Hot Under the Collar

8 Common Anxiety Symptoms and a Few Ways to Begin to Cool Off

By Rachael Bonaiuto, LPC

When you have anxiety, it’s easy to feel like others don’t understand what you’re going through. Anxiety itself can make you feel as though you’re suffering from symptoms, worries and concerns that are not only pronounced – they also feel inherent. Despite how personal this anxiety is to you, the truth is that anxiety is surprisingly common. I witness anxiety symptoms in most people I encounter on a daily basis – clients, students, friends, and family – in the store, at the bank, even at a red light.  Anxiety is uncomfortable at best, and can become paralyzing and defeating.  And it is common…. so incredibly common.

You are at home, preparing to go to a dinner party with work colleagues. You don’t want to go, you dread it, you think of reasons not to go, fantasize about your favorite elastic-waisted pants and the flavor ice cream that would accompany the movie night you’d rather have. You finally surrender to going, but begin to notice tightness in your chest.  As you stare, hot and bothered, at your closet of ‘not quite right’ clothes, your neck begins to hurt and the pain causes even more fear. You snap at your partner, who gently reminds you that you need to get going. You ignore the texts from co-workers asking you if you’ve left your house yet. You can barely breath and you are frozen.  You are experiencing anxiety and it is profoundly challenging.

So, what are some common symptoms of anxiety? Below are eight typical symptoms of anxiety and a few ways to manage this persistent condition.

  1. You feel constantly worried, tense and on edge
  2. You are plagued by fears that you know are irrational but just can’t shake
  3. You avoid situations/activities because they cause you nervousness & stress
  4. You have difficulty thinking, speaking, and following conversations
  5. You experience pain, stiffness, tension, pressure, soreness, or immobility
  6. Your body temperature increases or decreases without external reason
  7. You feel chest tremors, pounding heart, and/or labored breathing
  8. You don’t feel like yourself, detached from loved ones, emotionally numb

Many common anxiety symptoms show up in your body. You may first experience a knot in your stomach, and then you realize you are totally freaked out about an upcoming presentation. You feel a rapid heartbeat and tightness in your chest and later notice that you are completely anxious to drive in snowy weather.  Your jaw is clenched and your breath is constricted just before you unleash the pent up worry and resulting irritability toward your child.  If you can begin to notice the signals from your body that suggest you are anxious, you may find opportunity to take pause, check in, and navigate what you need in the moment.

Here are a few body-oriented tips for how to deal with anxiety:

1.     Pause:

  1. Find pause through breath. Inhale. Exhale. Feel your belly rise and fall. Notice the air come in through your nostrils and exit out your lips.
  2. Find pause through your senses. Pause to notice what you see. What do you hear and smell? Can you feel your clothes against your body? Experience your feet in your shoes, on the floor. Can you taste the salt on your lips or the flavor from your most recent meal?
  3. Find pause through movement. Go for a walk. Put on your favorite song and dance. Shake it out. Stretch your arms wide. Spread your legs and feel your feet rooted into the earth. Put your hands on your heart or give yourself a massage.

2.    Check In:

  1. Notice what is happening with your breath, senses, movements
  2. Notice, without judgment, what thoughts and feelings you have
  3. Simply observe what is happening in your inner landscape
  4. Scan your body for tension, tightness, fear, irritability, disorientation

3.    Take care:

  1. Ask yourself what you need? Remind yourself (or have someone else remind you) that it is okay to have needs.
  2. If you are having trouble accessing what you need, take another pause, a longer pause, lie on the earth and feel it beneath you.
  3. If you are in need of support, ask for help – from a friend, a loved one or a professional.

Anxiety can negatively impact your quality of life – the way you show up for others and for yourself. Knowing the common symptoms of anxiety can help you recognize when you or a loved one is experiencing unease. When you realize you feel anxious, it can be so valuable to pause, check in and take care of yourself in the moment. Building a deeper understanding of the symptoms and an awareness of what is happening in your body can provide access to your available resources through breath, sensation and movement. When you have access to your internal resources, you can also appreciate more deeply when you need additional support and when you are able to navigate your internal terrain on your own. This self-awareness provides empowerment, freedom and a deeper sense of compassion for self and other. Most importantly, if you are experiencing significant anxiety, seek professional help. Psychotherapy can be very effective in providing relief from the debilitating symptoms of anxiety.

Self-Harm Behavior

By Dr. Jan Hittelman

“My 13-year-old daughter is a cutter. She also smokes. I have done everything I can to stop her, but she did it again last night and I took her to the emergency room. On the way home, I asked her what I could do to help her stop cutting. She said if I would let her smoke cigarettes at home, that would help, because smoking soothes her and helps alleviate her need to cut.”

“What should I do?”

Cutting and cigarette smoking share a common thread; both are unhealthy ways to deal with negative emotions. While all of us struggle with feelings like sadness, anger, and anxiety, we each deal with our feelings very differently. Some adolescents have tremendous difficulty experiencing and working through their negative emotions and are limited to self-harm behaviors as a maladaptive coping mechanism. It is difficult for most of us to understand, but for some individuals cutting can seemingly provide their only source of relief and often develops into an addictive behavior that is very difficult to stop.

Common misconceptions regarding cutting are that it is a suicidal gesture and/or attention-seeking behavior. Those that cut use it as “a way to survive” and are usually not looking to kill themselves. Given how effectively they hide their scars by wearing long sleeves and purposely cutting in areas that are generally under clothing, this is clearly not an attention-seeking behavior. Rather, cutting is a desperate behavior that demands our attention.

Self-harm behaviors are a serious indicator that the individual needs professional help. It is important that the mental health professional have expertise in not only treating adolescents but also self-harm behaviors. Common co-occurring issues that also need to be treated or ruled-out include: history of sexual abuse, family dysfunction, risky sexual behavior and substance abuse.

Finding the right therapist for your daughter, who can help her learn how to deal with negative emotions in a more effective way and thereby reduce (and eventually extinguish) her self-harm behaviors (including cigarette smoking), would be the critical next step.

Screen Time Addiction

Q: How do I know when my child is spending too much time on the computer or playing video games?

A: As more people engage in high tech recreation, there are increasing concerns regarding the effects of these activities and the potential harm of excessive computer and video game use. Some of the key factors to consider are:

Time dedicated to computer and video game use: Many experts recommend limiting use to two hours a day. A more practical time guideline can be based on the individual and the impact of use on daily functioning.

Impact on healthy daily functioning: Excessive use is more of a concern if it negatively interferes with school performance, peer socialization, family interaction, exercise/weight control, and interest in other activities.

Behavioral Effects: There are numerous studies that show a correlation between exposure to violent video games and aggressive thoughts or behavior. None of these studies, however, can demonstrate long-term impacts or conclude that video gaming itself causes aggressive behavior.

What’s a parent to do? The first step is to have an open discussion with your children regarding computer and video game use. If your child has a healthy social life and continues to function well at home and in school, simply monitoring use may be sufficient. If the amount of daily use time is excessive and/or you have concerns about your child’s social, emotional or behavioral health, try setting clear guidelines. In addition, consider gaming and recreational computer time as a reward for completing homework, household chores, or engaging in prosocial activities. Help your child replace use time with other fun activities. Simply taking away the activity and leaving a vacuum, will likely lead to conflict and efforts to “get around” newly imposed rules.

It is also important to understand that excessive videogame/computer use may be a symptom of underlying emotional issues (e.g. depression, anxiety, social adjustment, etc.). Addressing the surface behaviors without treating these issues will only result in a reoccurrence of the undesired behaviors and/or new ones taking their place. If you have concerns about your child, consider an assessment by a mental health professional to determine the extent of the problem and better understand the underlying issues that may be fueling the behavior.

Dangers of Alcohol Poisoning

By Dr. Jan Hittelman

Q: I had a disturbing conversation with a friend about a parent’s experience with alcohol poisoning. The child had already been in trouble with the police, over alcohol use; and had passed out drunk again, when the parent was called to pick up the teen. The parent did not take the teen to the Hospital because the parent was afraid that the police would be involved again. I’ve known several teens in the past, whose lives were most likely saved by prompt medical attention. Is there any assurance that we can give parents that Medical Care asked for by a parent or guardian is not subject to reporting, so that they will do what is right for the child?

-Parent of 2 Teens

A: In June 2005 the Colorado General Assembly passed a series of laws (House Bill 05-1183) that include protections for the minor and up to two additional persons from prosecution if they call 911 to report that the minor is in need of medical attention due to alcohol consumption, give their names, stay on the scene and cooperate with medical and law enforcement personnel when they arrive. You can read the exact language of the law by clicking on:
These laws were enacted due to “incidents of death related to underage binge drinking”.

The danger of not taking someone who is suffering from alcohol poisoning to the hospital is that they can die. Alcohol is a depressant and when too much alcohol is ingested, there is a risk of slowing down the respiratory system and the person simply stops breathing. Tragically a parent would simply assume that they’re “sleeping it off”. It is important to be safe not sorry and seek medical attention.

When Gordon Bailey died from alcohol poisoning several years ago at a C.U. Fraternity, his parents were interviewed. Surprisingly they indicated that they themselves did not really understanding the fatal nature of alcohol poisoning and were haunted that they never sat their son down and educated him about this. The good news is that you can. After educating yourself on the subject, be sure to educate your children. And don’t wait until they’re in high school. These conversations should begin no later than the beginning of middle school, if not earlier. It is important to revisit this and other potential self-harm behaviors (other substance abuse including cigarettes, sexual behavior, bike helmets, seat belts, and other risk behaviors) frequently as your child develops and matures.

Ironically the two most dangerous drugs on the planet are the two that are legal; cigarettes and alcohol. This sends a very confusing message to our children. Particularly because parents and our general culture model the use of these two drugs far too often.

If you are aware that your child is regularly abusing alcohol, it is critical to intervene.
Depending on the seriousness and chronicity of the alcohol abuse, some of the interventions that may be necessary include: Alcohol classes, driving restrictions, substance abuse treatment, and attending Alcoholics Anonymous.

Addressing Alcohol Use in Teens

Q: What objective evidence is there that absolute prohibitions against alcohol in the home reduce teenage drinking vs. a European approach of drinking moderate amounts, such as wine at dinner? Secondly, how do researches reliably measure rates of teenage drinking? Don’t most substance abusers lie about their consumption, even to themselves?
Concerned Dad

A: Surveys of this kind generally rely on self-report. They are typically anonymous, which tends to increase the respondents’ honesty. That said there is no guarantee that they will be honest, as you point out. Still the results both in the U.S. and Europe consistently reflect disturbing rates of alcohol use by adolescents.

In terms of European drinking patterns, there has been increasing concern in European nations regarding the dangers of alcohol consumption. According to a recent study, “while 266 million adults drink alcohol at relatively lower risk levels, over 58 million adults (15%) drink more than this (i.e. 5 or more drinks at one time), including 20 million (6%) drinking at even more harmful levels. 23 million Europeans (5% of men, 1% of women) are dependent on alcohol” (Anderson, P., and Baumberg, B. 2006. Alcohol in Europe. A public health perspective).
The truth is that we would all be better off if we refrained from alcohol use altogether.

While there are reports that moderate alcohol consumption provides some health benefits, using that time to exercise would be far healthier. The best thing we can do for our children is model abstinence where drinking is concerned.

“Just Saying No” Is Only the Beginning

By Dr. Jan Hittelman

Being an effective parent can feel like a real uphill battle. This can be particularly true when our children are adolescents. A major challenge for parents of adolescents is that their developmental tasks include shifting from dependence to independence and experimentation. As a result, issues related to compliance with parental requests and experimentation with drugs, alcohol and other risky behaviors often make this a very difficult time. Both the challenge and solution for parents is to remain firm in their efforts to provide guidance to their children as early as possible, even when it seems most unwelcome.

Consider experimentation with marijuana. Local surveying of high school youth typically indicates that almost half have tried marijuana. Some youth and health service providers believe that these percentages are underestimates. Many parents of adolescents indicate that they too experimented with marijuana in their youth. Thus the conclusion often drawn is that teens will be teens and experimentation is inevitable, so why fight a losing battle? The more road blocks, through open discussion and efforts to provide firm boundaries, the better the chances are that your child will either not engage in this behavior or if they do, will hopefully not “over engage” to the point of irrevocable results. It is very difficult, for example, for the most expert professional to predict which youth will simply experiment with substances like marijuana and move on and who will develop lifelong patterns of chemical dependency. Similarly, we also know that marijuana is the second-most frequently found drug (after alcohol) involved in automobile accidents and the primary substance abused by adolescents in drug treatment.

It is also important to note that even the most vigilant parent may be unable to prevent their child from developing substance abuse problems, but there are steps that you can take to reduce the chances:

• Encourage ongoing discussions about substance use. Research shows that kids whose parents talk with them regularly about drugs and alcohol are 50 percent less likely to use them. For tips on effective ways to have this conversation, check out: and
• Be clear that any experimentation with drugs/alcohol is unacceptable. For students who believed their parents would strongly disapprove, current marijuana use was 5% versus 30% for youth who believed their parents would somewhat disapprove.
• Ask questions about parties that your children attend in terms of drug/alcohol use and adult supervision. When hosting a party understand your legal responsibilities and provide appropriate supervision.
• If you suspect substance use, consider an assessment and/or drug testing to determine the severity.
• Be a good role model. Parental use of drugs/alcohol sends a message that it’s OK to do.