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Using a Strengths-Based Biopsychosocial Approach to Addressing Anxiety
Instructor: Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC
Executive Director, AllCEUs
~ Define a strengths based approach
~ Define a biopsychosocial approach
~ Explore the symptoms of anxiety
~ Identify potential causes of and biological, psychological and social interventios for those symptoms

Why I Care/How It Impacts Recovery
~ Anxiety can be debilitating
~ Low-grade chronic stress/anxiety erodes your energy and ability to concentrate
~ Anxiety is a major trigger for:
~ Addiction relapse
~ Increased physical pain
~ Sleep problems
What Does Strengths Based Mean
~ It is easier (and more effective) to build upon something that already works to some extent.
~ Strengths-based approach helps people identify how they are already trying to cope and builds on that
~ There are two types of strengths
~ Prevention/Resilience Strengths
~ What you do on a daily basis to stay healthy and happy
~ Intervention/Coping Strengths
~ In the past when you have felt this way, what helped?
~ What made it worse?
What is a Biopsychosocial Approach
~ Bio-logical
~ Neurochemicals
~ Nutrition
~ Sleep
~ Sunlight & Circadian Rhythms
~ Psycho-logical
~ Mindfulness
~ Distress Tolerance
~ Coping Skills
~ Cognitive Restructuring
~ Social
~ Improving self-esteem and your relationship with self
~ Improving relationships with healthy, supportive others
What is Anxiety
~ 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
~ Overly intense/uncontrollable
~ Constant due to brain injury
~ Like depression, it can be caused by excess serotonin Serotonin: A Common Neurobiologic Substrate in Anxiety and Depression. EISON, MICHAEL S. PhD

Symptoms of Generalized Anxiety
~ Generalized anxiety disorder symptoms can vary. They may include:
~ Persistent worrying or obsession about small or large concerns that's out of proportion to the impact of the event
~ Inability to set aside or let go of a worry
~ Inability to relax, restlessness, and feeling keyed up or on edge
~ Difficulty concentrating, or the feeling that your mind “goes blank”
~ Distress about making decisions for fear of making the wrong decision
~ Carrying every option in a situation all the way out to its possible negative conclusion
~ Difficulty handling uncertainty or indecisiveness

Symptoms of Generalized Anxiety
~ 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

Symptoms of Generalized Anxiety (Kids)
~ Excessive worry about:
~ Performance at school or sporting events
~ Being on time (punctuality)
~ Earthquakes, nuclear war or other catastrophic events
~ A child or teen with GAD may also:
~ Feel overly anxious to fit in
~ Be a perfectionist
~ Lack confidence
~ Strive for approval
~ Require a lot of reassurance about performance

Biological Interventions
~ Your body thinks there is a threat. Figure out why
~ Supportive Care
~ Create a sleep routine
~ Helps the brain and body rebalance
~ Can help repair adrenal fatigue
~ Improves energy level
~ Nutrition
~ Minimize caffeine and other stimulants
~ Try to prevent spikes (and drops) in blood sugar which can trigger the stress response
~ Drink enough water
Biological Interventions
~ Supportive Care cont…
~ Sunlight
~ Vitamin D deficiency has been implicated in some mood issues
~ Sunlight prompts the skin to tell the brain to produce neurotransmitters
~ Sunlight sets circadian rhythms which impact the release of serotonin, melatonin and GABA
~ Exercise
~ Studies have shown that exercise can have a relaxing effect. Start slowly.
Biological Interventions
~ Supportive Care cont…
~ Medication
~ Benzodiazepines
~ Aromatherapy
~ Also…Clary Sage

Psychological Interventions
~ Anxiety=Threat Threat=Basic Fears
~ Failure
~ Rejection/Isolation
~ Loss of Control
~ The Unknown
~ Death/Loss (Person, Self Concept, Dreams)
~ Mindfulness & Acceptance
~ Observation | Acceptance | Labeling and Letting Go
~ Identify trigger thoughts
~ Distress Tolerance: It isn’t always about controlling your anxiety
~ Distract don’t react
~ Use distancing techniques– “I am having the thought that…”
Psychological Interventions
~ Relaxation Skills
~ What is relaxation…
~ Diaphragmatic breathing
~ Combat breathing
~ Meditation
~ Cued Progressive Muscular Relaxation
~ Self-Esteem (Fear of failure and rejection esp.)
~ Real vs. Ideal Self
~ Compassionate self talk
~ Spotlighting strengths & acceptance of imperfections

Psychological Interventions
~ Cognitive Restructuring
~ Address irrational thoughts and cognitive distortions
~ Reframe challenges in terms of current strengths (not past weaknesses)
~ Create an attitude of gratitude and optimism
~ Acceptance and Commitment Therapy (FEAR)
~ Fusion with your thoughts (Unhook)
~ Evaluations of your experience (Empower)
~ Avoidance of your experiences (Gradual exposure, Find Exceptions)
~ Reason given for your behavior (Challenging Questions)

Psychological Interventions
~ Recreation and Relaxation
~ There will always be stuff you could do…
~ Make a list of fun things

Social Interventions
~ Improve your relationship with yourself
~ Identify your needs and wants (Mindfulness)
~ Be your own best friend
~ Internal vs. external validation
~ Be compassionate
~ Develop healthy, supportive relationships
~ Learn about boundaries
~ Develop assertiveness skills (Ask for help and say no to requests)
~ Describe the ideal healthy, supportive relationship
~ Separate the ideals from the reals
~ Identify who that is, or where that could be found
~ Play the “What Does It Mean When…” game
Resources from New Harbinger
~ 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