Navigating Family Relationships When a Loved One Has Borderline Personality Disorder

Borderline personality disorder (BPD) is a serious mental health disorder that affects how a person sees themselves and others. Their unstable sense of self, intense fear of abandonment, erratic mood swings, impulsive behaviors, and unpredictable, intense emotional reactions can make it difficult for them to maintain healthy relationships, even (or maybe especially) with the people that matter most to them. People with BPD suffer from emotional dysregulation that makes it difficult for them to manage their own extreme emotional responses, and they may turn to unhealthy behaviors like violence, self-harm, or substance abuse to attempt to cope with emotional pain.

In the context of family relationships, the struggles of somebody with BPD have a negative impact on everybody in the family. Often family members describe their experience with a child or parent with BPD as feeling like they’re walking on eggshells, unsure of when they will unwittingly provoke an outburst, or a rollercoaster, in which moments of happiness and hope for improvement are rapidly replaced with anxiety and fear as their loved one lapses into destructive behavior again.


Borderline Personality Family Dynamics

When one family member has BPD, the overall experience is one of instability. One moment they may be loving, the next, lashing out. A child may be skipping school, or their self-destructive behavior may escalate to a suicide attempt. A parent with BPD may be overly attached and controlling or demonstrate affection inconsistently. Ongoing unpredictability skews how the family interacts with one another.

Stress and worry are constant, as family members fear for their loved one’s well-being. Guilt is another common feeling—parents may feel responsible for their child’s mental health and behavior, or children may feel that they somehow caused a parent’s mental illness. They may also feel exhausted or helpless when previous attempts to set healthy boundaries or provide support haven’t worked.

To complicate the issue, a family history of BPD or early disruption of family life are both risk factors for developing BPD. If you have BPD, you may not be the only one in your family struggling with their mental health, and parents may have unconsciously passed on patterns of toxic family relations. Improving family relationships often requires getting help for everyone, not just the family member with borderline personality disorder.


Starting with Self-Care

Therapy is the main form of treatment for BPD, helping you understand the disorder, improve your response to someone with BPD, learn to manage uncomfortable emotions and your response to their impulsiveness, as well as,  improve your relationships. Dialectical behavior therapy (DBT), a form of treatment developed by clinical psychologist Marsha Linehan, is considered one of the most effective types of therapy for BPD and those who are in the circle of someone with BPD.

DBT focuses on improving life skills through:

  • Distress tolerance: Learning how to tolerate negative emotions so that you don’t react impulsively or self-destructively.
  • Emotional regulation: Learning to recognize and handle emotions to improve control over thoughts, behaviors, and feelings.
  • Mindfulness: Learning to be focused on the present as well as nonjudgmental of yourself and others.
  • Interpersonal effectiveness: Learning skills to better handle relationships, such as how to communicate more effectively, how to advocate for yourself and set healthy boundaries, how to build relationships, and how to end relationships that aren’t healthy.

By cultivating acceptance and balance, patients are able to validate the emotions they’re experiencing while addressing and changing problematic behaviors.

Therapy can help you understand your triggers and put effective coping mechanisms in place before you need them. This might mean things as simple as stopping to use a breathing exercise or listen to music to ground yourself before negative emotions spiral out of control. It may mean knowing when to step away from a situation and giving yourself time to collect your thoughts and calm down. With these kinds of tools, you’ll be better equipped to work on your relationships with your family in a healthy, productive way.


Developing Better Relationships

When a family has been coping with borderline personality disorder, it’s likely that the person with BPD isn’t the only one who will need to learn healthier ways to interact. Family therapy can be extremely helpful in preventing parents and kids from slipping back into patterns that may be unintentionally triggering or enabling negative behaviors. The guidance of a mental health professional can also help a family learn how to better support your recovery, enabling them to replace feelings of helplessness and frustration with the rewarding sense of being able to help you make progress toward your goals. Families may also want to join a support group to connect with others who share their experience.


Finding Help

If BPD has upended your family, positive change is possible. Therapy can be instrumental in helping give you and your loved ones the tools to build the healthy relationships you want. To get connected with a therapist who can help with either online or in-person sessions, contact the SF Stress & Anxiety Center here. We’ll schedule a free initial phone consultation with one of our compassionate Care Coordinators to match you with the right therapist for your needs.


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Managing Stress and Anxiety When You Have ADHD

For somebody who has been diagnosed with ADHD (attention deficit hyperactivity disorder), stress and anxiety may be constant unwanted “bonus” problems that seem difficult, if not impossible, to separate from the disorder itself. While the symptoms of ADHD can look different in adults and children, the inattention, impulsivity, and restlessness/hyperactivity that characterize it tend to make even simple tasks at home, school, or work harder to complete. Daily life can become an ongoing source of uncertainty, worry, and stress—in fact, anxiety disorders are one of the most frequent comorbid diagnoses among adults with ADHD.

Of course, the relationship between ADHD and anxiety isn’t necessarily that simple. It can be a bit of a chicken-and-egg problem to figure out whether ADHD is the cause of anxiety or if they are issues that exist side by side. Either way, learning to cope with stress and anxiety when you have ADHD can help make treatment for both conditions more effective.


ADHD vs. Anxiety

ADHD and anxiety can have similar symptoms, especially ADHD-inattentive type (what was once known as ADD or attention deficit disorder). For example, being unable to focus or having trouble concentrating, experiencing sleep problems, or being restless or irritable can be symptoms of either anxiety or ADHD. The key difference is what underlies the symptoms. For someone suffering primarily from anxiety, distraction is caused by overwhelming fearful thoughts that make it difficult to concentrate, while someone with ADHD is easily distracted even in situations when they’re calm.

Unfortunately, determining the source of troubling symptoms might not be that straightforward, because people with ADHD are also likely to feel anxious about problems brought on by their struggles with their mental health condition. ADHD can negatively affect nearly every aspect of daily life, and someone coping with it can be highly aware of how they’re failing to live up to their own expectations but still have trouble changing their behavior. Missing important deadlines or meetings at work; being unable to prioritize important tasks; missing instructions because you couldn’t focus on a conversation; feeling guilty because an impulsive outburst offended someone you care about—these common situations that can arise from ADHD also produce anxiety.

The overlap in ADHD and anxiety symptoms can be the source of misdiagnosis or delayed diagnosis. It’s important for a mental health professional to carefully screen symptoms to rule out an anxiety disorder when diagnosing ADHD, and vice versa. Having an accurate diagnosis is the first step toward effective treatment.


Can ADHD Get Worse with Stress?

If you’ve been under stress and thought it made your ADHD even harder to deal with, you’re not imagining it. Your body’s physical response to stressors exacerbates classic symptoms of ADHD. Stress hormones are designed to activate a fight-or-flight response that, among other things, routes blood away from the prefrontal cortex, the part of the brain that governs executive function and which is already affected by ADHD. The stress response weakens working memory, mental flexibility, impulse control, coping skills, and the ability to sustain concentration. Worse, chronic stress can cause biochemical changes to the brain that make it harder for it to function correctly. It’s entirely possible to end up in a vicious cycle where stress exacerbates ADHD, leading to more stress. However, it is possible to break that pattern with the proper assessment and treatment.


Getting the Help You Need for ADHD, Anxiety, and Stress

The best treatment for ADHD and anxiety may vary somewhat by individual, especially if the anxiety they’re experiencing is primarily due to their ADHD. You’ll get better results if you know exactly what you’re dealing with, so if you don’t have a confirmed diagnosis already or think it might not be accurate, we encourage you to seek out assessment and testing to get a clearer picture.

In general, ADHD is treated with a combination of medication (either stimulant or nonstimulant), therapy, and behavioral tools. A comprehensive approach is essential for success—therapy is not a substitute for medication, and medication can’t replace therapy. Medications help balance levels of important neurotransmitters to improve the symptoms of ADHD. Therapy can assist in identifying negative thoughts and behavior patterns and help patients change them so they’re better able to function and manage their ADHD symptoms. Dealing with ADHD head-on, coming to understand that daily difficulties with it are not character flaws but the effect of a disorder with a neurological basis, and learning better coping strategies can all go a long way toward relieving ADHD-related anxiety as well as improving the overall diagnosis.


In addition, lifestyle changes can help you better deal with stress and anxiety when you have ADHD. Setting a regular schedule that incorporates breaks and exercise helps, as does maintaining a healthy diet, reducing the use of alcohol and/or caffeine, and quitting smoking. Learning relaxation techniques such as breathing exercises can help provide tools to mitigate feelings of stress before they become overwhelming. These changes will work best when you can be consistent; consider phasing them in gradually so they become habits that are easy to follow rather than an abrupt shift.


If you’re struggling with ADHD and anxiety, or suspect you might be, the SF Stress & Anxiety Center can help. Our experienced therapists use evidence-based methods to help you overcome the challenges you face and learn strategies that allow you to improve your quality of life. For your convenience, we offer both in-person and online sessions. Schedule your free initial phone consultation with one of our compassionate Care Coordinators to be matched with the right therapist for you.

Breathe Your Way Through Stress and Anxiety

What is the simplest, most effective way to address stress?  What can you do to slow your heart and feel more centered when things are challenging?  Deep breathing, and Square Breathing in particular, can help you recover, find your center and lower the impact of stress and anxiety.  


You take your lungs wherever you go

Because we are always breathing, bringing attention to this fundamental process can seem simple, even simplistic.  Fortunately, square breathing is one of the easiest and most effective stress reduction techniques we have.  

What’s the easiest way to lower your heart rate?

Just arrived at work and need to reset your focus?  Get centered with 5 rounds of square breathing.  Feeling a little socially anxious at the wedding reception?  Take a moment to step outside and do some breathing, then hit the dance floor.  Need a moment to decompress from work before attending to your home life?  Take a moment to yourself to re-establish your focus before you walk in the door.  

How do you breathe to relieve stress?

Sit down if a seat is available, and keep your back straight, while also relaxing your shoulders.  Relax your abdominal muscles to allow your lungs to expand into your diaphragm.  Inhale for 4 to 5 seconds, while counting.  Choose a number of seconds that fills your lungs to a deep breath without pushing too hard against that natural limit.  Hold your breath for that same count.  Exhale for the same amount of time.  Then stay at the bottom of your exhalation for 4 or 5 seconds, whichever feels right to you, before you repeat the cycle.  


Benefits of Deep Breathing 

Deep breathing calms down the Fight, Flight or Freeze response. A slow exhalation engages the parasympathetic nervous system, which is involved in relaxation.  It turns down your brain’s alarm center. This leads to a reduction in cortisol, the stress hormone.  Your shoulders tend to drop.  You can feel yourself correct your posture a little and expand your chest cavity to accommodate a deeper breath.  The awareness from breathing can make you feel more restful, calm and aware.  According to psychologist and author Rick Hanson, focusing on the breath can be profoundly centering.  

According to the New York Times’ Alisha Haridasani Gupta, just breathe, “When you slow your breathing down, ‘the parasympathetic system — what we call the ‘rest and digest’ system — hopefully takes over and helps calm you down,’ she said.”  Because stress and anxiety are deeply woven into the physiological stress response, square breathing can be key to resetting your mood, your perspective, and your awareness.  


Further Reading:

Harvard Medical School Relaxation Techniques  

Deep Breathing to Relieve Acute Stress

NHS Breathing Exercises for Stress  

University of Michigan One Minute Strategies to Relieve Stress


If you’re seeking further guidance and support in managing stress and anxiety, SF Stress & Anxiety Center is here to help. Our experienced professionals can provide personalized techniques and coping strategies for long-lasting relief. Schedule a consultation today to take control of your well-being.


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Understanding the Link Between Stress, Anxiety, and Eating Disorders

Eating disorders such as anorexia nervosa, bulimia nervosa, and binge-eating disorder are serious conditions that not only have a profoundly negative effect on physical and mental health, but are also difficult to treat. These problems often start in adolescence and in early adulthood, although they can occur at any age. The disordered eating behaviors that result can affect the body’s ability to get adequate nutrition and cause physical damage, with potentially serious long-term health consequences. While the exact cause of eating disorders is unknown, certain risk factors that can contribute to their development are well understood, including stress and anxiety. Understanding how these factors can trigger, influence, and exacerbate eating disorders is essential for effectively treating them. 


Can Anxiety Cause an Eating Disorder?

Stress and anxiety are a part of life, as much as we might wish otherwise. Sometimes stress can be helpful, such as when it motivates us to get an important project done before a deadline or study harder before a big test. However, when anxiety becomes unmanageable, persistent and overwhelming worry can make it impossible to function on a day-to-day basis or to maintain healthy relationships. While anxiety disorders may occur on their own, they can also occur with other mental illnesses such as depression.

Anxiety disorders are common among those also struggling with an eating disorder. According to statistics from the National Institute of Mental Health, 47.9% of those with anorexia nervosa, 80.6% of those with bulimia nervosa, and 65.1% of those with binge-eating disorder were also diagnosed with some form of anxiety disorder. The most common types of anxiety disorders associated with eating disorders are obsessive-compulsive disorder (OCD), social anxiety disorder (SAD), generalized anxiety disorder (GAD), and post-traumatic stress disorder (PTSD). Anxiety and eating disorders can interact in complex ways, which makes it essential not to overlook the role the former plays when treating the latter.

It’s easy to see how anxiety or a stressful life change—such as going away to college, family issues, a new job or promotion, or moving—could push someone already at risk into developing an eating disorder. A family history of eating disorders, having been teased or bullied about weight, past trauma, and/or frequent dieting are all factors that are known to increase the risk of an eating disorder, and adding stress to the mix may be the catalyst that provokes problematic eating behaviors. However, the relationship is more complicated than that. 


Understanding the Connection between Anxiety and Eating Disorders

Eating disorders are progressive—they often start intentionally as a way to feel a sense of control. Once a habit forms, though, it is easy to lose control over disordered eating behaviors and exercise habits. People with eating disorders become compelled to continue their destructive behaviors, which tend to worsen over time. In turn, the consequences of those behaviors can amplify the stress and anxiety they were initially meant to help relieve.

For example, someone with anorexia may begin severely restricting their food intake, repeatedly measuring their weight, or undertaking an extreme exercise regimen as a way of trying to cope with anxiety and a distorted body image. They may also develop ritualistic behaviors such as cutting food into tiny bites or weighing everything they eat. However, having to hide these behaviors from concerned family, friends, or colleagues can become a new source of stress and anxiety. In addition, malnutrition can also make anxiety worse.

Anxiety, stress, and bingeing can create a different dynamic that nevertheless serves to amplify the negative feelings that provoke disordered eating. Instead of avoiding food, people with bulimia or binge-eating disorder have episodes in which they consume large amounts of food in a short period of time. Negative emotions like sadness, loneliness, guilt, or hopelessness are often identified as triggers for a binge, which might begin with eating comfort foods to self-soothe but balloon into uncontrolled eating. Because this releases brain chemicals like serotonin, it works in the short term. In bulimia, that binge is followed by a purge (such as vomiting or laxative abuse) in response to the uncomfortable physical and emotional symptoms of the binge. The immediate feeling of relief, for both those with bulimia and people with binge-eating disorder, is quickly replaced by feelings of guilt and shame.

As with anorexia, binge-eating (whether it is followed by purging or not) is accompanied by secrecy and anxiety. Those suffering from these disorders tend to hide food, eat alone, and otherwise go to great lengths to hide their binges. Embarrassment over their lack of control over their behaviors may also amplify the negative emotions that are more likely to spark binge episodes. Physical consequences such as gastrointestinal problems or weight gain may become an additional source of stress and anxiety as well. 


Treating Eating Disorders and Anxiety

While someone might not develop an eating disorder from anxiety alone, when an anxiety disorder is also present, it is necessary to treat both conditions simultaneously. Otherwise, symptoms of anxiety can worsen disordered eating or cause discouraging relapses during treatment. Learning how to reduce anxiety and develop healthier coping mechanisms can help break the cycle of self-destructive behavior.

At the SF Stress & Anxiety Center, our therapists specialize in treating anxiety, using evidence-based methods to produce lasting relief. If anxiety has you feeling stuck, overwhelmed, or hopeless, we can help. To keep treatment accessible and convenient, we offer both in-person and online therapy. Schedule your free initial phone consultation with one of our compassionate Care Coordinators to be matched with the right therapist for you.


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How to Help Adult Anxiety

Feeling nervous or anxious at times is normal, especially if you’re going through a stressful period at work or home. However, there’s a vast difference between typical moments of nervousness in response to pressure and an anxiety disorder—intense, persistent, excessive worry and fear that interferes with your ability to function at work, at home, or in social situations. Adult anxiety is far from rare—according to the National Institute of Mental Health, 19.1% of U.S. adults experienced an anxiety disorder in the last year, and 31.1% of adults have experienced an anxiety disorder at some point in their lives. While it’s all too likely that you or someone you care about will be affected, adult anxiety can be effectively treated.

It isn’t fully understood what causes anxiety disorders, although most experts believe that multiple factors play a role. Genetic predisposition, your personality type, traumatic experiences, and prolonged or extreme stress can all interact to bring on anxiety that is difficult to control and out of proportion to the stressors you face. For example, if you’ve felt more anxious since the pandemic, you’re not alone. A recent study shows that one in three adults worldwide was living with an anxiety disorder during the COVID-19 pandemic due to uncertainty, disruptions in daily routines and health concerns for themselves or loved ones. Understanding what adult anxiety can look like and how best to respond can help keep anxiety from limiting the possibilities of your life. 

Signs and Symptoms of Anxiety

People suffering from anxiety disorders may experience a range of physical symptoms, as well as anxious thoughts and behaviors. Possible physical signs include a racing heart or heart palpitations, shortness of breath, nausea, diarrhea, sweating, shakiness, edginess or restlessness, dizziness, lightheadedness, insomnia, and/or becoming fatigued easily. Characteristic thought patterns can include a sense of impending danger or doom, racing thoughts, an inability to concentrate on anything except the present worry, a constant belief that the worst will happen, and persistent worry that is difficult to control. This physical and mental discomfort leads to common anxiety behaviors such as avoiding feared situations and social withdrawal.

People suffering from anxiety may be reluctant to socialize, afraid to talk on the phone, fearful of going out, and scared to interact in even simple ways with other people, such as speaking to a cashier at a store. When these symptoms of adult anxiety persist and/or get worse over time, interfering with your work, your relationships, or ordinary daily activities, you shouldn’t wait to seek help in the hope that they’ll go away on their own. 


Types of Anxiety Disorders

The type of anxiety disorder someone experiences may be differentiated by the situation that triggers their anxiety and their symptoms. Some types are:

  • Generalized anxiety disorder (GAD): Persistent, excessive worrying about everyday issues over a period of months or years, producing a sense of fear or dread that interferes with daily life.
  • Panic disorder: Regular attacks of sudden fear producing intense physical symptoms in the absence of any real danger or apparent cause.
  • Social anxiety: Intense and ongoing fear of being watched or negatively judged by other people. Some sufferers may experience fear or anxiety in all social settings, while others have difficulty only in certain situations, such as eating in front of others or performing or speaking publicly (performance anxiety).
  • Separation anxiety: Extreme fear or distress at being separated or the thought of being separated from a loved one. While some separation anxiety is a normal stage of development for very young children, as an adult disorder it can prevent normal functioning at work or home when the sufferer is away from their spouse, child, or other loved one.

Of course, not every case of anxiety fits neatly into a single category. Anxiety may also occur alongside other mental health disorders, such as depression or substance abuse. While this may complicate a diagnosis, it doesn’t mean that anxiety can’t be treated. 


Adult Anxiety Treatment

It’s common for people to believe they can’t control anxiety or their tendency to have panic attacks and that it’s just a problem they’ll have to learn to live with. In fact, that isn’t the case at all—many people are able to move past the symptoms of anxiety disorders and learn to improve their quality of life. If your attempts to manage anxiety on your own aren’t working, it is possible to get effective help.

One of the first steps should be to consult your primary care physician for a physical evaluation. Sometimes symptoms of anxiety can be related to an underlying health condition or medication you’re taking, so it’s best to rule that out as a possible cause or contributing factor. Properly treating any such medical condition may help alleviate anxiety.

If anxiety doesn’t spring from a physical cause, consulting a mental health professional should be your next move. Psychotherapy helps people with anxiety disorders identify the causes of their worries and fears and develop healthier coping mechanisms and skills to overcome anxiety. Two types of psychotherapy that can be effective for people with anxiety disorders are:

  • Cognitive behavioral therapy (CBT): This type of short-term therapy pairs cognitive and behavioral approaches to recognize our existing patterns of thought and behavior and examine how they can hold us back. Patients then learn how to change those thought patterns and habits. CBT sets specific goals that are meaningful for each patient and teaches them skills to take action to achieve them.
  • Dialectical Behavior Therapy (DBT): DBT is a modified form of CBT developed to help people develop mindfulness, tolerate distress, regulate their emotions, and improve their interpersonal effectiveness. It can include group therapy for behavioral skills as well as individual therapy sessions. DBT validates a patient’s experience while gently challenging them to make positive change.  

Lifestyle changes can also have a positive impact on getting anxiety under control when paired with psychotherapy. Regular exercise, getting adequate sleep, healthy eating, avoiding alcohol or recreational drugs, and cutting back on stimulants like caffeine can all be beneficial. In addition, relaxation techniques such as meditation or breathing exercises can help keep stress at manageable levels. Your therapist can help plan a mix of treatments for anxiety best tailored to your unique situation and needs.


Reclaiming Your Life from Anxiety

When anxiety takes hold, it can gradually take over your life, isolating and limiting you. At the SF Stress & Anxiety Center, our therapists can help you overcome your anxiety and develop psychological resilience so you can thrive in your professional and personal life. We offer both in-person and online therapy sessions to keep treatment accessible. 

To get started, schedule a free introductory phone call with one of our compassionate Care Coordinators to be matched with the right specialist.


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Dating Someone with Anxiety: What You Need to Know

Although everyone experiences anxiety at times, some people suffer from more debilitating or heightened forms that can impact their lives on a daily basis. In turn, this can require more understanding and compassion from their significant other. The truth is, dating someone with anxiety can present additional challenges, stresses, and strains to a relationship. For example, when cohabitating, an anxious partner’s difficulty sleeping can negatively impact the sleep quality of both partners. It may also be necessary to adjust to an anxious partner’s difficulty concentrating, nervousness, or restlessness.

While someone with anxiety might need extra patience, empathy, and support from their partner, that doesn’t mean the relationship is doomed; it just requires a lot more communication, which is crucial as a couple anyway. 

If you’re dating someone with anxiety or an anxiety disorder, but don’t know exactly how to help them, don’t worry. Here are some great tips on dating someone with anxiety, from ways to support your partner to an understanding of how anxiety can affect your relationship.


How to Support Your Partner With Anxiety

Ask them what they need.

Being in a relationship with someone who suffers from anxiety requires more communication on your part. Whenever a partner’s anxiety level is high, it’s important to be mindful of what they may need and ask what they require at the moment. For example, if they want to be held or if touch feels too overstimulating at the moment, you can just ask them what they need.

However, if they cannot articulate what they need in the moment, try a few low-key approaches such as playing some soft music; playing with pets; or focusing on any calming, pleasant physical sensation they need. Use a meditation app with them and offer to meditate with them for a few minutes or do something artistic and creative together. Games that require a lot of concentration and attention can also be helpful since they divert attention from anxiety. Puzzles or simple video games like Tetris or solitaire can be good at distracting them.

Don’t tell them to calm down or relax.

Even though you might think telling your partner to “relax” is helpful, you might actually be adding to their anxiety. When your partner is suffering from high anxiety, it is most likely that they are already fighting within themselves about how to deal with it, and other people saying this can sound more like a directive than comforting. 

Consider calming activities like meditation or a bath instead. Although it may be hard not to tell your partner what to do, trust that when they need you, they’ll tell you. Don’t take it personally if they need some quiet time or some alone time. Respecting them will improve your relationship.

Learn more about their type of anxiety.

In order to be able to help your partner as effectively as possible, you should learn as much as you can about their type of anxiety. This can include generalized anxiety disorder (GAD), social anxiety, separation anxiety, and/or panic attacks. While you may not be able to know exactly how your partner feels, making an effort to learn will benefit both of you.

In order to do this, you can read articles or books on the topic, follow social media accounts, or ask your partner directly what living with anxiety is like for them. As you become more familiar with their condition, you will be able to support them a lot better.

Don’t dismiss their emotions.

You may not fully comprehend what your partner is going through when it comes to anxiety, but that doesn’t mean their feelings are invalid. Whenever you dismiss someone by saying, “You’re overreacting” or “It’s not a big deal,” you can be gaslighting them, making them believe what they’re experiencing isn’t real.

Nevertheless, you shouldn’t let them run wild with their emotions, as this may cause them to spiral out of control. You do, however, want to create a safe space so your partner can navigate their anxiety-which can be difficult if you ignore or dismiss it. Studies show that we seek partners who see us the way we see ourselves in relationships and that this helps the relationship succeed. In a relationship, we want to feel comfortable to be ourselves instead of pretending to be someone we are not.

Be aware of the subtle signs of anxiety, too.

You might be able to spot some of the most common anxiety signs (for example, excessive worrying, restlessness, difficulty falling asleep and staying asleep) easier, but it’s also important to know about less common ones, so you don’t end up supporting behaviors that hurt your partner the most. For instance, perfectionism is often a sign of an anxiety disorder. This may be when our partner can never relax, never stops trying, or needs constant feedback that things are right. They might be feeling more anxiety than they let on. Those with anxiety might seek frequent assurance that they are doing things’ right’. They might be concealing anxiety if they never seem to get enough reassurance or validation.


How Anxiety Affects Relationships

They might have set ways of doing things.

If your partner has anxiety, they may have certain ways of approaching tasks that feel familiar and safe to them. Perfectionism, rigidity, and the desire to control things that do not need to be controlled are some traits they may exhibit. It’s important to understand that they’re usually harder on themselves than they are on anyone else.

One of the ways you can help is by setting boundaries about their need to control things. Discuss their feelings with them, so they feel understood, but also let them know how it affects you. For instance, if you and your partner disagree about how to clean the house because their standards are much stricter than yours, focus on a “good enough” standard and let them know that anything beyond that is on them. Additionally, if you don’t get enough relaxation time, carve out some for yourself that is non-negotiable.

They may have fears about the relationship.

For example, someone may worry about whether their partner will leave them or whether they are truly loved and cared for by them. In many cases, these concerns are unfounded and contradictory to objective reality.

To help cope with this fear, your partner may choose to become extra close, so much so that you may feel smothered. Ironically, this may lead you to create some separation or breathing room, which only confirms the anxious partner’s fears of abandonment. By understanding this, you can navigate the situation with clarity and have an honest discussion.


How to Set Boundaries

While you may love your partner, it’s completely natural to need to set boundaries with them on certain behaviors; what might be considered a healthy coping mechanism for them might impact you in a negative way. Talk with your partner about the specific behaviors that bother you, listen to their perspective, and encourage them to talk about their experience.

Once you find common ground with your loved one, encourage them to seek help from a therapist and continue to set boundaries when their behavior becomes an issue. Be mindful that setting boundaries doesn’t mean you should insult, dismiss, or criticize your partner. The best thing to do is empathize with them and let them know that there might be ways to improve their situation. Don’t take full responsibility for handling their anxiety yourself; don’t put more effort into it than they’re willing to, or you’ll burn yourself out.

At the end of the day, being in a relationship with someone who has anxiety can be a really nurturing and healthy experience. By being supportive, thoughtful, and empathetic about your partner’s anxiety, you’ll be able to build a foundation that will work for the both of you. If you are experiencing anxiety or dating someone who does and need help coping, contact us today for a free consultation to discuss how we can best support your needs.


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Tips for Mental Health That Therapists Use for Themselves

Working out and eating a healthy diet are two ways we care for our physical health. However, the strategies are less defined when it comes to mental health.

Nevertheless, we understand how important it is to take care of our mental health. Studies show that most people value their physical health just as much as their mental health. Yet, more than half of people say they spend more time working on their physical health than mental health.

Therapists know first-hand how important it is to care for your mental health. They see plenty of people experience problems because they’ve neglected their mental health for years. If you don’t prioritize your mental health, you will feel the difference. Mental health should be a priority for three reasons: 


  • Preventing mental health problems is easier than treating them. By taking care of yourself now, you may be able to prevent mental health problems in the future. By paying close attention to your mental health, you’ll be able to intervene earlier when problems arise. 


  • Physical and mental health are intertwined. Poor mental health may increase your risk for physical health issues, such as diabetes, heart disease, and stroke. So even if you care more about your physical health, neglecting your mental health may backfire. 


  • Your mental health affects your quality of life, too. Being in good physical shape is important, but psychological wellbeing is equally important. Mental health problems can impact your social life, your ability to complete your work, and your relationships. 


Here are five exercises you can do to improve your mental health:

  1. Plan something fun every week

In therapy, we often discuss “pleasant activity scheduling.” In essence, it means scheduling an activity that you enjoy. It could be as simple as choosing a time to watch a movie at home. Regardless of whether you live alone, schedule it on your calendar. The key is to schedule it in the future, so you have something to look forward to. 

You get a second boost in your mood when you do that fun thing and a third boost after it’s over because you’ve created a positive memory. It is a good idea to schedule at least one fun activity a week.

  1. Practice relaxation strategies

Knowing how to relax your mind and body is essential. Passively watching TV might not cut it either. Even though you’re watching TV, your muscles might still be tense, and your mind might never completely relax. Additionally, watching TV while scrolling through social media can keep you on edge and alert.

For real stress reduction, you might want to learn yoga or meditation practices. Additionally, you can learn and practice breathing exercises and progressive muscle relaxation. Try to incorporate regular stress relief into your schedule regardless of what you do.

  1. Establish a gratitude practice

The benefits of experiencing and expressing gratitude are numerous. In several studies, gratitude has been shown to be directly related to your overall wellbeing. People who are grateful tend to have fewer mental health problems, higher levels of happiness, and long-term positive psychological wellbeing.

While writing a letter of gratitude to someone is one way to experience these positive effects, you don’t necessarily even need to share your grateful feelings with anyone. You can also increase your mental strength by writing in a private journal.

  1. Foster your relationships

A key factor in good mental health is social support. Relationships play a crucial role in your life, so it’s important to invest time in them. Spend quality time with your loved ones, whether that’s a date night with your partner or a weekly dinner with your friends.

  1. Perform acts of kindness

Acts of kindness shouldn’t necessarily be about your personal gain, but by doing kind things for others, you do gain a lot. Whenever you are kind to someone, your brain releases feel-good hormones, such as endorphins and oxytocin. In addition to boosting your own mood, you will also boost the mood of the person you are giving to. 

Each day, choose a different person to show kindness to and perform one act of kindness. Or, you might volunteer once a week with a specific organization. 


Incorporating mental strength strategies into your daily routine

Identify strategies for building mental strength that you enjoy. This will increase your chances of sticking to them. Don’t force yourself to meditate if you hate it. Instead, look for another exercise you might like better. There’s plenty to choose from, and investing more time in your mental health is key to reaching your greatest potential.


How Therapy Can Benefit Your Mental Health

About 75% of people receiving therapy experience symptom relief and are able to function more effectively. Other benefits include:

  • Better daily habits to support a healthy lifestyle
  • Fewer negative thoughts
  • Greater focus and more satisfaction at work
  • Higher self-esteem
  • Stronger relationships with others

Ultimately, you’ll learn not only how to solve the problem that brought you into treatment but you’ll also gain new skills to help you cope with whatever challenges arise in the future. Contact us today to discuss how we can help.


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How to Support Your Child’s Mental Health

You know all the right things to do to protect your child’s physical health-feed them healthy foods, take them to the doctor, and ensure they get enough sleep and exercise. But what about helping your child grow up mentally healthy? It turns out there is plenty you can do as parents to help support your child’s emotional and mental well-being.


What Does ‘Good Mental Health’ Really Mean?

Mental health entails being able to deal with life’s ups and downs. Good mental health allows children to experience both comfortable and uncomfortable emotions without high levels of distress. In other words, they are able to handle uncomfortable feelings such as hurt and embarrassment and do not crumble under unexpected or disappointing circumstances. Despite challenges, they are able to persevere and can move on from failure. Mentally healthy kids can also adapt to change (within reason) and aren’t overly fearful about new experiences.

Your child’s ability to cope with new situations will vary as he or she grows and develops—a 2-year-old will have a harder time coping with new situations than a 12-year-old. Depending on your child’s temperament, more cautious children may be more fearful in new situations than those who are bold. A child’s confidence and resilience will vary considerably depending on their age, stage, and temperament. 

Strategies for Supporting Your Child’s Mental Health

What is the most important factor in helping your child develop positive mental health? You. In all of the literature on childhood mental health, the parent-child relationship is the leading indicator. Invest in the relationship, be present with your children, nurture your own mental health and well-being so you can be present with your children, and do not condition anything about your relationship with them on their behavior.

Here are some practical ways you can use to foster that strong parent-child relationship and boost your child’s resilience and flexibility.


Tips for promoting positive mental health:

  1. Be a Role Model

Children learn how to respond to frustration, challenges, and uncomfortable feelings based on the ways in which their parents deal with them. For example, if children see their parents react to frustration with anger and give up, they tend to do the same. A parent who communicates excessive fear about new things and tries to shelter the child from situations where any hurt or disappointment could occur is likely to have a child who is more fearful and avoidant as well.

  1. Limit Your Child’s Screen Time

The American Academy of Pediatrics recommends no screen time (other than video chatting) for kids under 2 and only one hour of quality children’s programming for kids 2 to 5. Limiting screen time can improve mental health. Children’s brains are much more sensitive to electronic use than we may realize. Excessive screen time has been linked to school problems, aggression, and other behavioral issues. The “sensory overload” causes kids to have poor focus and depletes their mental energy, which often leads to anger and explosive behavior. It is possible for kids to become overstimulated and “revved up,” and they may have difficulty managing stress and regulating their mood.

In addition to limiting screen time for kids, you should also put down your phone and show your kids how to balance electronics with other activities in life. Parents should also engage with their kids without devices present all the time to support healthy parent-child relationships and child development.

  1. Stop Helicoptering or Snowplowing

You’ve heard about helicopter parents (who hover over their children to ensure everything’s going well) and snowplow parents (who smooth the way for their children, so they don’t have to face any bumps in the road). Although well-intentioned, these types of parents prevent their children from experiencing disappointments and overcoming obstacles. When children are involved in activities with caregivers where they are able to succeed some of the time but have to overcome challenges other times, they are more likely to develop healthy self-esteem and mental health. 

Whether it’s climbing something higher or putting together a puzzle they’ve never done before, let them try something new. Don’t jump right in to rescue them if they encounter a problem, but support them through it so they can learn how to successfully manage something that’s a little challenging without falling apart. This is the perfect opportunity for you to offer encouragement and support. Allow your child to try new things, and if they fail, let them try again while creating a soft landing in case they fail.

  1. Focus on Your Child’s Physical Health

Providing the best building blocks for mental and physical health is essential. Physical health and mental health go hand in hand. Diet contributes to mood, attention, anxiety, and behavior. Mental health problems are more likely to occur in children who consume a diet high in processed foods that are devoid of nutrients. It is also crucial to make sure your kid gets enough sleep to maintain good mental health since poor sleep can impact mood, coping skills, and emotional resilience.

  1. Talk to Your Child About How They’re Feeling

Good mental health requires the ability to share feelings in a productive, healthy manner. Kids should be allowed to feel sad, frustrated, and hurt and supported to work through those feelings in appropriate ways. Help them manage big, uncomfortable feelings by modeling and supporting them to use techniques like deep belly breathing, movement, distraction, and talking.

  1. Accentuate the Positive

You can boost your child’s self-esteem by praising them for their efforts, not their successes. A good way to start is to point out what your child does well and how you notice them succeeding. The crucial thing is to praise a child’s effort despite their struggles or not being the best at whatever they’re doing so they develop a positive sense of self.

  1. Show That Making Mistakes Is Normal

Rather than harping on your child’s errors, show them your own occasional mistakes. Spotlighting your mistakes helps children understand that everyone makes mistakes and they aren’t a reflection of their worth. A positive, healthy sense of self-worth will help them avoid the stress and anxiety that comes with perfectionism.



In order to establish a strong foundation for your child’s mental health, you must build trust, demonstrate strong communication skills, and be a good role model. Being supportive of your child’s mental health also means getting them help or support when they need it.

You are the expert on your child. If they are acting in a way that seems strange or worrisome to you, don’t hesitate to reach out to a counselor. Don’t let fear or embarrassment keep you from getting your child help when they need it. It is the most supportive and courageous thing you can do. Treatment and intervention will enable them to care for their mental health.


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How to Care for Your Mental Health While Grieving

One of the most painful experiences in life is losing someone or something you love. When we lose a significant person, job, ability, or time, we may feel lost and confused about how to move forward. Loss can cause a wide range of emotions, and grief is a natural process we all go through.

What Does Grief Feel Like?

Everyone goes through grief at some point in their lives, but it can be an overwhelming and stressful experience. As a result, it can be difficult to predict how we might respond to a loss, as it is an individualized experience. You may experience any of the following after a loss:

  • Sadness or depression. After realizing the loss, you may isolate yourself and reflect on things you did with your loved one or focus on past memories.
  • Shock, denial or disbelief. Following a loss, some people may find themselves feeling quite numb about what happened, as their minds protect them from pain. In the early stages of grief, shock serves as an emotional shield to prevent overwhelming feelings.
  • Numbness and denial. After a loss, you may feel numb. It is natural and helps us to process what has happened at our own pace and not before we are ready. The problem arises when numbness is the only feeling we experience, and none of the other grief-related feelings can cause us to feel ‘stuck’ or ‘frozen’.
  • Panic and confusion. When someone close to us passes away, we may wonder how we will fill the void left in our lives and may feel like our identities have changed.
  • Anger or hostility. When we lose someone, it can seem unfair and painful. When you experience loss, you may feel angry or frustrated and seek to find someone or something to blame to cope.
  • Feeling overwhelmed. It is common for people to cry a lot or feel as though they cannot cope when grieving. Some people worry that their feelings are so overwhelming that they cannot handle them. Over time, however, the intensity of grief tends to lessen, and people learn to cope.
  • Relief. There are times when you may feel relieved upon the death of someone, especially when there had been a long illness, when someone was suffering when you were the person’s primary caregiver, or when your relationship was difficult. This is a normal response and does not mean you don’t care or love the person.
  • Mixed feelings. Having a difficult relationship with a person may make you think that you will grieve less or cope better because you had a difficult relationship with them. You may instead experience a mixture of emotions like sadness, anger, guilt, and anything in between.

It is possible to feel all of these things, none of them, or just a few of them. After a loss, there is no right or wrong way to feel. Some people seek help immediately by expressing their emotions and talking to others, and others prefer to deal with things slowly and quietly. Everyone grieves differently and on their own timeline.


Reasons You May Experience Grief

Many people associate grief with losing a loved one, but any significant loss that completely alters your life’s trajectory – especially if it is unexpected – can cause grief.

Life events that often lead to grief include:

  • Divorce and relationship breakups
  • Chronic or terminal illness
  • Loss of time
  • Loss of a job or other financial security
  • Retirement
  • Death of a pet
  • Loss of a friendship
  • A miscarriage
  • Loss of safety due to trauma or abuse
  • Selling a family home

It may seem selfish to take care of yourself after a heavy loss, especially if other people around you are hurting and need support too. However, putting your mental health on the back burner can increase your chances of depression, anxiety, and other conditions. One of the most important ways to cope with grief and begin the healing process is to take care of your mental health.

Here are some tips to give yourself space to grieve a loss while prioritizing your mental health.


Mental Health Tips for Coping with Grief and Loss

  1. Allow yourself time to grieve.

The process of grieving is unpredictable, complex, and exhausting. Accepting that grief takes time is an integral part of grieving. Once you’ve given yourself time to heal, the heavy weight of grief will gradually lift, and you’ll develop the strength to move forward with your life and relearn who you are. Allow yourself grace if you need additional time and support to move on from grief.

  1. Spend time with people you trust.

After a significant loss, many people prefer solitude to reflect and process their emotions. If you need some time alone, take it. Be aware, however, that prolonged isolation can result in loneliness, which negatively impacts all aspects of your health. Whenever you’re ready, speak to friends, family, clergy, or other people in your community who make you feel safe – even if you’re only talking on a video call or sitting in a room together. The company of another human can offer much-needed comfort and emotional support.

  1. Don’t neglect your health.

Experiencing a loss is not just an emotional endeavor. It can also impact your physical health if you have trouble eating, sleeping, or staying active. Because our minds and bodies are so closely connected, meeting your basic needs, such as food, sleep, and exercise, during a grieving period can help you remain physically healthy and mentally stable.

  1. Get back into your hobbies (or discover a new one).

It’s normal to lose interest in social activities or hobbies after a loss. The benefit of channeling your interests is that it allows you to cope with grief while stimulating your body and mind at the same time. Taking part in hobbies that you enjoy can keep you physically and mentally active, whether you are painting, gardening, writing, fishing, kayaking, or cooking. Consider exploring a new hobby and learning something new if your old hobbies no longer interest you.

  1. Talk to a mental health professional.

You may feel lost when you lose someone or something important to you. There was a drastic change in your life path, and you don’t know which alternative path to take. It’s okay to feel this way. However, a long period of grieving can be a sign that you need additional support. By discussing your struggles with a mental health professional, you can express your emotions and learn tools to find your next path (or carve out a new one altogether).

Whether your loss is recent or happened a long time ago, our mental health providers at SF Stress & Anxiety Center are here to help you move forward through in-office or telehealth sessions and is dedicated to supporting you on your healing journey.  Contact us today to schedule an appointment with our team. 


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How Social Media is Affecting Your Mental Health

Everybody is on social media. It’s muscle memory — when we need a brain break at work or while standing in line, we pick up our phones and open one of the options. As of 2022, almost 5 billion people worldwide were on social media, with average daily use totaling nearly 2.5 hours.

 There’s a reason these apps are so popular. It is designed to be addictive. Dopamine is released when you use the apps, and you feel good when others like your posts and react to them. It is possible, however, for the connection between social media and mental health to go sour. Here’s what you need to know and how to keep that from happening.

 How does social media affect mental health?

Most people agree that social media has a negative impact on mental health. But why? Let’s dig into how social media affects our perception of the world. Apart from the obvious negativity and bullying that can occur on the internet. 

 Because social media use is still relatively new, we don’t yet have research exploring its long-term effects. However, multiple studies have linked it to multiple mental health issues such as anxiety, depression, and lower self-esteem. 

 It can worsen anxiety and depression symptoms 

The constant use of social media can worsen anxiety and depression symptoms and increase feelings of loneliness. It has been shown that excessive social media use, coupled with emotional dependence on the platforms, can worsen anxiety and depression symptoms.

 However, the problem cuts both ways. Some people use social media to cope with feelings of anxiety or depression, according to researchers. You can get caught up in the vicious cycle of scrolling through social media when you’re bored or anxious without realizing that your actions may make things worse. 

 It can cause feelings of inadequacy 

The emphasis on social media is on interaction, such as likes and comments on photos and videos. It feels great when you post something and get a lot of feedback. As a result, you feel validated for posting in the first place. However, what happens if you don’t get the interaction you’d like with your pictures or videos? If you rely on social media for self-validation, you may feel down when you do not receive the expected recognition. 

 Social media comparison can lead to low self-esteem. In an age when filters smooth the skin or make the water of a beach selfie a deep and alluring blue, it can seem impossible to keep up with what others are sharing online. In addition, unrealistic body image expectations may lead to what experts call “body surveillance,” the monitoring of one’s body to the point where it becomes judgmental, especially among adolescents. 

 It can interrupt your sleep cycle

According to studies, 70% of people reported getting on social media in bed before falling asleep, and 15% spent an hour or more a night on their phones. Checking your feed before you go to sleep is a common nighttime ritual for most people. 

What if we told you that it shouldn’t be? According to the same study, people who check their social media in bed are more likely to suffer from insomnia. The use of social media before bed can delay your bedtime and cause you to sleep less, and the sleep you do get won’t be of good quality. 

 In addition, there is the blue light your phone emits, which interferes with your circadian rhythm. Aside from that, social media stimulates the mind and body. If you want to sleep better, put your phone away.

 Warning signs your online habits are unhealthy

It is possible to become dependent on social media, which can also lead to negative consequences. Consider these warning signs when determining whether social media is affecting your mental health.

  • You leave no time for self-care.
  • You spend more time on social media than you do with friends or family.
  • Your symptoms of depression or anxiety spike. 
  • You often compare yourself to others and feel jealous of what they are posting.
  • You are distracted from school or work.
  • You have trouble falling asleep.
  • You feel like you need to check social media every few hours. 

 Here’s how to protect your mental health from social media

It’s not a bad thing to use social media. And you can use it in a healthy way to enrich your life. Maintain a healthy balance between social media use and mental health by following these tips.

  • Decrease your time on social media: According to studies limiting social media use to 30 minutes can improve your well-being. Be deliberate about how much you log on to social media if you think it negatively impacts your mental health. Set a screen time limit or create a schedule for checking social media. It’s not necessary to quit cold turkey. It is important to be realistic about what you want from social media and what it will take to get there. 
  • Don’t start or end your day with social media: Timing is important. Start or end your day on an enjoyable note instead of a potentially negative one. Researchers have found that those checking Facebook at night were likelier to feel unhappy or depressed. 
  • Use that time for something else: Social media can be useful. However, logging on just to scroll through your downtime can cause problems. Think about why you’re logging on. You can then shift your focus from social media to other activities — like exercising or taking up a new hobby. 
  • Spend time with friends and family: Although social media platforms can be a place of connection, they can also cause loneliness if you’re not getting what you expect. Face-to-face contact and quality time cannot be replaced by social media. Spending time with family and friends can help combat this problem.


Despite its downsides, social media isn’t all bad. It can be a way to connect meaningfully and keep up with others. It can also be an outlet for self-expression and creativity. There can be good things about social media. Make sure you are intentional about how and why you use your platforms. Consider why you are scrolling when you grab your phone and poke that all-too-familiar Instagram camera. Are you putting off activities you should be doing, such as taking a walk or fulfilling obligations? Being mindful of how much and for what reasons you use social media can positively impact your mental health.

Are you struggling with the impact of social media on your mental health? Don’t face it alone. Visit to get professional support and guidance tailored to your needs. Start your journey to a healthier, more balanced life today!


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