Anxiety Explained: Diagnosis, Therapy, and Hope

In this episode of OK State of Mind, a Family & Children’s Services podcast, Dr. Stevan Lahr, Medical Director, and Kaitlin Foster, Vice President of Adult Outpatient Services, unpack what anxiety truly is—and what it isn’t. From the biology behind the brain’s fight-or-flight response to the emotional toll of everyday stress, the conversation explores how anxiety manifests, how to recognize it, and why it’s one of the most treatable mental health conditions.

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Transcript

Dr. Lahr: [00:00:00] I'm sure you probably had the same example in school we did. It was like if you're in the forest and a bear walks out mm-hmm. You're gonna have, what's gonna happen? Your heart's gonna race, you're gonna get tunnel vision, you're gonna wanna run that fight or flight. Right. That's really, that's anxiety.

Mm-hmm. Right there. And that makes sense in some of these situations. Mm-hmm. But it's, it becomes a disorder when that part of your brain is just getting triggered. Maybe for no reason at all. And so I think it's important to have an awareness of what in your environment could. B, causing your anxiety, but don't think that you have to know what that is or, or that we're gonna have to find out what that trigger is for you to get better.

Mm-hmm. 'cause a lot of the time, if it's a disorder, it's just coming out, it can just come out of the blue. 

Chris: Mm-hmm. The amygdala in the human brain evolved to spark a fight or flight response when a threat was perceived. This response served humanity well, and it still does. However. With fewer threats of impending [00:01:00] peril at the claws of wild animals, the amygdala can sometimes be overactive or oversensitive leading to chronic or recurring anxiety.

Now, I may be oversimplifying a little bit, but I would note that a 2017 study from the National Alliance on Mental Illness estimated that 19.1% of adults have an anxiety disorder. Today we're speaking with two experts about causes of anxiety, consequences of anxiety, and key resources that can help in dealing with this seemingly ubiquitous condition.

On this episode of Okay, state of Mind, a Family and Children's Services podcast. So we're here today with Caitlyn Foster and Dr. Steven Law. Can we just start out the podcast today with some quick introductions? Caitlyn, tell us a little bit about what you do here at Family and Children's Services. Sure.

Kaitlin Foster: My name is Caitlyn Foster. I am a licensed marriage and family [00:02:00] therapist in Oklahoma, and I am the Vice President of Adult Outpatient Services. So I oversee the programs that provide office-based treatment to adults that are struggling with a severe mental illness. 

Dr. Lahr: All right, and Dr. La, I'm Dr. Steven La.

I'm a board certified general psychiatrist, and I'm the medical director at Family and Children's Services, and so I help oversee all of our psychiatric and nursing and medical services here. 

Chris: Yeah, and you might remember Dr. La from a previous podcast. It's been. A year and a half. It's been quite a while.

It's been a long time. Yeah. I, 

Dr. Lahr: I don't know what I did wrong for you to wait so long, but, 

Chris: well, we're glad to have you back and glad to have you here today, Caitlin. Thank you. Um, may is Mental Health Month and so today we're talking about an aspect of mental health that I think really impacts. A broad swath of individuals, and that is anxiety.

I mean, I'm was feeling it walking into the studio today. So we wanna [00:03:00] focus on this a little bit, maybe see if we can't, um, identify causes, what it is and, and what we can do about it. That's what I really want to know. Can we just talk a little bit about what anxiety actually is? 

Kaitlin Foster: So I think one thing that.

Has been a recent trend in terms of mental health field, and I know we're, we'll talk about social media and how this impacts it, but anxiety seems to be the mental health diagnosis of the month. 

Mm-hmm. 

Kaitlin Foster: And sometimes we use anxiety to describe other things that we're feeling. Yeah. So it's a, it's a term that we say, I'm feeling anxious when we might actually be feeling embarrassed, or I might be.

Excited because I'm anticipating something. And so I think we don't always have the language that we need. Mm-hmm. To talk about anxiety. 

Mm-hmm. 

Kaitlin Foster: And so that's one of the things that we work with when we're working with our clients is you say you're feeling anxious, but I actually think it might be this other.

[00:04:00] Feeling that you may not have the words to describe yet? Yeah, 

Dr. Lahr: that's a great point. I think it's, it gets confusing too, because we use the same word to mean different things. Mm-hmm. So anxiety is a normal emotion. And so it may be confusing to some people who are not familiar with mental health to say, well, why would you treat that?

I mean, everyone gets anxious every now and then. Mm-hmm. And there's a difference between normal anxiety and an anxiety disorder. Yeah. Right. So we really have to kind of focus in on that. That word disorder and kind of define that a little bit. And so whenever we are evaluating someone for, um, anxiety, we're looking at, in a typical situation.

Would most people experience that, right? Is this a normal reaction? Mm-hmm. And then we go away from just focusing on what the feeling is and then how is it affecting you? So if you're able to, you do your normal daily task, get good rest, have a normal diet, then you're probably not having [00:05:00] an anxiety disorder, right?

Mm-hmm. So it's going to impair the way that you. Function in life, and it's not just gonna be a feeling. Right? So the anxiety, that feeling is really just one of the symptoms that kind of keys us in that there could be something going on here and we need to look at that a little deeper. 

Chris: All right. What are a couple of different types of anxiety disorders?

Dr. Lahr: There's a whole, like what chapter? Two chapters of anxiety disorders on there. I'd probably say some of the more common ones. Yeah. Would be what we call generalized anxiety disorder. Um. Panic disorder and then social anxiety disorder. Would you say that Caitlyn? 

Kaitlin Foster: Yeah. And post-traumatic stress disorder also falls under the category of an anxiety.

Mm-hmm. We think about PTSD as a trauma related disorder, which that is how it starts, but then the symptoms and the presentation of it also qualify it as an anxiety disorder. 

Chris: Hmm. Are the other ones you mentioned trauma disorders, are they, do they [00:06:00] come from another source? You, I think it's a, it's a mixed 

Dr. Lahr: bag.

Mm-hmm. Right. So, you know, you know, with post-traumatic stress disorders, you have to have had that trauma mm-hmm. For you to develop. Yeah. Right. Whereas some of the other disorders, let's take, um, you know. Panic disorder. Yeah. It's possible that you had some type of experience that triggered that, but also it's not required, so it could just completely come out of the blue.

Mm-hmm. And that's another reason why it's not normal anxiety. Mm-hmm. Right. If you can always identify, this makes me anxious and you're able to deal with it, or, um, it doesn't impact your life, then you probably don't have an anxiety disorder. Mm-hmm. But if you're just sitting there and. All of a sudden you're having a panic attack and you don't know why.

Then that kind of goes in that column of, well, this could be something that we need to look at. 

Mm-hmm. 

Chris: Um, if a person is experiencing, I'm just gonna call it normal anxiety or everyday anxiety. [00:07:00] Is there a need for an individual to, to seek help with that? I mean, is there gonna be benefit there or is help gonna primarily help those who have an anxiety disorder?

Sure. That's a good question. 

Kaitlin Foster: So my therapy stance is that everyone needs therapy. Yeah. Mm-hmm. So I would say to anyone, whether you, whether you feel like you have an anxiety disorder or not, that you could benefit from seeing a therapist. Mm-hmm. And working on life skills, coping skills, relationships, skills, whatever.

You may need some help with or another perspective. I do think that, like Dr. Lar was talking about the disorder piece, sometimes there are clues mm-hmm. Or hints that something might be developing, whether it's with a child, you have a child that's highly sensitive and is reporting anxiety about going to school every day, or they're afraid to go to bed every night.

Um, or even as an adult. If you start to experience more and more anxiety, sometimes that's leading into an anxiety disorder. Mm-hmm. So [00:08:00] it's always best to get some help with that mm-hmm. Before it spirals into something else. 

Dr. Lahr: Yeah. I don't think there's, it's ever a, a bad idea to ask a second opinion of what's going on.

Yeah. Right. Yeah. And, uh. It really, you know, it's such a, it's a really an umbrella term anxiety because it, it affects different people, different ways. I think you have, if you are having that question, like, should I talk to someone? You've probably just answered your question. Yeah. For yourself. You probably should talk to someone and just, I can't, uh uh, there's been a number of times when someone's come to see me and, um, at the end of the interview I'm like.

Everything you're experiencing is normal and there's really nothing else that we need to do. And it's such a kind of relief Yeah. For that person to know like, oh, other people experience this. Yeah, a hundred percent. Other people experience this and you're doing everything you're supposed to do and there's really nothing else that we need to do for that.

Chris: Yeah. I mean, hearing that I can imagine is just incredibly therapeutic, you know, and beyond, you [00:09:00] know, prescribing medicine or any sort of, um, follow up just. Hearing that has got to be huge for, for people. Um, you talked a little bit earlier about triggers, um, and we were talking about that a little bit in the context of PTSD, but also other anxiety disorders.

What triggers do you two see in, in your practices? 

Kaitlin Foster: Definitely if you've experienced a trauma. Mm-hmm. Anything that. Remind you of the trauma or if the scenario is very similar, whether it's in your home or in a public place to the, the time and place where that trauma happened, that can be a trigger. But one of the things that we don't talk about frequently is that life transitions can also Oh, 

yeah.

Kaitlin Foster: Trigger anxiety sometimes. Mm-hmm. It can trigger any severe mental illness or struggles, but life transitions like. The death of a parent, the birth of a child, children moving out of the house, um, job [00:10:00] change, moving in terms of where you live. All of those things can also bring up things that maybe you thought that you had already dealt with and they were in the past.

But just that that change and the stress of those life transitions can sometimes bring those things back. 

Chris: Hmm. Yeah, I just moved my daughter back from college last week. It's interesting you say that, uh, the transitions piece, uh, because, uh, and she is a, she's a, a good student and has a, has a healthy social life, and I could sense in our conversation that she was, you know, feeling a little something.

Mm-hmm. Because. Uh, she had, she was telling me she had created this life for herself at school, at college, and she's having to leave it for a little while. She'll go back. She's a freshman, so she'll be back in the fall. But, um, I think that the life transition piece, I, I wonder if sometimes we. Uh, play it down a little bit.

'cause we're like, oh, [00:11:00] well yeah, of course I'm going home from the college or, yeah. So I can see that being a really a 

Dr. Lahr: significant one. You know, whenever you come see a doctor or a therapist, there's always like, oh, there has to be a problem. And if there's a problem, that's something that's we don't want or something that's bad.

Mm-hmm. And anxiety is normal and it has a purpose. And so, you know, one of the, um. And, you know, we're talking about, let's just talk about the triggers for a minute, and life changes. You know, everyone's like, oh, this is really an, you know, high anxiety, I'm losing my job, or I lost a loved one. Uh, but any transition can cause anxiety.

And so looking at, you know, what is the purpose in the brain? Anxiety is that red of our system. Danger system in the brain, it's supposed to cue you in, um, that you need to take action or just be more aware of your surroundings. And so, you know, I, I'm sure you probably had the same example in schools we did, it was like, if you're in the forest and a bear walks out mm-hmm.

You're gonna have, what's [00:12:00] gonna happen? Your heart's gonna race, you're gonna get tunnel vision, and you're gonna wanna run that fight or flight. Right. That's really, that's anxiety. Mm-hmm. Right there. And that makes sense in some of these situations, right? Mm-hmm. It would. It's, it becomes a disorder when that part of your brain is just getting triggered maybe for no reason at all.

And so I think it's important to have an awareness of what in your environment could be causing your anxiety, but don't think that you have to know what that is or, or that we're gonna have to find out what that trigger is for you to get better. Mm-hmm. 'cause a lot of the time, if it's a disorder, it's just coming out, it can just come out of the blue.

Chris: Mm-hmm. Right. A person who has an anxiety disorder. Will that anxiety disorder always be with him or her, or does a person move out of an anxiety disorder? 

Dr. Lahr: Uh, well, first everything's on a spectrum, right? Mm-hmm. So there's people that have very mild anxiety to very severe anxiety disorders, but as a group, this is a very treatable [00:13:00] disorder.

Mm-hmm. And, um, of all the things that we, we do every day, it's one of the only ones where therapy is recommended, first line over medication and only in mm-hmm. Real severe cases. Do we have to be on both? Mm-hmm. It is, uh, probably one of the mo more treatable disorders that we have and definitely not guarantee that you're gonna have it Mm.

Or be the, have the symptoms of it. Yeah. Ongoing. Mm-hmm. 

Kaitlin Foster: And like what you said about it serves a purpose. 

Mm-hmm. 

Kaitlin Foster: Because the goal is not to stop all feeling 

right. 

Kaitlin Foster: The goal is not for me to never feel anxious or to make this go away completely. In therapy, you can learn how to manage it or how to separate out the way that you're feeling from your thoughts or your behaviors.

But there is a purpose to that anxiety, and sometimes we need to relearn what that purpose might be. Mm-hmm. Mm-hmm. But it's not that we're trying to squash everything. Yeah. So we don't ever feel it [00:14:00] ever again. Yeah. And 

Chris: that might be one of those misconceptions we were talking about earlier, that anxiety is wrong.

Mm-hmm. Or you are wrong, or there's something wrong with you. If you're feeling anxiety, we have evolved to experience anxiety. It's, it's a lifesaving It is, yeah. Feature. So 

Kaitlin Foster: we need it. 

Dr. Lahr: Yeah. People don't like to be uncomfortable. Yeah. Yes. Yeah. And so sometimes, and sometimes that's our job too, to determine, yes, is this really anxiety or is just discomfort.

Mm-hmm. And there's a big difference there. They can feel the same, uh, but they play out very differently. 

Chris: Hmm. Do you think that anxiety has become more popular in the world we live in today? Is it becoming increasingly and popular probably is not a good word, but is it, but common? How about common? I'm, 

Dr. Lahr: I'm picturing like, uh, you know, the, the in high school, the pop, like which of our diagnosis is, or which, what's gonna be the mean girl diagnosis right now?

Who's, who's, who's gonna get voted most? Popular most continuum. Right? Where are you on that list there for anxiety? 

Kaitlin Foster: Ooh, let's throw [00:15:00] out social media here. Yeah. I do think it's become sensationalized. Yeah. Um, but truly over covid as well. Mm-hmm. There was a lot of anxiety about many things. 

Mm-hmm. 

Kaitlin Foster: Am I going to get sick?

Am I going to lose my job? Mm-hmm. When am I going to see my family again? So there was valid reasons for that, but I do think. As a whole, we've had a hard time coming down from it. Mm-hmm. Social media doesn't help that. Yeah. Because it's a very popular phrase or term, and like we talked about earlier, that's not always accurate.

So we may not have the language to describe what we're feeling, but it may not be anxiety. Social media hasn't given us the tools mm-hmm. To, mm-hmm. Really talk about what's happening. 

Chris: Yeah, that's a good point. It, it has presented the, uh, the issue, but it hasn't presented anything mm-hmm. To help us with it.

That's interesting. 

Dr. Lahr: Yeah. Yeah. You know, I think, uh, social media has, I. A lot of [00:16:00] great aspects to it. Mm-hmm. And I'm glad it got the word out right. So we're talking more about mental illness, we're talking more about anxiety and other disorders, but like you said, it hasn't really, it hasn't resolved mm-hmm.

The issue. Mm-hmm. So 

Chris: are there any new or emerging trends in treating anxiety right now? I suspect you two will come at this from different perspectives. Mm-hmm. So I, I'm, I'm interested to hear what you both have to say about this. 

Kaitlin Foster: So from a therapy perspective, one of the treatment modalities that we've really embraced recently is it called acceptance and commitment therapy.

Okay. 

Kaitlin Foster: It's a newer treatment model. It was around pre covid, but um, it really works with the idea of. Like what I was saying, the goal is not to get rid of mm-hmm. The anxiety. It's to become aware of my body, what I'm thinking, what I'm feeling, and. Realize that just because I'm having a thought or a feeling doesn't mean [00:17:00] I have to act on it.

Mm. 

Kaitlin Foster: And I'm gonna act in accordance to my values and the things that I feel like are important, not necessarily what I'm feeling in this moment. 

Mm-hmm. 

Kaitlin Foster: So, teaching individuals the skills to, yes, I recognize that I'm feeling anxious, or I'm having this thought that no one likes me, or no one will talk to me when I go to this party.

Mm-hmm. But. I value community, and so I'm gonna go ahead and give that presentation, or I am going to go to that party. I. So that's one of the ones that we've really trained on at Family and Children's recently. Mm-hmm. And our clinicians have really enjoyed using that with clients. 

Chris: Sounds like everybody could benefit from that.

I 

Kaitlin Foster: agree. Yeah. 

Chris: I'm listening to you and thinking, Hmm, can I. Implement this in my own life. 

Kaitlin Foster: I'll give you some names. 

Dr. Lahr: Okay. Maybe after the, the cameras go off, you can do a session. Yeah, yeah. Absolutely not. Could do that. Okay. Yeah. Uh, from the medical side, there's not a whole lot I. New for the [00:18:00] treatment of anxiety.

We've had kind of decades of research with using SSRIs, SNRIs, um, and other medications that really, um, help anxiety, a common kind of misconception that we run into all the time. Um, let's say you get diagnosed with panic disorder or, or generalized anxiety disorder, and then I'll have people come back to me and say, Ugh.

My doctor gave me an antidepressant. Mm-hmm. I told them I'm not depressed, that I have anxiety, and so most of those. Medications. The full classification name is antidepressant slash anti-anxiety medication. Oh, okay. Okay. And so the chemicals that we're targeting there mostly are, are serotonin and norepinephrine.

Those are the two most common ones. And those antidepressants and those are the same chemicals, um, that regulate anxiety. Okay. Mm-hmm. They're also the same chemicals that regulate gut motility and a lot of stuff in your stomach. And so if you've ever had, you [00:19:00] know, stage fright or any type of anxiety, it's almost impossible to have high anxiety and no GI symptoms.

Mm-hmm. Or stomach issues. It's practically impossible. Yeah. Because it's the same chemicals. They're being kind of triggered in the same way with the same process. Just in your brain. You're having that feeling of anxiety and it's gonna get trans. It's something going on to your stomach. 

Chris: Hmm. Okay. And you mentioned something earlier that I thought was interesting.

I, I just genuinely don't know. This, do medication and therapy frequently go hand in hand or infrequently? Go hand in hand? I would 

Dr. Lahr: say 

Chris: frequently. Oh, okay. Okay. Okay. 

Dr. Lahr: Almost, um, all the disorders that we treat, especially anxiety, um, will have a, a therapeutic. Um, treatment arm, that's very important. Mm-hmm. Um, but for, uh, not everyone that's gonna be completely effective.

So, you know, like we said, there's that range. So a lot of the time, if it's mild, even mild depression, but mild [00:20:00] anxiety therapy's gonna be probably where you're gonna start. Mm-hmm. Um, and in some cases it may just be a change in lifestyle that's actually going to get improvement. Hmm. Once you get into that severe range, I'm trying, I don't really know if really.

Any disorder that once it kind of gets into that more severe realm where medication and some type of therapy is not recommended. Mm-hmm. 

Chris: Okay. 

Dr. Lahr: I have to work with Kaitlyn hand in hand a lot of the times. Okay. No matter what we talk frequently. Yeah, 

Chris: yeah, yeah. All right. Uh, not in a clinical sense, what would you say to someone that might currently be struggling with anxiety, a friend or a family member?

How are you gonna approach that with him or her? 

Kaitlin Foster: So I'm pretty practical when it comes to things like, what's our first line of defense, assuming this is not a severe disorder. Mm-hmm. Where we're gonna recommend medication immediately, or talking to a prescriber. So I'm gonna look at things like, how much coffee are you consuming?

Oh [00:21:00] yeah. How much time are you spending outside? Are you in community with people that make you feel accepted and supported? And. Are you getting enough sleep at night? Mm-hmm. What are you eating? Are you consuming a lot of sugar or things that are not helping your body to function in the best way? So, and that's also what we look at in therapy is some of those.

Seemingly basic components, but it's amazing the impact that those things have. Mm-hmm. On how you feel. 

Dr. Lahr: Yeah. You know, you're not sleeping well Mm. And you're drinking too much caffeine, but it doesn't really, you know, that's not the first thought when you're having, you know, like, my, my chest is getting tight and I'm just feeling really hype.

You're like, oh wait, could it be that I haven't? Yes. It could be that you haven't slept and you've, you know, a gallon of caffeine every morning. Mm-hmm. So, uh, definitely you wanna start with. Those type of, uh, interventions. Yeah. First to see how much benefit you can get from it. 

Yeah. [00:22:00] 

Chris: I think that's another misconception that the idea that anxiety is this mystical thing that, you know, you might be affected by it or you might not while you're holding your, you know, venti, uh, coffee in your hand with a double shot.

I mean, I've had so much nothing, but Have you had any food today? Carbs and sugar today? No protein. Yeah. It just seems like that so much of it. Is just, is just practical. Mm-hmm. Questions of lifestyle. 

Kaitlin Foster: Mm-hmm. And for all of our clients, Dr. Lau I'm sure can speak to this as well, but we recommend that they have a PCP that they're connected to and that they get an annual physical because there are other physical components to that.

Um, but just for me, that's what I would. Hmm. If I'm talking to a friend, if I'm talking to a family member and they're saying that they're starting to feel more anxious and they're not really sure why, those are the things I would start with. But sometimes it's rooted in things that are going on physically too.

Mm-hmm. 

Dr. Lahr: That's a good point. And [00:23:00] um, you know, we say anxiety. It's a normal emotion. People, you know, I have felt anxious, but it's also a symptom. Um, and so that's why, you know, when you say anxiety to me, I'm going through a different kind of checklist in my brain than maybe when someone says that, you know, they're.

Anxious to their financial advisor or to their mom or to their dad. Right. And um, so I'll throw out one of those $10 words that we get to learn when we go to medical. That's why they cost, it costs so much money. Oh, okay. To go to school. Right. 'cause you have to learn these big words. So, you know, any, an anxiety disorder, there's no symptom that is called.

Pathognomonic. Okay. Pathognomonic symptoms. Have you had this word yet? I don't know this word. I'm gonna 

Kaitlin Foster: learn it for free. This 

Dr. Lahr: for free. 

Kaitlin Foster: I don't pay $10. That's 

Dr. Lahr: right. You didn't have to go through all that. You can Venmo him later. Yeah. Yeah. Oh, that's a good idea. Let me give you my Venmo. Okay. Uh, so pathognomonic means the symptom.

Every time you have it means you have this disorder. Like there's [00:24:00] only this one disorder or very few disorders that have this symptom, and so we can target it immediately. Right? A panic attack or having anxiety, um. Only kind of drex us in a general direction, but just like Caitlin and I have talked about all the different psychiatric reasons why you might be anxious, right.

That could, it could be a disorder, it could be generalized, it could be panic, it could be start of PTSD if you've had a trauma. There's also probably the exact same list on the medical side. 

Mm-hmm. Have 

Dr. Lahr: you had your thyroid looked at? Thyroid? Uh, problem. Blood sugar. Mm-hmm. Just that change in blood sugar can cause symptoms that appear to be anxiety and they may make you feel anxious, but there's not, and it just goes on and on and on.

So I think that's really important for, um, us as providers too, is we're going through that checklist of, okay, we've checked over your lifestyle. Uh, we're taking your history, we're talking about your coping skills, we're getting all the diagnostic, but also when was the last time you saw your primary care doctor?

Mm-hmm. What were your [00:25:00] labs? Uh, sometimes people kind of, you know, raise their eyebrow, like, why do you wanna know what my blood work was? I'm here to talk about my feelings. Mm-hmm. 

Kaitlin Foster: Right. These things are connected. Sometimes they're 

Dr. Lahr: all connected. 

Chris: Yeah. Yeah. 

Hmm. 

Chris: Do you think there's a stigma around anxiety disorders, folks experiencing anxiety?

Is it received well? Hmm. How do you see it? 

Kaitlin Foster: I think that's a complicated question because of some of the things that we've talked about with social media. Mm-hmm. It being very used as a blanket statement. Mm-hmm. Yeah. And so it is a little bit more common or popular. I think where the stigma may come in is when we talk about the impact on functioning.

Mm-hmm. 

Kaitlin Foster: Because everyone thinks they have anxiety right now. Mm-hmm. But also they're not understanding that it impacts some individuals more than others. 

Chris: Yeah. That's a great point. It like, is it debilitating? Mm-hmm. 

Kaitlin Foster: Yeah. And it really can be. Mm-hmm. For some people. Mm-hmm. Like when you're talking about people that have absolutely.[00:26:00] 

Obsessive compulsive disorder or agoraphobia, those are both in the anxiety category. Mm-hmm. Those are life altering diagnoses. Mm-hmm. And so it's hard. People may not feel comfortable. Talking about those things when it's like, well, everyone has anxiety now. Mm-hmm. You're fine. Just get over it. You'll deal with it.

And it's like you said earlier, it's on a spectrum and you do have the severe end of that spectrum, and those things are not as well known about or as accepted. 

Dr. Lahr: Mm-hmm. That's a good point because you have the, you know, the people on. On TikTok or Instagram, they're screaming that they have anxiety as they're in line for Starbucks and someone messed something up and you know you're, mm-hmm.

And then you have, you know, I got triggered because my drink is wrong. Yeah. Because my trigger, my drink was wrong. And then you have the people that're unable to leave their house. Right. So it's hard for, you know, it's, I think some of it goes back to that, that language. Right. So anxiety. Is not just a common feeling that everyone has, it [00:27:00] also can lead to a disorder.

Mm-hmm. Right. 

Dr. Lahr: And that's, it's really, really hard. I think so, I think that's, you know, stigma, misunderstanding. 

Yeah. 

Dr. Lahr: Um, I think really is probably rooted a lot in the fact that we use this one word to mean many different things. Mm-hmm. And so it's a feeling, but like I said, it's also a symptom. 

Mm-hmm.

Right. 

Chris: Is there anything that you two do? I'm, I'm curious. With you two being experts in this field, is there anything you two do? Day to day. When you're dealing with your own anxiety, do you have any suggestions or um, routines or activities or anything like that that you do or maybe that you just encourage other people to do?

Only 

Dr. Lahr: the ones that are podcast appropriate? 

Chris: Yeah. 

Kaitlin Foster: Let me narrow down that list. So I would say I'm pretty structured in my day-to-day life. Mm-hmm. And part of that is just to help myself manage mm-hmm. With the stressors of life [00:28:00] and being a parent and a working, working mom, working professional. I try to drink a lot of water.

Mm. 

Kaitlin Foster: Um, I also work out on a very regular basis. Mm-hmm. And both of those things. Just help me stay grounded. They help me stay where I work out is in a, a group setting. So also help me stay connected. And it's just a place that I can go where I'm not in charge of anything or anyone, and it's just for me.

So both of those things, and also spending time with family. Mm. Mm-hmm. Um, those things are important to me and I try to make those things a priority throughout the and on the weekend because I know the, these are the things that help me. Feel good and help me stay a functional human 

Dr. Lahr: being. Yeah. All right.

Sounds good. My job's really not stressful, Chris. Oh yeah. I don't really suffer from it. That must be nice. Yeah, I know. You know, I do some of the same things, uh, uh, routine, working out, making sure that, [00:29:00] uh, that's probably one of the number one ways to handle my stress. And if you look in the literature, it's getting growing support as one of the, uh, uh.

Kind of maybe base level of handling mood and anxiety. Mm-hmm. How are, how are you moving your body? Mm-hmm. And what type of working out you do. And then trying as much as possible to set, uh, appropriate, you know, work family. Um, extracurricular boundaries is really important, so it's really easy, especially in our jobs just to be consumed by everything, you know?

Mm-hmm. And so there's always that next patient. Like it is literally a bottomless well, um, that you'll never be able to meet any of it if you don't take care of yourself. And so I think it's really hard as, um, caregivers and as medical professionals to remember that we have to prioritize our. Our health and our mental health so that we can continue to do this job.

And so, you know, I try to [00:30:00] do something small on a routine basis that helps lower my anxiety. Yeah. So I have a, a somewhat strict cutoff time on Fridays of like, I don't answer anything for work after this time. Mm-hmm. When it, when, when that works out, it's great. Yeah. Um, some of the suggestions I, good goal.

It's a good goal. I mean, if you don't make it a goal, you'll never reach it. Right. You at least reach it 

Kaitlin Foster: 50% of the time. 

Dr. Lahr: I think so. I think so. Um, and I've made this suggestion to, to patients before, looking at your daily routine and then, um, how can you just make minor modifications? Mm-hmm. That will help.

And so, um, you know, most of us probably bathe every day. Hopefully, hopefully we'll see. Well, I had for, I went on vacation years ago and um, the soap in this hotel was amazing. I just loved it. Right? So I found it, and I only use it like once a week, right? Oh. So to make it like, okay, so then you remember the memories.

You have that, and you just can kind of fill your whole brain, just kind of relax after [00:31:00] that. And it's really nice. So it doesn't have to be big, huge types of things, just finding, but it does need to be. Routine. Mm-hmm. Right. I think, um, as, I can't remember where I read it, but article recently came out that said that one week really is kind of that perfect vacation length.

If once you go much further than that, you don't get as much mental health benefit, that stress reduction. So taking more frequent. But maybe not as long breaks can be very good for your mental health. So that's what I try to do as well as kind of schedule a day off randomly so that, um, I, I'm taking that pause and.

Having fun. Yeah, I love that idea. Which is also very good for anxiety is fun. I ask all my patients, what have you done for fun? Yeah. Since I've seen you last and you know, you kind of, sometimes people are like, Hmm. But it really tells us a lot if you're out there and able to do things, socialize. Okay, then we know that you're social anxiety is a little bit better under control or you're able to.

Plan [00:32:00] out something. Okay. Your executive functioning is doing really well and, and, you know, engaging and, and fun is a great way to reduce stress. Mm-hmm. 

Chris: Mm-hmm. Okay. So in your experience, what does success look like? Do you have a, a story or an anecdote or anything that you can share with us of what success dealing with anxiety looks like?

Kaitlin Foster: So everyone's journey is going to be different. Mm-hmm. And sometimes what we see when people enter mental health treatment, whether that's for therapy, medication, both, is that they've waited till the very last until they couldn't wait any longer. And then they show up in our office ready for an immediate change.

Yeah. Mm-hmm. 

Kaitlin Foster: And that's hard because you've been struggling with this feeling or these symptoms for probably a long time it's been building and then. When you can't do it yourself anymore, you show up and we help you with that. Mm-hmm. So it does take some time and that's not always comfortable. That's not always [00:33:00] what you want to hear, but um.

That is something when you are meeting with a provider, meeting with a therapist, they will all give you the same message and that give it a little bit of time. Mm-hmm. Give it time for these medications to work. Give it time for you to learn new things in therapy. Learn new skills, learn how to set boundaries or care for yourself in other ways.

And we do see symptoms reduce. When you're able to implement the things that we talk about or that is recommended to you for your course of treatment. But also you have to think about it through a long-term perspective in that this isn't something that's just a one and done. Mm-hmm. In terms of, I go in, I get medication, I see a therapist for six months, and then I'm cured.

Mm-hmm. And I never have to talk to anyone again, or I'm. Not going to feel these feelings ever again. These things are cyclical and so [00:34:00] like we were talking about with the life transitions. Mm-hmm. You go to therapy or you start taking medication and you start to feel better and sometimes that means that you stop seeing your therapist or you go off of medication and you're able to manage.

Mm-hmm. But then something happens. And you need to go back into treatment. And that's something that we see frequently and we're happy to welcome people back that have been in our care previously. Um, I don't know that it's something where the goal is I'm going to cure you completely. Yeah. Or this is going to go away completely.

Mm-hmm. Our goal is let me arm you with skills and with medication if that's what you need to help you. Start to feel better and feel like this is manageable. Mm-hmm. And then you can go in and out of treatment as necessary. Yeah. 

Chris: Mm-hmm. I think that's another one of those, uh, misconceptions. I mean, okay, I'm here, fix me quickly.

Mm-hmm. I wanna go home. Mm-hmm. But we've spent literally a lifetime. [00:35:00] Building these, some of these things in us and it's just gonna take time. Take 

Dr. Lahr: time. Yeah. Time is normally the thing that helps the most and it's the thing we can't control Uhhuh, right? So we don't know how long that's gonna be all the time.

I'd also add that, you know, when you're coming in, if you're saying, uh, you know, I want to get better, or, you know, the therapeutic response is gonna be well. What does success look like for you? Mm-hmm. When you say, I want to get better, what does that look like for you? Yeah. Because remember, we wanna get back to that.

How is this impacting your daily life? Mm-hmm. What are you not able to do right now that you want to do later? Right. Or maybe something that you were able to do in the past. Mm-hmm. And we want to be able to get back to that. So that allows us to set a goal. Yeah. It's very measurable. Mm-hmm. If you say, I used to, um, go out every Friday night with friends and now I can't.

Okay. Now we know that we will be getting better when we're able to go back out Friday. So then anything that is measurable is gonna [00:36:00] help anxiety. 

Mm-hmm. 

Dr. Lahr: And then just looking at. The, you know, how long everyone, you know, how long is this gonna take? You know, I never wanna say, well, I don't know. That's fair.

That increases anxiety. You know, we, you need a little bit of a concrete stuff. So, um, kind of talking about realistic expectations. And so if you were to come in for a panic disorder, which is where you have, you know, possibly chest pain, you're chest, you're sweating, you're feeling overwhelmed, tunnel vision and anxiety, and that's the.

Only thing that you have going on, there are therapies out there that say that you'll get relief from that with 12 weekly sessions. Hmm. Okay. So that's a, that's a really short amount of time. Yeah. Um, but it's also very intense. I don't how many people have you ever seen with. Only panic disorder going on and can, can commit to 12 weekly sessions.

Mm-hmm. Not common. Not common. Right. [00:37:00] So I would say, you know, but I kind of use that if you're in that lower acuity of a a disorder, kind of that 12 week part, we should see something. Right? Yeah. We might not be at a hundred percent, but we should definitely be seeing movement in the right direction and that direction is gonna be defined.

In partnership with you, right? 'cause you are gonna know how you felt before this started and what your, what goals that got in the way 

of mm-hmm. 

Chris: And if a person's ready to make that move mm-hmm. They're ready to seek this, what, what steps can they take? What do they need to do? To, uh, to, to start heading that direction?

Kaitlin Foster: Yeah. So if they're wanting to receive services from family and Children's, we are a very easy to access system. 

Chris: Mm-hmm. 

Kaitlin Foster: You have different options in terms of how you enter our care, and if an individual wants a scheduled appointment, they can call our call center at (918) 587-9471. Sometimes [00:38:00] scheduling an appointment is very overwhelming.

Mm-hmm. And just thinking about, I'm gonna have to give you a day and a time, and I don't know my work schedule next week. So we also offer walk-in intakes for children and for adults. So whenever you are available and ready, people can walk in and do an intake or an assessment with us. And what that process looks like is we're really sitting down with you to help you identify and define what is going on.

Mm-hmm. What am I here for? What am I wanting help with? What symptoms have I been experiencing recently? And. What will success look like for me? Mm-hmm. What are my goals in treatment? We do a, a thorough assessment, and then we also help individuals with a treatment plan and writing a personalized treatment plan for them.

And after that we also, if they're wanting medication, get them scheduled with our medication clinic and, um. Individuals that are [00:39:00] in our care have access to a wide variety of services. So whether that's meeting with a therapist for individual therapy sessions, meeting with a peer recovery support specialist, um, for group, you can also meet with our nurse.

You meet with a medical provider for medication. Anyone that is a part of our system, a client of family and children's, has access to all of those different things. 

Chris: All right. Lot of, a lot of great resources and lots of ways to access them. Um, as we wrap up here as a psychiatrist and a therapist, what gives both of you hope in this space?

When we're talking about anxiety and anxiety disorders, I. 

Kaitlin Foster: I've worked for family and Children's for 16 years, and I think the thing that keeps me coming back, keeps, keeps me going, um, in the morning, is just I know that things can and will get better. Hmm. Because I've seen that over time with [00:40:00] so many different individuals that we've worked with, people that.

Were unhoused or coming out of prison that had a severe mental illness or came to us in just a very broken place. We've been able to work with them and provide them with resources and mental health treatment, and we've seen them become success stories over time. Yeah, and that's just so encouraging to me.

Sometimes it takes. A little while. Mm-hmm. Sometimes I do leave and come back, but just knowing that we're here for the community and that we have been around for such a long time and been providing just excellent care for so many years, I'm happy to be a part of that. And it just keeps me very excited about the work that we do.

Yeah. 

Dr. Lahr: Mm-hmm. That's awesome. Mm-hmm. From a medical standpoint, I'd say that. Anxiety is my second favorite disorder to treat. Oh, okay. Okay. And why is Because it's very treatable, right? It's [00:41:00] very frustrating in medicine whenever, you know, there's a lot of chronic illnesses, there's a lot of things that the patient can do, everything they're supposed to.

The doctor does everything they're supposed to, and it's really hard to see if there's been improvement or how to define what that success is. Spike. And a lot of the times, anxiety disorders are not one of those. Mm. And so, you know, um, they, they respond very well to therapy. They respond very well to medication, they respond very well to lifestyle changes.

Everything that we think, say, do believe is a chemical reaction. Mm-hmm. And so mm-hmm. That, that get, why I like that is there's so many different avenues there that we can make a chemical change in our brain. Right. So that could be medication, it could be. Talking it out, having a therapy session. It could be changing our social situation, a new job, learning new skills.

There's a lot of things that can help change the brain in that, in that way. And for anxiety, because a lot of times these [00:42:00] symptoms are very. Distressing, right. We're having physical pain, we're having mm-hmm. Stomach issues. We are avoiding a certain place. It's very tangible. And then we, uh, start working that treatment plan.

We start getting into treatment, and now we're able to do those things so we can measure it, we can see that response and it's very rewarding. Yeah. 

Chris: That's great. Well, a lot of great information today about something that so many people deal with and I'm just really thankful that you two could be with us today.

Thanks. Thank you, Chris. Thanks for having us. Yeah, absolutely.

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