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451 – Biopsychosocial Impact of Anxiety and Strategies for Prevention and Intervention

Impact of Anxiety and Interventions
Instructor: Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC
Executive Director, AllCEUs
~ Review the symptoms of anxiety in adults and children
~ Explore the impacts of anxiety
~ Identify strategies for prevention and intervention

Why I Care/How It Impacts Recovery
~ Anxiety can be debilitating
~ In many cases neurotransmitter imbalances not the initial cause of anxiety, but a symptom
~ Low-grade chronic stress/anxiety erodes your energy and ability to concentrate
~ Anxiety is a major trigger for:
~ Addiction relapse
~ Depression
~ Increased physical pain
~ Worsening of physical illnesses
~ Chronic anxiety can make people more vulnerable to PTSD
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 possible danger (Thank you!)
~ It can become a problem when it is overly intense/uncontrollable because of
~ Overgeneralization
~ Poor coping skills
~ Emotional reasoning and cognitive distortions
~ Biochemical issues (nutrition, hormones, sleep deprivation)
~ It can be caused by excess serotonin, norepinepherine or glutamate or too little GABA (est. 80% adults have neurochemical imbalance)
~ What is causing the neurochemical imbalance (water heater)

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 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

Physical Impacts
~ HPA-Axis overstimulation / excess cortisol
~ Metabolic syndrome
~ High blood pressure
~ High blood sugar
~ GI disturbances and ulcers
~ Sleep disturbances
~ Increased aging
~ Headaches
~ Infertility
~ Sexual dysfunction
~ Weakened immune system
~ Fatigue
~ Restlessness
~ Hair loss
~ Autoimmune issues
Cognitive & Emotional Impacts
~ Difficulty taking perspectives
~ Difficulty concentrating
~ Becoming easily confused
~ Having memory problems
~ Negative self-talk
~ Having marked mood swings (emotional dysregulation)
~ Finding it hard to make decisions

Social Impacts
~ Social withdrawal
~ Reduced support system
~ Difficulty taking perspectives
~ Reduction in leisure activities

Biological Interventions
~ Your body thinks there is a threat. Help it restore itself so it is ready to fight the lion
~ Supportive Care
~ Create a sleep routine
~ Helps the brain and body rebalance and restore HPA-Axis functioning
~ Improves energy level through removal of adenosine and systemic repair
~ Nutrition
~ Provides the building blocks
~ Provides sufficient energy
~ Helps set circadian rhythms
Biological Interventions
~ Supportive Care
~ Medication
~ Buspirone
~ Exercise
~ Exercising at a low intensity (40-50% of THRZ) has been shown to reduce cortisol
~ Yoga + Mindfulness
~ 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

Psychological Interventions
~ Mindfulness & Acceptance
~ Identify a Rich and Meaningful Life and
~ Observation | Acceptance | Labeling and Letting Go
~ Identify trigger thoughts
~ Differentiate between expectations and current reality

Psychological Interventions
~ Distress Tolerance: It isn’t always about controlling your anxiety
~ Distract don’t react
~ Ride the wave
~ Use distancing techniques–
~ I am having the thought that….
~ Vacation
~ Thought stopping
~ Imagery
Psychological Interventions
~ Basic Fears
~ Failure
~ Explore the dialectics
~ Encouragement
~ Rejection/Isolation
~ De-personalize
~ Explore the dialectics
~ Loss of Control & The Unknown
~ Focus on one thing in the moment
~ Think of prior experiences
Psychological Interventions
~ Relaxation Skills
~ What is relaxation…
~ Diaphragmatic breathing
~ Combat breathing
~ Meditation
~ Cued Progressive Muscular Relaxation
~ Self-Esteem
~ Real vs. Ideal Self
~ Compassionate self talk
~ Don’t reject yourself
~ Silence the inner critic
~ Spotlighting strengths & acceptance of imperfections

Psychological Interventions
~ Cognitive Restructuring
~ Address cognitive distortions
~ Reframe challenges in terms of current strengths (not past weaknesses)
~ Create an attitude of gratitude and optimism
~ Acceptance and Commitment Therapy
~ What is truly important?
~ What are you thinking  what thoughts can help you move toward what is important
~ What are you experiencing (seeing/hearing/feeling/smelling)?  What can you do, say, listen/stop listening to etc. that can help you move closer to what is important

Psychological/Social Interventions
~ Recreation
~ There will always be stuff you could do…
~ Sometimes a break is what you need to get a breakthrough
~ Make a list of fun things (opposite emotions)
~ Activities
~ Contributing
~ Sensations

Social Interventions
~ Improve your relationship with yourself
~ Identify your needs and wants
~ Be your own best friend
~ Internal vs. external validation
~ Be compassionate
~ Develop healthy, supportive relationships
~ Learn about boundaries
~ Develop assertiveness skills
~ Describe the ideal healthy, supportive relationship
~ Separate the ideals from the reals
~ Identify who that is, or where that could be found
~ Anxiety is a natural emotion that serves a survival function
~ Excess 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 reducing physical and psychological vulnerabilities
~ Improving health behaviors
~ Identifying and building on current coping strategies
~ Addressing cognitive distortions
~ Developing a healthy, supportive relationship with self and others

Resources from New Harbinger