Generalized Anxiety Disorder (GAD) is characterized by excessive worry about a number of different domains (e.g., work, health, family, school) resulting in impairment. Tension, headaches, stomachaches, or other bodily symptoms often accompany GAD. GAD is not a transient reaction to a stressful event, and symptoms must be present for a duration of at least six months to meet criteria. Many individuals with GAD also report depressive symptoms. CBT techniques, including Acceptance and Commitment Therapy (ACT) can be effective in helping those with GAD to challenge negative thinking patterns and develop new behaviors.
Health anxiety can appear with or without the presence of bodily symptoms. Individuals with health anxiety often have symptoms that are very similar to OCD, with persistent worries and repetitive behaviors to alleviate stress. These behaviors may include things like researching health symptoms online, frequent doctor visits, and checking one’s body for new symptoms. Others with health anxiety do the opposite and avoid anything that reminds them of illness. If you have health anxiety, the NOATC can help! We use a combination of evidence-based methods, including exposure, to address health anxiety and help you re-engage with the life you want.
Panic attacks occur when individuals experience physiological (bodily) symptoms of anxiety. The onset of panic attacks is abrupt and intense and may include symptoms such as sweating, trembling, difficulty breathing, sensations of choking, numbness, tingling, heart palpitations, and heat/chill sensations. Often, individuals have a fear of losing control, "going crazy," or dying as a result of these symptoms. When someone becomes worried about having panic attacks and changes their behavior (e.g., avoiding planes or crowded areas) as a consequence of the attacks, they may meet criteria for panic disorder or agoraphobia. Treatment for panic disorder often involves a specific type of exposure technique called interoceptive exposures as well as other cognitive-behavioral techniques.
Considered an extreme form of social anxiety, selective mutism is a condition marked by individuals’ failure to speak or socially interact in certain social situations. Most commonly, selective mutism manifests as children failing to speak in the school setting while maintaining social interaction in the home environment or with friends. Because individuals in the child’s environment may adapt their interactions to allow for communication by non-verbal means, the treatment of selective mutism requires the inclusion of family members and other significant adults (e.g., teachers) to be successful.
Children with Separation Anxiety Disorder have persistent and excessive fears about separation from their loved ones. Their fears may center on their own health/safety or that of their loved ones. Moreover, they may experience unpleasant physical sensations, such as headaches and stomachaches when they are away from loved ones. When these symptoms begin to cause interference in daily living, such as difficulty attending school or getting restful sleep, kids can benefit from CBT with exposure that targets their fears.
Many people report fears of specific objects or situations, such as spiders, heights, or flying. When these fears are significant enough to impact one’s daily living or lead to considerable avoidance, a diagnosis of specific phobia may be warranted. Individuals with specific phobia may experience physical symptoms of anxiety, such as increased heart rate, rapid breathing, sweating, trembling, and nausea, when they encounter their fear. Treatment of phobias relies on exposure techniques to reduce discomfort with the feared stimulus.
Please call us to see if your symptoms are a good fit for our services. We have a few clinicians who specialize in trauma-related anxiety as well. If they have availability, we are glad to set you up with one of them.
Obsessive-compulsive disorder (OCD) is marked by the presence of unwanted and distressing thoughts, images and impulses (obsessions) and repetitive physical or mental acts that alleviate discomfort (compulsions). Individuals with OCD often experience anxiety associated with their symptoms but may also experience disgust or a subjective “not-quite-right” feeling. Some people experience frequent overt compulsions, such as cleaning, arranging, checking, or reassurance seeking, while others experience mental compulsions or rely on avoidance to reduce distress. In sum, OCD is a widely variable disorder that causes impairment across areas of functioning. Our clinicians use the gold standard of care - Exposure and Response Prevention - for the treatment of OCD. Other CBT elements such as Acceptance and Commitment Therapy may be added. For more information about OCD, visit the International OCD Foundation’s website.
Individuals with Body Dysmorphic Disorder (BDD) focus on minor or imagined defects in their appearance and spend excessive time engaged in appearance-related behaviors (e.g., grooming, mirror checking, reassurance seeking). They may also experience high levels of depressive symptoms and avoid activities during which they feel they may be scrutinized. Despite poor public awareness of BDD, some studies have indicated prevalence rates of about 1 in 50 individuals. The treatment for BDD is similar to that for OCD and has positive outcomes. For more information on BDD, visit this link.
Hoarding disorder is marked by persistent difficulty discarding or parting with possessions due to a perceived need to save them. A person with hoarding disorder experiences distress at the thought of getting rid of the items resulting in excessive accumulation of items, regardless of actual value. Hoarding Disorder is frequently accompanied by other mental health issues such as depression, anxiety, ADD/ADHD, and OCD that can interfere with and complicate efforts to address the hoarding. Research shows that individuals with hoarding disorder also struggle with processing issues in the areas of attention, categorization, organization, and decision making. Additionally, hoarding is triggered by trauma and loss. For more information on hoarding visit the International OCD Foundation's website.
Hoarding behavior is often misdiagnosed as hoarding disorder due to the shared feature of excessive accumulation of items. When diagnosing hoarding disorder, the possibility that the hoarding is attributable to another medical condition (e.g., brain injury, cerebrovascular disease, etc.) must be ruled out. Additionally, the possibility that the symptoms are not better accounted for by the symptoms of another mental health disorder (e.g., obsessions in OCD, decreased energy in major depressive disorder, etc.) must also be ruled out. When hoarding symptoms are the byproduct of other mental health issues, once the symptoms of those issues are alleviated, unlike in hoarding disorder, the hoarding symptoms often resolve.
Hair pulling and skin picking are considered obsessive-compulsive spectrum disorders, meaning that they are related to OCD but present slightly differently. Individuals who engage in these behaviors are often unaware of how often they pull and pick. Therefore, an initial component of treatment is helping in increase awareness through tracking methods. A functional analysis of the behaviors will then examine the environmental cues, thoughts, feelings, and events that contribute to the behavior. Treatment is then developed and applied based on this analysis. For more information about trichotillomania and excoriation disorder, visit the Trichotillomania Learning Center here.
Tourette Syndrome is characterized by the presence of both verbal and motor tics. Common verbal (or phonic) tics include behaviors such as throat clearing, sniffing, squealing, grunting, or chirping. More complex verbal tics may include full syllables, words, or phrases and can become loud in volume. Common motor tics include behaviors such as blinking, twitching, grimacing, and jerking. They can also become more complex and include full-body movements or lead to soreness, stiffness, and pain. We offer the Comprehensive Behavioral Treatment for Tics (CBIT) to help behaviorally manage tics. This treatment works best if individuals are motivated to reduce their tics, so we discourage it for individuals, such as some children, who are not concerned about addressing their tics. For more information about tics, visit The Tourette Association of America- (https://tourette.org/)
The Comprehensive Behavioral Treatment for Tics (CBIT) can be effective for individuals who do not meet criteria for Tourette Syndrome. These individuals may exhibit only motor or vocal tics or may not have had the tic symptoms for a significant amount of time. To see if you are a good candidate for the treatment of tics at the NOATC, contact us to schedule a free screening.
ADHD is another common co-occurring condition that we tend to see with anxiety and OCD. For children with ADHD, we can often work with parents and schools to help with behavior management training. For adults with ADHD, we can structure our treatment of OCD or anxiety in order to promote success.
Many people with anxiety and OCD also experience Major Depressive Disorder. In fact, for many anxiety and OC-related disorders, co-occurring depressive symptoms are the norm rather than the exception. Depressive symptoms can include reduced motivation, low mood, tearfulness, emotional numbness, feelings of guilt, and eating or sleeping either excessively or less than usual. At the NOATC, our clinicians use evidence-based methods such as Cognitive Behavior Therapy, Dialectical Behavior Therapy skills, and Acceptance and Commitment Therapy to address clients’ depressive symptoms. If you have depression plus anxiety or OCD, we are an excellent fit for your needs.
Not everyone will neatly fit into the categories above. We understand that sometimes individuals want support for their anxiety even when it isn’t to the point of having an anxiety disorder. Contact us for a free screening to see if we are a good fit. Additionally, we know that anxiety disorders and OCD do not occur within a vacuum. Many people with these disorders also struggle with depression, ADHD, autism spectrum disorder, disordered eating, and other concerns. We will integrate techniques into treatment that address these co-occurring issues. Individuals with ongoing substance abuse concerns or active anorexia are asked to seek treatment for these concerns prior to seeking services at the NOATC.
155 Franklin Rd, suite 135
Brentwood, TN 37027
Phone: (615) 412-1155
Fax: (615) 412-1170
Social Anxiety Disorder
Social anxiety disorder is characterized by discomfort with social situations in which an individual feels noticed, observed, or scrutinized. Affected individuals often have a fear of embarrassment, humiliation, or criticism by others. This leads them to either avoid social situations or endure them with distress. In children and adolescents, social anxiety disorder can lead to school refusal or avoidance. In adults, it can affect social and occupational functioning. Individuals with social anxiety disorder may also demonstrate symptoms of perfectionism or “people-pleasing” behavior. Treatment consists of CBT with exposure techniques, coupled with assertiveness training. Acceptance and commitment therapy may also be beneficial.