Have you ever felt overwhelmed by anxiety?
Anxiety stems from stress, and is a normal part of life—but it can affect your health. We experience anxiety at work, at school, and even at home.
While anxiety can never be eliminated entirely from our lives, it can be managed. It is also important to distinguish between normal feelings of anxiousness and a clinically-diagnosed anxiety disorder—like panic disorder—which may require medication and counseling.
To learn more about causes and treatments of anxiety, listen to an informative podcast by Summit Medical Group’s Dr. James Korman, who discusses healthy coping skills for anxiety.
Selected Podcast
Effective Management of Anxiety
Featured Speaker:
James R. Korman, PsyD
James R. Korman, PsyD, ACT, is Director of the Behavioral Health and Cognitive Therapy Center and Director of Integrative Medicine at Summit Medical Group in Berkeley Heights, New Jersey. In addition to his positions at Summit Medical Group, Dr. Korman is Clinical Assistant Professor in the Department of Family Practice at the University of Medicine and Dentistry-New Jersey Medical School in Newark. Transcription:
Effective Management of Anxiety
Melanie Cole (Host): Have you ever felt overwhelmed by anxiety? We all have at one time or another in our lives, but true anxiety and the things that you need to be concerned about are the ones that maybe you need to get some help for. All of us need a little help at some point in our lives. My guest today is Dr. James Korman. He’s the director of the Behavioral Health and Cognitive Therapy Center and the director of Integrative Medicine at Summit Medical Group. Welcome to the show, Dr. Korman. Tell us a little bit about anxiety. What constitutes true anxiety from just generalized worry, and when do we think that red flags are sent up that this is something to be concerned about?
Dr. James Korman (Guest): Oh, sure, Melanie. Let me start off by telling you that anxiety is really a normal human emotion that everybody experiences from time to time. Many people feel anxious or nervous when faced with a problem at work, before taking a test, or making an important decision. In order to really understand anxiety, you have to understand it has two primary symptoms. One is worry, and this is when people are repeatedly thinking or ruminating about a feared situation and ways to manage or solve it. The other primary symptom are really physical reactions. This is when people have racing hearts, sweating, shaking, shortness of breath, dizziness, et cetera. And this is really an activation of our sympathetic nervous system or our fight or flight response, and this is the body’s natural mechanism that allows it to protect itself by either fleeing a feared situation or fending off an attacker. Like we’re saying, anxiety can be normal and actually helpful in small, limited doses, as it can help motivate people to address the feared situation and find a solution to it. However, when anxiety goes on for too long a period of time at too high a level, it actually begins to reduce or hurt people’s motivation and ability to solve problems, and that’s when we start thinking that there could be a problem and it could be an anxiety disorder.
Melanie: Who would be the first person that someone would seek out if they were having an anxiety disorder, if they were letting their psychological stresses affect their physiological self and, as you said, notice some of these actual changes? Who would we seek out? What would we do?
Dr. Korman: Sure. I think that first of all, when people start to notice that those symptoms really start to significantly negatively impact their work, school, or social life, they really should be talking to somebody. One of the effective treatments that are available is cognitive behavioral therapy, and I certainly would advocate people to go looking for a good cognitive behavioral therapist.
Melanie: What can they expect from that type of treatment?
Dr. Korman: Well, cognitive behavioral therapy believes that it’s not the events in people’s lives that cause them problems but it’s how they think about those events that causes them problems. We know that people who have a lot of anxiety or anxiety symptoms, they spend a lot of time thinking about and worried about the future. They believe that there’s going to be bad outcomes constantly, and then they start reacting physically, emotionally, behaviorally if that bad thing is going to happen. One of the things that cognitive behavioral treatment does is help people to evaluate the validity of those ideas and thoughts. We teach people very specific skills to think as realistically as possible so that they’re spending more time in the present and far less in the future. We also know that people tend to only focus on information that supports their thinking. They tend to ignore information that suggests their thinking isn’t true, or they change information to fit their beliefs. People who are anxious and worried tend to only focus on the data and information that supports their worried, catastrophic, and bad thinking about the outcomes. And then finally, we really work on people’s behavior. Because when people are very anxious, they tend to look into the future. They think the future is bad. Then they start only looking at the information that supports it, and then they start acting upon those ideas as if they’re true. We call those safety behaviors, and people will engage in a lot of avoidance of things that make them anxious. And we have to get people to behave in ways that make sense. And so, we often will do behavioral experiments to help people to find out if the bad outcome is going to take place, and if it does, can they really manage it much better than their thinking. We shift people from a prevention mode, which is where people react with anxiety, into a coping mode, learning how to handle and manage feared outcomes, rather than trying to prevent or escape them.
Melanie: That’s absolutely brilliant, Dr. Korman, because it is how people feel. And I’ve seen this so much with this type of worries where you’re looking at the future and envisioning all of these bad things. If somebody has anxiety disorder and this is something that they live with, will it be a part of the rest of their lives, or can this cognitive behavioral therapy help to kind of put the kibosh on that and make it so that this is not something that affects them for the rest of their lives?
Dr. Korman: Research really does support the idea that cognitive behavioral therapy can be very effective in significantly reducing the symptoms of anxiety or eliminating them. There’s some very good research that shows that people do not have to suffer from anxiety disorders for the rest of their lives. Some people may find that they have worry, and they have certain anxiety symptoms, but what happens is those symptoms become far less important. They’re much easier to just push away, and they can manage their lives in a much better way.
Melanie: So many people are looking toward medications these days to help with their anxiety, to help with their worry and their stress levels, and we’re learning more and more, Dr. Korman, about how bad stress really is and cortisol levels. What do you think about the medication situation that we’ve got going on out there, and how does it compare to the outcomes of cognitive behavioral therapy?
Dr. Korman: That’s an interesting question. I’m not anti-medication in any way. I do think it can be very helpful for people, especially when they’ve been having long span of anxiety problems, or when anxiety is at such a high level they have difficulty engaging in the treatment that we want them to do. I think medications are very good on a short-term basis. I think they can be used for people, again, who have a longer-term history. But the outcome studies for cognitive behavioral therapy does show that it can be extremely effective, and a combination of the two can be effective in the short term. But for most patients, they can often come off of the medication over time, and the CBT strategies that we give them is more than enough to manage their symptoms.
Melanie: Aside from those strategies, what can people do at home, in their daily lives, and behavioral modifications, things that they can do that can help them deal with these stressors and worries right then when they’re happening?
Dr. Korman: Well, right then, I think some of the important things is if there’s one big question that I often ask my anxiety patients, especially when they’re very stressed, is what is the worst thing that could happen in whatever it is that you’re dealing with. And, if that thing was to take place, could you handle it? Could you manage it? And almost all of my patients, when they think about a feared outcome and we start thinking about, “Can you manage this situation?” they always say yes. That usually brings down their worry and anxiety. That’s one really good technique to be asking yourself when you’re in one of those stressful or anxiety-related situations. What’s the worst thing that could happen, and could I really handle this and manage this? What would I do? Certainly, when people are in very stressful situations, I often tell them to take a break, walk away from it for a few minutes, give them time to think about it. Certainly, exercise is a great thing. Take a break from the situation. And we know that exercise if great for managing things that happen right then, so you walk away, go for a walk, and certainly as a maintenance. Exercise is just a great thing for anxiety, depression, and every other disorder you can think of.
Melanie: What about meditation, deep breathing? Do those things work to help calm people down or center them?
Dr. Korman: Absolutely. In fact, I’m a big advocate for meditation, and in particular, I’m a big advocate for something called mindfulness meditation or mindfulness-based stress reduction. It’s a great approach. It helps people to stay centered. It helps them not to get caught up in how they’re thinking or feeling, and they can be very, very present. Because remember, anxiety and stress is always about the future. And anything that centers us and helps us to stay present in the moment certainly reduces those symptoms and that worry. Mindfulness meditation is a great approach to help people to do that.
Melanie: In just the last few minutes, Dr. Korman, if you would, give us your best advice for the listeners who suffer from anxiety disorders or stressful situations, that they’re not sure that they can handle, and what you would tell them when you first met them, to give them hope that this is a manageable situation and why they should come to Summit Medical Group for their care.
Dr. Korman: Well, of course the first thing I would recommend is seek help. There is no reason to have to suffer or struggle through these symptoms on your own, and certainly, getting help and getting help sooner than later is going to benefit them. Also, when people come to see me or any of my other clinicians here at Summit Medical Group, I want to make sure they understand that they can be treated. CBT is very effective. We help people, usually within the first two to three sessions, they’re already starting to feel better because we’re getting them to think more clearly and we’re getting them to behave in ways that don’t reinforce their anxiety thinking. It really is effective, and they should be very hopeful that their symptoms can be treated and treated well.
Melanie: Thank you so much for such great information. You’re listening to SMG Radio. For more information, you can go to summitmedicalgroup.com. That’s summitmedicalgroup.com. This is Melanie Cole. Thanks so much for listening.
Effective Management of Anxiety
Melanie Cole (Host): Have you ever felt overwhelmed by anxiety? We all have at one time or another in our lives, but true anxiety and the things that you need to be concerned about are the ones that maybe you need to get some help for. All of us need a little help at some point in our lives. My guest today is Dr. James Korman. He’s the director of the Behavioral Health and Cognitive Therapy Center and the director of Integrative Medicine at Summit Medical Group. Welcome to the show, Dr. Korman. Tell us a little bit about anxiety. What constitutes true anxiety from just generalized worry, and when do we think that red flags are sent up that this is something to be concerned about?
Dr. James Korman (Guest): Oh, sure, Melanie. Let me start off by telling you that anxiety is really a normal human emotion that everybody experiences from time to time. Many people feel anxious or nervous when faced with a problem at work, before taking a test, or making an important decision. In order to really understand anxiety, you have to understand it has two primary symptoms. One is worry, and this is when people are repeatedly thinking or ruminating about a feared situation and ways to manage or solve it. The other primary symptom are really physical reactions. This is when people have racing hearts, sweating, shaking, shortness of breath, dizziness, et cetera. And this is really an activation of our sympathetic nervous system or our fight or flight response, and this is the body’s natural mechanism that allows it to protect itself by either fleeing a feared situation or fending off an attacker. Like we’re saying, anxiety can be normal and actually helpful in small, limited doses, as it can help motivate people to address the feared situation and find a solution to it. However, when anxiety goes on for too long a period of time at too high a level, it actually begins to reduce or hurt people’s motivation and ability to solve problems, and that’s when we start thinking that there could be a problem and it could be an anxiety disorder.
Melanie: Who would be the first person that someone would seek out if they were having an anxiety disorder, if they were letting their psychological stresses affect their physiological self and, as you said, notice some of these actual changes? Who would we seek out? What would we do?
Dr. Korman: Sure. I think that first of all, when people start to notice that those symptoms really start to significantly negatively impact their work, school, or social life, they really should be talking to somebody. One of the effective treatments that are available is cognitive behavioral therapy, and I certainly would advocate people to go looking for a good cognitive behavioral therapist.
Melanie: What can they expect from that type of treatment?
Dr. Korman: Well, cognitive behavioral therapy believes that it’s not the events in people’s lives that cause them problems but it’s how they think about those events that causes them problems. We know that people who have a lot of anxiety or anxiety symptoms, they spend a lot of time thinking about and worried about the future. They believe that there’s going to be bad outcomes constantly, and then they start reacting physically, emotionally, behaviorally if that bad thing is going to happen. One of the things that cognitive behavioral treatment does is help people to evaluate the validity of those ideas and thoughts. We teach people very specific skills to think as realistically as possible so that they’re spending more time in the present and far less in the future. We also know that people tend to only focus on information that supports their thinking. They tend to ignore information that suggests their thinking isn’t true, or they change information to fit their beliefs. People who are anxious and worried tend to only focus on the data and information that supports their worried, catastrophic, and bad thinking about the outcomes. And then finally, we really work on people’s behavior. Because when people are very anxious, they tend to look into the future. They think the future is bad. Then they start only looking at the information that supports it, and then they start acting upon those ideas as if they’re true. We call those safety behaviors, and people will engage in a lot of avoidance of things that make them anxious. And we have to get people to behave in ways that make sense. And so, we often will do behavioral experiments to help people to find out if the bad outcome is going to take place, and if it does, can they really manage it much better than their thinking. We shift people from a prevention mode, which is where people react with anxiety, into a coping mode, learning how to handle and manage feared outcomes, rather than trying to prevent or escape them.
Melanie: That’s absolutely brilliant, Dr. Korman, because it is how people feel. And I’ve seen this so much with this type of worries where you’re looking at the future and envisioning all of these bad things. If somebody has anxiety disorder and this is something that they live with, will it be a part of the rest of their lives, or can this cognitive behavioral therapy help to kind of put the kibosh on that and make it so that this is not something that affects them for the rest of their lives?
Dr. Korman: Research really does support the idea that cognitive behavioral therapy can be very effective in significantly reducing the symptoms of anxiety or eliminating them. There’s some very good research that shows that people do not have to suffer from anxiety disorders for the rest of their lives. Some people may find that they have worry, and they have certain anxiety symptoms, but what happens is those symptoms become far less important. They’re much easier to just push away, and they can manage their lives in a much better way.
Melanie: So many people are looking toward medications these days to help with their anxiety, to help with their worry and their stress levels, and we’re learning more and more, Dr. Korman, about how bad stress really is and cortisol levels. What do you think about the medication situation that we’ve got going on out there, and how does it compare to the outcomes of cognitive behavioral therapy?
Dr. Korman: That’s an interesting question. I’m not anti-medication in any way. I do think it can be very helpful for people, especially when they’ve been having long span of anxiety problems, or when anxiety is at such a high level they have difficulty engaging in the treatment that we want them to do. I think medications are very good on a short-term basis. I think they can be used for people, again, who have a longer-term history. But the outcome studies for cognitive behavioral therapy does show that it can be extremely effective, and a combination of the two can be effective in the short term. But for most patients, they can often come off of the medication over time, and the CBT strategies that we give them is more than enough to manage their symptoms.
Melanie: Aside from those strategies, what can people do at home, in their daily lives, and behavioral modifications, things that they can do that can help them deal with these stressors and worries right then when they’re happening?
Dr. Korman: Well, right then, I think some of the important things is if there’s one big question that I often ask my anxiety patients, especially when they’re very stressed, is what is the worst thing that could happen in whatever it is that you’re dealing with. And, if that thing was to take place, could you handle it? Could you manage it? And almost all of my patients, when they think about a feared outcome and we start thinking about, “Can you manage this situation?” they always say yes. That usually brings down their worry and anxiety. That’s one really good technique to be asking yourself when you’re in one of those stressful or anxiety-related situations. What’s the worst thing that could happen, and could I really handle this and manage this? What would I do? Certainly, when people are in very stressful situations, I often tell them to take a break, walk away from it for a few minutes, give them time to think about it. Certainly, exercise is a great thing. Take a break from the situation. And we know that exercise if great for managing things that happen right then, so you walk away, go for a walk, and certainly as a maintenance. Exercise is just a great thing for anxiety, depression, and every other disorder you can think of.
Melanie: What about meditation, deep breathing? Do those things work to help calm people down or center them?
Dr. Korman: Absolutely. In fact, I’m a big advocate for meditation, and in particular, I’m a big advocate for something called mindfulness meditation or mindfulness-based stress reduction. It’s a great approach. It helps people to stay centered. It helps them not to get caught up in how they’re thinking or feeling, and they can be very, very present. Because remember, anxiety and stress is always about the future. And anything that centers us and helps us to stay present in the moment certainly reduces those symptoms and that worry. Mindfulness meditation is a great approach to help people to do that.
Melanie: In just the last few minutes, Dr. Korman, if you would, give us your best advice for the listeners who suffer from anxiety disorders or stressful situations, that they’re not sure that they can handle, and what you would tell them when you first met them, to give them hope that this is a manageable situation and why they should come to Summit Medical Group for their care.
Dr. Korman: Well, of course the first thing I would recommend is seek help. There is no reason to have to suffer or struggle through these symptoms on your own, and certainly, getting help and getting help sooner than later is going to benefit them. Also, when people come to see me or any of my other clinicians here at Summit Medical Group, I want to make sure they understand that they can be treated. CBT is very effective. We help people, usually within the first two to three sessions, they’re already starting to feel better because we’re getting them to think more clearly and we’re getting them to behave in ways that don’t reinforce their anxiety thinking. It really is effective, and they should be very hopeful that their symptoms can be treated and treated well.
Melanie: Thank you so much for such great information. You’re listening to SMG Radio. For more information, you can go to summitmedicalgroup.com. That’s summitmedicalgroup.com. This is Melanie Cole. Thanks so much for listening.