Therapist speaks on rising anxiety in younger generations

Mar 7

“Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults (19.1% of the population) age 19 and older every year.”

Over the past couple of years, anxiety disorders have been at an all-time high. These disorders include generalized anxiety disorder, panic disorder, social anxiety disorder, specific phobias, obsessive compulsive disorder and post-traumatic stress disorder.
In the younger population specifically, these disorders are largely impactful on how people think, behave and interact within society. Fortunately, while these disorders are on the rise, so is the number of people seeking out therapy.

Monica Mehalshick is a therapist and the CEO of The Nourished Nest, a virtual private practice that provides mental health services in various states across the country. Mehalshick has seen first-hand how anxiety affects people and has insight into how it affects more recent populations, such as millennials and Gen Zers.

“Nine out of 10 Gen Z [individuals] with diagnosed mental health conditions struggle with anxiety.”

With anxiety often comes “two roads,” according to Mehalshick. “There’s usually anticipatory fears and then there’s racing thoughts.”

Anticipatory fears, or anticipatory anxiety, is a fear of and worry about things that could/will happen in the future, specifically bad things. On the other hand, racing thoughts are fast-moving, repetitive thoughts that occur in an overwhelming pattern. While someone can experience both, there is often one that overrides.

Mehalshick has noticed that there is a lot of anticipatory fear.

“I think that we live in a culture of instant gratification where things happen really quick. If you want something, it’s here tomorrow, or if you have [Amazon] Prime, it’s here between 10 and 3,” said Mehalshick. “And we get used to that — when we want something to happen and it happens quickly, and it’s enabled. When something doesn’t happen, it’s terrifying.”

When there is an upcoming situation or event that we don’t have much control over, the anticipatory fear seems to begin. Specifically, waiting for that moment is what triggers that fear.

What also impacts that is social media — we know everything about everything, and that brings fear, especially when we are so physically disconnected at the same time.

“[Gen Z and millennials] specifically have grown up in a very uncertain world. There’s so much information that I don’t think the brain can process it. And when the brain doesn’t feel like it has control, it causes racing thoughts and fear.”

When someone feels that lack of control, their mind can take over. But Mehalshick emphasizes there are ways to find “even a sliver” of control.

In the midst of uncontrollable conflict, like war, we can tell ourselves, “I have control of how much TV I watch. I have control of how much social media that I engage in. I have control of telling people, I do not want to necessarily talk about this because this is triggering my fear,” Mehalshick said.

The issue that many therapists see, however, is that it takes work and time. It takes work and time to find coping mechanisms that are effective, to seek therapy, to have self-control over things that are harmful, to set boundaries with people.

This is a large reason why many mental health medications, such as antidepressants, are overprescribed.

When it comes to tactics like journaling, yoga, meditation and more, “I hear it doesn't work — because people haven’t done enough of it. And if there’s a quick alternative [medication] that will shut the stuff off quicker, people go to that because it’s an instant gratification,” Mehalshick said. “I don't think a lot of people want to do the work because it’s hard, but it’s totally doable.”

Unfortunately, it doesn’t work like that. Medication isn’t a quick fix — in fact, it often takes weeks for a medication to set in. With that often comes side effects, as well as the large possibility that the medication may not work at all, or even make the symptoms worse.

The most common issues with medication management reported that additional therapy was required (23.6%), not taking as prescribed (nonadherence) (23.3%) and adverse drug reactions (poor side effects) (17.8%).

Mehalshick tells her clients who start medication for anxiety that “you are starting with 10%: 10% of your solution or your strategy will be that medication, and the other 90 is you.”

Of course, this doesn’t mean that medication shouldn’t be taken. For many, medication is vital and needed in order for those coping mechanisms to even be effective — people sometimes need to get down to a baseline before they even have the mental capability to put in that effort and try alternative methods.

But the medication itself isn’t the only factor — it’s also the person prescribing it. For those who see a primary care physician, they may not be given the correct medication or may not even have a follow up.

“Good practice is following up in four weeks,” Mehalshick said. “For women, it takes about four to six weeks to kick in for an SSRI because we have a higher percent of body fat, and plus, then you throw in we all metabolize things a lot differently. And imagine getting medication and not checking in with someone for six months. How do you know it works?”

While medication management will almost always be a process, a strong start is seeing a psychiatrist or physician that specializes in mental health. But with that also comes seeing a mental health professional.
At The Nourished Nest, therapists prioritize assessment and understanding the client first before suggesting medication. That way, the client is more likely to receive the type of care they need best, whether it’s medication or not.

With anxiety comes another important aspect: trauma. “The brain is complicatedly stupid,” said Mehalshick. “The brain does not know the difference between if you watch Michael Myers going up the stairs and when you go up the stairs in your own home in the dark. [The brain] literally says, ‘Oh, no, she’s going up the stairs.’ It does not know that you are not being chased by Michael Myers. But it will act that way. Because that day, the brain had a disruption in normal functioning, which is trauma. And that causes anxiety because your brain is going to protect you because it’s incredible. That’s why I think a lot of people don’t address the anxiety because they don’t realize that it’s a residual reaction to stuff they’ve experienced before.”

What many professionals and researchers have found is that trauma and fears remain in the mind and body until they are addressed. One of the most well-known books in the field is “The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma” by Dr. Bessel van der Kolk. Written by a scientific researcher with more than 30 years of research and clinical practice experience, the book talks about how experiences, specifically traumatic ones, trigger responses in the body and mind that affect how a person functions.

Again, it comes down to control. Taking control of those experiences through talk therapy, as well as other therapeutic methods, is the way to control that anxiety.

“There are five billion different ways to help anxiety,” Mehalshick said. “It might be yoga. It might be pilates. It might be medication. It might be getting an emotional support dog. It might be a bunch of things. But it’s a free exchange: if it doesn’t work, bring it back. We’ll try again. But you’ve got to actually do it. Don’t tell me for two weeks that you have. You did it once. It has to be consistent, and when people are consistent, we find that they have a better success rate.”

Aside from those common recommendations we hear about, there are also other ways to manage anxiety — and surprisingly, some of them include using your phone.

“I love the Calm app ... my son and I use it for sleep stories,” Mehalshick suggested.

The app also has quick meditations (or longer ones if you prefer) and other auditory methods of reducing anxiety and promoting good sleep.

Mehalshick also suggests the Daylio app for people who want to track their mood. She says that for her clients with anxiety, it often nudges them to check in during the day.

Other methods include, as Mehalshick says, “crunchy” methods, or natural methods like taking supplements including ashwagandha, magnesium and St. John’s Wort. Remember to consult with a physician before taking these, as they could interact with some medications.

Natural methods also include exercise, getting adequate sunlight and sensory activities.

“Sensory stuff is really good. I know a lot of our staff will talk about taking a cold ice bath. I know that’s kind of been the trendy thing, just kind of getting in connection with your sensory, like the therapy dough,” Mehalshick reflects.

Mehalshick uses lavender sleep spray and also does a sage cleanse in her office each day. Along with her son, she uses therapy dough, which she sells on The Nourished Nest website. Their Pinch Me Dough is a holistic, drug-free, portable stress-reduction tool that’s great for those with anxiety.

And, of course, there’s therapy. Whether it’s individual therapy to help find coping mechanisms or to discover traumatic experiences stuck in your body or group therapy to find a support system of people also struggling with anxiety, the benefits are real.

“There’s no cure for anxiety and that sucks,” Mehalshick empathizes. “A lot of people say, ‘Oh, my God. So now I’m stuck with this.’ Yeah, you are. But here’s the thing: if you manage it, it’s much better.”

“I would rather say, ‘Listen, I have a mental health disorder and I’m learning how to manage it,’ versus ‘I can’t fix it, therefore, I’m broken.’”

The Nourished Nest offers therapy services, including couples, individual and group therapy, for those in select states in the United States. They accept most insurances as well. Additionally, interns often offer therapy at no charge through the practice, and many group offerings are open to those around the country with select discounts as well, such as for students.

The Nourished Nest offers an anxiety book club support group for anyone located in the United States for an affordable price. Use promo code SHEMADE for $30 off. Students can receive a discount as well, and giveaways for the group will be posted on The Nourished Nest Instagram profile.

Visit https://www.thenourishednest.com/ for more.

Header photo by Polina Zimmerman / Pexels