Allenmore Psychological Associates remains OPEN. During this period of concern and anxiety having access to quality behavioral health care is important and our staff is dedicated to ensuring your behavioral health care needs are met. In the unlikely event that the WA Department of Health directs us to close we will notify patients via telephone on the day of their appointment (similar to our Snow Day policy). If you are an existing patient who is demonstrating symptoms associated with the coronavirus or impacted by related closures (e.g. cannot find day care due to a school closure) and need to cancel we ask that you inform our staff as soon as possible, APA will not charge you for a late cancellation.

Anxiety Disorders

The clinical staff at Allenmore Psychological Associates are very knowledgeable and skilled regarding the diagnosis and treatment of Anxiety Disorders. In fact, they have been providing effective anxiety treatment in Tacoma, WA for over 30 years. It is common for people who have anxiety problems to feel that they are the only one suffering from this type of problem and to be embarrassed by their symptoms. At Allenmore Psychological Associates, we know that anxiety related problems are both very common and very treatable through counseling. For example, it would probably surprise many people to learn that nearly 18 percent of Americans, 18 years of age and older are currently effected by an anxiety disorder. Eight percent of teens age 13 to 18 experience anxiety disorders. Women are 60 percent more likely to have anxiety disorders than men.

To better understand this prevalent problem, some background information about anxiety disorder can be helpful. It is important to distinguish anxiety from fear. Fear is an emotion we experience in relationship to an external situation. The feared object or event is real or within the realm of possibility. We might feel intense fear when involved in combat, a car accident or a confrontation by a wild animal such as a mountain lion while walking in the woods. Less extreme fear may be experienced when facing challenging situations such as a job interview, meeting someone for a first date or engaging in public speaking. Everyone feels fearful at one time or another. On the other hand, when we experience anxiety, the focus is more internal and the thing we are anxious about is some danger that is ill- defined, distant and exaggerated or unrealistic. It might be anxiety about an uncertain future, about losing control, or about an event that is unlikely to occur. At such times, we are affected physiologically, psychologically and behaviorally. Physiologically we may experience rapid heart beat, sweating, dry mouth, an upset stomach, muscle tension or light-headedness. Psychologically, we feel worried, apprehensive and uneasy due to how we are appraising and thinking about the situation. Behaviorally, we may “freeze up” and find it difficult to act “naturally” or to communicate with others. Anxiety can range in intensity from mild uneasiness to a full blown anxiety or panic attack.

What is an Anxiety Disorder?

Experiencing a certain amount of anxiety is an inevitable part of life in the world in which we live. It doesn’t always present a problem and in certain instances may be appropriate such as in regard to a potential loss or failure. Anxiety becomes problematic and is defined as a disorder when it is too intense, lasts too long or leads to avoidance or phobic behavior that interferes with social and occupational functioning. There are a number of different anxiety disorders that can treated in therapy. The most common anxiety disorders are panic disorder, panic disorder with agoraphobia, specific phobias, social anxiety disorder, generalized anxiety disorder and separation anxiety disorder. Each disorder has different symptoms but all involve irrational and excessive fear or dread. As stated above, anxiety disorders are more prevalent than any other type of mental health problem. It is not uncommon for people to experience multiple anxiety disorders. In addition, anxiety disorders may co-occur with depression, substance abuse and a variety of physical illnesses.

The causes of different anxiety disorders vary, but in most instances probably involve biological, psychological, environmental and developmental factors. Several areas of the brain play an important role in the development of anxiety disorders. These are principally the amygdala and hippocampus. The amygdala is a structure deep in the brain that alerts other parts of the brain that a threat is present. The hippocampus is a structure that stores memories some of which are of situations that are perceived as threatening. These two structures work together to create fear and anxiety. Psychological variables such as stress, trauma, mistaken beliefs, anxious self-talk, and personality traits including perfectionism, excessive need for control and excessive need for approval can also be determining factors. Substance abuse, diet, health problems and environmental factors such as pollution and exposure to toxic substances may also contribute to anxiety. Anxiety problems typically arise from multiple causes.

Signs and Symptoms of Anxiety Disorders


Panic Disorder:

Panic disorder is characterized by the sudden onset of very intense anxiety that occurs spontaneously and for no apparent reason. The period of intense anxiety usually lasts only a few minutes but can also occur in waves that can last for an hour or two. During a panic attack people often experience a number symptoms that can include shortness of breath, heart palpitations (rapid or irregular heartbeat), chest pain discomfort, sweating, choking, nausea, dizziness or unsteadiness, trembling or shaking, numbness or tingling in the extremities, hot flashes or chills and a fear of dying or a fear of going crazy. To be considered a panic disorder, an individual has to have two or more panic attack,s and one of them followed by anticipatory anxiety or intense worry that another panic attack will occur. The number and frequency of panic attacks experienced by someone with panic disorder can vary. An individual can have a few panic attacks and then not have another one for a month or a year afterward. Or, several panic attacks a week can occur until the person seeks treatment. Many people, after having a panic attack, consult with their doctor believing there is a medical cause for their symptoms. While these typically no significant medical problem is discovered, it is still a good idea to rule out any medical causes such as hypoglycemia, hyperthyroidism, excessive use of caffeine, or withdrawal from alcohol, tranquilizers or sedatives. Most people tend to develop panic disorder by their late adolescence or early twenties. To learn more about panic attacks and how to prevent them, please visit our resources section.

Generalized Anxiety Disorder:

Generalized anxiety disorder is a chronic form of anxiety that involves worrying about stressful life circumstances involving work, school performance, finances, health, or relationships. Typically, the person suffering from generalized anxiety disorder spends a great deal of time worrying about a wide array of different topics and cannot control their worrying. The intensity and frequency of the worrying is way out of proportion to the likelihood of the feared event actually occurring. Symptoms of generalized anxiety include muscle tension, difficulty sleeping, fatigue, irritability and difficulty concentrating. It is often correlated with the presence of physical problems that can include tension headaches, irritable bowel syndrome, insomnia and high blood pressure. For the diagnosis of generalized anxiety disorder to be made, the person must experience significant distress and their social and occupational functioning must be adversely impacted. The disorder can occur at any age and can co-occur with depression.


In a third of the people who develop panic disorder, agoraphobia may subsequently occur. Agoraphobia literally means the fear of open spaces. What is feared is the possibility of having another panic attack. Situations are avoided where escape is difficult or help might be unavailable. Hence, people may fear and avoid being on freeways, confined places such as bridges or tunnels, public transportation such as buses, trains, planes or subways, and crowded places such as shopping malls, grocery stores or restaurants. There is typically nothing inherent in these situations which is anxiety provoking, but these are situations where escape might be difficult or embarrassing for the person. People with agoraphobia are afraid of how they might act and what other people might think of them if they were to have a panic attack. The most common characteristic of someone suffering from agoraphobia is anxiety about being far away from home or from a “safe person.” Some panic disorder sufferers have a hard time leaving their homes and in extreme cases may become housebound.

Social Anxiety Disorder:

Social anxiety disorder or social phobia involves an intense fear of embarrassment and humiliation in one or more social situations where one is exposed to the scrutiny of other people. The level of fear is much greater than ordinary anxiety experienced by people in social situations who are non-phobic and is out of proportion to the threat posed by the situation. Furthermore, the intensity of the fear often causes the person to avoid the phobic situation. The most common form of social phobia involves the fear of public speaking. Other common social phobias are fears of having a conversation, meeting new people, eating or drinking in front of others, using a public restroom, blushing in front of others and being in large groups or crowds. Symptoms can include sweating, blushing, rapid heart rate and nausea. To be considered a social phobia, the anxiety must cause significant distress that is persistent and interfere with work and social activities or relationships. Social phobias often begin in late childhood or adolescence and persist through young adulthood. They have a tendency to diminish in intensity later in life. Many people with social anxiety disorder have another anxiety disorder such as panic disorder or generalized anxiety disorder. They also may be depressed and have substance abuse problems.

Specific Phobias:

Specific phobias involve intense anxiety and avoidance of particular objects or situations. With specific phobias there are no spontaneous panic attacks or fear of panic attacks. However, the person may have a panic reaction to the feared object or situation, despite recognizing that their anxiety is irrational. The anxiety and avoidance behavior associated with the phobia causes significant distress and may interfere with social relationships and occupational functioning. Some of the more common specific phobias are animal phobias (fear of snakes, rats, spiders and bats), acrophobia (fear of heights), claustrophobia (fear of closed or small spaces), hypochondria (fear of diseases), medical or dental phobias and blood-injury phobias.

Separation Anxiety Disorder:

Separation anxiety disorder involves excessive anxiety having to do with being separated from those people to whom one is attached. There is excessive worry and anxiety about losing major attachment figures or harm coming to them from sickness and death. The anxiety is persistent as opposed to episodic and lasts at least four weeks in children and adolescents and at least six months in adults. The disturbance caused by the disorder is significantly distressing and leads to major impairment in academic, social and occupational functioning.

Anxiety Disorder Caused by a Medical Condition:

Certain medical conditions can cause anxiety and panic reactions. The most frequently observed medical conditions that might cause generalized anxiety or panic attacks are Hyperventilation Syndrome, Hypoglycemia, Hyperthyroidism, Mitral Valve Prolapse, Premenstrual Syndrome (PMS), and inner ear disturbances caused by infection, allergy or Meniere’s Disease. For this diagnosis to apply, there must be evidence from medical history, physical examination, or laboratory test results indicating a direct pathophysiological relationship between the anxiety symptoms and a medical condition. Also, the anxiety symptoms must cause significant distress and interfere with social, occupational and other functioning.

Substance/Medication Induced Anxiety Disorder:

Substance or medication inducted anxiety and panic can result from substance (alcohol or drug) intoxication or withdrawal, or due to exposure to or withdrawal from a prescription medication. It must be established that the anxiety symptoms are the direct physiological result of a substance or medication. As an example, if an individual withdraws too rapidly from a prescription medication, experiences panic attacks and has no previous history of an anxiety disorder, they might be given this diagnosis.

Anxiety Treatment

Based upon research and clinical evidence, there are a number of different treatment approaches and strategies that are helpful in counseling with various anxiety disorders. At Allenmore Psychological Associates, some of the approaches used to treat anxiety are Cognitive Behavior Therapy (CBT), Acceptance and Commitment Therapy (ACT), Mindfulness-Based Treatment of Anxiety and Eye Movement Desensitization Reprocessing (EMDR). EMDR is an effective evidence-based method of treating anxiety disorders. Allenmore Psychological Associates is pleased to be one of the few clinics in the Tacoma area to employ psychologists with EMDR certification.

The approach and strategies that are selected for treatment depends upon information gathered about your symptoms and your personal history and the type of anxiety disorder from which you suffer. Comprehensive evaluation may also involve the administration of psychological rating scales and tests. An individual treatment plan will then be formulated with specific goals, objectives and treatment strategies that will be utilized to reach those goals and objectives. Different strategies will be employed to treat different anxiety disorders. For example, in counseling for Panic Disorder some of the following strategies are commonly employed:

  • Relaxation Training – This involves learning abdominal breathing and progressive muscle relaxation to help reduce physical arousal caused by a panic attack and to address anticipatory anxiety about having a panic attack. Please visit our resources section for helpful books, apps, an article and helpful handouts on relaxation skills.
  • Cognitive Therapy – Cognitions or thoughts and mental images play a significant role in relationship to Panic Disorder. People who have Panic Disorder develop catastrophic thinking regarding their symptoms. For instance, they may think they are going to have a heart attack, go crazy or do something really foolish or embarrassing. Learning to identify these thoughts and to eliminate them or at least change the way you view them is important.
  • Interoceptive Desensitization– People who develop Panic Disorder usually become somatically focused. This means they look for and become focused upon anything occurring in their body that seems “abnormal” such as the heart palpitations, shortness of breath, dizziness, faintness, nausea or abdominal distress, weakness or unsteadiness that usually accompany a panic attack. Becoming desensitized to these symptoms and becoming less focused on the body is an important aspect of treatment.
  • Lifestyle and Personality Changes – Stress management, exercise, and diet changes such as reducing or eliminating stimulants and sugar are an important part of treatment. Also, learning to address the excessive need for control, the need for approval from others and to change perfectionistic tendencies thorough counseling may be important.
  • Medication – Treatment with medication may be indicated. Medications such as SSRI antidepressants that include Celexa, Lexapro or Zoloft and benzodiazepines such as Xanax, Ativan or Klonopin may be indicated in conjunction with the above counseling strategies.

Some of the strategies that are helpful in treating Panic Disorder also are useful in treating other anxiety disorders such as Social Anxiety Disorder. These include relaxation training, cognitive therapy and in some cases medication. In addition to these strategies, exposure to feared social situations is often a critical part of the treatment. This involves first teaching the client coping strategies and relaxation skills in counseling, then gradually exposing the person to the social situations that cause distress. This treatment process often includes homework assignments outside our clinic walls, and allows clients to become desensitized to these feared situations with support over time. Treatment might also include social skills training and assertiveness training as needed. 
The treatment for Agoraphobia and Specific Phobias would involve a similar approach and emphasize exposure to the feared situation(s). Generalized Anxiety Disorder is also treated with relaxation training and cognitive therapy, as well as techniques used to reduce worry behavior including mindfulness meditation, problem solving and distraction.

Contact Us for Help with Anxiety Disorders

Our counselors have extensive experience and training in treating a variety of anxiety disorders. We enjoy working with clients to overcome the suffering that anxiety symptoms bring. We have been helping people by offering anxiety treatment in Tacoma and the Puget Sound region for over three decades. Let us help you overcome your anxiety symptoms, and keep them from negatively impacting your life. For more information about the treatment available at Allenmore Psychological Associates, call (253) 752-7320.

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