Your Brain on Anxiety · 2020. 9. 25. · Defining Anxiety. 6. What’s normal?! Anxiety disorders are the most common disorder to occur in childhood and adolescence • 13 of every

Your Brain on Anxiety

Wendi Kozlowski, LPC-SClinical Manager - Round RockPathlight Mood and Anxiety Center

Wendi Kozlowski, LPC-S

NON-DISCLOSURE STATEMENT

T h e a u t h o r s w h o s e n a m e s a r e l i s t e d i m m e d i a t e l y b e l o w c e r t i f y t h a t t h e y h a v e N O a f f i l i a t i o n s w i t h o r i n v o l v e m e n t i n a n y o r g a n i z a t i o n o r e n t i t y w i t h a n y f i n a n c i a l i n t e r e s t ( s u c h a s h o n o r a r i a ; e d u c a t i o n a l g r a n t s ; p a r t i c i p a t i o n i n s p e a k e r s ’ b u r e a u s ; m e m b e r s h i p , e m p l o y m e n t , c o n s u l t a n c i e s , s t o c k o w n e r s h i p , o r o t h e r e q u i t y i n t e r e s t ; a n d e x p e r t t e s t i m o n y o r p a t e n t - l i c e n s i n g a r r a n g e m e n t s ) , o r n o n - f i n a n c i a l i n t e r e s t ( s u c h a s p e r s o n a l o r p r o f e s s i o n a l r e l a t i o n s h i p s , a f f i l i a t i o n s , k n o w l e d g e o r b e l i e f s ) i n t h e s u b j e c t m a t t e r o r m a t e r i a l s d i s c u s s e d i n t h i s m a n u s c r i p t .

We n d i K o z l o w s k i , L P C - S


Learning Objectives

• Define Anxiety and understand different presentations for children/adolescents and adults

• Gain an awareness of what is happening in our bodies when we are anxious

• Identify helpful therapy modalities

• Walk away with tools to use in the moment


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• Group definitions and experiences with anxiety.

• What does anxiety look like?• Physiological, behavioral, and psychological reactions

• 3 factors that contribute: biology, cognitive-emotional influences, and chronic stress

• Fight, flight, freeze, fold responses to perceived threats

• What does anxiety look like in children/adolescents?• Withdrawn, sporadic attendance, tantrums, aggressiveness, restlessness, fatigue, back pain,

sweating, and a multitude of different physical ailments (tummy, head hurts)

• Often confused with ADHD or mood disorders/Anger - anxiety responses vary.

Defining AnxietyFeeling Anxious?


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What lies beneath behaviorsDefining Anxiety


Defining Anxiety

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What’s normal?!

Anxiety disorders are the most common disorder to occur in childhood and adolescence

• 13 of every 100 children (ages 9 – 17) is dealing with an anxiety disorder• Symptoms typically begin at age 6, traceable back to elementary school• Of this 13%, only 18% seek mental health treatment.

• That calculates out to only 2/100 kids who receive treatment!

• How does this statistic affect our classrooms/relationships/etc. ?

• Often effective help isn’t found until early adolescence, when academic requirements become more challenging.

HOWEVER…..Developmentally:

School-aged kids haven’t fully learned self-control. They are still developing their social skills.

• Learning how to make friends, how to handle aggression, how to control their urges and emotions.

• If we don’t think within normal developmental milestones, these tasks can turn into sources of stress and a failure to meet (unrealistic) expectations.

• Remember, we are teaching “adult level” skills!


Defining Anxiety

• Like depression, women are twice as likely to be affected, compared to men.

• The effects of chronic stress have been linked to a weakened immune system, weight gain (due to extended cortisol release), and heart disease.

• The wear and tear caused by chronic stress or anxiety could be tied to an increased risk of depression and dementia.

• Anxious people:– Overestimate the likelihood of negative future events.

– They underestimate how much power they have over changing negative situations

– They over-plan to accommodate all possible future scenarios.

– They fail to lower pessimism after success (faulty re-calibration of prediction error)

– They have a hyper-focused attentional system – more likely to interpret most neutral events/comments as negative.

– They are blind to available safety options.

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Other Important Facts


Defining Anxiety

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Cornell University Center for Teaching and Learning (2008) looked at the correlation between anxiety and performance:

• Too little anxiety results in a lack of motivation.

• Conversely, high anxiety negatively affects memory and concentration.

• Moderate levels of academic anxiety create the motivation needed to drive academic performance.

Wait, so we need anxiety? How much is too much?


What’s happening to me?!

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• The feeling of anxiety is part of your body’s stress response. Your fight/flight/freeze/fold response is triggered, and your system is flooded with norepinephrine and cortisol.

– These chemicals are designed to give you a boost in perception, reflexes, and speed in dangerous situations.

– They increase your hear rate, get more blood to your muscles, get more air into your lungs, and in general get your ready to deal with whatever threat is present. Your body turns it’s full attention to survival.

“Paper Tigers”

**A variety of problems arise when our bodies never turn off our fight/fight response and we live with the physical and emotional effects of anxiety on a day to day basis.



10Wendi Kozlowski, LPC-S


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• The AMYGDALA is an almond-shaped structure deep in the brain that is believed to be a communications hub between the parts of the brain that process incoming sensory signals and the parts that interpret these signals.

• Alerts the rest of the brain that a threat is present and triggers a fear or anxiety response.

• The emotional memories stored in the central part of the amygdala may play a role in anxiety disorders involving very distinct fears: such as fears of dogs, spiders, or flying.

• Part of our emotional, “reptile brain”

The Amygdala



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• The HIPPOCAMPUS is the part of the brain that encodes threatening events into memories.

• Studies have shown that the hippocampus appears to be smaller in people who were victims of child abuse, those who served in military combat, and those who experience chronic stress/anxiety.

• Crucial for processing long-term and contextual memories. Unfortunately, in crisis, all types of memories become limited EXCEPT memories that support the anxiety, trauma, or stressor.

The Hippocampus



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Your Brain on Anxiety


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What can I do about anxiety? Changing perspective

(4) Attribute the unpleasant experience to an unpleasant quality about your character.• If you have a bad case of diarrhea, does that say anything about

the quality of your family relationships?

• If you are experiencing discomfort in your joints, does that invalidate an opinion you may have about the wonders of life?

• Indigestion, heartburn, joint pain, loss of certain faculties, etc. are all the result of biological processes that occur without your conscious involvement.

• These are purely physical sensations arising in your body that have nothing to do with the quality of your character. As a result, there is no connection between them and the inner qualities of your being and character.

• You having explosive diarrhea tells me absolutely nothing about who you are as a person.

It’s time to truly start looking at anxiety and other mental health issues from this mindset!


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What can I do about anxiety? Helpful Therapy Modalities

• CBT (Cognitive Behavioral Therapy)

• DBT (Dialectical Behavioral Therapy)

• ACT (Acceptance & Commitment Therapy)

• ERP (Exposure & Response Prevention)

• Mindfulness

• Expressive Modalities (Art, Music, Movement, Yoga)

• Equine Therapy or Animal Assisted Therapy

• Play Therapy for younger children

• Family therapy and/or Parent Coaching

• Crisis intervention when needed


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What can I do about anxiety? Tools to use in the moment


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What can I do about anxiety? Tools to use in the moment

• S L O W D O W N – intentionally start here then connect to the body (5 senses check in)

• Chair/Wall push ups

• Smell a flower, blow out a candle / Smell pizza, blow to cool it off

• Sensory items (pillow, blanket, vest, objects.)

• Hug something

• Blow bubbles

• A-Z lists (start easy, get harder – written or verbal)

• Grounding exercises (all my neighbors, 1-20, 1-2-3-4-5 Senses)

• Tense and relax each muscle group

• Technology Apps (CALM, Meditation Jar, etc.)


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When in doubt, reach out!Red Flags: When anxiety gets in the way of functioning: vomiting/disruptive physical symptoms, sleep disturbances, or if anxiety is keeping the person from going to school/work or affecting relationships

Levels of care:• Outpatient therapy• Intensive Outpatient/Partial Hospitalization (Pathlight)• Residential Treatment• Acute Care

Community Resources:NAMI Austin - https://www.namiaustin.org/Pathlight Mood & Anxiety Centers- http://www.pathlightBH.comAustin Child Guidance Center - https://www.austinchildguidance.org/Texas Health & Human Services (HHS) - https://hhs.texas.gov/services/health/mental-health-substance-abuse

**Mobile Outreach Team Williamson County: 512-943-3545; CIT: 512-218-5515**Mobile Crisis Outreach Team Travis County: 512-472-4357; CIT: 512-854-3445

What can I do about anxiety?Resources


https://www.namiaustin.org/

http://www.pathlightbh.com/

https://www.austinchildguidance.org/

https://hhs.texas.gov/services/health/mental-health-substance-abuse

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Mental Health Support Group for People of ColorOpen to community members and ERC/Pathlight alumni (Adults, 18+)Every Monday at 7:00 p.m. ETAs we listen and learn what our community needs through these trying times, this support group is intended as a closed space designated for BIPOC (black, indigenous, people of color) where attendees can feel supported without having to explain themselves. This peer support group will provide support for the unique mental health challenges that individuals in this group may be facing. This support group will be run weekly, on an ongoing basis. Please note, the group is a supplemental support and is not a replacement for higher levels of care, therapy, or medical advice.Please email [email protected] with any questions you may have about the group.

Virtual Family & Community Support Group - For Loved Ones of Adults & Adolescents with Mood and Anxiety DisordersOpen to caregivers, support persons, family, and community members (Adults 18+)Every Wednesday | 7 p.m. ETJoin fellow support persons and family members for a weekly virtual Support Group offering support, education about mood and anxiety disorders, and connection with other individuals with shared experiences. Participation in the group is online, free, and open to anyone supporting someone with a mood or anxiety disorder. Participants can attend as often as they would like with no pressure to attend group every time. A four-week commitment is encouraged. Please note, the group is a supplemental support for families, and it is not a replacement for behavioral health treatment, therapy, or medical advice.Please email [email protected] with any questions you may have.

Virtual Anxiety and Depression Support GroupOpen to community members and Pathlight alumniEvery Wednesday | 8 p.m. ETThis group is a friendly, safe, and supportive place for alumni and community members to share information and experiences. You can connect with other people experiencing anxiety

and depression and related disorders, ask questions, and learn tools to care for yourself and others. Please note, the group is a supplemental support and is not a replacement for higher levels of care, therapy, or medical advice.If you are interested in joining the group, please email [email protected] for the consent form and log in information.

Virtual Insight Alumni Anxiety and Depression Support GroupOpen to Pathlight alumni (Adults 18+)Every Wednesday | 7 p.m. ETJoin fellow Pathlight (formerly Insight) Mood and Anxiety alumni for support, education, and connection in navigating the twists and turns of recovery. Participation in the groups is online and there is no cost to attend. Participants are asked to commit to attending for six weeks to make full use of the group, and you can start at any time. Please note, the groups are a supplemental support and are not a replacement for eating disorder treatment, therapy, or medical advice.If you are interested in joining the group, please email [email protected] for the consent form and log in information.

What can I do about anxiety?Resources – Pathlight Virtual Support Groups


mailto:[email protected]




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American Academy of Child & Adolescent Psychiatry. (2013) The Anxious Child. Facts for Families, Number 47. Retrieved from https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/Facts_for_Families_PaPag/The_Anxious_Child_47.aspx

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders DSM-V). (5th ed.) Washington, DC: American Psychiatric Association.

Beidel, D., Taylor-Ferreira, J., & Turner, S. (1999). Teaching study skills and test-taking strategies to elementary school students. Behavior Modification, 23, 630-646.

Gasparovich, Lindsay (2008). Positive Behavior Support: Learning to Prevent or Manage Anxiety in the School Setting. Retrieved from http://www.sbbh.pitt.edu/files/other/anxiety_lng_newsletter.pdf

Huebner, D. (2006). What to do when you worry too much: A kid’s guide to overcoming anxiety. Washington, DC: Magination Press.

References


https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/Facts_for_Families_PaPag/The_Anxious_Child_47.aspx

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National Alliance on Mental Health. (2008). Anxiety disorders in children and adolescents. Retrieved from http://www.nami.org.

Peleg-Popko, O. (2002). Children’s test anxiety and family interaction patterns. Anxiety Stress and Coping, 15:1, p.45-59.

Substance Abuse and Mental Health Services Association. Children’s mental health facts: Children and adolescents with anxiety disorders. Retrieved from http://mentalhealth.samhsa.gov/publications/allpubs/CA-0007/default.asp.

Vardell, Don. 2015. Residential Anxiety Treatment. Fairfax, VA: Independent Educational Consultants Association (IECA) Insights.

Wilson, Reid and Lynne Lyons. 2013. Anxious Kids, Anxious Parents: 7 Ways to Stop the Worry Cycle and Raise Courageous & Independent Children. Arlington, VA: Health Communications Inc.

References


THANK YOU!!

Wendi Koz lowski , LPC-SW e n d i . K o z l o w s k i @ E R C P a t h l i g h t . c o m

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Your Brain on Anxiety · 2020. 9. 25. · Defining Anxiety. 6. What’s normal?! Anxiety disorders are the most common disorder to occur in childhood and adolescence • 13 of every