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5 Tips for the Anxious Athlete

3/3/2026

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Sarah Vanderpool, LCMHC, NCC, LPSC

Psychotherapist

In addition to being a licensed psychotherapy, I am also a former competitive athlete and current coach. With the latter role, helping my athletes prepare for competition, both mentally and physically, is my job. But as parents, as coaches, and as athletes, what do we do when our brain becomes unmanageable and negatively affects athletic performance? While there is certainly no “one size fits all,” I’ve used my knowledge as a coach, parent, and mental health professional to compile what I think is a helpful list of things to consider for athletes who have pre-competition anxiety.

Feeling anxious before a big game or competition is completely normal, but when nerves start to interfere with your performance or enjoyment, it’s time to take action. Many athletes struggle with pre-game jitters, overthinking, or fear of failure, but with the right mindset and strategies, anxiety can actually become a powerful source of focus and motivation.
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​1. Fuel Your Body
Put good in, get good out. Athletes must properly fuel their body for optimal competition results. This includes proper nutrition throughout practices, days/hours leading up to, and after the main event. A well-fueled body performs better and recovers faster. See what Abby Olmstead, Registered Dietitian Nutritionist, has to say about fueling your body properly for competition: Fueling your Body for Game Day.


2. Be a Goldfish
Goldfish have a short memory — and that’s a good thing. Finding the mental toughness to shake off mistakes and stay focused on what is happening in the moment can be challenging, but practice makes permanent. Keep moving forward and focus on what’s next – you got this!

3. Visualization
Mentally rehearse success. Picture yourself performing confidently and skillfully. See it from a 3rd-person perspective (like you’re watching yourself from the stands) and from your own eyes. This is what people mean when they say “eat, sleep, and breathe your sport”. Utilize positive visualization any time you have a free moment and make it part of your pre-game routine.

4. Pre-Game Routine
Routine builds confidence and reduces nerves. Everybody’s pre-game routine might look a little different, but the goal is the same – train your muscle memory well before game time. Include sleep, nutrition, breathing, and visualization. Add music, positive self-talk, or a specific warm-up — whatever helps you lock in. If you’re not sure what to do, ask your coach and/or teammates for help. Or your trusty mental health therapist 🙂

5. Breathe
Slow breathing = calm body and clear mind. When anxiety rears its unwanted head, you’ll want to have some coping skills in your back pocket to help mitigate the frustrating effects anxiety can have on your body and your performance. When you can control your breathing, it helps regulate heart rate, which is directly impacted by anxiety. Slow your breathing, and make your exhale longer than your inhale. Try 4-7-8 breathing:
  • Inhale for 4 seconds
  • Hold for 7 seconds
  • Exhale slowly for 8 seconds
Pro tip: Struggle to exhale slowly? Hiss like a snake to control the airflow.

You have more power over your mind than you realize. So go, right now, and practice your breathing and visualization, and make a few notes on what a pre-game/competition routine might look like for you. In part two, I’ll talk more about managing adrenaline, and practicing for permanence, not perfection.

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Sarah Vanderpool
Author Sarah Vanderpool, LCMHC, NCC, LPSC is a Licensed Professional School Counselor and Licensed Clinical Mental Health Counselor. She specializes in working with children, adolescents, and college-aged adults. As a former competitive athlete, Sarah has a niche in sports psychology and enjoys supporting youth and adults who participate in both competitive and recreational athletics alike to overcome psychological obstacles such as stress, anxiety, concentration, confidence, anger, and depression.
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Monday Message: Sending You Light

1/26/2026

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Many of us are carrying a lot right now.

​Heavy hearts. Big feelings. A mix of sadness, anger, fatigue, and worry... sometimes all at once.

This week, I want to gently invite you to do two simple things.

First, let yourself feel it.
There’s no right way to hold this moment. Cry if you need to. Take a long walk. Light a candle. Hug someone you love. Sit quietly and breathe. Give yourself permission to be human.

Second, remember that you are not alone.
Even in hard seasons, we find each other. We are the helpers: showing up quietly, steadily, imperfectly, and with care.

I’d like to share a song that has been grounding me: Melanie DeMore singing Sending You Light.

Take a few minutes this week to close your eyes and breathe. Let it wash over you.

🎧 https://youtu.be/cIsZuoNFtXg

I’m sending you light, steadiness, and care... for who you are and how you keep showing up, even when it’s hard.

And if this season feels heavier than you can carry alone, know that we are here for you. You don’t have to be in crisis to reach out. Sometimes having a warm, steady, compassionate space just to talk things through can make all the difference. 

​Look for the good. There is always so much good among us.

We will make it through together. Always. 💛

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Chantal D. Hayes, MA, LCMHC-S

Founder & CEO
Banyan Tree Counseling & Wellness
​Banyan Integrated Health

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Psychotropic Medications 101

5/10/2022

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In the practice of psychotherapy, therapists learn about and utilize many tools to help our clients find lasting change, improving their overall mental health and wellbeing, and psychotropic medications can be one of those tools.
​It is important to realize that not everyone needs medication to treat their mental health symptoms, and not everyone who needs medication will need it forever. The purpose of this article is to provide basic education about psychotropic medications, because I find that most of my clients who take psychotropic medications are under-educated about them, and many clients who do not take medications are scared to start for the same reason.

How do psychotropic medications affect the brain?

​Mental health disorders (anxiety, depression, bipolar disorder, etc…) are a result of chemical imbalances in the brain, specifically of the neurotransmitters serotonin, norepinephrine and dopamine.  These chemical imbalances can be endogenous (genetic factors, internally caused), exogenous (life events, trauma, external factors), or both.  Psychotropic medications work to create balance in neurotransmitters by adjusting how the receptors in the brain absorb the chemical, effectively reducing negative symptoms.  Different medications work on different neurotransmitters, and it varies individually what each person’s brain needs or will respond to, depending on symptoms and brain chemistry.  
​

What are the types of psychotropic medication?

Anti-Anxiety Medications
  • Benzodiazepines: Work on the GABA receptors in the brain, have the same effect on the brain as alcohol.  Can be addictive and can easily form a dependence resulting in withdrawal if not tapered. Examples: Xanax (Alprazolam), Klonopin (Clonozepam), Ativan (Lorazepam)
  • Anxiolytics: Work on serotonin, dopamine, and noradrenaline receptors. Example: Buspar (Buspirone)
  • Beta-Blockers: Slow down heart rate, reduce adrenaline, and block the physical symptoms of anxiety so the mental ones are easier to manage.  Generally used for short-term, event-related anxiety (public speaking, anxiety attacks, etc…. Example: Hemangeol (Propranolol)
  • Alpha-Blockers: Used to treat high blood pressure, relax blood vessels so blood flows more freely.  This medication has had much success in eliminating nightmares related to anxiety and Post Traumatic Stress Disorder. Example: Minipress (Prazosin)
  • Antihistamines: Affect serotonin and block histamine. Example: Vistaril (Hydroxyzine)
  • Nerve Pain Medications: Slow down brain impulses, stop misfirings in the brain.  Also used for fibromyalgia and seizures.  Examples: Lyrica (Pregablin), Neurontin (Gabapentin)
    ​
Anti-Depressant Medications
  • Selective Serotonin Reuptake Inhibitors (SSRI): Increase serotonin levels, can also be used to treat anxiety. Examples: Celexa (Citalopram), Lexapro (Escitalopram), Zoloft (Sertraline), Paxil (Paroxetine), Prozac (Fluoxetine)
  • Serotonin-Norepinephrine Reuptake Inhibitors (SNRI): Increase Serotonin and Norepinephrine.  Can also be used to treat anxiety.  Examples: Strattera (Atomoxetine), Cymbalta (Duloxetine), Effexor (Venlafaxine), Pristiq (Desvenlafaxine)
  • Tricyclics: Increase norepinephrine and serotonin, and block acetylcholine, have a sedative effect.  These are older medications that are not widely prescribed after the advent of SSRI and SNRI medications.  Examples: Amitriptyline, Amoxapine, Tofranil (Imipramine), Pamelor (Nortriptyline)
  • Monoamine Oxidase Inhibitors (MAOI): Limit monoamine oxidase, which removes norepinephrine, serotonin and dopamine.  These are older medications with many diet restrictions and side effects. Examples: Marplan (Isocarboxazid), Nardil (Phenelzine), Parnate (tranylcypromine)
  • Serotonin Antagonist and Reuptake Inhibitors (SARI): Increase serotonin in the brain by blocking a specific receptor, have a sedative effect. Examples: Desyrel (Trazodone)
  • Atypicals: work on serotonin, dopamine, and norepinephrine receptors. Examples: Viibryd (Villazadone), Trintellex (Vortioxetine), Wellbutrin (Bupropion), Remeron (Mirtazapine).​
    ​
Antipsychotic Medications
Used to treat Bipolar Disorder, Schizophrenia, Personality Disorders, Severe Depression and Severe Anxiety.
  • Typical (older) Antipsychotics: Block a specific type of dopamine receptor, have a sedative effect. Examples: Thorazine (Chlorpromazine), Haldol (Haloperidol), Prolixin (Fluphenazine)
  • Atypical (newer) Antipsychotics: Block a specific type of serotonin and dopamine receptor. Examples: Abilify (Aripiprazole), Seroquel (Quetiapine), Geodon (Ziprasidone), Risperdal (Risperidone), Zyprexa (Olanzapine)
    ​
Mood Stabilizers
Used to treat the mood swings of Bipolar Disorder, and sometimes to enhance the effect of other medications when treating Depression. Reduce excitability in the brain, to calm overstimulated and overactive neurons. Many anticonvulsant medications are used as mood stabilizers. Examples: Lithium (Eskalith), Depakote (Divalproex Sodium), Lamictal (Lamotrigine), Tegretol (Carbamazepine), Topamax (Topiramate), Trileptal (Oxcarbazepine)
​
Stimulants
Used to treat Attention Deficit Hyperactivity Disorder (ADHD), increase dopamine and norepinephrine. Can be addictive and can easily form a dependence. Examples: Adderall (Amphetamine), Vyvanse (lisdexamfetamine), Focalin (dexmethylphenidate), Ritalin/Concerta (methylphenidate), Dexedrine (dextroamphetamine)
​

Who can prescribe psychotropic medications?

While a licensed therapist or counselor may be knowledgeable about psychotropic medications, only medical professionals can prescribe them. The medical professionals with the most knowledge and training in prescribing psychoactive medications are Psychiatrists.  Psychiatrists are medical doctors (MD) that have completed residency and training in psychiatry.  Most psychiatrists do not engage in talk therapy; they focus on symptom and medication management in brief (15-20 minute) appointments.
 
Other medical professionals able to prescribe psychotropic medications are Primary Care Physicians (MD/GP), Physician Assistants (PA), Psychiatric/Mental Health Nurse Practitioners (PMHNP), Nurse Practitioners (NP), Certified Nurse Midwives (CNM), and Gynecologists/Obstetricians (OB/GYN).
​

How do I know if I need psychotropic medications?

In my practice, for someone who is not currently taking psychotropic medications, I will generally recommend medications if we seem to continue hitting a wall with ongoing negative symptoms, despite all reasonable efforts to improve them.  If adding structure, recognizing and changing thinking, improving overall physical health, learning emotional identification and expression, and addressing spiritual health doesn’t improve symptoms markedly, this indicates to me that the symptoms are endogenous in nature, and need chemical help to mitigate.
 

What do I need to be aware of if I start taking psychotropic medications?

All medications generally have some risk of side-effects, some more troublesome than others.  Speaking with your prescribing physician and doing your own research are important before starting on any psychotropic medication.  Most common side-effects for psychotropic medications are disturbances in sleep and appetite.  Some of these can be mitigated by adjusting the time of day they are taken (morning if the medication is activating to your brain at night), and taking them with food to reduce nausea.
 
Research has shown that the most effective treatment for mental health disorders is a combination of medication and therapy.  Taking psychotropic medications without including therapy will not result in lasting change and improvement in symptoms.  For real and sustained life change, medications can help provide enough of a lift or relief of symptoms so work can happen in therapy, to prevent recurrence of negative symptoms.
​
 
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Author Jamie Cullen, LCMHC, LMHC, LCPC is a Licensed Clinical Mental Health Counselor and Clinical Coordinator at Banyan Tree Counseling & Wellness specializing in adult and childhood trauma, addictions, disordered eating, grief and loss, and co-occurring disorders. She has experience working with both chemical and process addictions, specifically their root in trauma, and is passionate about helping individuals enter and maintain recovery, utilizing therapy, psychoeducation, and community supports.
References:
http://www.drugs.com
http://www.pdr.net

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If Your Body Parts Could Talk...

8/17/2020

1 Comment

 

If your body parts could talk, what would they say?

I've used this worksheet with my own children, with students I've taught, and with clients, both children and adults. Teaching kids to "tune in" to their bodies is an essential skill and doesn't always come naturally.

There are so many benefits to learning this skill! One is emotional regulation-- kids who can listen to their body have an easier time managing and coping with their feelings, especially the really big ones, like anger, disappointment, fear, frustration, guilt, sadness.. .

They feel more capable, confident, have a more secure sense of self.

They have less behavioral problems, better social skills with peers, more empathy and supportive relationships...

It's not just a skill for kids., Adults benefit in similar ways, too, with overall mental stability, positive sense of self, solid relationships, increased career satisfaction. 

Take a moment today to tune inward,. Breathe in for 4 seconds, hold for 7, and slowly release for 8. Then scan your body and really listen to what each body part is telling you. Maybe some are silent, while others are screaming!

That's ok, no judgement.

All you have to do is listen.

Click to download the PDF to use at home.
if_body_parts_could_talk.pdf
File Size: 452 kb
File Type: pdf
Download File

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1 Comment

6 Simple Ways to Help Your Child With Anxiety

10/12/2015

2 Comments

 
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​Are you worried about your anxious child?
​You are not alone. 

Anxiety is one of the most predominant mental health problems children and teens are facing today. The good news is, it is highly treatable. If you’re one of the millions of parents struggling to help your child with anxiety, here are 6 simple user-friendly tips:

1. Educate Yourself

What exactly is anxiety? If you’ve ever heard of the “fight or flight” response then you’re halfway there. Imagine you’re alone walking through the woods and suddenly come face to face with a bear. Your heart starts pounding fast, your muscles tense, and your senses become intensely alert. For a split second you're paralyzed with fear. You must make a decision: defend yourself or run.

This is the fight-or-flight response.
 
And it's a completely normal reaction (we humans wouldn't be here without it.) Hundreds of years ago, when we were faced with a physical danger on a daily basis, it was a very important and well-needed response (for instance, to keep ourselves from getting mauled by a bear). In today’s world, most of our dangers are not physical. They’re psychological. And they can’t always be addressed the moment they come up. The longer our fight-or-flight response remains active, the more physically and emotionally drained we become.

​Long ago when there was an imminent physical threat, it usually passed quickly and our fight-or-flight response was deactivated. In our world, since there are so many potential psychological endangerments, sometimes the fight-or-flight response never really gets turned off. This is when a child may begin to see the world as a fearful place. They are stuck in “survival mode.” Not a fun place to be.
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2. Talk About It

​Many parents believe that talking about anxiety will make their child even more anxious. The reality is, providing your child with information about anxiety can help reduce his or her confusion or shame. Understanding what causes anxiety can help children to overcome it. Use "kid terms" to help explain the fight-or-flight response. Discuss why it was helpful back then, how it can be helpful now, and how it can be equally detrimental. Helping kids understand that feeling afraid isn't the same as actually being in a dangerous situation is empowering and can help them feel more in control. 

3. Validate Feelings

​Always validate and show acceptance of your child’s worried thoughts and anxious feelings. Make sure your child knows you truly believe what they are saying and that having those scared/worried/anxious feelings is okay. Share some things you were anxious about as a child, and then ask them what their biggest worries are. If they don’t want to talk right away, give them ample opportunities to open up with you through play or downtime during their favorite relaxing or fun activities. 

4. Help Recognize Anxiety

​Anxiety manifests physically. Ask your child to show you where in their body anxiety occurs, and where it feels the worst. It can be helpful to have your child name their anxiety. For instance, a child could call his anxiety “Mr. Worry Monster” and learn to talk to that anxiety as if it were a person and tell him to go away when not welcome: “Mr. Worry Monster is back this morning, Mom, but since it’s time for school I’m not listening to him. I told him to go away!” Once kids are less afraid, it becomes easier to approach events and situations that have been previously avoided.

5. Encourage Mindfulness

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​Many children have little time to just “be.” They are easily distracted and tired, juggling school, family, community activities, sports, etc. Sometimes it can just be too much. By practicing mindfulness, kids learn to hit the “pause” button and become aware of how they are thinking and feeling in the present.  There are countless studies showing the benefits of mindfulness and it’s positive effects on our physical and emotional well-being, for both children and adults.​
​ 
One basic exercise I use with my clients is called “Balloon Breaths.” I ask the child to pretend there is a balloon in his belly. Ask him to place his hands on his belly and breathe in slowly in through his nose to fill his lungs all the way up. Meanwhile, blow up the balloon to demonstrate how the “balloon in the belly” gets fully expanded. Next, ask your child to open his mouth and slowly blow all of the air back out, letting his belly sink down flat, as you slowly let air out and deflate the balloon. Some of my clients even carry a little deflated balloon around with them, in their pocket or backpack, as a simple reminder to take “balloon breaths” when they feel anxious thoughts and feelings coming on. By learning a few techniques like this, your child can be well on his or her way to overcoming anxiety. 

6. Be a Role Model

​Your child constantly observes and emulates your behavior. Your actions lay the foundation from which your is child building his own beliefs and understanding about the world. If you shy away from discussing mental health, so will your child. If you are open and accepting of your own anxieties and how to deal with them, then so will be your child. If you take time to make sure your emotional and physical needs are met, your child will learn that self-care is an important part of life. 
 
Overcoming anxiety can be a long road, but it can be done. With the consistent practice of mindfulness and other anxiety-reduction techniques, as well as practicing good self-care, keeping a positive attitude, your child can learn how to lower his or her anxiety level. Making an appointment with a local child therapist is often the most important first step. He or she can help facilitate this course with the family, and is often an invaluable teacher and guide in the process. 

If you think your child is suffering from anxiety or experiencing a high level of stress, please contact me to set up an initial session where we can discuss your unique issues and develop an individual plan for your child that works.


Resources:
 
Banyan Tree Counseling: http://www.banyantreecounseling.com
 
Anxiety & Depression Association of America: http://www.adaa.org/
 
Child Mind Institute: http://www.childmind.org/
 
Worry Wise Kids: http://www.worrywisekids.org/
 
The Anxiety Disorders Association of British Columbia: http://www.anxietybc.com
 
KidsHealth: http://kidshealth.org/parent/emotions/feelings/anxiety.html

2 Comments

Sacred Space

10/5/2015

1 Comment

 
Some photos of Banyan Tree Counseling's space: Suite 203, 1348 Westgate Center Dr. Winston Salem, NC 27103. There is lots of growing, healing, thriving, playing, and difficult yet joyful work happening in this sacred space... Come join us!
Calling a therapist is often the best thing you can do for yourself, your child, or your family. Our fees are affordable and office is centrally located. We look forward to connecting with you. 
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Handing Out Sticks

9/6/2015

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From: Boggle the Owl
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    Banyan Tree Counseling & Wellness

    We are a team of licensed clinicians with a holistic, strengths-based, and evidence-based approach. We offer counseling for people of all ages, life coaching, group therapy, educational consulting and advocacy, assessments, and dietary nutrition services.
    ​

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Counseling/Psychotherapy    •    Psychiatric Services     •     Medication Management    •     Nutrition counseling
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​Phone:

ph: (336) 448-4451
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​3305 Healy Dr


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Wilmington, NC 28401
​

**Wilmington is accepting telehealth clients. In-person availability Summer, 2026!**
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