How Anxiety Can Affect Relationships, Intimacy, and More

The moment someone feels that their relationship is stuck, or they are struggling to overcome challenges that are holding back their marriage from being something more, one of the first thoughts that many couples have is “we should look into couples counseling.”

Couples counseling is a highly effective, extensively researched way for couples to learn to communicate, work through their problems, and grow. But what we as therapists often find is that the problem isn’t always the couple as a unit. Rather, it can often be individual struggles that a person is dealing with that stand in the way of both partners’ happiness.

Anxiety and Relationships

Some people have a fear of commitment. Others have trauma from their past. Others need to learn how to accept love from someone. Some people need help examining their beliefs about relationships in order to address them effectively.

Yet for some people, the issue isn’t necessarily about the relationship at all. An example of this is anxiety. Anxiety is an overwhelming mental health condition. A person struggles with restlessness, rapid thoughts, stomach issues, sweating, nervousness, and general unease. If the person has a condition like panic disorder, then they are also frequently experiencing bouts of severe anxiety that leave them drained, empty, and inside their own mind.

“Lots of times when we see a patient that is struggling with intimacy issues, arousal, or isn’t able to focus on their partner’s needs, we also find that they struggle with anxiety” says Dr. Marc Shulman, a psychologist on Long Island that provides couples counseling and anxiety therapy. “We can support them through their relationship, but we still need to address the anxiety individually so that they can give and receive love better with their partner.”

While we often talk about the symptoms of anxiety and how they affect the individual, anxiety can also affect a person in a way that alters the relationship as well. Anxiety causes:

  • Irritability
  • Tiredness/Insomnia
  • Poor Libido or Premature Ejaculation
  • Forgetfulness

Anxiety can make it easy to get overwhelmed, it can make it harder to communicate, and it can make it harder to feel happy.

“Anxiety is a constant distraction,” says Dr. Sadi Fox. a psychologist and couples counselor with Flourish Psychology in Brooklyn. “If someone is frequently distracted by and affected by their anxiety, it’s easy to understand why their relationship – especially the parts that require positive feelings, like intimacy, become more difficult for a person to manage.”

Dr. Sehdev, a psychiatrist in Dallas that specializes in anxiety, sexual dysfunction, and TMS therapy, notes that intimacy, specifically, is often affected by anxiety. “One of the medications that we might prescribe for some types of sexual dysfunction are the same medications used to treat anxiety and depression, such as SSRIs.” If the person’s relationship is being affected by intimacy, anxiety is often one of the first places we look.

The Complexity of Relationships

I specialize in individual relationship counseling. This type of therapy involves working with someone as an individual, with the idea and goal of helping the person with their own individual needs so that they can really give themselves to relationships better.

While there is a space for couples to work together, it’s important to remember that relationships are made up of two individuals, each with their own needs. There are many situations in which it is best to work with both partners together, but there are also many situations where the best approach is to address each couple individually, because each one needs a space they can share, grow, and address their own issues.

Anxiety may only be one of these many issues, but it does serve as an example of how relationships are complex, and how often growing as a couple means also addressing specific challenges that you face as individuals. If you’d like to learn more about individual relationship therapy, please contact me today.

Mental Healthcare as a New Year’s Resolution and its Long Term Benefits

First and foremost: Happy New Year! I hope you had a wonderful time with your family and friends over the holiday season. Every year has its challenges, but the hope is that we can look back on the past year and still be able to remember some joys and progress that we made on ourselves over the last 12 months.

Still, it is a new year once again, which means it’s time to think about the future. Many of us have long given up on the idea of resolutions, but it is still not uncommon to think about what’s in front of you and create goals or have hopes for ourselves that we want to reach.

What Stopped Us From Resolutions?

Whether you call these “new year’s resolutions” or not, we’re all familiar with the idea that many new years resolutions “fail.”  As Flourish Psychology writes, in the form of a Seinfeld joke: “Making resolutions is very easy. It’s keeping the resolutions that is the problem. Anyone can make a resolution. But keeping the resolution is the most important part of the resolution.”

There are many reasons that these resolutions, goals, and desires for ourselves fail, but most of the time, the issue is because they are all related to our mental health. It’s very difficult to care for your body when you do not care for your mind. It is nearly impossible to achieve a goal when you’re sad, down, anxious, or otherwise stressed.

Indeed, our mental health doesn’t just prevent our resolutions. Many times, without us realizing it, they *are* our resolutions. When we set a goal to do something like “learn a new language,” we are not only doing that to expand our abilities. We are also doing it because we believe it will make our lives happier and more fulfilling. The goals we undertake are, often, designed to improve our mental health.

That’s why, this year, maybe the resolution you should have is the one that will help you achieve all your goals and provide benefits that last a lifetime. This year, you should resolve to address your mental health.

Why Mental Health Care is the Best Resolution

The primary benefit of addressing mental health as a resolution is that your mental health plays a role in all other components of your life, including any other goals that you may want to take on and the benefits of achieving those goals. For example, if you resolve to travel more, and you do, but you struggle with depression, that travel is not going to bring you the fulfillment you hope for. It’s also going to make it harder to get yourself to travel.

But there are other benefits as well. Mental health care is:

  • Easier to implement – All it takes is one call to a therapist and you can get started. While you will still want to find a therapist that fits you and your personality, once you find one, you’re already able to start.
  • Greater Accountability – No one forces you to go to the gym, and no one can force you to eat a healthy diet. That makes it too easy to give up on your goals. But a therapist helps to keep you accountable, something that helps make sure you’re continuing to work to achieve those goals.
  • Fits Who You Are – If you’re a person that has never wanted to exercise, for example, and you try to force yourself to exercise, it’s going to be easy to give that up. But mental health is catered to you, so it is always in line with your goals and beliefs.

Better mental health is a resolution that you can keep every year, and it will always provide you with other dividends, such as improved ability to reach other goals and more energy to stay focused on the tasks at hand.

Barriers to Mental Health as a Resolution

Mental healthcare is a smart goal for 2024 and beyond. But there are a few barriers. I’m licensed in California, Texas, and Florida, and there are issues that can affect people that may stand in the way of addressing their mental health. In Texas, the issue is a dramatic shortage in providers. Lauren Shanks, a Texas insurance agent and owner of Kaia Insurance in Conroe, TX, writes “therapists are often covered by private insurance, but the issue is a lack of providers. Texas has been slow to remove (and in some cases have actively created) barriers that can make it harder for patients to find therapists in the state able to treat them.”

California is doing better on the health insurance and mental health legislation front. According to Mary of LyteSpeed Learning, an online insurance course provider for the state, the CA legislature has passed several bills such as Senate Bill 326 and Assembly Bill 531, all of which expand access and pour resources into the state’s mental healthcare programs.” Jeff Adler of LTCR Pacific, a long term care insurance provider, agrees, stating that California’s health insurance programs have helped open the door for better mental health related care.

The issue in California, however, is time and cost. Cost of living here is high, making it a bit more difficult to pay out of pocket (despite the benefits), and many of us now work remotely, which can make it difficult to stay with the same therapist as you move around the state.

Work With a Therapist for Your Mental Health

Despite these barriers, the value of addressing mental health cannot be understated. While many other resolutions and goals are admirable, there is little denying that mental health plays a role in all of your goals, and many people push off receiving therapy and other mental health services for far too long. If you’re ready to go into 2024 caring about your mental health, please contact me today.

Tinder – Swipe Life – Being Friends with Your Ex – Archive

Tinder – Swipe Life (Archived Article from Former Editorial Website)
I was quoted in this article by Suzannah Weiss.

Being Friends with Your Ex
by Suzannah Weiss
Published: Wednesday, May 06, 2020

I never understood the phrase “falling out of love.” In fact, when I first heard it, I found it deeply disturbing. I’d learned about love as something that lasts forever, something strong enough to outlast any breakup.

The first time I fell in love, I honored this belief. My partner and I told each other early on that we’d love each other forever, no matter where our relationship went. The deep caring I had for him did not disappear after he broke up with me, and we remained friends for years before drifting apart. Even now, I still have love for him, though I have no romantic or sexual attraction to him at all.

Two years later, when I broke up with my second boyfriend, I told him, “Relationships don’t end — they just shift.” We’d talked about the soul-level connection we had and our shared past lives, so the idea of being completely out of each other’s lives was not conceivable to either of us. We shared the belief that love is unconditional, which means it’s not conditional upon being in a relationship. Once you love someone, you always will.

He and I still talk every once in a while about what’s going on in our lives or the world. We’ve occasionally even said “I love you” with the understanding it’s meant platonically. I’m in another relationship, which I talk openly with him about, and he’s been in other relationships at various points. As with my first ex, the sexual and romantic attraction faded, but the love did not.

Then there are the flings that never made it far before landing in the “friend zone,” as it’s called, as if friendship were a consolation. There’s the guy I dated for a month in college, stopped speaking to for a year, then begun inviting to my dorm for drinks and friendly banter. And there are several people from dating apps I took on one or two dates, decided it wasn’t a match, then became good friends with.

Most of us learn as kids that the proper trajectory for a relationship is to date, become serious, and then get married and stay together as life partners. But why is this considered a more desirable path than, say, dating, becoming close friends, then being in each other’s wedding parties? When we get too attached to one particular outcome, we miss out on the potential that each unique relationship holds.

“Being friends with an ex can have many advantages because this is a person who likely knows you on a deeper level than other people. This allows you to have someone you can confide in, aside from any partner, and who can support you,” says marriage and family therapist Amy McManus. “It’s extremely hard to be friends if this is not the case.” This may take a while, and that’s OK. “It can take time to process a breakup, whether or not you initiated the breakup,” says Tully.

That’s why I’ve typically waited a few months or even years to befriend exes. I once tried befriending an ex right after we broke up, but I ended up crushed that we were only friends and jealous when he mentioned love interests. So, I now wait until I’m over a person, which often means waiting until I’m dating someone else.

McManus advises against even being friends with or following exes on social media until you’re over them. “If you are not in another relationship and you see them with another person on social media, it can be depressing, and it can easily suck you into obsessing and stalking,” she says.

It’s easiest to be friends with an ex if you broke up a while ago, are both seeing other people, and have limited circumstances under which you see each other, like when you’re visiting their city, says McManus. However, if either of you is seeing someone else, this can also add another layer of complication. “If a person still cares for their ex, it can be problematic in a current relationship,” says Tully.

If your partner feels uncomfortable about your friendship with your ex, you should ask yourself whether they have a reason to be. Even if you’re no longer romantically involved with your ex, certain behaviors like flirting or bad-mouthing your significant other may border on emotional cheating.

Perhaps you can find a compromise that helps your partner feel comfortable, like only hanging out with your ex in a group. However, if you feel your partner’s request that you avoid your ex is unreasonable, you don’t have to honor it, says Tully. The important thing is to make sure you’re not sacrificing your time with your partner to spend time with your ex, but that’s true for all your friends.

As for me, my current partner doesn’t think anything of my friendships with exes. I don’t hide them from him because I have nothing to hide, and he recognizes that. He also knows it means that even if things don’t last between us, he’ll remain in my heart as well.

Society pressures us to put relationships into boxes with labels, like “ex” or “partner” or “friend.” But the truth is, people’s roles in our lives are always shifting, and embracing these shifts is the only way to appreciate every relationship for what it is. That way, the end of a relationship doesn’t seem so devastating — because it’s really the beginning of a new one.

Tinder used to have an online lifestyle magazine called Swipe Life. I was able to salvage the above article with the help of the WayBack Machine at

Seeing Anxiety as a Physical Disorder – Not Only an Emotional/Mental Response

One of the challenges that we face as psychotherapists is the framing of the conditions we treat as strictly mental health disorders. If a person struggles with depression, for example, there is this societal response that is basically framed as “you should try to feel better,” as if the struggle is partially about decision making or a person’s thought processes.

What we often emphasize, however, is that the mind and body are distinctly connected, and that the person’s experience is not based solely on what they’re thinking about in the moment. So much so, in fact, that a person can experience the physical symptoms of a disorder without even realizing they have the disorder.

About Anxiety that is Entirely Physical

Our brains are so much more than just thoughts. Behind the scenes, are brains are creating neurotransmitters (chemical messengers) that send actions and behaviors all over the body. They’re also processing information that we do not think about on a cognitive level – which means that even when you’re watching TV, or resting, your brain is trying to process emotions, events, experiences, traumas, and so much more while your thoughts are on your TV show or a fun conversation you’re having with a friend.

That is why some people experience mental health conditions that are strictly, if not almost entirely, physical. This is especially common with anxiety. This idea of physical only anxiety is not new, but many people are unaware that anxiety can be this physical – that a person can have feelings of anxiousness without realizing that they have anxiety, and without the worries and fears that we typically associate with the condition.

The only reason this is possible is because our brains are sending messages that our minds aren’t picking up. Our minds are processing things in the background while we’re thinking about other parts of our day. It is because of this that mental health should not be seen solely as an issue related to “thinking” but as a physical disorder as well.

Treating Mental Health When the Symptoms are Physical

The idea of a physical only mental health issue isn’t limited to anxiety. Depression can also have many physical symptoms without as many mental ones, as can other mental health challenges, like ADHD. That is why it is important for people to talk about mental health conditions as if they may be more than just mental – because sometimes, a person may not realize they’re struggling with the condition if their symptoms are typically only physical in nature.

Dr. Malik of AvemaPsych Medical, a psychiatrist in Houston, writes “it can be more difficult to diagnose patients that have mostly physical symptoms unless the patient is aware of and can communicate that those symptoms exist. Sometimes, there are mental symptoms that the person ignores. Other times, we need to talk further about what the symptoms may mean in order to make a diagnosis. If more people were aware that mental health can manifest physically, it would mean more people would get the help they need.

Therapy for Anxiety, Depression, and More

I believe that everyone deserves to receive support for their mental health and wellness, regardless of whether they have a diagnosable condition. I also believe that it is important for people to be aware when their quality of life is being affected by their mental health, even if the specific symptoms do not “sound like” anxiety, depression, or other mental health conditions.

I am licensed to provide psychotherapy in CA, TX, and FL, and I am local to the Los Angeles area if you’d like someone near you. Please contact me today to learn more about my therapy services, or to get some of the mental health support that you need.

What Causes Anxiety? We’re Not Always Clear, and We Don’t Always Need to Know

So many of us struggle with different forms of anxiety. We might worry about our relationship or our future. We might have trouble in social situations. We might have a severe fear of bugs or heights. Anxiety manifests itself in many different ways, many different days.

Those of us in the LGTBQ+ community know how much anxiety is often a force in our lives. But what you may not know is that anxiety’s cause isn’t always clear, and sometimes, the cause may be something you did not expect.

Anxieties Causes – Genetics, Traumas, and Posture?

One of the best examples, and one that I personally love, comes from Flourish Psychology in Brooklyn, a private practice in NYC with therapists that specializes in anxiety and eating disorders. They wrote about how anxiety, quite literally, can be caused by underdeveloped butt muscles.

Yes, it’s true. It may not be common, and anxiety is often far more complex than just “back and butt muscles,” but it is absolutely true that something as simple as our breathing habits – habits that can be caused by poorly developed posterior muscles – can be enough to trigger anxiety and panic attacks.

During our sessions, we’re going to find ourselves frequently exploring some of the past. We’re going to try to see if there are any traumas that may have contributed to your anxiety, or any behaviors that may play a role. We’re going to try to explore very deep topics that we hope will help us find out more about what may have led to some of your anxiety and mental health challenges.

We may find many reasons that make perfect sense why you have anxiety. But we also may find nothing. And that’s okay. It doesn’t matter if your anxiety is caused by past trauma, or by bullying, or by feeling uncomfortable in your own skin. It also doesn’t matter if your anxiety is caused by genetics, nor does it matter if your anxiety is caused by not doing enough squats.

What matters is that anxiety is treatable, and while we may explore the “inner you,” we will also know that there are therapies, like CBT, that can be used to ensure that you’re able to better address anxiety no matter its cause.

Your Anxiety Therapist in Los Angeles – Patrick Tully LMFT

My name is Patrick Tully, and I would like to help you with your anxiety. As a therapist, I know that anxiety is treatable. It doesn’t matter if it’s your back muscles, your upbringing, or something else – together, we can help treat anxiety and help you find some relief from your symptoms. Contact me today to learn more.