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Using a Strengths-Based Biopsychosocial Approach to Addressing Anxiety

Anxiety can be debilitating.  Whether it is acute panic or low-grade chronic stress/anxiety erodes your energy and ability to concentrate.  Additionally, it is a major trigger for: Addiction relapse, increased physical pain, sleep problems and increased depression or feelings of hopelessness and helplessness. When addressing anxiety issues, It is easier (and more effective) to build upon something that already works to some extent. The strengths-based approach helps you identify how you are already trying to cope which is working at least to some extent, and builds on that. There are two types of strengths. Prevention/resilience strengths are what you do on a daily basis to stay healthy and happy.  Just like it sounds, these activities help you prevent distress and shore up energy so you can bounce back when you do encounter distress.   The other type is intervention/coping strengths.   These are things you do when you are in distress/anxious that help you feel at least a little better for at least a little while.  Everyone has these, so we can build on and strengthen them.  Ask yourself,  in the past when you have felt this way, what helped? What made it worse?  Sounds pretty simple, right?  Well it kinda is. Many people focus on one or two things to prevent and deal with anxiety.  The biopsychosocial approach looks at what you can do to help your body prevent and deal with anxiety (the biological part), what you can do to address unhelpful thinking patterns that drain your energy and make you vulnerable to distress or keep you stuck in your anxiety (the psychological part) and which social supports you can enlist to buffer the anxiety and how to improve your interpersonal skills to make those relationships stronger. It is helpful to take a look at what you are dealing with and understand its function. Anxiety is half of the “Fight or Flight Response.” It is an excitatory response. It’s function is to protect you from danger.  It can become a problem when it is Overgeneralized and you worry about most things most of the time Overly intense/uncontrollable, even if the worry is just about one or two things Constant—You feel worried and anxious, but can't even identify why. Like depression, it can be caused by an imbalance in brain chemicals which can be brought on by….you guessed it…biological factors like inadequate sleep, poor nutrition, hyperthyroid; psychological factors such as pessimistic thinking which keeps your threat response system constantly activated waiting for the other shoe to drop, and social factors including lack of supportive relationships and low self esteem which, again, can lead to a feeling of danger or threat which triggers the fight or flight reaction in the brain.   Generalized anxiety disorder symptoms can vary. They may include:

  • Physical signs and symptoms may include:
  • Fatigue
  • Irritability
  • Muscle tension or muscle aches
  • Trembling, feeling twitchy
  • Being easily startled
  • Trouble sleeping
  • Sweating
  • Nausea, diarrhea or irritable bowel syndrome
  • Headaches

Children may have slightly different symptoms which include excessive worry about:

  • Performance at school or sporting events
  • Being on time (punctuality)
  • Earthquakes, nuclear war or other catastrophic events
  • Fitting in
  • Being perfect
  • Their ability to succeed (Lack confidence)
  • Gaining approval

When you are anxious, your body thinks there is a threat. Figure out why.  (That is often the most difficult part) Additionally, from a biological/physical standpoint, it is important to create a sleep routine which helps the brain and body rebalance, can help repair adrenal fatigue, improves energy level and may help raise serotonin levels (the body's natural anti-anxiety chemical).  Proper nutrition can also provide the body with the building blocks it needs to make serotonin and eliminate some of the triggers for anxiety. Minimize caffeine and other stimulants including nicotine. Try to prevent spikes (and drops) in blood sugar which can leave you feeling shakey. And, drink enough water which can prevent foggy head and fatigue and help your body function more efficiently. Sunlight can also be helpful,  Aim for 14 hours of bright light each day, starting with real sunlight if you can get it.  Vitamin D deficiency has been implicated in some mood issues.  Sunlight prompts the skin to tell the brain to produce neurotransmitters, and sets circadian rhythms which impact the release of serotonin, melatonin and GABA. Finally, get a physical to rule out hormonal imbalances which may be causing anxiety.  (Note: Anxiety is common in women going through menopause.) Once you have tried to make sure your body-machine is operating as efficiently as possible, look at some psychological interventions.  Anxiety is a response to a threat.  In most humans, those threats can be sorted into a few broad categories: Failure, Rejection/Isolation, Loss of Control, The Unknown.  As you categorize your stressors/threats/triggers you will likely find they fall into one or two of these categories more often.  Addressing those often means working on self-esteem so you aren't afraid of letting others down if you fail and getting rejected.  You can also explore what failure means to you, and ways to view it positively, such as evidence that you had the courage to try something outside your comfort zone.  You can explore and address all of the ways you reject yourself, and start becoming your own best friend.  You can also develop strategies for handling the unknown and things out of your control.   Social Interventions start with improving your relationship with yourself. Identify your needs and wants. Be your own best friend, doing for yourself what you want someone else to do for you.  Extend the compassion you have for others toward yourself.  I often find people are much harder on themselves than anyone else. (a perfect example of self-rejection).  Finally, develop supportive relationships with people who can (and will) help you in times of anxiety.  It may be a friend who “talks you down” and helps you remember to use your distress tolerance skills.  It may be someone who can just come over and hang out or be on the phone with you when you are struggling. To sum up, anxiety is a natural emotion that serves a survival function.  Excessive anxiety can develop from:

  • Lack of sleep
  • Nutritional problems
  • Neurochemical imbalances
  • Failure to develop adequate copings skills
  • Cognitive distortions
  • Low self-esteem/a need for external validation

Recovery involves:

  • Improving health behaviors
  • Identifying and building on current coping strategies
  • Addressing cognitive distortions
  • Developing a healthy, supportive relationship with self and others