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Getting help for anxiety can often be another source of anxiety. Here’s how to take that important first step.

Of all the mental health maladies that can strike patients, generalized anxiety can be one of the most frustrating. Even though sufferers are desperate for help, the nature of anxiety—that creeping, persistent inner feeling that warns of unlikely danger at every turn—can leave people who are seeking treatment unable to make the leap. As the what-ifs accumulate, counseling is delayed, and the condition continues to worsen.

If this sounds familiar, you may have already hesitated at the thought of making a first-time therapy appointment for anxiety. And while you may rationally know it’s for the best, the uneasy dread fostered by the condition may prevent you from following through.

“A lot of anxiety stems from fear of uncertainty,” says Debra Kissen, Ph.D., Clinical Director of the Light on Anxiety Treatment Center in Chicago. “With fear, you know what you’re afraid of. With anxiety, it’s about what could happen.” And what could be more uncertain than revealing yourself to a stranger?

That apprehension has prompted many anxiety-afflicted patients to avoid being seen, But as Kissen points out, that doesn’t need to be the case. If you’re thinking of consulting with a professional for your anxiety but haven’t yet picked up the phone, here are a few things you should keep in mind.

One of the biggest reservations people have about therapy, Kissen says, is opening up. For anxiety suffers, that can lead to a series of questions with imaginary answers. What if the therapist judges me? What if he or she doesn’t like me? Or can’t help me?

“It’s reasonable to be afraid of addressing the thing that makes you uncomfortable,” Kissen says, “especially with a stranger. But when a client comes in and it’s addressed in a factual way, there’s immense relief in facing it. You’ll be relieved you’re starting the process.”

For some, that discovery phase apprehension can be immediately replaced with a new discomfort, particularly if people suffer from health-related anxiety. That’s when the diagnosis itself becomes a cause for alarm. “People can fear certain words like ‘mental health’ or ‘anxiety’ or ‘panic,’” Kissen says. “But a solid clinician will be able to cut through that and explain that the brain can be trigger-happy when it comes to certain things. These are false alarms. The brain is just trying to be ‘safe.’”

In other patients, anxiety can be social in nature—they’re uncomfortable among strangers, or in articulating themselves when not surrounded by familiar faces. “Some individuals may feel fearful not knowing what to expect in therapy and they may also feel increased social anxiety meeting the therapist for the first time,” says Erin Graves, a registered associate clinical social worker at the Therapeutic Center for Anxiety and Trauma in San Diego, California. “One of the hallmarks of anxiety is avoidant behavior and entering therapy may initially leave a person feeling vulnerable and emotionally exposed.

“With the help of a competent therapist, those initial feelings of anxiety will likely dissipate and become more manageable over time.”

This is by no means a complete overview of how anxiety can conspire to keep you entrenched in self-doubt and unease. But once you’ve recognized most anxiety for what it is—a misguided sense of self-preservation—you may find yourself ready to tackle it head-on. If your first session is looming, Graves says it could be beneficial for some newcomers to provide their own reinforcement. “I would suggest they acknowledge the courage required to take this first step to get support from a therapist,” she says. “I find starting with small helps, perhaps by self-talk like, ‘I’m just starting with this appointment,’ ‘I can get through this,’ ‘This may be helpful,’ or ‘Why not give something new a try?’”

To further reduce uncertainty, both Kissen and Graves recommend that patients do a little prep work, writing down a list of questions they have for the therapist, checking the provider’s website for information or intake questionnaires, and understanding that first-time appointments aren’t nearly as monumental as they seem. “A first appointment typically consists of an assessment, [which is] is learning about the client’s physical and mental health history, family history, sources of social support, connection to spiritual or religious supports, presenting issues and goals for treatment,” Graves says. “We then prioritize the client’s goals and collaboratively develop a treatment plan. We also discuss informed consent and complete office paperwork. I send the client home with various assessment tools to get a more specific gauge of their symptoms.”

In other words, a fear of diagnosis or disclosure shouldn’t weigh too heavily on a patient—much of the first visit will be devoted to establishing a foundation for continued treatment. With that in mind, it’s best for the patient to come in with a specific concern. “It’s good to have notes to express your specific worries,” Kissen says. “You might have trouble in crowds, or be afraid of getting fired.” Kissen also reminds patients that making an appointment isn’t a lifelong commitment. “If it doesn’t feel like the right fit, no one is making you sign up for the rest of your life.”

If you’re still feeling skittish about picking up the phone, Graves advises to remember one key fact about anxiety: you’re not alone. “I think it can be helpful to normalize anxiety as part of the human condition. Often people with anxiety feel there is something wrong with them. I like to remind clients that we all have anxiety from time to time. The benefit of therapy is learning tools and techniques to better manage anxiety so it doesn’t manage you or prevent you from fully participating in life.”

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