Everyone gets nervous or anxious from time to time. For some people, however, anxiety becomes so frequent and forceful that it begins to interrupt their lives. This presentation focuses on differentiating between common worries and clinical anxiety, and provide information about how to address it.

1. Anxiety
“It’s all in Your head”
Presented by:
Nicole D. Swain,
LPC, NCC, ACS, ACT
March 2017

2. The Body’s 911 System

3. Fight or Flight Reaction
• Productive if you were in a situation where you need
to protect yourself

4. 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

5. 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

6. 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

7. 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

8. Anxiety?
• A Fight or Flight Reaction
• Worry or Concern
• Often concern about the physical
reaction or its meaning (Perception)

Fear

Panic
• Avoidance

9. 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

10. 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

12. 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

13. Medication
• Bezodiazapens

Xanax

Klonopin

Ativan
• Antidepressants (SSRIs)

Zoloft

Lexapro

Prozac

Paxil
• Buspar

14. 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

15. Information Skewed
PackMan
I am afraid to
fly in an
airplane
(-)
(-)
(-)
(+)
(+)
(+)
(-)

16. 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

17. 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

18. 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

19. 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?

20. 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)

21. Stress Reduction & Management
• Environmental Stress
•
Managing the environment
• Physical Reactions
•
Meditation
•
Relaxation Skills

22. Environment
• Reduce:
•
Excessive temperatures
•
Excessive noise
•
Poor air quality
•
Reduce repetitive work tasking and
strenuous movements.
•
Same old routine - novelty
•
Alcohol

23. Physical Reactions
• Increase

Exercise

Regular and Balanced Meals

Socializing

Sleep

Hobbies and Fun

24. 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

25. Stress Reduction
• Breathing Techniques
• Mindfulness Meditation
• Guided Imagery
• Yoga

26. 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)