What are Anxiety and Worry?

“What if…” or “What will I do if…”—everyone has had these thoughts. Thinking this way is a natural human process; in fact, without this ability, we might find ourselves in dangerous situations. However, when these thoughts become excessive, it may be a sign of a mental health concern.

An Ancient Survival Skill

Anxiety is an evolutionary ability to imagine the future. It is because of this trait that humans have been able to survive for so long. In ancient times, when survival was a day-to-day struggle, the capacity for “anxiety and worry” was constantly necessary. It allowed us to face threats, such as encountering a bear, by instantly choosing between “Fight, Flight, or Freeze” to protect ourselves.

Excessive Anxiety = A Brain Malfunction

The part of the brain responsible for feelings of anxiety and worry is the amygdala.

When we encounter a dangerous situation, the amygdala reacts faster than any other part of the brain, commanding the body to fight, flee, or freeze. As a result, the body undergoes various physical changes:

• Increased heart rate

• Sweating

• Shallow breathing

These reactions prepare the body to respond to a crisis. While this is a normal response, for some individuals, the amygdala begins to overreact due to various factors. This overactivity is what leads to clinical mental health issues.

In modern times, we rarely face life-or-death situations daily. However, without the capacity for anxiety, we would recklessly engage in dangerous behavior. In fact, there is a documented case of a woman whose amygdala ceased to function; despite being told repeatedly, she could not understand the danger of walking alone at night.

Causes of Amygdala Malfunction

1. Thinking Patterns

One reason the amygdala malfunctions is the influence of the prefrontal cortex. This is the part of the brain responsible for logical thinking, and it is strongly connected to the amygdala. If the prefrontal cortex engages in patterns of thought that generate anxiety, the amygdala may trigger a “false alarm” even when no danger is present.

2. Lifestyle

The amygdala is also heavily influenced by lifestyle. For example, research shows that a lack of adequate sleep reduces the frequency of REM sleep, making the amygdala more prone to malfunctioning.

3. Trauma

Another potential cause is past trauma. When we encounter objects, places, or sounds that remind us of a traumatic event, the amygdala can misfire, triggering a stress response.

Diagnostic Criteria for Anxiety Disorders

One of the mental health conditions resulting from these malfunctions is Generalized Anxiety Disorder (GAD). Below are the general diagnostic criteria:

1. Excessive anxiety and worry occurring more days than not for at least 6 months.

2. Finding it difficult to control the worry.

3. The anxiety and worry are associated with at least three of the following symptoms:

   • Restlessness or feeling keyed up

   • Being easily fatigued

   • Difficulty concentrating or mind going blank

   • Irritability

   • Muscle tension

   • Sleep disturbance (difficulty falling or staying asleep, or restless sleep)

For an anxiety disorder self-assessment, please click here.

Note: A formal diagnosis must be made by a mental health professional. Please use these criteria for reference only. If a screening suggests you should seek help, please feel free to contact me.

In my next blog post, I will discuss coping strategies for managing excessive anxiety and worry.

Tatsuya Arakawa, LMFT Licensed Marriage and Family Therapist (California)

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Hello, I am Tatsuya Arakawa, a licensed mental health therapist.

Being a business owner or executive is a role that grants great freedom, but it also carries immeasurable responsibility. Constantly being forced to make decisions—ranging from the trivial to the monumental—is more taxing than many can imagine. Furthermore, in many cases, there are matters that simply cannot be discussed with anyone, leading to a profound sense of isolation. In fact, based on my experiences working for many executives, I can say with certainty that I have yet to meet one who does not experience loneliness.

This article is for those who are struggling with it.

Loneliness and Mental Health

Loneliness is an incredibly painful sensation. At a fundamental level, the human brain has not changed much since ancient times. Just as early humans lived in groups to survive, modern humans require connections with others to remain physically and mentally healthy. The old cliché, “No man is an island,” is an absolute truth.

Furthermore, humans specifically need family and friends with whom they can be their authentic selves. However, if you are surrounded only by relationships based on “profit and loss” or strategic calculations, human interaction itself begins to feel like work. Unfortunately, many business owners find themselves primarily in these types of transactional relationships.

As a result, their sense of loneliness deepens.

This isolation can lead to a significant decline in mental health, potentially resulting in clinical diagnoses such as depression or anxiety disorders.

The Importance of Preventive Care

Many executives—especially those with a strong sense of responsibility—have a powerful awareness that they are supporting the company, their employees, their families, and the families of those employees. Consequently, they tend to put their own needs last. This neglect is often clearly reflected in their mental health care.

In most cases, people only realize they need care after the impact on their work and life has become overwhelming—such as being unable to focus on work at all or suffering from sleep disorders due to crippling anxiety. However, just as you receive an annual physical or go for a massage, the ideal approach is to receive regular mental health care. By engaging in consistent care, you can prevent issues from escalating to the point where they interfere with your work and cause significant trouble for your employees and stakeholders.

I hope this information provides you with helpful insight.

Tatsuya Arakawa, Licensed Marriage and Family Therapist (LMFT 82425)

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When a child develops a mental health issue and requires therapy, the therapist acts as the primary clinician. At the same time, it is essential for the parents to undergo their own transformation. Except in rare cases, a therapist only sees a child for about one hour a week. The rest of their time is spent under the “umbrella” of their parents. Often, that very umbrella is a contributing factor to the child’s condition. Unless the umbrella itself changes, the child’s illness will not heal.

In this article, I would like to discuss what parents can do to facilitate the healing of their child’s mental health.

1. Acknowledge the Reality

The first step is to acknowledge that the parents are often the primary reason for the child’s struggles. Acceptance is incredibly painful and by no means easy. However, far too many parents try to shift the blame onto the environment (such as school or friendships) or claim the child was “simply born that way,” refusing to recognize how much they have influenced the child’s distress. Unfortunately, this denial only worsens the child’s condition.

Additionally, I often see parents react defensively, saying things like, “Fine, so everything is my fault, isn’t it?” and blaming the person pointing out the responsibility. We are not looking to assign blame; we are identifying the cause to solve the problem. Identifying the root cause is critical—without it, the issue cannot be resolved. When parents misinterpret this as a personal attack, constructive dialogue becomes nearly impossible, and recovery is delayed.

2. Listen to Your Child

Once you have reached a place of acceptance, the next step is to truly listen to your child. There are several key points to keep in mind:

First, do not try too hard to “correct” them. Children say things that are wrong or, from an adult’s perspective, highly questionable. Listen anyway. They say these things precisely because they are children. If you focus solely on correcting them, you are effectively not listening to them at all. Furthermore, speaking down to them with “shoulds” and “musts” is counterproductive. This is a form of over-control, which is detrimental to mental health.

Instead, simply listen. Use body language to show you are fully present: look at them, turn your body toward them, stop doing other tasks while they speak, and nod. Show genuine interest in your child. Try to discover what they are thinking, feeling, and dreaming. In many cases, parents know far less about their children than they think they do.

(Note: If your child is still young, such as an elementary schooler, playing together may be more important than talking. For young children, play is the most vital tool for communication.)

3. Seek Balance

Finally, balance is essential in everything. Parents of children with mental health issues often tend to have been either too strict or too indulgent. When a child becomes ill, strict parents often swing to the opposite extreme of being too soft, while indulgent parents suddenly become overly harsh.

Discipline and household rules should not be viewed in black and white. Your approach should not be “always strict” or “always lenient.” This binary thinking itself can be passed down to the child, contributing to their mental health struggles.

Focus on balance instead. For example, if you were too strict before, it means you were successful at enforcing rules, but likely at the cost of the child’s autonomy. In that case, you should shift toward an approach that places more value on their independence.

I hope this provides a deeper and more accurate understanding of mental health.

Tatsuya Arakawa Licensed Marriage and Family Therapist (LMFT 82425), California

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In my previous blog post, I explained what childhood depression is.

This time, I would like to talk about how therapy can help.

Building Trust with the Child

Whether the client is a child or an adult, therapy cannot succeed without a foundation of trust. In fact, this therapeutic relationship itself makes up a large part of the healing process.

Having a trustworthy adult to talk to once a week.

Having a trustworthy adult who listens sincerely every week.

Having a trustworthy adult who does not say, “You must do this,” or “You can’t do that,” but simply stays by their side through difficult times.

When a child experiences this kind of support, they begin to feel:

“I want to try my best.”

“I can keep moving forward.”

“Even if I fail, I can get back up again.”

That sense of safety and trust is what allows healing and growth to begin.

Parents Also Need to Change

However, no matter how much a child grows or heals through therapy, there are things that the child alone cannot change—and one of those is the home environment.

Even if a therapist provides a warm and healing hour each week, the child still spends the rest of their time under their parents’ care.

In most cases, the main source of a child’s emotional distress lies within the family environment.

If that environment doesn’t change, even when the child improves through therapy, it is very likely that their symptoms will return over time.

Therefore, I also meet regularly with parents—not only with the child—to discuss how parents themselves can begin to change.

This doesn’t mean that everything about their parenting has been wrong. There are always positive aspects that should be continued.

At the same time, I help parents understand why certain areas need improvement and guide them through specific ways to make those changes.

By supporting both the child and the parents in this way, the ultimate goal of therapy is for the child to be able to say goodbye to the therapist and still live happily with their parents—with smiles and connection at home.

Tatsuya Arakawa, LMFT #82425

Licensed Marriage & Family Therapist

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Hello, my name is Tatsuya Arakawa, Licensed Marriage and Family Therapist.

In this blog, I would like to talk about depression in children.

Common Image of What Depression Looks Like.

When most people think of depression, they imagine symptoms such as staying in one’s room or lacking energy. Of course, these are common symptoms of depression. However, in children, depression often presents with different symptoms than those typically seen in adults. Below are some of the most representative ones.

Symptoms of Depression in Children

Defiant Attitude

When children show defiant behaviors, people often underestimate them believing that they are in the “rebellious phase.” As a result, it is often dismissed simply as part of growing up. While defiance can sometimes be a normal developmental stage, there is a possibility it is not. Such behavior may actually stem from depression. Especially when a child’s defiance is excessive, it is important to first consider the possibility of depression.

Irritability and Anger

Similar to defiance, irritability and anger can also be symptoms of depression in children. Naturally, some irritability is normal in childhood. However, when a depressed child exhibits these emotions, they often appear more frequently and with greater intensity than usual. If such behavior is brushed off as “just their personality,” there is a risk of missing signs of depression, which could eventually develop into a severe condition. In such cases, the possibility of depression should not be overlooked.

Thinking About Death, Suicide, or Self-Harm

Although often underestimated, thinking about death can also be a symptom of depression. This may include wondering what happens after death or how one’s death might affect others. While curiosity about such topics can sometimes be developmentally appropriate, it should never be ignored.

When such thoughts progress to thinking about suicide—for example, wondering how to end one’s life or actually planning it—the likelihood of severe depression becomes very high.

Similarly, thoughts or acts of self-harm, though different from suicide, also strongly indicate the presence of serious depression.

In summary, these are some key points about child depression. I hope this information is helpful.

Additionally, you may find it useful to take the diagnostic test linked here. 

Tatsuya Arakawa

Licensed Marriage and Family Therapist, #82425

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In a previous article on the characteristics of neurodivergent individuals and strategies for them, I discussed one particular trait: “difficulty adapting to changes in the environment,” and in that piece I also talked about possible ways to cope with it.

In this blog, I would like to focus on another trait of neurodivergent individuals and explore strategies to address it. This time, the trait is “tendency to think in black-and-white.”

First, let me explain what this means. A tendency to think in black-and-white refers to the difficulty of engaging in flexible thinking. It often means seeing things only in extremes—either 1 or 0—while struggling to recognize what lies in between. For example, in relationships, one may judge others only as “liked” or “disliked,” finding it very difficult to acknowledge situations where it is neither, or to accept that both positive and negative feelings toward the same person can coexist.

Such a way of thinking often causes difficulties. For instance, in relationships, no matter how much someone likes person A, if A says something displeasing, the feelings may instantly flip from “like” to “dislike.” Even if the relationship had been very close, all the positive history may suddenly feel erased, with only “dislike” remaining in focus. (In fact, many neurodivergent individuals share this type of struggle.)

Of course, this trait also has its benefits. In environments where black-and-white thinking fits, the future becomes easier to predict, which can reduce anxiety and worry. Also, accepting ambiguity or “gray areas” can be challenging for anyone, not only for neurodivergent individuals. Thinking in black-and-white terms can be simpler and more straightforward. When things are going well, such thinking may not cause problems at all. However, when things don’t go well, it can lead to significant challenges.

Recognizing this kind of thinking on one’s own is often very difficult. Therefore, if someone around you points it out, it may be helpful to take a step back and consider, “Perhaps I do tend to think this way.” This can serve as an opportunity for greater self-awareness.

In my next post, I plan to discuss possible strategies for this characteristic.

I hope this information helps you gain accurate knowledge.

Licensed Marriage and Family Therapist (#82425)

Tatsuya Arakawa

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In a previous article on the traits and strategies for neurodivergent individuals, I discussed one of the key characteristics—difficulty adapting to changes in the environment. In this article, I will talk about what can be done specifically to address this challenge.

First, it is important to determine whether the environmental change is causing significant disruption in daily life. Disruptions may include symptoms of anxiety disorders, such as difficulty concentrating or irritability, or symptoms of depression, such as sleep disturbances or persistent low mood. If such disruptions are present, it is important to address them as early as possible. On the other hand, if no disruptions are present, it may not be a significant problem at the moment, and simply being mindful may be enough. However, one point to keep in mind is that some people may be unaware of the disruptions they are experiencing or may convince themselves that they are unaffected. In such cases, support from those around them becomes especially important.

If disruptions are present, here are some specific actions individuals can take:

1. Accept the problem

The first step is to acknowledge the issue as a problem. This is by no means easy—in fact, accepting it can be one of the hardest steps. Without acceptance, it is difficult to adopt a mindset of problem-solving, and many people instead try to convince themselves there is no problem and suppress their feelings. Unfortunately, this does not make the problem disappear. In fact, leaving such issues unaddressed often causes them to worsen, leading to greater distress over time.

2. Recognize that struggling is natural

For neurodivergent individuals, environmental changes are generally unwelcome, even when the changes are positive, such as a promotion. Therefore, rather than criticizing yourself by thinking, “I shouldn’t be struggling over something like this,” it is important to embrace yourself with the mindset that “it’s natural to feel this way.” While this may not eliminate the distress, it can help ease it.

3. Engage in activities you enjoy

Many neurodivergent individuals avoid spending time on activities they enjoy, often due to the pressure to quickly adapt to new environments. However, doing things you love is especially important during difficult times. It doesn’t matter what the activity is—start small, but make time for what brings you joy.

4. Seek support

Trying to solve problems entirely on your own is often challenging. Start by talking to someone you trust. Be as open as possible about what you’re struggling with. If talking about it feels too difficult, simply spending enjoyable time together can also help.

5. Reevaluate your daily habits

Improving your daily routines will not automatically eliminate distress, but it can often reduce it. For example, if you’re having trouble sleeping but are consuming excessive caffeine throughout the day, it is only natural that falling asleep would be difficult. Examining such habits can be a good starting point.

6. Consult a professional

That said, if, for example, your sleep difficulties are caused by depression, improving daily habits alone may not be enough to resolve the problem. If disruptions have persisted for some time, and you have tried various strategies without significant improvement, seeking professional help is important.

I hope this information provides you with helpful and accurate knowledge.

Tatsuya Arakawa, LMFT(82425)

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In a previous blog post, I wrote about what neurodiversity is, the struggles faced by neurodivergent individuals, and ways to help make life a little easier for them.

In this article, I’d like to take a deeper look into the characteristics of neurodivergent individuals and how we can support them.
This time, I will focus on the trait of “difficulty coping with changes in environment.”

One common trait among neurodivergent individuals is that it generally takes them more time to adapt to changes in their environment compared to neurotypical individuals. This is closely related to another trait often seen in neurodivergent people: a strong preference for routines.

So, why do they prefer routines and dislike change? One of the major reasons is anxiety. Life inevitably brings change—moving to a new place, starting a new school, beginning a new job, and so on. Naturally, anyone would feel anxious when facing change, no matter how big or small. However, even without any environmental change, neurodivergent individuals tend to experience anxiety more easily than neurotypical individuals. As a result, when a change does occur, they often experience heightened anxiety.

When it comes to routines, following them can provide a sense of safety and stability. Therefore, even if nothing in the environment changes, being unable to follow a routine for any reason can itself trigger anxiety. And when the environment does change, it usually disrupts routines. This creates a “double punch”—anxiety from the change itself, and additional anxiety from the inability to follow routines—leading to overwhelming emotional distress.

In fact, it is not uncommon for neurodivergent individuals to be diagnosed with not only ADHD, for example, but also with co-occurring mental health conditions such as anxiety disorders.

As we can see, anxiety, difficulty with environmental changes, and a strong preference for routines are all deeply interconnected.

So, what can we do about this? I’ll be discussing this in more detail in the next article.

I hope this article has helped you gain a better understanding through accurate information.

Tatsuya Arakawa, LMFT

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Previously, I talked about what neurodiversity is and the struggles faced by neurodivergent individuals.

In this article, I would like to share some tips that may help neurodivergent people live a little more comfortably.
As a fundamental premise, ideally, one should undergo testing by a psychologist who has received proper training in the United States or Europe to determine whether they are indeed neurodivergent. Furthermore, receiving therapy from that psychologist or a properly trained therapist can be a great source of support following the assessment.

Now, let’s get into the main topic.

Acceptance

The first step is acceptance. If you have been told multiple times by those around you that you may exhibit neurodivergent traits, it is important to consider that possibility and accept that this is how others perceive you.

What is crucial to understand here is that this is not a “disease.” If asked whether it is a “disorder,” technically it may be, but as I’ve explained before, that is only because the current society is not designed for neurodivergent individuals. From a social standpoint, it may be viewed as a disorder, but that does not mean it is “bad” or that one is “inferior.”

At the same time, unless we accept reality as it is, we cannot recognize problems for what they are. As a result, issues may arise in various situations. Therefore, acceptance is the first and most significant step forward.

Understanding Strengths and Weaknesses

For example, one common trait among neurodivergent individuals is difficulty with sustained attention. However, many people with this trait can hyperfocus—displaying intense concentration—when it comes to things they enjoy or are interested in.

Another trait is a strong attachment to routines or preferences. While this can make it difficult to be flexible, it also means that once a goal is set, the individual can persist without wavering and move steadily toward it.

These traits can be either strengths or weaknesses depending on the situation. By understanding how these characteristics manifest, one can leverage strengths and mitigate the difficulties that arise from weaknesses.

I hope this helps you gain accurate knowledge and understanding. 

Tatsuya Arakawa, LMFT #82425

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