxiety symptoms, including worry, panic, and physical tension.

Cognitive Restructuring

Transform anxious thought patterns into more balanced, realistic perspectives.

Physiological Regulation

Master techniques to calm your nervous system during stress responses.

Exposure Confidence

Gradually face feared situations with new coping skills and increasing comfort.

Preventative Practices

Develop daily habits that build resilience against future anxiety and stress.

Reclaimed Freedom

Re-engage in activities that anxiety previously limited or prevented.

Frequently Asked Questions

We're here to answer your questions about this service.

How is your approach different from medication?

While medication can be valuable for symptom management, our therapeutic approaches address the underlying causes and thought patterns while teaching lifelong coping skills. Many clients find therapy provides sustainable relief, either alongside medication or as an alternative. Research shows that combining therapy with medication often yields the best outcomes—therapy teaches you skills that last forever, while medication provides relief to engage more fully in treatment.

Do you treat specific phobias?

Yes, we offer evidence-based exposure therapy for specific phobias such as fear of flying, needles, heights, enclosed spaces, animals, or other triggers. This gradual, supported approach has high success rates (80-90%) for phobia reduction. We create a personalized fear hierarchy and progress at your pace, ensuring you feel safe and in control throughout the process.

How quickly will I notice improvement?

Many clients report some symptom relief within the first few sessions as they begin implementing basic regulation techniques like breathing exercises and thought challenging. More significant and lasting changes typically emerge within 8-12 weeks of consistent practice. However, everyone's timeline is different based on anxiety severity, consistency with therapy homework, and life circumstances.

What if my anxiety returns after treatment?

Occasional anxiety is a normal part of life, but the tools you learn in therapy become lifelong skills. When anxiety resurfaces during stressful periods (job changes, relationship transitions, health challenges), you'll know exactly how to manage it using your CBT toolkit. Many clients schedule occasional "booster" sessions during high-stress periods. We also provide resources for ongoing practice to maintain your progress.

What's the difference between worry and an anxiety disorder?

Everyone worries sometimes—that's normal. Worry becomes an anxiety disorder when it's excessive, difficult to control, interferes with daily functioning (work, relationships, sleep), causes significant distress, and occurs most days for at least 6 months. If worry is taking over your life, making decisions difficult, or causing physical symptoms that disrupt your day, it may be time to seek support.

Can anxiety therapy help with panic attacks?

Absolutely. Panic attacks are highly treatable with CBT and exposure therapy. We teach you that panic attacks, while terrifying, are not dangerous—your body is having a false alarm. You'll learn interoceptive exposure (safely inducing panic sensations in session), breathing techniques, cognitive restructuring to reduce fear of panic, and how to break the "fear of fear" cycle. Most people see significant reduction in panic frequency and intensity within 8-12 weeks.

Do I need to talk about traumatic events from my past?

Not necessarily. While some anxiety is rooted in past trauma, anxiety treatment focuses primarily on present-moment symptoms, thought patterns, and behaviors. You're never forced to discuss anything you're not ready to address. If past trauma is relevant to your current anxiety, we can incorporate trauma-focused approaches at a pace that feels safe for you.

What if I'm anxious about starting therapy?

Many people with anxiety feel nervous about therapy itself! We get it. Your first session is low-pressure—we'll explain how therapy works, answer questions, and teach you one or two immediate coping techniques you can use right away. You control the pace. Telehealth sessions can feel less intimidating than in-person if social anxiety is a concern. And our free 15-minute consultation lets you "test the waters" before committing.

Can you help with health anxiety and fear of medical procedures?

Yes, health anxiety (hypochondria) and medical phobias are specialties of ours. We help you distinguish between realistic health concerns and anxiety-driven catastrophizing, reduce compulsive checking behaviors and excessive doctor visits, tolerate medical uncertainty, and gradually face feared medical procedures through exposure therapy. Many clients with needle phobias, fear of medical tests, or health anxiety see significant improvement.

Will I have to take medication?

No, medication is not required. Many people manage anxiety successfully with therapy alone, especially for mild to moderate symptoms. For severe anxiety, panic disorder, or if therapy alone isn't providing sufficient relief, we may recommend discussing medication with your doctor. All medication decisions are collaborative and based on your preferences, symptom severity, and treatment response. If you do take medication, we coordinate with your prescriber to ensure comprehensive care.

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