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Anxiety Disorders: Symptoms & prevention

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We go to the doctor when we have severe pains, fevers or other physical symptoms. We take vitamins, have routine checkups, exercise and adapt our diets to prevent physical illnesses. As we commemorate Mental Health Awareness Month at The Family Institute, we’re talking to our expert clinicians about the connections between physical and mental health, as well as what can be done to prevent more serious mental illnesses.

Today’s insights come from Jenny Welbel, LPC, a staff clinician with the Institute’s Cognitive Behavior Therapy Program.



A Natural State of Anxiety

Anxiety is a natural state that everybody experiences and that is designed to protect and prepare individuals. Therefore, a healthy amount of anxiety can enhance performance in school or at work (driving us to study harder or prepare longer for a presentation) and it serves to protect us from danger.

However, transient anxiety becomes problematic and may be symptomatic of an anxiety disorder when it is persistent, highly distressing, and impairs everyday functioning – making it difficult or even impossible to carry out the things we need to do at work, school or with our loved ones. For example, it is expected that a high school senior may be anxious about where he or she is going to college. But, if this same college senior, is spending hours worrying about where they are going to school, loses sleep because he or she is filling out dozens and dozens of college applications, and gets so nervous before college interviews that he or she gets sick, the individual’s anxiety is no longer considered productive or helpful. Similarly, many individuals may get nervous before meeting new people. But, if an individual is so nervous about meeting new people that he or she avoids social functions all together, or experiences frequent panic attacks before any social gathering, he or she may be struggling with an anxiety disorder.

In addition, it’s important to keep in mind that given that although a certain amount of anxiety is normal, and often productive, there are some things that could take normal anxiety and make it abnormal. Specifically:

  1. Sleep: Maintain as regular of a sleep-wake time as possible. If your schedule gets disrupted because you had to pull an all-nighter, start the next day by getting up at your regular time.
  2. Alcohol: Some people try to cope with stress and anxiety by using alcohol. However, alcohol can make it less likely that you will use healthy coping strategies in the moment, may increase the number of stressors in one’s life, and can make anxiety even worse the next day.
  3. Avoidance: We all tend to stay away from things that we don’t like, but if we do so because the thing in question causes us fear or anxiety, we may actually be perpetuating the fear.  For example, if an individual avoids giving presentations because he is afraid that he will embarrass himself, he is preventing himself from learning that, most likely, his fear does not come true. And, if it was to come true, he could handle it better than anticipated.


Know Your Own Cues

Mental health  is a state of emotional and psychological well-being and balance.

Maintaining that mental well-being and balance is different for everyone — some people use yoga, exercise, religion or other activities to try and keep themselves balanced and feeling well.

In addition to those personal activities, another important way individuals can work to maintain their own mental health is by knowing their own cues that something is off. We often know when we’re off balance and things just don’t feel right. Cultivating that self-awareness so that we can identify moments of struggle is a way we can help prevent larger issues. It’s important to ask yourself: When you feel anxious, how long does it normally last? How are you able to cope with it and/or manage those feelings? If you know those details about yourself, you’ll be able to more easily identify moments when anxiety is lasting a bit too long or interfering too much with your everyday life — and then get the help you might need.


Reducing Stigma Leads to Prevention.

While knowing our own cues that our mental well-being is off-balance is an important way to help prevent larger mental health issues, it can only go so far. Many people do recognize that something is off-balance — but then don’t seek out help because of the stigma surrounding mental health treatment. By reducing that stigma, we could help those individuals feel safer and more secure in getting the help they need, possibly preventing more severe issues that result from a lack of treatment.

By creating environments — families, workplaces and schools — that are more open to discussions of mental illness and less judgmental of what they actually mean, we will create safe spaces for people to talk about their struggles and ask for the help they need. For example, while many workplaces and schools offer accommodations for people struggling with anxiety disorders, some individuals may feel embarrassed or ashamed to actually seek out those accommodations. By reducing the stigma surrounding mental illness and creating a more accepting environment, workplaces and schools can encourage those individuals to get the help they need.

As a society we need more policies in place to help reduce this stigma, and more awareness. If parent, teachers, caregivers and other individuals know what to look for and how to handle it, we can get to the issues earlier and prevent further problems and complications.


The Family Institute offers affordable counseling throughout the Chicagoland area. To learn more about our therapy and mental health services, please visit our website.

Coping With Economic Uncertainty

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Financial worries can become stressful and overwhelming for many families. It’s difficult to maintain a sense of personal well-being when news about the economy seems to go up and down. Financial worries can severely strain a marriage, and children can be negatively affected. Here are some tips for families as they cope with financial stress.

Educate yourself about your financial situation.

As a couple, sit down together and look at the details of your situation. If it’s too difficult to do this alone, have a financial professional or trusted friend look at the numbers with you. Educating yourselves is the first step towards assessing the problem and looking for solutions.


Focus on what you can control, not on what you can’t.

Focusing on what you can’t control leaves families feeling helpless. It’s healthier to focus on what you can do. Can you save more or spend less? Can you balance your budget by making small changes in your spending or saving habits?


Communicate to your children in age-appropriate ways.

Children are often very sensitive to sudden financial stress, such as a parent losing a job.  When you talk to your children, be both straightforward and reassuring. Try to strike a balance between giving age-appropriate information but not overwhelming your children with unnecessary details.


Work together as a family on a financial plan.

When financial worries become overwhelming, family relationships can be affected by the strain. Work with each other to make a financial plan. Young children can help clip and organize coupons. Older children can organize a garage sale or save spare change that can be used as the family’s “fun money.”


Take joy in life’s simple things.

Make sure that you don’t focus on money matters to the exclusion of life’s pleasures. Spend time with family and friends and enjoy activities that don’t cost anything — reading books from the library, going to the park, visiting museums on free admission days, etc.


Consider those less fortunate than you.

Counting your blessings is one of the best ways to reduce stress and worry. Spend time volunteering for those less fortunate, and you will probably feel better about your own situation. Your family can spend a couple of hours volunteering at a homeless shelter, nursing home, or hospital.


Take care of your physical and emotional health.

Make sure your family is getting enough sleep, eating right, and exercising. If you notice that you or a family member worries constantly, is irritable, not sleeping well, withdrawn from friends of family, or using drugs or alcohol, it’s time to seek professional help.

Tips for Gaining Mastery of Your Anxiety

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panic attack word cloudAll human being experience at least some anxiety. Although impossible to eliminate, cognitive-behavioral therapy for anxiety (CBT) offers principles for helping to master excessive anxiety. The following tips can also help you handle anxious feelings.


Mind over mood.

Excessive anxiety is almost always associated with negative thoughts, beliefs or images. When we are anxious (or sad or angry), we view the world “through dark-colored glasses,” creating negative thoughts that maintain and/or heighten anxiety. To better cope, identify your scary thoughts, and then look for evidence (hard facts) to counter and negate those thoughts. Identify an alternative, more balanced way of thinking about the issue.

Face your fear.

Avoidance often brings some immediate relief but does nothing to reduce anxiety and may contribute to maintaining it in the long run. Replace avoidant patterns of behavior with gradual increasing exposure to the triggers of one’s anxiety. For example, if one is fearful of public speaking, practice in front of a small group and build up to a medium-sized group and then a large group of people, until the anxiety subsides.

Accept your anxiety.

Many struggle to fight or escape when they start to experience excessive anxiety. This fear creates a vicious cycle: we get anxious about something in the environment (work, school, a relationship, etc.) and then get anxious about our initial anxiety response. They harder we fight, the more power we give it. Work on accepting your anxiety rather than fighting it.


This article comes from an issue of Institute News Online, the families tri-annual newsletter. It was written by Rick Zinbarg, PhD, the Institute’s Patricia M. Nielsen Research Chair and Director of The Family Institute’s Anxiety and Panic Laboratory. To learn more about Dr. Zinbarg or our anxiety services, visit our website.

Our upcoming Circle of Knowledge event, Straight A’s & Stressed: Navigating childhood, teen and young adult anxiety also deals with issues of how to manage anxious feelings. See below for the event details and visit our website for more information.

Straight A’s & Stressed: Navigating childhood, teen and young adult anxiety

Friday, April 10, 2015
10:30 a.m. registration, 11:00 a.m.-12:30 p.m. presentation & lunch
Exmoor Country Club, 700 Vine Avenue, Highland Park

$25 per person, space is limited
Register online today!
Deadline to register: April 3, 2015

For more information, call 312-609-5300, ext. 480 or email

Straight A’s & Stressed: Navigating childhood, teen and young adult anxiety

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Sick and tired of studyingFrom bitten nails and stomachaches to all-night study sessions, our kids display their anxiety in a variety of ways. However, not all anxiety is bad, and it can be difficult to know the difference between productive anxiety and anxiety that has become a problem.

On April 10th, The Family Institute will host a Circle of Knowledge event to address the issues facing parents as they learn to navigate their children’s anxieties. During this event, Dr. Danielle Black, Director of the Child & Adolescent program, will help parents differentiate between normal worry for our children, teenagers and young adults as they face the pressures of school, sports and socializing, and more severe anxiety symptoms that may be signs of a larger issue. She will also explore how anxiety can be turned into a positive thing that can help your kids become successful.

See the event details below, and visit our website to learn more or register for this event.

Friday, April 10, 2015
10:30 a.m. registration, 11:00 a.m.-12:30 p.m. presentation & lunch
Exmoor Country Club, 700 Vine Avenue, Highland Park

$25 per person, space is limited
Register online today!
Deadline to register: April 3, 2015

For more information, call 312-609-5300, ext. 480 or email

Psychology & Sports: When is the pressure too much?

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Player and coachClose to 30 million kids currently participate in athletics, and the benefits of sports participation are plentiful. Studies show that athletes who have had positive experiences in sports report higher self-esteem, positive body image, decreased unwanted pregnancy, decreased use of drugs and alcohol, physical competencies, gender flexibility, opportunities for social developmental, mental toughness and resilience (Richman and Shaffer, 2000).

However, children’s involvement in sports can also pose difficulties, particularly because training schedules are becoming more demanding and competition is more serious. According to information provided by the Center for Kids First, children are reporting that they are enjoying their sports participation less. In addition, attrition rates for sports participation are rising — 70% of youth athletes quit before the age of 15. Many children stop playing their sport because too much pressure is placed on them by their parents and coaches. Some kids even report poor treatment by their coaches, like being yelled at, insulted or pressured to play with an injury.

Sports participation may also affect children’s mental and emotional health. A recent study by Maniar, Chamberlain and Moore (2005) suggests that student-athletes are more at-risk for mental health difficulties than non-athletes, such as alcohol abuse, social anxiety and depressive symptoms. Athletes also suffer from clinical depression at similar rates as non-athletes. It is possible that the new culture of athletics, which emphasizes toughness, fighting through pain, and not showing weakness, is responsible for negatively impacting children’s mental health.

Clearly, children’s involvement in sports activities impacts their lives and the lives of their families. How can parents help their children have positive athletic experiences? How can parents manage the role that sports play in the their family’s lives?

There are a few potential questions that parents and other caregivers can ask to help assess the impact sports are having on children’s well-being:

  • Are children suffering from a grueling schedule or high demands from coaches that affect the way they feel about themselves? While it may seem that this just part of “playing the game,” these are potential problems that are important to discuss with children.
  • Are the children physically healthy? This is also an essential consideration. While sports participation can increase physical fitness, middle school and high school athletes can be prone to injury before their young bodies reach full maturity.
  • If they have been injured, are the children ready to play again? Having to sit on the sidelines and watch your teammates play without you is difficult enough, but dealing with the pressure to come back from the injury can also be overwhelming for children. Many athletes feel they should just play through the pain — athletes are supposed to be tough, right? — and if they don’t play they may worry that they’ll lose their place on the team. It is important for kids to know that adequate rest and recuperation will be better for them in the long run.
  • Does the child have a specific goals for playing? Do he/she hope to someday become a professional athlete? Is he/she working toward a college scholarship? Or is he/she simply trying to have a good time, get a good workout, and spend time with friends? There’s no harm in supporting your child’s dream or aspiration, as long as it doesn’t interfere with his or her functioning or self-confident. Part of developing healthy self-esteem is working toward a goal, regardless of outcome.

As a parent, the best thing you can do is communicate openly with your child about his/her experiences. Is he/she feeling badly about a recent performance? Is he/she nervous about upcoming competitions? Does he/she seem tired or ambivalent about participating in the sport? These conversations are perfect opportunities for parents to discuss with their children how to balance all their commitments, as well as how to handle stress and nervousness in a way that’s productive rather than inhibitive. And if you do notice that your child is struggling, helps is always available.


This article comes from a Clinical Science Insight white paper by Family Institute affiliate Mary Cooley, MSMFT, LMFT. Visit our website to learn more about Mary and our affiliate staff.

The Family Institute’s child and adolescent services help these groups maximize their potential and overcome and cope with their challenges. We counsel parents and families to strengthen their cores and foster nurturing environments. Visit our website to learn more about how we can help.


How Does Mid-Life Offer A One-of-a-Kind Opportunity for Women?

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In some ways, it’s an enviable problem to have — the kids are off in their own lives and you have both the time and energy to be asking the question “What’s next?”

Whether a woman has stayed in the paid workforce throughout the child-raising years, or stayed at home and devoted the bulk of her energies to family and household, there is a noticeable space that shows up once the children are even semi-launched. For the first time in decades, many women get to consider how they want to re-prioritize their lives. Yet obstacles, both internal and external, can get in the way of this potentially exciting project.

At our next Circle of Knowledge event on Thursday, March 12th in LaGrange, IL, Dr. Cheryl Rampage will explore how to address both kinds of obstacles, to maximize satisfaction in this chapter of life.

Watch Dr. Rampage discuss these issues and what she’ll address at this event below, as well as more event specifics.


The Pleasures and Challenges of Retooling at Midlife

Presented by Dr. Cheryl Rampage

Thursday, March 12, 2015
11:30 p.m. registration, 12:00 p.m. presentation & lunch
Edgewood Valley Country Club, 7500 Willow Springs Road, La Grange

$45 per person; space is limited
Register online today!
Deadline to register: March 5, 2015

For more information, call 312-609-5300, ext. 480 or email

The Winter Blues: How to cope with the intense winter weather with Hollie Sobel, PhD

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_tree_snowy_fieldToday we’re taking a break from our couples post to address another important topic impacting mental health across the country: the winter.

If you’re in the Chicagoland area like we are at The Family Institute, or in one of the many other places impacted by this brutal winter weather, you may be wondering if we’ll ever get a break.

Coping with weather — the snow, ice, up-and-down temperatures and overall dreariness — can have an emotional and psychological toll on those experiencing it.

As we face record low temperatures in Chicago, Family Institute staff clinician Hollie Sobel, PhD, provides tips on how you and your family can deal with the winter’s ups and downs.


It’s about control—or a lack of it.

While winter may be some people’s favorite season, for others it is an incredibly frustrating time of year. Regardless of your feelings about winter, the weather can keep us from doing the things we want or need to do, causing a change in routine that we can’t control. While one may think Snow day! Yay!, the disruption can cause stress and frustration, particularly for people who have a hard time coping with change.

Age matters.

The winter impacts people differently based on their ages and life stages.

Adults deal with issues of commuting to work, arranging childcare on snow days, and changes in routine.

Children may not understand why they can’t play outdoors and often complain about boredom.  Parents can have a difficult time managing their children’s level of hyperactivity while they are stuck inside. In addition, children may find the end of winter and subsequent temperature fluctuations (sunny at 50 degrees one day, snowstorm the next) confusing, or even bittersweet.  Whereas a parent is likely to view the start of the spring thaw as a positive thing, a child sees his/her snowman melting away in the front yard.

For aging populations, the winter can be an isolating time of year. They lose their independence by not being able to walk or drive outside the way they can in warmer months, and tasks like getting to the doctor become much more difficult.

It’s important to note the different needs of the people in your family during this season, particularly in long winters such as this one. What you may need and how you may cope is most likely different than those of your children, your aging parents, or other family members.

Take the opportunity to problem solve and get creative.

It’s not all bad! This trying season provides a lot of opportunities to practice problem solving techniques. Here are just a few ways in which you can get creative and proactive as you deal with what seems to be a never-ending winter:

  • Don’t go through it alone: Parents can work with other parents to arrange activities for their kids; aging populations or people who live alone can reach out to family members or neighbors for help or company; individuals and/or families with extra needs can reach out to local agencies for guidance or support. The winter can feel isolating for everyone — reach out to others to cope and ease the stress.
  • Find your calm: Winter can cause stress and anxiety — conflicts can arise from being stuck in close quarters, and the loss of control can take its toll. If you can’t make it in to the office, work in your pajamas, or practice mindfulness Anything you can do to accept the situation will work in your favor.
  • Make your own consistency: The abrupt weather changes of this time of year can make one’s head spin. If change is particularly hard — whether from the loss of routine that comes with winter storms, or from the back and forth between winter and spring — be sure to structure your days as best you can to keep yourself on track.
  • Be creative: Try some fun things to take your mind off the weather’s ups and downs. If it snows again, instead of dwelling on the disbelief that it happened again, do something fun with it. When the snow starts to melt again and your child’s snowman starts to disappear — make a new one out of cotton balls to keep the cheer alive.




Hollie Sobel, PhD, provides individual, family, and group psychotherapy.  Hollie Sobel, PhD, has specialization in using researched-based cognitive-behavioral techniques with children and adolescents to improve mood, decrease levels of anxiety, and enhance functioning across home, school and social settings. She includes children/adolescents and parents in the treatment planning process, as family involvement is often important in reaching treatment goals.

To read Hollie Sobel, PhD’s full bio or make an appoint, visit our webpage.

The Family Institute offers a wide variety of affordable counseling care that treats whole individuals and their loved ones throughout the Chicagoland area. Find out more at our website.

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