Therapy That Works...

Facebook Fridays – Rizwan (08/01/14) - By Chris Gearing

Friday, August 01, 2014

Watch Dr. Sylvia answer a question from Rizwan on Facebook about Generalized Anxiety Disorder and how it's different from clinical depression - click here.

Rizwan from Facebook wrote in:

“I know a lady in my circle. She is regularly very worried because of some family issues. She doesn’t sleep well and also feels low these days. Her appetite is less than normal now for her. Is she suffering from GAD?”

Thanks for your question on Generalized Anxiety Disorder, Rizwan. To better understand this disorder, here are some important facts to keep in mind:

Generalized Anxiety Disorder or GAD is known as the “worrier” diagnosis.

People with GAD tend to ruminate on anxious or negative thoughts, which propel them into a seemingly endless cycle of anxiety. The more they worry, the more the habit is reinforced.

Over 40 million Americans suffer from GAD. That’s 18% of the population! In fact according to many sources, anxiety is the number one diagnosis in the US. However, most sufferers don’t get help for it and continue to hurt when there are proven remedies for this condition.

Here are a few of the most common symptoms for GAD:

  • Excessive anxiety and worry
  • Difficulty controlling worried thoughts
  • Restlessness or feeling on edge
  • Easily fatigued
  • Difficulty concentrating or mind goes blank regularly
  • Irritability
  • Muscle tension
  • Insomnia or restless sleep

Clinical Depression commonly co-occurs with Generalized Anxiety Disorder, and it is another one of the most common mental health diagnoses in America.

In fact, forty two percent of GAD patients also have clinical depression. The combination of the two conditions can propel us into an endless loop of catastrophic thinking that convinces us we are helpless and hopeless. The depressed and anxious brain tends to avoid objectively evaluating the evidence and instead jumps to catastrophic conclusions. Relapsing into depression is tragically common and is more likely when the previous episode was severe and incapacitating.

Common symptoms of Clinical Depression include:

  • Depressed thoughts and mood
  • Low energy, fatigue, and sudden loss of energy
  • Diminished interest or pleasure in the usual activities
  • Significant weight loss or weight gain
  • Sleeping too much or too little
  • Restlessness or feeling slowed down
  • Feelings of worthlessness or excessive guilt
  • Diminished ability to think or concentrate
  • Difficulty making decisions
  • Recurrent thoughts of death or suicide

Unfortunately, there is quite a bit of overlap between the symptoms of anxiety and depression and it is often very difficult to differentiate between the two.

Most depressed people have anxiety and vice versa. For example, many people who are depressed tend to worry, sleep and eat erratically, and feel low and empty much of the time. Anxious people may also worry, sleep and eat erratically, and feel blue some of the time. It is my opinion that while anxiety and depression often co-occur, one of the conditions precedes the other and is usually more dominant.

However, it is extremely important to differentiate between the two diagnoses since therapy approaches and medication heavily rely on an accurate diagnosis. Different psychotherapies and medicines are used to specifically treat each condition.

If you are worried about your friend having one of these problems Rizwan, please seek the help of a clinical psychologist or mental health professional who can use a combination of interviews and psychological testing to provide the correct diagnosis for effective treatment.


The Anxiety and Depression Association of America (ADAA)

The Diagnostic and Statistical Manual of Mental Disorders - IV - RT

Facebook Fridays – Curtis (06/20/14) - By Chris Gearing

Friday, June 20, 2014

Watch Dr. Sylvia answer Curtis from Facebook's question about long distance relationships - click here.

Curtis from Facebook writes in:

“My girlfriend and I just went long distance after being together for a year. Our relationship is strong, [and] we are best friends as well as a couple. She left 2 days ago and I can’t see her again until Christmas time. Any advice on how to make it work?”

Well Curtis – first, congratulations on finding such a wonderful partner and I sincerely hope that things work out for both of you. Here are some a few tips to keep in mind:

Built On Friendship

Many people forget that a deep and abiding friendship is one of the cornerstones to love. Romance thrives when you genuinely enjoy your partner and have fun when you interact either on the phone or face-to-face. Consider this to be one of your most important strategies to survive and even thrive during the physical separation. There are a million ways to keep your friendship alive when you are away from one another by playing through words and activities. Playing games together online like “Words With Friends,” video chatting through Skype, posting on each others’ Facebook walls, or sharing pictures on Instagram or Tumblr are all great ways to stay connected.

Building Trust

Most people don’t realize that trust is built one interaction at a time. We reinforce trust through staying faithful to one another, but we also show our trustworthiness when we interact with sincere and total focus. Whenever you interact with her, be emotionally present and give her all of your attention. Women find undiluted focus intoxicating. Also, make sure you remain committed to timely answers to texts, emails, or any social media interaction. Even if you’re just explaining that you’re busy right now, she’ll appreciate your attentiveness and care.

Radical Acceptance

Being away from the one you love can be difficult, particularly for long stretches of time. If you find that your stress or anxiety is growing, use a distress tolerance technique called “radical acceptance.” Dr. Marsha Linehan, the inventor of Dialectical Behavior Therapy, invented this technique. Radical acceptance asks you to separate what you can control and what you cannot control. Focusing your attention and efforts on what you can control will calm you down and makes you more confident. Remember that radical acceptance does not ask you to enjoy what is happening. It simply asks you to focus on controllable factors and let go of what is out of your control. Once you can do this, you can focus on what you can do to keep your relationship vibrant and healthy.

Express Yourself Verbally

While actions are very important, there is no substitute for the power of words, particularly for women. Send a poem that you wrote or borrowed from a famous poet that tells her how much you love her or that you were simply thinking of her. Send a loving phase along with a favorite picture of both of you or even a Pinterest board to plan your next vacation. And most important of all, when you talk to her, tell her that you love her and you miss her.


The Work of Dr. John Gottman

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