Anxiety“It’s all in Your head”

Presented by:

Nicole D. Swain,

LPC, NCC, ACS, ACT

March 2017

The Body’s 911 System

Fight or Flight Reaction

• Productive if you were in a situation where you need to protect yourself

It is a Matter of Perception• Its associated physical reactions is your body

preparing itself for a threatening situation

• When we perceive threat we prepare ourselves for action

• Very rarely attacked by Bears so threat is now:• Social• Emotional• Financial• Work related

Emotional Reactions

• Feeling angry, irritable or easily frustrated

• Feeling overwhelmed

• Feeling nervous or anxious

• Feeling that you can’t overcome difficulties in your life

• Having trouble functioning in your job or personal life

• Feeling afraid or worried

• Feeling Helpless or Hopeless

• Desire to hide or runaway

Cognitive Reactions

• Difficulty Making Decisions• Confusion

• Difficulty Naming Familiar Items

• Poor Concentration

• Blaming Others• Memory Problems• Replaying Events Over & Over

• Thinking the Future is bad

Behavioral Reactions

• Difficulty functioning at work or home

• Withdrawal• Isolation• Suspiciousness

• Working more and being less productive

• Excessive Humor or Silence

• Increased Smoking, Alcohol or Food• Change in Activity Level• Angry Outbursts• Crying Spells

• Sleep

Anxiety?

• A Fight or Flight Reaction

• Worry or Concern

• Often concern about the physical reaction or its meaning (Perception) Fear Panic

• Avoidance

Anxious Thinking

• Future Focused• Future is Bad• React As-If bad thing is happening or going to

happen• Avoidance/Safety Behaviors• How often does bad thing happen?• Possibility Vs Probability

Panic Attack• Discrete period of intense fear or discomfort in which four of the

following develop abruptly & reach peak in 10 minute:• palpitations, pounding heart, racing heart• sweating• trembling/shaking

• sensation of shortness of breath or smothering• feelings of choking• Chest pain or discomfort• Nausea or abdominal distress• feeling dizzy, unsteady, lightheaded, faint

• derealization or depersonalization• fear of losing control or going crazy• fear of dying• paresthesias• chills/hot flashes

Anxiety Disorder Treatments

• Cognitive Therapy Techniques - Learning ways to evaluate situations clearly.

• Is there a true threat or not?• Is the situation exceeding my coping or am I just thinking it is?• If it is exceeding my coping what should I do about it?• Is the Anxiety and Panic I’m feeling truly dangerous? • Are they really thinking badly of me?

• Stress Reduction & Management• Reducing environmental stress and its physical reactions• Managing the environment• Relaxation Skills

• Medication

• Medications• Benzodiazepines Buspar SSRIs

• Behavioral Therapy • Relaxation training• Breathing• Exposure

• Cognitive Therapy• Cognitive-Restructuring• Desensitization• Coping strategies• Guided Imagery

Medication

• Bezodiazapens Xanax Klonopin Ativan

• Antidepressants (SSRIs) Zoloft Lexapro Prozac Paxil

• Buspar

Cognitive Therapy

• Not events in life that causes problems

• How we think about those events Negative Automatic Thoughts (NATs)

• Take our Thoughts to be 100% true

• Focus on Information that Confirms them Especially when Anxious

Information Skewed

PackMan

I am afraid tofly in anairplane

(-)

(-)

(-)

(+)

(+)(+)

(-)

Thinking Errors

• Fortune Telling I know what is going to happen and it will be bad

• All-or-Nothing Thinking (Black and White)• If I’m not a total Success, I ‘m a Failure

• Catastrophization • I’ll be so upset I will not be able to function

• Discounting the Positive• I did this project well but I just got lucky

• Emotional Reasoning• It’s true because I feel it is

Thinking Errors

• Magnification/Minimization• Getting a B proves I’m stupid. I got an A+

because the test was easy

• Mind Reading• He’s thinking that I don’t know what I’m doing

• Personalization• He didn’t look at me because he hates me

• Should and Must Statement• I must always do my best. I should never make a mistake

Using Cognitive Therapy

• Identify the Stress/Anxiety Thought (NAT)

• Take NAT as a thought to be evaluated

• Use Socratic Questioning to Evaluate NAT

• If needed Experiment to Validate the NAT

Testing Your Thoughts

• Ask yourself:

• What makes me think the thought is true? • What makes me think it is not true or not completely true? • What is an alternative way to look at the situation? • What is the worst thing that could happen and could I live through

it? • What is most likely to happen? • What will happen if I keep telling myself the same NAT over and

over? • What if I was to change my thinking? • What would I tell a friend who was going through the same exact

thing I am going through?

• Now that you have tested your NAT what is a more realistic way to think about your situation?

Testing Thoughts

• True Friend not speaking much to me Did not return my call yesterday I have lost a friend in the past

• Not True of or not Completely True She did say she has been very busy at work Her mother just got out of the hospital She has always been honest with me

• Worst She ends our friendship without explanation. (I’d be upset &

cope)

Stress Reduction & Management

• Environmental Stress • Managing the environment

• Physical Reactions• Meditation• Relaxation Skills

Environment

• Reduce:• Excessive temperatures• Excessive noise• Poor air quality• Reduce repetitive work tasking and

strenuous movements.• Same old routine - novelty• Alcohol

Physical Reactions

• Increase Exercise Regular and Balanced Meals Socializing Sleep Hobbies and Fun

Physical Reactions

• Relaxation Exercises• Will reduce fight/flight reaction

• Like riding a bike for the first time.

• It is a skill that takes time and practice to do it effectively!

• Don’t expect much after trying it one or two times

• Relaxation exercises can seem deceptively simple at first

• With Practice they are very effective

Stress Reduction

• Breathing Techniques

• Mindfulness Meditation

• Guided Imagery

• Yoga

Resources• Web-based information:

Anxieties.com Noiseinyourhead.com

• Mind Over Mood Dennis Greenberger, PhD & Christine Padesky, PhD

• Worry Cure: 7 Steps to Curing Your Worry Robert Leahy, PhD

• Mindfulness for Beginners Jon Kabat-Zinn, PhD (Audio CD)