NYC marriage counseling, couples counseling therapist Irina Firstein, LCSW CBS Interview Psychotherapist New York


What is Anxiety?

Everyone feels anxious from time to time. Stressful situations, such as deadlines, tests, social obligations, fearful experiences make us feel nervous and scared. Some anxiety is needed for survival; it helps us be more alert and attentive to possible challenging or threatening situations.

Some people experience extreme fear and worry that do not subside and become more or less constant and chronic. This usually is a sign of anxiety disorder. The frequency and intensity of anxiety can become overwhelming and may interfere with daily functioning.

What are the major kinds of Anxiety Disorders?

There are several major kinds of Anxiety Disorders. The most common one is Generalized Anxiety Disorder, which is characterized by incessant worry about different things like health, money, kids and a sense of impending doom.

Untreated, Generalized Anxiety may evolve in a Panic Disorder which involves sudden, intense and unprovoked feelings or terror and dread. Oftentimes panic attack is mistaken for a heart attack or some serious medical issue and those having it end up in Emergency Room for an evaluation. More often then not, they are sent home with a prescription for anti anxiety medications and referral for treatment. Those suffering from Panic disorder, are chronically scared by possibility of the next attack, which tends to bring on the next attack. This becomes a vicious cycle of constant fear.

Other kinds of Anxiety Disorders are Phobias, Obsessive Compulsive Disorder and Post Traumatic Stress Disorder.

Treatment for Anxiety

It is critically important to treat anxiety. If left untreated, it can become a chronic condition which can impair day to day functioning and ability to perform normal activities. For example, if panic is untreated, those suffering from recurring panic attacks will be likely to avoid any situation which they may think will be likely to trigger the attacks. Such avoidance can interfere with job and family responsibilities as well as general quality of life.

The effective treatments for anxiety disorders are cognitive/behavioral therapies, EMDR, dynamic therapies as well as medication management. In many cases the symptoms of anxiety will subside relatively quickly after a few months of treatment.

In sessions with clients who suffer from anxiety we start with understanding biological, interpersonal and situational causes and roots of presenting symptoms as well as explore coping strategies for managing particular symptoms that are being experienced. When appropriate a referral for medication will be made.

When to seek treatment:

  • Persistent fears
  • Negative thinking involving catastrophic situations
  • Panic attacks
  • Increasing avoidance of more and more situations for the fear of triggering panic or other anxiety symptoms
  • Visits to Emergency Room with heart palpitations / fear of heart attack


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