Why Panic Attacks and Anxiety Cause Shortness of Breath

Key Takeaways

  • Shortness of breath during a panic attack is part of the body’s fight-or-flight response.
  • Breathing slowly through your nose and exhaling can help manage shortness of breath.
  • Practice relaxation techniques when calm to prepare for panic attacks.

During a panic attack or sudden anxiety episode, the fight-or-flight response is activated, which can lead to an intense cascade of uncomfortable symptoms, including shortness of breath and hyperventilation. Whether you have had a single panic attack or have been diagnosed with panic disorder, experiencing shortness of breath can feel incredibly unsettling and frightening.

A better understanding of shortness of breath and its link to panic attacks and anxiety may help you or a loved one find appropriate resources, support, and strategies that aim to reduce and/or eliminate symptoms.

Breathing Characteristics of a Panic Attack

Shortness of breath and hyperventilation are intimately connected. When you feel shortness of breath, you may breathe faster, which can lead to hyperventilation—and, in turn, hyperventilation can trigger or worsen shortness of breath. You may also experience other symptoms of a panic attack or panic disorder during this time.

Shortness of breath. When experiencing a change in your breathing pattern during a panic attack, you may experience dyspnea or shortness of breath. You may feel as if:

  • You are gasping for air (known as “air hunger“)
  • Your breathing feels shallow and restricted; you have to force yourself to take a deep breath
  • You feel as if you are choking or being suffocated
  • You may feel restriction or tightness in your chest

Hyperventilation. In addition to experiencing shortness of breath, you might experience over-breathing or hyperventilation, which can have the following effects:

  • Your breathing pace is quicker than usual, and it is challenging to slow down
  • Rapid breathing decreases the carbon dioxide in your blood
  • You may feel confused and out of it
  • You may experience symptoms of faintness, nausea, numbness or tingling, and dry mouth

What Causes Shortness of Breath

Breathing can be a good marker for an individual’s internal state, so it makes sense that if an individual is experiencing panic, anxiety, and/or high levels of stress, their breathing will reflect that.

According to research, changes in breathing patterns can increase anxiety, trigger a panic attack, and intensify a panic attack that has already begun. Scientific study has also made the following connections:

  • Genetics and hormones. Shortness of breath in the context of panic attacks and panic disorder have a genetic and/or hormonal component.
  • Survival response. Shortness of breath is linked to the body’s fight-or-flight response as the body attempts to take in more oxygen and prepares to defend itself.

Can Anxiety Cause Shortness of Breath?

Yes, anxiety can both cause and exacerbate shortness of breath. Symptoms of anxiety can include feeling short of breath, air hungry, and a smothering feeling. In turn, feeling short of breath can also increase your anxiety due to the uncomfortable and frightening symptoms. In terms of panic attacks, shortness of breath may occur before the onset of a panic attack or increase during one.

Treatment

If you or a loved one are experiencing panic attacks, know that there are many treatment options available. Because the root cause of panic attacks and panic disorder will vary from individual to individual, it’s best to be evaluated by your doctor or mental health professional to determine the underlying cause. You may have to try multiple treatment options or combinations to figure out which one is the best fit.

When to Talk to Your Doctor

Experiencing shortness of breath or hyperventilating during a panic attack can be terrifying. Because panic attacks and panic disorder can be associated with other underlying diseases or disorders, it’s important to speak with your doctor so they can identify what is causing your shortness of breath.

Medication

Medication may be effective for some individuals in treating panic attacks and panic disorder. Medication may help reduce overall anxiety, decrease the frequency and intensity of panic attacks, and reduce the anxiety associated with panic attacks. Medication options that have proven efficacy in treating panic attacks and panic disorder in some individuals include:

Psychotherapy

Anxiety-focused psychotherapy may be used in conjunction with medication or on its own. Which route someone opts to try in terms of treatment may depend on the intensity and frequency of their symptoms as well as their personal preferences. Psychotherapy may address triggers for anxiety as well as the impact panic attacks have had on your personal life.

Therapeutic styles used to treat panic attacks and panic disorder include:

  • Cognitive behavioral therapy
  • Dialectical behavior therapy
  • Exposure therapy
  • Rational emotive behavior therapy
  • Psychodynamic psychoanalysis

Coping with Shortness of Breath

Experiencing shortness of breath during a panic attack can feel stressful, isolating, and scary. Because panic attacks can begin without a known trigger, it’s important to have a tool kit of techniques to stop or manage a panic attack. If you are having difficulty with daily activities or are having thoughts of harming yourself or others, it’s important to connect with a professional immediately.

  • During the start of a panic attack, recite a mantra to yourself that you can repeat (for example: “This will pass” or “I’m going to be okay”).
  • Practice a relaxation technique when you are not having a panic attack. Practicing while you are in a more relaxed state may help you feel better prepared to use your strategy when you feel a panic attack beginning.
  • Begin practicing mindfulness meditation to help you gain better insight into your thoughts in a non-judgmental way.
  • Track your symptoms with a panic attack diary to better understand your unique panic attack experience.
  • During a panic attack, try to reconnect to your body and surroundings by doing an exercise of threes. Count three things you see around you, three things you feel, three things you can hear, and three things you can smell.
  • Try breathing in a paper bag. This re-breathing of your exhaled air brings balance back to the oxygen and carbon dioxide in your bloodstream, helping you feel normal again.
  • After a panic attack, call a supportive friend or loved one to talk through your experience.
  • Consider calling your therapist or doctor if this particular panic attack was especially intense or if the frequency of your panic attacks is increasing.

What Can You Do When You Feel Short of Breath?

Mindful breathing may help you return to your typical breathing pattern during a panic attack or ground yourself afterward. Follow these basic guidelines:

  1. Notice your breath. Visualize yourself beginning to slow your breathing down. You may picture your stomach rising and falling at a very slow pace.
  2. Place your hands on your rib cage. Now, inhale slowly through your nose, filling your rib cage with air. Slowly exhale through the nose, noting how the rib cage contracts.
  3. Repeat several breaths, counting to 10 as you inhale and 10 as you exhale. With each breath, try to notice any tension in your face, neck, and shoulders. Imagine your breath flowing through any tension within your body.
  4. Place your hands on your belly. Stay with your deep, smooth breathing. Take a deep breath in for 10 seconds and fill your belly with air. Notice how your belly rises into your hands as you inhale and how your navel pulls into the spine as you exhale for 10 seconds. Repeat for several more breaths.
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Paulus MP. The breathing conundrum-interoceptive sensitivity and anxiety. Depress Anxiety. 2013;30(4):315-320. doi: 10.1002/da.22076

  2. Johnson PL, Federici LM, Shekhar A. Etiology, triggers and neurochemical circuits associated with unexpected, expected, and laboratory-induced panic attacks. Neuroscience & Biobehavioral Reviews. 2014;46:429-454. doi:10.1016/j.neubiorev.2014.07.027

  3. Kim Y-K. Panic disorder: Current research and management approaches. Psychiatry Investig. 2019;16(1):1-3. doi:10.30773/pi.2019.01.08

  4. Rodrigues PA, Zaninotto AL, Neville IS, et al. Transcranial magnetic stimulation for the treatment of anxiety disorder. Neuropsychiatr Dis Treat. 2019;15:2743-2761. doi:10.2147/NDT.S201407

Additional Reading

Katharina Star

By Katharina Star, PhD

Katharina Star, PhD, is an expert on anxiety and panic disorder. Dr. Star is a professional counselor, and she is trained in creative art therapies and mindfulness. 


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How to Spot a Spiritual Narcissist

Key Takeaways

  • Spiritual narcissism is when someone uses their spirituality to feel superior to others.
  • Spiritual narcissists may lack empathy and use their beliefs to control or shame others.
  • Set firm boundaries when dealing with a spiritual narcissist to protect your well-being.

If you’ve ever seen a selfie taken by someone in a yoga class or meditation retreat and were confused by the idea of ego mixing with spirituality, you may have witnessed spiritual narcissism in practice. It’s the idea that even though spiritual practices like religion, meditation, or kindness are supposed to drive us away from a focus on our egos, sometimes we get fooled into thinking our practices make us better than others.

Examples of spiritual narcissism can range from the toxic positivity of “good vibes only” that leaves others feeling emotionally invalidated, to threats that you’re going to hell or that you will suffer and be punished for not believing in a specific religion.

It’s different from other types of narcissism by being particularly focused on how one’s daily practices make them more evolved than others, rather than encompassing all areas of a person’s life. And it’s more common than you might think: Studies have shown that spiritual practices are linked to “supernatural overconfidence.”

Read on to figure out how to identify the signs of spiritual narcissism, the psychology behind it, and how to deal with spiritual narcissists when you encounter them.

Nadia Audigie / Moment / Getty Images


Signs and Characteristics of Spiritual Narcissists

There are numerous signs and characteristics that a spiritual narcissist may display. “Spiritual narcissists are individuals who use their spirituality or religious beliefs as a means of gaining power, control, and admiration from others,” explains Dr. Sanam Hafeez, NYC Neuropsychologist and Director of Comprehend the Mind.

She says “they believe that they are more spiritually evolved than others and use this belief to justify their actions, even if it means hurting others.”

Hafeez mentions that not everyone who exhibits one of the following behaviors is necessarily a narcissist of any type. “It’s important to note that not everyone who uses spiritual language or expressions is a spiritual narcissist. These signs should be considered in the context of an individual’s overall behavior and patterns,” she explains.

Signs

The following signs are among the ways you might be able to identify a spiritual narcissist:

  • They act superior: “Holier than thou” is a common term for how a spiritual narcissist presents. That’s because they believe they are more evolved than other people. “They may look down upon those who don’t share their beliefs or level of spiritual understanding,” says Hafeez.
  • Lack of empathy: A spiritual narcissist may act outwardly nice, but their behavior shows they aren’t impacted by how others feel.
  • The use of religion/spirituality as a manipulative tool: Rather than keep their spiritual practice to themselves, a spiritual narcissist weaponizes it to control or harm others. “They may shame, humiliate, or use their spiritual knowledge to exert power over others,” says Hafeez.
  • Criticism through the veil of spirituality: “Spiritual narcissists may use their spiritual beliefs to criticize and tear down others who don’t share their level of spiritual understanding or beliefs,” Hafeez tells us.
  • Validation seeking behavior: Like other types of narcissists, spiritual narcissists seek validation for their behavior. The difference is typically that they’re seeking validation for their spiritual or religious practices, or the acts they perform under the guise of those practices. This can also include seeking praise.
  • Toxic positivity and lack of responsibility: A spiritual narcissist is happy to take credit for good actions, but likely won’t own up to negative ones. Additionally, they’ll encourage you to only focus on the positive elements of any situation, and may accuse you of being a “negative person” or “not a true believer” if you’re experiencing something terrible you can’t just shake off.

Everyday Examples

Chances are that you’ve encountered a spiritual narcissist at some point in your life. Hafeez says these are the varying ways in can present in daily life:

  • Attention seeking behavior, such as someone who needs to be the center of attention even at a spiritual or religious gatherings: This could include someone who is constantly snap chatting during prayer circles or meditation classes or someone who establishes or leads cult-like groups where they exert control over their followers under the guise of spiritual authority. These individuals may demand absolute loyalty and obedience, exploiting their followers for personal gain or ego gratification.
  • Superiority or a Holier-than-Thou Attitude: Individuals with spiritual narcissism may adopt an attitude of superiority or condescension towards others who they perceive as less spiritually evolved. This can involve judgment around your behaviors, judging or looking down upon those who don’t adhere to their spiritual beliefs or practices.
  • Placing beliefs on you when you haven’t asked or even given permission for that to be done: Whether that means saying you’re going to hell if you don’t attend their church or proselytizing at you without your permission, a spiritual narcissist won’t have good boundaries around your lack of interest.
  • Spiritual Materialism: This occurs when individuals use their spiritual beliefs or practices as a means of acquiring material wealth, status, or power. For instance, someone might flaunt their expensive spiritual retreats or possessions as a sign of their enlightenment or superiority.
  • Using Spirituality for Validation: Some individuals may use their spiritual beliefs or practices to seek validation or attention from others. They may constantly talk about their spiritual experiences or insights in order to gain admiration or approval.
  • Manipulating Others: Spiritual narcissists may manipulate others by using spiritual language or concepts to justify their actions or control those around them. They might employ guilt or shame to coerce others into conforming to their beliefs or desires.
  • Spiritual Bypassing: This involves using spiritual beliefs or practices to avoid dealing with difficult emotions or personal issues. Instead of facing their own shortcomings or struggles, individuals may use spirituality as a shield to avoid taking responsibility for their actions or seeking necessary help.
  • Grandiosity and Self-Importance: Spiritual narcissists often exhibit grandiose beliefs about their own spiritual superiority or enlightenment. They may see themselves as special or chosen individuals with a unique connection to the divine, while disregarding the perspectives and experiences of others.
  • Lack of Empathy: Despite espousing spiritual values like compassion and empathy, spiritual narcissists may lack genuine empathy towards others. They may be dismissive of others’ struggles or hardships, focusing instead on their own spiritual achievements or aspirations.

The Psychology of Spiritual Narcissism

Spiritual narcissism is similar to other forms, such as covert or communal narcissism in that all are types of narcissism. That said, falling victim to spiritual narcissism does not mean that a person has narcissistic personality disorder.

“Becoming a spiritual narcissist can stem from various factors, and it is not limited to individuals prone to narcissism in general,” says Hafeez, who notes that narcissistic personality disorder (NPD) is a clinically diagnosed personality disorder and that spiritual narcissism is not.

Spiritual narcissism can happen to anyone, and it may have perfectly innocent beginnings. We might take up meditation, or yoga, or join a religious movement, and begin to erroneously think that our new practice makes us more evolved or a deeper person than others we know.

This isn’t necessarily harmful until one begins to act on these ideas. It’s important to remember that people aren’t inherently “better” or “worse” than others, and that everyone is a being worthy of kindness and consideration.

It can be helpful to be mindful of your enthusiasm for a new practice as going to an extreme in it could result in your doing it more for your ego than your spiritual practice.

Spiritual Narcissism and Relationships

As you might expect, it can be tough to be emotionally close to a spiritual narcissist.

When someone exhibits spiritual narcissistic tendencies, they often prioritize their own needs, beliefs, and desires above those of others. This self-centered behavior can lead to a lack of empathy and understanding in relationships.

A spiritual narcissist also might not treat you well, as they weaponize their own misunderstanding of being better than others against people. “Spiritual narcissists may use their spiritual or religious beliefs as a means to control, manipulate, or shame others, causing emotional harm,” Hafeez says.

And because they innately seek validation and praise, she says that you may end up stuck in an unbalanced dynamic, in which your needs aren’t prioritized and those of the spiritual narcissist are.

Spiritual narcissism can lead to the downfall of close relationships, especially if it continues on for long a period of time. “These behaviors can erode trust, foster resentment, and ultimately lead to the breakdown of relationships and friendships,” Hafeez says.

If you’re feeling beaten down by your relationship with a spiritual narcissist, don’t blame yourself. “It can lead to feelings of frustration, emotional exhaustion, and a sense of being invalidated or dismissed,” says Hafeez. That’s because “the constant need for attention and validation can leave individuals feeling drained and unimportant in the relationship.”

Additionally, she says the narcissism “can also create a toxic environment where one’s own spiritual journey is overshadowed and manipulated by the narcissist’s agenda.”

How to Deal With Spiritual Narcissists

While ideally a spiritual narcissist would pause and reflect on their actions on their own, there’s a chance that won’t happen and you’ll have to deal with the situation directly. Hafeez says it’s paramount that you be firm in your boundaries and communicate in an assertive manner, in order to maintain your own self of self-worth and emotional wellness.

You may wish to find support from others as well. “Seeking support from trusted friends, family, or professionals who understand narcissistic dynamics can also provide guidance and validation,” suggests Hafeez. A professional can also help you educate yourself about spiritual narcissism, which can help you on your path

‘Understanding the dynamics of narcissistic behavior can help you navigate the relationship more effectively and protect your own well-being. Educating yourself about narcissism can also help you develop strategies for dealing with their manipulative tactics,” Hafeez suggests.

She warns that a spiritual narcissist might become emotionally abusive or toxic, so you should be on the lookout for those behaviors and in the habit of prioritizing your own self-care and personal growth aside from this person.

Engage in activities that bring you joy, reduce stress, and help you maintain a sense of self. This can include hobbies, exercise, meditation, therapy, or spending time with supportive people.

Additionally, you must remember that someone else’s behavior is not a reflection on you. “Recognize that the behavior of a spiritual narcissist is not a reflection of your worth or value,” says Hafeez.
“Their actions are driven by their own insecurities and need for validation. Try not to internalize their criticisms or manipulations,” she adds.

Lastly, Hafeez tells us that direct confrontation should be avoided. “Engaging in direct confrontation with a spiritual narcissist may escalate the situation and lead to further harm. Instead, focus on setting boundaries and assertively expressing your needs without engaging in power struggles or arguments,’ she suggests.

Healing and Recovery

It may take time, but it is completely possible to heal fully from your relationship with a spiritual narcissist. Whether or not that is done with them still in your life is your decision, and will be dictated by their role in your life; it’s harder to separate from a parent than an acquaintance, for example.

As with every major life issue, therapy can help you immensely in recovering from the abuse of a spiritual narcissist. Additionally, you’ll want to make sure you prioritize your own self-case and emotional wellness.

Spiritual narcissism is what happens when a person mistakenly lets their spiritual or religious practice go to their head and think it makes them superior to others. A spiritual narcissist may seek validation and praise for their actions, might lack empathy, and isn’t likely to take responsibility for their mistakes. It can be challenging to engage with one, and relationships with them can be problematic. If you are in relationship with someone like this, you’ll want to find support, whether through friends or a therapist. You may need to distance yourself from the person, if not end the relationship entirely. Spiritual narcissism isn’t a formal diagnosis, and it can be recovered from.

Headshot with pink hair

By Ariane Resnick, CNC

Ariane Resnick, CNC is a mental health writer, certified nutritionist, and wellness author who advocates for accessibility and inclusivity.


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Signs, Effects, and Ways to Cope


Key Takeaways

  • Anxiety can make people overly dependent, controlling, or avoidant in relationships.
  • Talking to a partner about anxiety can help manage its effects on relationships.
  • Therapy and relaxation techniques are useful for managing anxiety in relationships.

Anxiety can negatively impact many aspects of your life, including your relationships. Not only can anxiety affect how you function in your daily life, but it can also interfere with your ability to communicate and connect with other people.

Having an anxiety disorder can impact relationships in different ways. Understanding the different ways feelings of anxiety might interfere with your relationships can help you find ways to cope.

This article explores a few specific ways in which your anxiety can lead to problems maintaining connections with others, as well as strategies you can implement (on your own or under the guidance of a mental health professional) to help you navigate these unhealthy attachment patterns.

Signs of Anxiety in Relationships

There are a number of behaviors that people might engage in when they are experiencing anxiety in relationships. Some of these signs include:

  • Worrying that the other person is lying
  • Fearing that the other person likes other people better
  • Worrying about the other person cheating
  • Worrying that their anxiety will negatively affect the relationship
  • Overthinking every conversation, phone call, or text
  • Pushing people away first in order to avoid rejection
  • Feeling you need to control how your partner spends their time and who they talk to
  • Feeling jealous when your partner spends time with others or wants some time alone
  • Avoiding relationships altogether

People won’t necessarily experience or exhibit all of these symptoms to the same degree. The way that each person experiences anxiety in a relationship depends on the nature and severity of their anxiety condition. 

People who have anxiety disorders are more likely to be single and have higher rates of divorce.

How Anxiety Affects Relationships

There are a few major ways that anxiety can impact a relationship. When you are experiencing feelings of anxiety, you may respond by being either too dependent or too avoidant. Both responses can take a toll on how you interact and communicate with others.

Dependence

Some people with anxiety have an intense desire for closeness to their partners (or friends), depending on them constantly for support and reassurance.

Along with being overly dependent, people with anxiety may find themselves prone to:

  • Overthinking
  • Planning for all worst-case scenarios
  • Being indecisive
  • Fearing rejection
  • Seeking out constant communication (and getting anxious if a partner or friend does not respond quickly)

People with anxiety and overly dependent relationships may also struggle with anger toward those they feel dependent on, acting out in ways that are destructive to their relationships.

Controlling Behaviors

People who have anxiety need to control every detail of their environment in order to manage stress and find peace. Below are a few signs that you are engaged in controlling behaviors in your relationships and daily routines to minimize your anxiety:

Avoidance

On the other end of the spectrum, some people avoid relationships as a way of dealing with their anxiety. They may avoid negative emotions (for example, disappointment or frustration) by not revealing their feelings, opening up, or being vulnerable.

A person who avoids close relationships may be perceived as cold, emotionally unavailable, lacking empathy, or even standoffish, even though they may long for closeness.  

One study found that people with social anxiety disorder were less likely to receive support from their romantic partners and that less support and more severe anxiety symptoms increased the likelihood of breaking up.

Treatment for Anxiety in Relationships

If anxiety is hurting your relationships, it is important to talk to a healthcare practitioner or mental health professional. There are treatments that can help you manage your anxiety, improve your communication, and develop healthier interpersonal relationships.

Medications

Medication is often an essential part of anxiety treatment. While the medications prescribed for anxiety, like selective serotonin reuptake inhibitors, are not curative, they can help decrease your symptoms and help you feel better as you rework your anxious thoughts and behaviors with your therapist. 

Medications are often most effective when they are used in conjunction with psychotherapy.

Psychotherapy

Various types of therapy can help treat anxiety disorders, including cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and exposure therapy. Such therapies can also improve communication in relationships.

A therapist who specializes in one type of talk therapy called cognitive-behavioral therapy can help you devise strategies to reassure yourself and take thoughtful action on your own instead of needing your partner for comfort each time you are anxious.

If you find yourself being overly distant in your relationships, cognitive behavioral therapy, along with other types of therapy, such as psychodynamic psychotherapy, may be helpful. A mental health professional can help one explore past and present relationships and the emotions surrounding those interpersonal connections.

A therapist will also help you understand how anxiety impacts your relationships. For instance, exploring your emotions more deeply may be a good strategy for someone who tends to be avoidant.

Coping With Anxiety in Relationships

In addition to professional help, there are also tactics and strategies that people can use to help manage feelings of anxiety when they are in a relationship.

If you find yourself developing overly dependent attachments, developing ways to cope with your anxiety and relying more on yourself to feel better can take the pressure off your partner or friend.

For instance, if you find yourself becoming angry or suspicious in these relationships, first remind yourself that your thoughts may be fueled by your anxiety. Then, take a few moments to think about any facts that support your worry and try to regain some perspective.

Other techniques that might be helpful include:

Frequently Asked Questions


  • How do you deal with personal anxiety in relationships?

    The first step is to identify what is behind your personal anxiety and look for ways to soothe yourself. It can also be helpful to talk about your anxiety with your partner or other loved ones. Develop routines that help minimize your stress and anxiety while practicing self-care and relaxation strategies to ease feelings of anxiety.


  • How do people with anxiety act in relationships?

    People with anxiety may sometimes respond by either seeking reassurance or avoiding rejection. Seeking excessive reassurance can lead to clinginess or dependence, while fear of rejection might contribute to avoidance and other symptoms that negatively affect relationships with others.


  • How does anxiety create problems in relationships?

    Anxiety can lead to excessive worry, anger, or irritability. Constantly seeking reassurance can be stressful for both people in the relationship and contribute to arguments. On the other hand, anxiety can also contribute to being overly controlling or becoming avoidant and detached, which makes it hard to form a meaningful connection.


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Fall Is for Flirting—10 Cozy Date Ideas to Make the Most of the Season


Key Takeaways

  • Fall is a great time to take advantage of the crisp weather and vibrant colors in nature before it gets too cold to stay outdoors.
  • Pick from any of these accessible yet romantic date ideas that relationship experts recommend. 
  • Dating your partner adds variety to your routine, creates new memories, and strengthens your connection and commitment to each other.

Ahhh autumn. Probably the best season for romance. The sweltering summer months are over, and it finally feels like cuddle weather.

Whether you’re planning a surprise for your partner or brainstorming fall date ideas together, let our list of ideas inspire your autumn romance. From pumpkin picking to cozy movie nights, here are some to get you in the mood for fall.

Get Your Nature Fix on a Foliage Hike

If you’re located in an area where you can truly experience the season’s changes, why not enjoy the beauty of the fall colors outdoors?

“There is nothing better than slowing down with your partner and connecting, plus getting those endorphins up equals creating more joy in the relationship,” says professional counselor Abbey Sangmeister, MSEd, LPC. “Hikes are a great way to explore and connect without added distractions.” 

Research local hot spots for leaf peeping, or cozy up together in a park for a picnic complete with hot apple cider or pumpkin spice lattes. You could even time your date around sunset to take in even more of the vibrant colors.

Go Wine Tasting

Wine tasting isn’t merely an indulgence in rich flavors; it also sets the stage for deeper connections,” says Julianna Lyddon, a certified life coach with a master’s degree in marriage, family, and child therapy.

“Enrich the experience by posing insightful questions like, ‘If money were no object, what would be your dream job?’ or ‘What genuinely ignites joy in your heart?’” Lyddon says. “Moving beyond casual conversation, you open the opportunity for a stronger and more authentic connection.” 

Warm Up By a Blazing Bonfire

Chilly evenings wrapped up in blankets around a flickering fire are pure fall magic. It also has some serious romance potential, especially if you lean on each other to warm up. Make s’mores, sip some tea, tell spooky stories, or dive into deep conversation.

“You could make the experience meaningful by sharing childhood or life experiences that describe what fall and all of the tastes and smells mean to each of you,” suggests Rikki Dymond, a dating coach with Flirtini. “Being vulnerable is a great way to build trust and get to know your date or partner on a deeper level.” 

Play in the Leaves

Channel your childhood spirit by diving into a giant pile of colorful, crispy, fall-scented leaves. “It is so important to find play in our daily lives—especially as adults,” notes Sangmeister. “Good childhood fun is a great way to connect and bond. Keep some of the leaves and create some art to remember the date.” 

One study found a correlation between playing as adults and overall life satisfaction. Another found that people who play more have lower stress levels and are able to cope more healthily in their daily lives.

Pick Out a Pumpkin Together

“For a fun, possibly new date experience, grab your partner and go for a stroll through a pumpkin patch, picking out some cute pumpkins while you’re there,” Dymond says. “Be sure to cozy up to your date as you walk and bring some hot cocoa to warm things up!” You can always head to a farmers’ market or supermarket if there isn’t a pumpkin patch near you.

“Choose various sizes and shapes, then work together to carve pumpkins,” suggests mental health counselor Daniel Rinaldi, LMHC. “Brainstorm creative pumpkin carving ideas together and see whose design turns out the best. Carve your initials into the pumpkin for an extra romantic flair!”

Cook a Seasonal Meal Together

Start this date by heading to the local farmers’ market or grocery store to gather ingredients for a season-appropriate meal. Maybe it’s tasty pork chops with apples, a classic batch of chili, or stuffed acorn squash. Then, come home and whip up your meal. 

“Cooking together is the ultimate bonding experience because you work on how to communicate and come together to create something, plus who doesn’t love a cozy meal?” Sangmeister says.

If it’s a meal that takes a while—like smoked meats or soup, break out some board games or connect in conversation while you wait. 

Have a Spooky Movie Night

Plan to spend the evening together cozied up with some tasty popcorn, festive beverages, and a Halloween movie. Go classic with an iconic thriller or keep it low-key with something a bit more campy.

“Nothing says ‘I like spending time with you’ more than cuddles and clutching each other during a scary movie,” Dymond says. The discussions around choosing the movie can also reveal a lot about each other’s tastes and preferences!

Go Apple Picking (and Bake a Tasty Pie)

Apple picking is another way to enjoy the autumn weather with your special someone, and it’s definitely a great moment for some cute photos together, too. Rinaldi says to research different orchards together (which builds communication skills) and then hand-pick the best apples together. 

“You can take a little time and research different apple varieties and their best uses, talk about your favorite apples and why you like them, and do an apple tasting together,” Rinaldi says. “Afterward, you can bake an apple pie together. When baking the pie, take turns with different tasks and share stories about your favorite fall memories or traditions.” 

Take a Scenic Fall Drive and Have a Picnic

Scout some of the best spots for leaf peeping within a few hours and head out for a fun road trip to take in the views. Rinaldi says to put on a podcast or some tunes, and to pack some fall snacks to enjoy along the way.

To really enjoy your surroundings once, consider hiking through the woods, laying out a picnic spread, or dabbling in some yoga or meditation together.

Try a Couples’ Tarot Reading

If you’re curious about new age practices, consider getting your tarot cards read together, suggests Lyddon. This feels particularly on theme throughout autumn and close to Halloween, and whether you believe in the validity of the reading or not, it can spark some interesting conversations.

If you are a believer, Lyddon says, “This experience can offer insights into your bond’s future trajectory or even help longtime partners reconnect with each other on a deeper level.”


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What Is Distress Tolerance?


Key Takeaways

  • Distress tolerance is the ability to handle emotional distress without making it worse.
  • Techniques like distraction and self-soothing can help manage intense emotions.
  • Distress tolerance skills are taught in therapies like dialectical behavior therapy (DBT).

Distress tolerance is a person’s ability to manage actual or perceived emotional distress. It also involves making it through an emotional incident without making it worse. People who have low distress tolerance tend to become overwhelmed by stressful situations and may sometimes turn to unhealthy or even destructive ways of coping with these difficult emotions.

Everyone experiences a wide variety of stress in life. These stresses can range from daily annoyances to significant events such as a job loss, divorce, or the death of a loved one.

Whether the stress is large or small, your ability to tolerate distress can affect how you manage the situation. Strong negative emotions such as shame, fear, anger, anxiety, guilt, and sadness can be difficult to manage. The stronger these emotions are, the more difficult they can be to control.

Poor Distress Tolerance

It can be challenging to identify the specific emotions you’re experiencing. This can make them feel even more frightening, unpredictable, and out of your control.

Unfortunately, the relief these self-destructive measures provide is short-lived, and to make matters worse, the distressing emotions often return even stronger, with additional feelings of shame and guilt, which is more upsetting.

Healthy Distress Tolerance

The good news is that learning distress tolerance techniques can help you:

  • Prepare in advance to cope with intense emotions
  • Enjoy a more positive long-term outlook for dealing with them

Research has found that distress tolerance can be effective in helping people better regulate anger and impulsivity. Reducing impulsivity may also have other helpful benefits, such as making people less likely to engage in unhealthy or even risky behaviors as a way of coping with distress.

Factors Impacting an Individual’s Distress Tolerance

While research has shown that distress tolerance can be beneficial in the treatment of a variety of psychological disorders, there are a number of factors that can make building these skills challenging.

Biological Influences

Distress tolerance may have biological influences. Research suggests that biology can play an essential role in influencing how well a person tolerates feelings of emotional distress.

Neural networks, brain chemistry, and specific brain structures may be associated with behaviors such as pursuing rewards or escaping distress.

Research also indicates that babies are born with a particular temperament which is hard-wired and with them at birth. Temperament is a strong predictor of personality traits that develop down the road. There are three main temperaments including:

  • Easygoing babies are calm, adaptable, and have a higher stress tolerance.
  • Slow-to-warm babies are more cautious and shy and may express mild stress until they are more familiar with people and situations.
  • Challenging babies are more emotionally reactive, have difficulty adjusting, and take longer to soothe when stressed.

These brain differences and varying temperaments indicate that some people might struggle with a heightened reaction to stressors, and building their distress tolerance skills is more challenging. This doesn’t mean those skills cannot be developed—but it might take longer or require more effort.

Distorted Beliefs

There are thinking patterns that can make it more challenging to cope with emotionally upsetting events. These automatic thoughts are cognitive distortions, which everyone has to some degree.

Examples of distress-intolerant beliefs can include:

  • “I can’t cope with this.”
  • “I will never feel better.”
  • “This is terrible.”
  • “I hate this feeling.”
  • “Life never goes my way.”
  • “I am always upset about something.”
  • “I have to get away from this feeling.”

Note when you use words on the extreme end of the spectrum like “always,” “never,” “love” and “hate.” Such distress-laden beliefs can lead to escape behaviors such as withdrawal, avoidance, and sometimes self-harm.

  • Withdrawal can include isolating yourself and even turning to drugs or alcohol to help cope and alleviate feelings of distress.
  • Avoidance often involves staying away from situations that lead to discomfort, sometimes making it difficult for a person to function normally in their daily life.
  • Self-harm can involve turning uncomfortable emotions inwards and engaging in behaviors that are harmful to the self, such as picking, hair pulling, binge eating, or cutting.

Types of Distress Tolerance Techniques

Learning distress tolerance skills can make a very positive difference in your ability to handle difficult emotions. Distress tolerance techniques that may be helpful include distraction, self-soothing, radical acceptance, and more.

Learning distress tolerance skills can help you get through emotional crises and bring more enjoyment into your life.

Distraction

Distraction can be a very effective way of taking action to increase your distress tolerance. It involves using various methods to take your mind off your feelings of distress. Switching activities might include occupying your mind with a good book or TV show, walking your dog, or finding productive ways to release your energy, like vacuuming the house or washing the dishes.

Improving the Moment

This strategy involves using a variety of strategies to help make the stressful situation more tolerable. Visualizing a relaxing scene, looking for the silver lining, or taking a mental break to do something pleasant are all examples of ways that you can improve the moment.

Weighing the Pros and Cons

This distress tolerance technique involves considering the potential pros and cons of tolerating or not tolerating distress. It can be a good tool for weighing the short-term and long-term consequences of an action.

Radical Acceptance

Rather than focusing on things that cannot be changed or that are out of your control, radical acceptance involves just accepting things as they are and letting go of feelings of regret, anger, or bitterness. 

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Self-Soothing

Finding ways to calm yourself and keep negative emotions in check is an important part of building distress tolerance. Different sensory experiences, such as sight, sound, smell, taste, or touch, can all be used to self-soothe during difficult moments.

How to Practice Distress Tolerance Skills

Many practical and effective behaviors for distracting you from intense emotions are emphasized in DBT and other types of therapy, including:

  • Getting active: Do something involving movement that you know you enjoy, such as walking in beautiful surroundings. Or do something you’d be doing now​ if you weren’t feeling so upset.
  • Contributing: Go outside yourself by focusing on helping others (for example, volunteering at a school or nursing home).
  • Comparing: Think of a time when you were even more emotionally distressed than you are now. Give yourself praise and credit for getting through that crisis and doing all you can to get through this one.
  • Triggering opposite emotions: Ask yourself, “What’s the opposite feeling to the distress I’m feeling now?” Then, do something to make you feel the opposite way. For example, if you’re angry, watch a comedy show or movie that always makes you laugh.
  • Thinking big: The idea is to fill your brain with other thoughts so there’s no room for the distressing ones. You need a lot of detail for this one, so imagine something like decorating a beautiful new home room by room or, if you’re in a crowd, guessing each person’s profession.
  • Self-soothing: You may already be familiar with this calming technique, in which you use sight, sound, smell, touch, and taste to “treat” yourself to comforting, pleasurable experiences. But this time, think of how you’d comfort a loved one who’s in the situation you’re in now. Then, comfort yourself in the same caring and compassionate way.
  • Putting your body in charge: Some mental health professionals consider this the best way to get unstuck from the grip of intensely distressing emotions. It’s based on the idea that where your body leads, your emotions will follow. So get going! Run up and downstairs. If you’re inside, go outside. If you’re outside, go inside. Your body and your emotions will thank you.

The goal of distress tolerance is to become more aware of how your emotions influence your response to distressing situations. Other stress management techniques that may help you build greater self-awareness and manage emotional stress more effectively include meditation, progressive muscle relaxation, deep breathing, and stretching exercises. 

You can learn and practice any of these techniques on your own, but they can also be incorporated into different forms of psychotherapy that focus on teaching distress-tolerance skills. Some of these forms of therapy are discussed in the next section.

Psychotherapy to Improve Distress Tolerance

Although research on distress tolerance is still emerging, it has already shown that poor distress tolerance plays an important role in both the development and maintenance of a number of mental health conditions, including:

For example, one key theory suggests that the inability or unwillingness to tolerate emotional distress is the key mechanism underlying the development of borderline personality disorder (BPD).

Because of this, a number of different types of therapy have emerged that incorporate aspects of distress tolerance skills-building. Some of these include:

More About Dialectical Behavior Therapy

Dialectical behavior therapy (DBT) can provide you with skills directly focused on increasing your distress tolerance. DBT is a technique that was initially developed to treat borderline personality disorder (BPD) but has also been used to treat a range of other conditions, including anxiety and mood disorders, PTSD, substance use, and other personality disorders.

It is a form of cognitive behavioral therapy (CBT) that incorporates four skills:

  1. Mindfulness
  2. Interpersonal effectiveness
  3. Emotional regulation
  4. Distress tolerance

More About Interoceptive Exposure

Interoceptive exposure can help increase your ability to tolerate the effects of intense negative emotions on your body, such as increased heart rate and muscle tension. It is another form of CBT that involves gradual exposure to physical sensations associated with threats or stress.

Stress can cause physical sensations that influence how people think about and respond to stressors. By eliciting these sensations, people can work to identify the unhelpful thoughts and actions associated with these feelings.

The goal of interoceptive exposure is to desensitize people to these physical sensations and help them learn that while these feelings might be uncomfortable, they can be managed.


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Dealing With Depression After a Breakup


Key Takeaways

  • Breakups can lead to feelings of sadness or depression that may require help from a doctor or therapist.
  • Having a strong social support network and practicing self-care can help you cope with post-breakup sadness.

Breakups can take a serious toll on your well-being. Not only can the end of a relationship lead to major life changes in finances and living situations, but breakups also create a great deal of emotional turmoil. Some splits are easier than others. You might be able to let go and move on fairly quickly. In other cases, you might feel angry, sad, bitter, anxious, and heartbroken. 

All of these emotions can be perfectly normal after a romantic breakup—but if they lead to prolonged feelings of sadness or apathy and significant impairment in areas of life functioning, this might be a sign that something more serious is going on. Stressful life events such as a breakup or divorce can sometimes trigger prolonged and severe emotional distress. 

One study found that even normal post-breakup emotional states closely resemble clinical depression.

Experiencing depressive and other symptoms following the end of a relationship is sometimes diagnosed as an adjustment disorder with depressed mood, also sometimes referred to as situational depression. Because these feelings with adjustment disorders can last six months to two years, it is important to understand the signs and symptoms so that you can find help and support if you need it.

Symptoms of Breakup Depression

Feelings of sadness can vary from mild to severe after a breakup. Sometimes these feelings can be strong for a relatively brief period of time. In other cases, people might feel a range of mild to strong feelings of sadness that fluctuate and linger for a longer period of time.

Because emotional responses to a breakup can vary so greatly, it can be difficult to discern when to reach out for additional support. More serious symptoms that may indicate depression include:

  • Feelings of hopelessness or helplessness
  • Losing or gaining weight; appetite changes
  • Sleeping too much or too little
  • Loss of pleasure and interest
  • Feelings of worthlessness
  • Feeling sad or empty
  • Fatigue and lack of energy
  • Listlessness
  • Thoughts of death or suicide

Grief and sadness are human responses to stressful and painful life events. Research has found that breakups can influence people in a number of profound ways.Following the end of a relationship, people report experiences such as distress, loneliness, and a loss of self-esteem.

Allow yourself time to grieve the loss of the relationship. Responses may include a period of mourning, sadness, frustration, bargaining, anger, denial, and regret. It is a period of adjustment, so you grant yourself as much time as needed to feel what you feel, process, and heal. While upsetting, these feelings usually start to shift with time as you heal and recover mentally, emotionally, and relationally from the breakup.

If your symptoms seem more serious than normal sadness after a breakup or if your symptoms seem to be getting worse, talk to your doctor about what you are feeling.

Causes of Depression After Breakup

As a form of situational depression, the end of a relationship is what triggers these feelings. A breakup can be a point of major change in a person’s life. Not only does it mean no longer being involved with someone you once loved, but it can also lead to an entire cascade of life changes.

Shared friends may choose sides, which can lead to the end of other relationships. You might have to adjust your finances, your living situation, or even cope with the challenges of co-parenting children with your ex.

Breakups can also influence how you view yourself.

One study found that the end of romantic relationships influenced how university students felt about their own academic performance, including their ability to concentrate, their homework, and test scores.

Another study found that breakups not only altered self-concept but that people who have a greater disruption in their self-image are also more likely to experience more post-breakup emotional distress.

All of these adjustments can be challenging. They can make you feel confused, insecure, anxious, and sad. And in some cases, it may trigger more severe and longer-lasting symptoms of depression.

Diagnosis of Depression After Breakup

Breakup depression is not an actual medical term or diagnosis, but this does not mean that what you are feeling after a breakup does not represent a real condition.

If you decide to talk to your doctor or mental health professional about it, they may ask you a number of questions about your symptoms including their duration, frequency, and intensity.

Depending on your symptoms, your doctor might diagnose you with adjustment disorder with depressed mood (sometimes referred to as situational depression). Adjustment disorders are conditions that can occur when you have marked distress or difficulty functioning following a stressful life event. 

To be diagnosed with this condition according to DSM-5, you must:

  • Begin experiencing symptoms within three months of the identifiable stress (in this case, a breakup)
  • Have symptoms that are out of proportion to the severity of the trauma that also take into account other things in your life that might influence your symptoms
  • Have symptoms that are not the result of another mental disorder

Treatment

The good news is that even if you do experience depressive symptoms triggered by a breakup, they usually begin to get better on their own by six months after the event. As time passes, your situation improves, and you begin to recover from the breakup, in most cases, you will find yourself gradually feeling much better.

If your symptoms are mild to moderate, you may be able to handle them on your own by practicing good self-care and surrounding yourself with a strong support system.

If your symptoms are more severe or if you just feel that you need a little extra help coping, talk to your doctor or therapist. Counseling can be helpful to help you gain perspective, address negative thought patterns, and establish coping skills that may help you both now and in the future.

If your symptoms are severe or do not seem to be improving, your doctor may also prescribe medications such as antidepressants that can help.

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Coping With Depression After Breakup

Whether you’re are having normal post-breakup sadness or something more serious, there are things that you can do to make it easier to cope once a relationship ends. While there is no way to predict who will experience breakup depression, there are things that you can do to help make yourself more resilient to stressful events.

Some things you can do include:

  • Forming a strong social support network, including online networks
  • Caring for yourself and your health
  • Learn problem-solving skills
  • Work on improving your self-esteem
  • Create goals to work toward
  • Take steps toward solving your problems
  • Find a sense of purpose in your life
  • Allow yourself time and space to process feelings in ways that feel true, honoring, and supportive for you (i.e. through art, music, movement, journaling, etc.)

Research has also shown that writing about what you are feeling or positive experiences can improve coping after a traumatic event.

Finding ways to stay occupied can also be helpful. While you might be tempted to brood, doing things that keep your mind and body busy keep you from ruminating over negative thoughts. Try digging into a new project around the house or start up a new hobby that you’ve been wondering about.

Exercising and spending time with friends can also be a great way to elevate your mood and cope with post-breakup stress. Research has also shown that writing about what you are feeling or positive experiences can improve coping after a traumatic event.

Breakups can interrupt your sense of personal agency and even challenge your self-concept. Focusing your attention on the aspects of your life where you do have more control, such as your work or your hobbies, can help you restore your sense of mastery and help you feel more empowered.


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ADHD and Asperger’s: Symptoms, Causes, Treatment

Key Takeaways

  • ADHD is marked by hyperactivity, impulsivity, and attention problems.
  • Asperger’s involves social interaction and communication difficulties, along with repetitive behaviors.
  • Understanding how neurodivergent brains work and recognizing their strengths can help people understand their characteristics and thrive.

ADHD and Asperger’s are two conditions that are often confused because they have some overlap in characteristics such as social difficulties and impulsiveness. Additionally, it’s common for people to have both conditions. However, there are also several key differences between the two conditions.

Asperger’s syndrome is now more correctly referred to as an autism spectrum disorder. It is mainly characterized by social and communication difficulties. Meanwhile, ADHD is characterized by hyperactivity, impulsivity, and inattention.

Symptoms of ADHD and Asperger’s

The characteristics of Asperger’s and ADHD can overlap, but there are also some key differences. Both conditions can cause social difficulties, but people with Asperger’s typically have more significant problems in this area. They may have trouble understanding social cues and may prefer to be alone.

People with ADHD, on the other hand, may be more likely to seek out social interaction but then have difficulty sustaining it due to their impulsivity and hyperactivity.

Key Differences Between Asperger’s vs. ADHD

Below is a bullet point list of some of the characteristics of each condition and how they are similar or different.

  • People with Asperger’s often have narrow interests and may become obsessed with certain topics. People with ADHD tend to have broader interests that may change frequently or impulsively.
  • Asperger’s is characterized by repetitive behaviors, while ADHD is not.
  • People with Asperger’s may have difficulty with change and need routines, while people with ADHD may seek out change and dislike routines.
  • People with Asperger’s often have problems with motor coordination, while people with ADHD do not typically have this problem.
Asperger’s

  • May have fewer interests and become obsessed with particular topics

  • Repetitive behaviors

  • A person may like routine and dislike change

  • Marked by motor coordination difficulties

ADHD

  • May have broader interests that change more frequently or impulsively

  • No repetitive behaviors

  • A person may dislike routine and welcome change

  • Motor coordination difficulties are not present

Causes of ADHD and Asperger’s

Asperger’s and ADHD are both neurodevelopmental disorders, which means they are caused by problems with brain development. It is not known exactly what causes these problems, but it is thought that both genetics and environment play a role.

Causes of Asperger’s

Some research suggests that Asperger’s may be linked to a problem with the wiring and connections in different networks in the brain.

It is also thought that Asperger’s may be linked to abnormalities with the neurotransmitter serotonin.

Causes of ADHD

Some research suggests that ADHD may be linked to a problem with the neurotransmitters dopamine and norepinephrine. This theory is supported by the fact that people with ADHD often respond well to medications that affect dopamine and norepinephrine levels.

Diagnosing ADHD and Asperger’s

Both ADHD and Asperger’s are diagnosed based on symptoms. There is no medical or laboratory test for either condition. Instead, doctors typically use history, interviews, and behavior rating scales to make a diagnosis.

It is important to note that both conditions can be diagnosed in childhood, but the characteristics may change over time.

Asperger’s Diagnosis

Asperger’s is typically diagnosed in childhood. To be diagnosed with Asperger’s, a person must have significant problems with social interaction and communication and restricted, repetitive behaviors, while typically having good verbal skills.

The term Asperger’s was replaced with autism spectrum disorder in the fifth edition of the “Diagnostic and Statistical Manual of Mental Disorders” (DSM-5). Below are some of the diagnostic criteria for a diagnosis:

  • Significant problems with social interaction
  • Deficits in non-verbal communication
  • Repetitive behaviors or interests
  • Insistence on sameness and inflexibility

ADHD Diagnosis

ADHD is also typically diagnosed in childhood. To be diagnosed with ADHD, a person must have problems with hyperactivity, impulsivity, and attention.

ADHD can be divided into three subtypes: predominantly inattentive, predominantly hyperactive/impulsive, and combined presentation.

Below are some traits associated with each type:

Inattentive:

  • Problems with paying attention
  • Easily distracted
  • Difficulty following instructions

Hyperactive/impulsive:

  • Excessive activity
  • Problems with waiting for turns or taking turns
  • Talking excessively

Combined:

  • Symptoms of both inattentive and hyperactive-impulsive types.

Treatment for ADHD and Asperger’s

It is important to properly diagnose ADHD and Asperger’s because the treatments are different. There is no cure for either condition, but there are treatments that can help people function more effectively in their environments.

Asperger’s Treatment

There is no medication to “treat” Asperger’s because it is not a condition that needs to be cured or fixed. Instead, it is a neurotype characterized by differences in how a person’s brain functions.

Sometimes, medications or therapy may help people with Asperger’s manage certain aspects of mood, anxiety, and behavior.

There is no specific treatment for Asperger’s, but there are treatments that can help people cope with challenges. These treatments typically involve accommodations, speech-language therapy, and occupational therapy.

Medications may also be prescribed to help with specific symptoms, such as anxiety or depression.

ADHD Treatment

Treatments for ADHD typically involve medication, educational accommodations, and neurodiversity-affirming therapy.

Medications used to treat ADHD include stimulants and non-stimulants. Educational accommodations involve working with teachers to help children with ADHD learn better in school.

Neurodiversity-affirming therapy can help people with ADHD and Asperger’s learn to appreciate their strengths and cope with the challenges of living in a neurotypical-centered society.

Prevention

There is no known way to prevent Asperger’s or ADHD, given that the causes are unknown. However, early diagnosis and treatment can help minimize symptoms and improve functioning.

Below are some tips for parents of children with Asperger’s or ADHD:

What This Means For You

If you think you or your child may have Asperger’s or ADHD, it is important to talk to a doctor. These conditions can be difficult to manage on your own and there are treatments that can help. Early diagnosis and treatment is important for the best possible outcome.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Arlin Cuncic

By Arlin Cuncic, MA

Arlin Cuncic, MA, is the author of The Anxiety Workbook and founder of the website About Social Anxiety. She has a Master’s degree in clinical psychology.


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