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We’ve all been anxious or worried at some point in our lives - that’s normal. But when anxiety takes over and become a regular part of our day, it can be exhausting. You probably know the symptoms:

• feeling fear, dread, or like you can’t stop worrying

• not being able to fall asleep because you can’t stop thinking

• panic attacks - rapid heartbeat, difficulty breathing, dizziness, etc.

Anxiety can also manifest in different ways. It might look like:

• Social Anxiety: worries that lead to avoidance of social situations, like being embarrassed around others, of being judged by others, of interacting with new people, etc.

• Obsessive Compulsive behaviors: unwanted, intrusive thoughts, images, or urges to perform a ritual that if not done, causes a lot of distress.

• Body Focused Repetitive Behaviors: hair-pulling, skin picking, scratching, etc.

• Specific Phobias: fears that are debilitating, like of needles, heights, snakes, elevators, vomiting, leaving the house, large open spaces, closed spaces, etc.

• Health-Related Anxiety: fears of you or a loved one having an untreated medical condition and a need to excessively check to ensure you or they are healthy.

Without understanding ourselves and why we act the way we do, we tend to repeat the same patterns in relationships. We will find ourselves drawn toward emotionally unavailable or reactive people and our attempts to be close and connected end in us feeling frustrated or misunderstood. Understanding our attachment styles helps us find balance, security, and interdependence.

We navigate our relationships using something called an attachment style. An attachment style is essentially a way that we’ve learned to connect and interact with others. How close we allow ourselves to be, how much we rely on others for comfort, how much we trust others, etc.

While in general, we tend to operate within one attachment style, we can fall into different categories based on the relationship (ie. friends vs. romantic partners).

In adults, there are 4 different styles:
secure: healthy relationships; comfortable expressing emotions; open communication; not overly reactive; can rely on our partners and they can rely on us.

anxious-preoccupied: The person with an anxious-preoccupied style experiences high anxiety and seeks to be close to others. Often, they find comfort and safety within someone else. They may be “preoccupied” with this person, need to be close, and find emotional security with them. When separated, this attachment style experiences heightened anxiety and often has a fear of abandonment. Without an understanding of attachment styles, unfortunately, sometimes people with this style can be labeled as “clingy” or “demanding.”

avoidant/dismissive: The person with an avoidant/dismissive style is not fearful of losing relationships and tends to distance themselves from deep, vulnerable connection. People with this attachment style are often seen as “self-sufficient” or “independent” and struggle to rely on others or seek support. Emotional connection and closeness is often avoided. Unfortunately without understanding attachment, sometimes people with this style can be viewed as cold or rejecting.

disorganized/fearful-avoidant: the person with the disorganized attachment lacks stability or a sense of security. Often, relationships are something they want and fear at the same time. In a way, they are constantly being pulled between the dismissive/avoidant and the preoccupied styles. Understandably, this causes signifiant distress and people with this style struggle to regulate their emotions.

Body image is defined by our beliefs, assumptions, and general attitude toward our weight, shape, size, and overall appearance. Negative body image is marked by judgment, self-criticism, and unhealthy, unrealistic comparison. Not only is it time-consuming, but poor body image can also make everyday experiences feel daunting and overwhelming. Body image struggles can include:

• Body assessment rituals: mirror checking, measuring the size of body parts, repetitive weighing.

• Clothing: indecisiveness in getting ready, “nothing looks good,” fixation on the fit of clothing (ie. wearing items that are baggy, or stretchy, or form fitting), wanting to hide or exaggerate parts of the body.

• Comments: repetitive comments (quietly or aloud) disparaging or scrutinizing your appearance, or comparing your body to others’.

• Isolation/Social Withdrawal: avoidance of situations where the body is more of a focal point (a “dress-up” event, large gatherings, wearing a swim-suit, shopping at the mall, etc).

• Make-up: excessive time and energy spent on appearance (highlighting or hiding parts of body).

• Perception: when the outcome of your day is dependent upon how you feel about your body, feeling “good” about yourself only when you’ve made an alteration to your body.

• Photos/Social Media: management of the way photos are taken (editing pictures, hiding behind others, avoidance of photos), or fixation on unrealistic ideals on social media.

Oftentimes, attachment and relationship concerns lead to something called codependency. Codependency often manifests itself in the form of low self-esteem and a strong need for approval from others. Like most relational patterns, codependency exists on a spectrum. You can overly rely on others (overly dependent) and/or avoid closeness with others (anti-dependent). In the middle of the spectrum there’s a healthy balance of give and take in relationships (interdependence).

Some characteristics of being overly-dependent:

• Needing others to like you.

• Worrying you will hurt or disappoint someone by sharing an opinion different than theirs or by saying “no.”

• (Wanting to be rescued) wishing someone would nurture, take care of you, and/or prove that you’re worth caring about by bending their boundaries (i.e. being there at any hour of the night).

• Not feeling anger (tend to feel depressed instead) or expressing anger through being passive aggressive.

• Accepting sexual attention when you want love, or, using sex to gain approval.

• Finding yourself attracted to people who are unavailable or can’t seem to give you what you need.

Some examples of being anti-dependent:

• Friendships or relationships can feel like a chore - you don’t seem to feel the closeness that others describe in their relationships. You may have gotten to the point where you’re okay with not having that connection.

• When people get close you find a reason to pull or push them away.

• Other people rely on you and it’s important for you to feel needed.

• You try to push down your feelings (maybe you believe they are unnecessary, weak, or unhelpful).

• Find yourself judging others. Instead of acknowledging your strengths, your self-esteem improves when you compare yourself to others (ie. I’m better at ____ than they are.”)

• Having strong opinions about the way that others should do things.

• Offer advice or direction without being asked.

• (Rescuing) Being there for someone at any hour of the night, willing to do anything to help, bending your boundaries to help someone else etc.

Complex trauma (or C-PTSD) can be understood as trauma or abuse that is prolonged, repetitive, and has taken place over an extended period of time (often months or years). In addition to symptoms of trauma or PTSD, those with C-PTSD also experience significant issues with:

• Attachments: lacking trust, isolation and withdrawal, difficulties with intimacy/closeness, poor boundaries, repeated abandonment of the self, repeated searches for a “rescuer,” and failure in self-protection.

• Affect/Emotion Regulation: difficulty identifying or expressing emotions or feeling states, “shame attacks,” overwhelming, seemingly intolerable emotions experiences, “emotional flashbacks,” chronic suicidal ideation, self-injury, persistent depression, or explosive or very inhibited anger.

• Dissociation: difficulty remaining in the present moment and “fading out;” lapses in time or memory; feeling disconnected from thoughts, feelings, memories, or surroundings.

• Perception of Self: helplessness, hopelessness, persistent feelings of loneliness, sense of being different than others, beliefs that no one can understand.

• Perception of Perpetrator: preoccupied with the relationship, idealization or gratitude, acceptance of the beliefs of perpetrator, perpetrator’s reality supersedes their own.

Depression has a number of different causes. It might be due to something going on in our lives, our biology/genetics, personality factors, our thoughts and the way we perceive things, etc.

Sometimes, it’s clear that we’re depressed. We have the symptoms we’ve heard people talk about:

• feeling hopeless or helpless

• tearfulness or crying spells

• low self-esteem or being really critical of ourselves

• having suicidal thoughts

• not wanting to get out of bed or leave the house

But there are other signs of depression aren’t always so clear:

• feeling tired all the time, even though you get enough sleep

• sleeping too much or too little

• moving slowly or feeling restless

• eating more or less than you used to; gaining or losing weight

• feeling less motivated or less excited to do things

• difficulty making decisions

• convincing yourself out of things that could be fun

• boredom

• not feeling as smart as you used to

• difficulty thinking clearly, remembering things as easily, or having trouble concentrating.

• a drop in grades or work performance

• wishing you just wouldn’t wake up or that something might lead to you dying

• pulling away from friends or family

• lack of sexual desire

Disordered Eating may include symptoms of restricting, dieting, emotional, compulsive, or mindless eating, or other inflexible ways of relating to food. Other examples may include:

• fad diets

• cleanses

• misuse of supplements or protein shakes

• use of diet pills or steroids

• eliminating food group(s)

• or even habits like pushing yourself to exercise when you aren’t feeling well.

While there are many eating disorders, at Bloom, specialized treatment is available for

• Anorexia Nervosa

• Bulimia Nervosa

• Binge Eating Disorder

• OSFED (Other Specified Feeding or Eating Disorder)

• Orthorexia Nervosa

• ARFID (Avoidant/Restrictive Food Intake Disorder)

• Exercise Addiction

While there are various types and definitions of trauma, the only person who can decide if something was traumatic is you.

Trauma occurs when we live through (a) deeply distressing situation(s). It can be an isolated incident, short-term, or long-term and chronic.

Trauma impacts our physical, emotional, mental, and social well-being. It can also lead us to mistrust ourselves, others, or even the world around us.

Common examples of trauma include:

• physical, sexual, or emotional abuse

• childhood neglect

• interpersonal violence

• poverty

• racism or sexism

• discrimination or oppression

• rape or sexual assault

Trauma can also look like:

• chronic bullying or rejection

• sudden loss of a loved one

• attachment wounds

• emotional abandonment

• frightening medical procedures or treatment experiences

• abuse of power or status

• repeated gaslighting and manipulation