Anxiety therapy in NYC

Our team of therapists with doctoral-level training have expertise in helping you respond to anxiety with actionable steps so you feel empowered, understand what may be underneath. Whether you’re struggling with social anxiety, health anxiety, or chronic worry about many things, there are ways to address those thoughts, feelings, or sensations so they don’t take over your life.

We know it feels terrible to spiral, be stuck in your own head, and experience dread. While we can’t predict what life throws our way, we’ll help you find your bearings instead of living reactively. Being anxious can get in the way of your relationships, work, health, and your ability to be present or enjoy things. It’s exhausting and frustrating to spend energy preparing for scenarios that you may later regret.

Although anxiety does have a helpful purpose (it does!) in our lives, it’s not meant to be our baseline. Anxiety therapy can help you gain insight, learn practical skills to respond differently, and build your self-trust and resiliency for whatever comes next. If you’re interested in learning more, schedule an introductory call with one of our therapists who specialize in anxiety. We’d love to connect and share how we work.

 

Signs and symptoms of anxiety

  • Ruminating or uncontrollable repeated thinking about a situation

  • Always playing out the worst-case scenario “just in case”

  • Panic attacks

  • Feeling on edge and jittery throughout the day

  • Easily distracted or difficulty focusing

  • Avoidance and procrastination

  • Difficulty being present

  • Poor sleep or insomnia

  • Changes in appetite (stress eating or loss of appetite)

  • Muscle tension and headaches

  • Reassurance seeking (asking friends, family, internet searches)

  • Repetitive behaviors such as checking that everything is in place

 

What’s the difference between stress and anxiety?

Stress is the activated response we have to a situation happening in the present, whereas anxiety is a response we have to a possible “what if” situation in the future. There is however, a lot of overlap in how stress and anxiety can feel, and we tend to use the words interchangeably - so getting confused about which one you’re experiencing is common.

With both, you may think a lot about a situation, feel overwhelmed, have trouble sleeping, lose your appetite. You may even start by being stressed dealing with a situation, then feel anxious about the unknown outcome. The main difference is that you’re stressed because a situation taxes your energy or resources - you’re worn thin because you’ve been problem solving a complicated family situation, working long hours, or responding to your kids. Anxiety can also wear you down, but it’s about hypotheticals that haven’t happened.

Stress and anxiety both have a purpose and place in our lives, but aren’t meant to be our baseline. Stress also naturally resolves itself when the situation that triggered it is over. What’s hard about anxiety is that since it’s about hypotheticals, your imagination may never stop. You could worry about countless scenarios, therefore feel anxious all the time.

If you’re struggling with anxiety, you’re not alone. According to the Anxiety and Depression Association of America, anxiety affects nearly 1 in 5 adults every year, making it the most common mental health concern for individuals 18 years of age and older.

Is anxiety good or bad?

It can be both! Anxiety does have a purpose in our lives, and a little anxiety can be helpful. All that worst-case scenario-ing pushes us to anticipate the future, which is useful for planning and problem solving. Anxiety can keep us safe and motivate intentional action.

However, long-term, chronic anxiety is debilitating and means there’s an imbalance in thinking and action. More often than not this kind of anxiety results in circular thinking, low tolerance for any risk, and difficulty trusting in your own capacity to face hard things or uncertainty. Chronic anxiety ends up having a significantly negative impact on your physical health, how we connect with others, and what we believe is possible.

 

Types of anxiety disorders

What’s an anxiety disorder?

While everyone experiences some anxiety from time to time, if your anxiety becomes significant and you begin to struggle at work, in relationships, or in managing parts of your daily life, you may have an anxiety disorder.

The good news is that you don’t have to continue to feel this way - research shows that anxiety disorders are very treatable through therapy and with professional support.

Generalized Anxiety Disorder

Generalized Anxiety Disorder is characterized by chronic, excessive worry about a range of topics and situations, more days than not in a week, that is difficult to control, for over 6 months. You may also experience muscle tension, difficulty focusing, irritability, fatigue, feeling keyed up, or changes in your sleep.

Panic Disorder

Panic Disorder includes experiencing reoccuring panic attacks, which are surges of intense fear and physical distress peaking in a few minutes. A panic attack includes physical symptoms, such as shakiness, sweating, dizziness, heart palpitations, chills, shortness of breath, chest pain, or a sense of being detached from your body or about to die. In panic disorder, there is a persistent worry of future panic attacks and changes in your behavior to avoid panic attacks for at least a month.

Obsessive Compulsive Disorder (OCD)

OCD is characterized by time-consuming presence of obsessions (intrusive, unwanted, repetitive thoughts or images) or compulsions (repetitive behaviors or mental acts). Obsessions often cause distress and attempts are made to neutralize the thought. Compulsions may feel absolutely necessary or to prevent unwanted outcomes.

Social Anxiety Disorder

Social Anxiety Disorder is a specific and consistent worry of negative scrutiny by others in social situations, often having to do with being afraid of embarrassment or judgment, lasting over 6 months.

Phobias

Phobias are anxiety about a specific situation or object considered disproportionate to the actual threat (e.g., fear of flying, dogs, elevators) resulting in immediate fear and endured with intense dread or avoided completely for over 6 months.

 

Causes of anxiety

There is no one cause of anxiety, but we know that individual factors like genetics, personality or temperament, parental modeling, physical health issues, and negative or traumatic experiences increase the likelihood that you will struggle with anxiety. It’s also important to think of social and environmental factors for anxiety, which tend to be chronic stressors out of one person’s control. For example, experiencing racism or prejudice isn’t an easily solvable problem and can maintain long-term anxiety.

How does experiencing racism affect mental health

A meta-analysis of nearly 300 articles published across 30 years found that the correlation between racism and poor mental health was twice as large as the correlation between racism and poor physical health (Paradies et al., 2015). Experiencing race-based discrimination has been specifically connected to generalized anxiety, even when controlling for other confounding variables that may explain the reason for one’s anxiety (Soto, Dawson-Andoh, & BeLue, 2011; Cuevas et al., 2020).

For many, this information is intuitive - as any form of social oppression is often frequent, systemic, and unresolved, resulting in chronic stress and disempowerment. Living in this context keeps our “fight or flight” nervous system on for prolonged periods of time. If your mental health has been affected by racism (or other forms of oppression), we encourage you to bring it up in therapy.

 
big sunflower in field of sunflowers

How can therapy for anxiety help?

Therapy for anxiety helps you get out of your head and back into the driver’s seat of your life. Your therapist can be a stable source of support while you learn to make changes that decrease your anxiety and strengthen you ability to stay calm, grounded, and in control. While your worries may be valid, it doesn’t mean that your mind and body should be filled with anxiety all day.

Example goals in anxiety therapy

  • Understand what anxiety actually is and how it works

  • Understand what panic attacks are and how to respond in healthy ways

  • Reduce worry and make rumination productive

  • Grow self-awareness and build self-confidence

  • Process unresolved past experiences or traumatic memories that may be propelling your anxiety

  • Understand the different types of anxiety disorders and clarify if your anxiety may be connected to something else needing attention (e.g., trauma, ADHD, relationship dynamics)

  • Try alternative resources, such as medication or lifestyle changes (e.g., exercise, sleep)

  • Build strategies and self-care routines that effectively manage anxiety and stress

  • Strengthen problem solving skills versus rumination skills

Types of therapy for anxiety

There are many types of therapy that effectively address anxiety. Here are some of the many approaches that our therapists are well-versed in and use in treating anxiety disorders.

Cognitive Behavioral Therapy (CBT)

CBT focuses on identifying connections between your thoughts, emotions, and behaviors. Since anxiety is significantly connected to how we think and is also a physiological response, learning to notice unhelpful ways of thinking and having behavioral strategies will help you manage your anxiety. Anxiety can also be tied to deeper core beliefs about who you are, relationships, or the world. CBT helps you evolve those unhelpful beliefs so you feel more empowered and resilient.

Mindfulness or MBCT

Anxiety means we are stuck in our heads, our thoughts on overdrive about the future. Mindfulness helps you slow down and pay attention to the present. Mindfulness Based Cognitive Therapy, or MBCT is a specific therapy that focuses on incorporating mindfulness, non-judgmental acceptance, and self-compassion as you work on the thoughts that may be exacerbating worry or panic. Techniques can include meditation, breathing, and body scans that help you quiet an overactive nervous system.

Emotion Regulation Therapy (ERT)

ERT was originally created to treat generalized anxiety and focuses on a combination of education about feelings, mindfulness practices, and prioritizing values-based actions over anxiety-based ones. ERT can help you reconnect with what matters most to you so you stay can respond with personal intention instead of reactivity.

Psychodynamic Therapy

Psychodynamic therapy focuses on gaining insight about past experiences that shaped your sense of self and relationships. Understanding the root causes of your anxiety can help you make key changes that change your perspective and how you approach the future.

Multicultural Therapy

Multicultural therapy celebrates individual differences and all identities as equal and valuable. Multicultural Therapy highlights what your social identities means to you, and how the intersections (gender + race + sexuality) shape your experiences and mental health. Not all spaces are welcoming, open-minded, or safe - and multicultural therapy can help you understand your anxiety from a lens of identity and within a broader social context.

Trauma Therapy

Trauma-informed therapy focuses on understanding and addressing the effects of traumatic experiences on your mood, relationships, body, and sense of self. Sometimes the hypervigilance or feeling of being on edge may stem from past painful memories or events where you had to stay alert or ready in case something terrible could happen. Even if you may not need to be on the lookout any longer, sometimes your brain, body, and emotions can get stuck on “alert” mode. Trauma therapy can help you re-set your perspective and nervous system so you can experience calm when it makes sense to.

 

Anxiety therapists in Manhattan, NYC

Our team of psychologists at Manhattan Therapy Collective are trained in a range of relational, multicultural, and evidence-based therapy approaches for anxiety, such as Cognitive Behavioral Therapy and mindfulness interventions. We encourage you to reach out for support - we would love to connect with you and answer your questions.

If you have always “been a worrier”, being anxious may feel like the norm or even be a way you motivate yourself in life. It may never have occurred to you to imagine your life (or head space) without an anxious voice playing out every scenario. This is often be the case for high achievers or those in high-performing workplaces where the effects of anxiety (e.g., preparing in advance, identifying risks) were rewarded.

Anxiety does have a place in our lives, as a protective emotion that keeps us safe from harm. Therapy helps you listen to anxiety when it makes sense to, and set helpful limits so it doesn’t have complete power and control in your life. If you’re interested in learning more, book a free consultation today.

 

FAQs about therapy for anxiety

 

  • Ultimately, the decision to try therapy is up to you, and we support you either way. Yes, everyone does experience anxiety about possible future scenarios from time to time. However, we encourage you to consider therapy if you have noticed that your anxiety is frequent, persistent, and starts getting in the way of your work, relationships, health, personal goals, or daily routines.

  • Absolutely not. We will never push you to try or do anything that you are not interested in. We have found that sometimes people who have not found mindfulness or relaxation techniques effective have not received adequate coaching or support in their skills practice, making it unlikely that they would feel any real benefit. Since there is a neurobiological basis of anxiety, we do find that the use of behavioral techniques (such as deep breathing and meditation, among many others) can result in significant progress. That being said, there are many ways to address anxiety effectively, and we will work together to use what works for you!

  • If you are interested in medication, we can discuss that decision with you and can provide a psychiatric referral. We will work with you and your physician or prescriber to create a sustainable treatment plan that works best for you. This may or may not include medication for a short-term period or a more open-ended period of time. Sometimes patients are interested in trying out psychotherapeutic techniques prior to trying medication for their anxiety. Since anxiety can affect things like concentration and sleep, sometimes starting a medication prior to starting therapy creates helpful stability so you can be more present for your sessions. We will always collaborate and reevaluate what makes the most sense for you.

 
 

References:

Cuevas, A. G., Mann, F. D., Williams, D. R., & Krueger, R. F. (2021). Discrimination and anxiety: Using multiple polygenic scores to control for genetic liability. Proceedings of the National Academy of Sciences, 118(1), e2017224118.

Paradies, Y., Ben, J., Denson, N., Elias, A., Priest, N., Pieterse, A., Gupta, A., Kelaher, M., & Gee, G. (2015). Racism as a Determinant of Health: A Systematic Review and Meta-Analysis. PloS one, 10(9), e0138511. https://doi.org/10.1371/journal.pone.0138511

Soto, J. A., Dawson-Andoh, N. A., & BeLue, R. (2011). The relationship between perceived discrimination and generalized anxiety disorder among African Americans, Afro Caribbeans, and non-Hispanic Whites. Journal of anxiety disorders, 25(2), 258-265.