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Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
Managing your anxiety
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Managing your anxiety

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  • 1. Managing your anxiety Fleur-Michelle Coiffait Fiona Gellatly Trainee Clinical Psychologists University of Edinburgh & NHS LothianMonday, 14 May 2012
  • 2. Welcome  Introductions  Housekeeping  Outlineof 2 sessions  ExpectationsMonday, 14 May 2012
  • 3. Who gets anxious?  Research shows that almost 1 in 5 of us will suffer from anxiety at any one time  In Edinburgh alone there will be 22,305 people suffering from anxiety  We all get anxious but it becomes a problem if we can’t cope with itMonday, 14 May 2012
  • 4. 14 Most common signs reported by people in the  Worry  Feeling on edge  Anger  Unable to switch off  Poor sleep  Poor concentration  Tiredness  Tearful  Feeling irritable  Drinking too much  Feeling worthless  Feeling hopeless  Waiting for the  Panic attacks worst to happenMonday, 14 May 2012
  • 5. How anxiety can affect us Environment Thoughts Behaviour Anxiety Emotions BodyMonday, 14 May 2012
  • 6. Group exercise  Take some post-it notes  On each one, write one example of how anxiety affects you  E.g. Anxiety makes me go out less Anxiety means that my heart races  15 minsMonday, 14 May 2012
  • 7. Break  15 minute breakMonday, 14 May 2012
  • 8. Fight / flight / freeze  Instinct (e.g. animals)  Stress/anxiety is an instinct  Alerts mind and body to threat  Keeps us ‘on alert’ until danger passes  Ancient survival mechanism  Example: walking alone at night  Sensing danger -> adrenalineMonday, 14 May 2012
  • 9. Adrenaline  Body’s activator -> energy  Adrenal glands in our kidneys  Carried through bloodstream, affects autonomic nervous system (ANS)  ANS controls functions such as our heart rate, pupil dilation, and secretion of sweat and salivaMonday, 14 May 2012
  • 10. Fight / flight / freeze Sweating Pupils dilate Heart rate Adrenaline Breathing and Heightened oxygen awareness Muscle tension Bladder/bowelsMonday, 14 May 2012
  • 11. Fight / flight / freeze  This reaction does not wear off instantly  Our bodies are concerned the threat may return  Hot, flushed, tired  Calm much later  We don’t decide to react this wayMonday, 14 May 2012
  • 12. However…  Today the threats we experience often do not require us to fight or flee  Now there is less focus on survival but more on social factors such as our own and others perceptions of ourselves. We will consider ways of combating this later.......Monday, 14 May 2012
  • 13. How anxiety can affect us Environment Thoughts Behaviour Anxiety Emotions BodyMonday, 14 May 2012
  • 14. How anxiety can affect our: Behaviour Avoidant Behaviour Negative Behaviour Making decisions Speaking too fast Driving Unable to sit at peace Shopping Poor performance Socialising Always rushed Staying alone Smoking/drinking more Talking to neighbours Accident prone Reading about illness Irritable, Stammering Using buses/trains Nail biting ResponsibilityMonday, 14 May 2012
  • 15. How anxiety can affect our: Behaviour  Anticipate we will cope badly  Common sense is ‘stressed? then avoid it!’  Unfortunately, this is not helpful  No easy way around this  Stress can often be invisible  Visible in our behaviour  Often aware of our reaction, self-consciousMonday, 14 May 2012
  • 16. How anxiety can affect our: Body Bladder/ Heart Bowel Dry rate Sleep Faint Headache mouth Chest Numb Shaking Unreal pain Anxiety Anxiety Jelly Pins & Muscle Breathless legs needles pain Choking Nausea Tired SweatingMonday, 14 May 2012
  • 17. Break  15 minute breakMonday, 14 May 2012
  • 18. How anxiety can affect our: Thoughts  Thoughts can be a bit like a football commentator  Whether we pay attention depends on many things  No two people worry about the same thing, although there are common themes  How we feel can affect the strength and type of thought we have  How we think affects how we behaveMonday, 14 May 2012
  • 19. Fearful Thoughts  Can include fears of: Looking foolish Worry Madness Poor concentration Illness/disease Irritability Challenges Feeling keyed up Losing control Nightmares Being alone Loss of interest Being criticised  Feeling ‘cut off’ Rejection Easily startled Meeting people Self criticismMonday, 14 May 2012
  • 20. Worrying about worrying: A vicious circle Notice Worry symptoms Symptoms Worry about increase worryingMonday, 14 May 2012
  • 21. Emotions  Worried  Despair  Sad  Frustration  Guilty  Injustice  Fear  Low  Angry  Let down  Insecure  Helpless  Resentful  Flat  Unreal  JealousMonday, 14 May 2012
  • 22. What causes anxiety?  Personality factors/genetic make-up  Childhood experiences  Modelling  Perception  Life events  Changes or breaks in routineMonday, 14 May 2012
  • 23. Reducing anxiety: Breathing exerciseMonday, 14 May 2012
  • 24. Calming breath Quick strategy to reduce bodily symptoms, can be used in any situation:  Breathe in through nose on a count of 4  Hold for 2 seconds  Release slowly over 6 seconds  Say the word “relax” as you breathe outMonday, 14 May 2012
  • 25. End of day one  Thank you very much  See you tomorrow – same time, same place!Monday, 14 May 2012
  • 26. Day two  General discussion  Any thoughts or issues that came up overnight that you would like to share?Monday, 14 May 2012
  • 27. Day two  Maintaining factors and how to intervene in the vicious cycle  Progressive muscle relaxation  General questionsMonday, 14 May 2012
  • 28. Anxious thoughts  They often happen out of the blue  You may be unaware of them  Although they are not necessarily ‘true’ people believe them at the time  The thoughts often appear when you least want them  They are usually about the near future  If other people believed the thoughts, they would become anxiousMonday, 14 May 2012
  • 29. Anxious thoughts increase due to other changes… Become more and more self- Self-esteem and Question your conscious self-confidence ability to cope drop Feel threat from all Anxious Worry becomes sides thoughts second nature increase Problems keep Body reacts coming easily, or for no Brings out the reason worst in youMonday, 14 May 2012
  • 30. Understanding our thoughts: Unhelpful thinking  Catastrophising  Black and white thinking  ‘Shoulds’ and ‘musts’  Jumping to conclusions  Mental filter  Emotional reasoning  Over-generalisation  PersonalisationMonday, 14 May 2012
  • 31. Break  15 minute breakMonday, 14 May 2012
  • 32. Distraction Dwelling on worries leads to more worries 1. Try mantras, e.g. “I am calm” (flashcard) “Relax” “I am in control” Close your eyes and slowly repeat the words 2. Describe everything you can see or hear in detailMonday, 14 May 2012
  • 33. Exercise and activity  Anxiety gives you lots of energy  Reduce the anxiety by burning up the excess energy  Cardiovascular exercise is best: E.g. walking, swimming, jogging, fitness classes, sports  Exercise gets you out of the house and meeting others  Added benefit of improved healthMonday, 14 May 2012
  • 34. Avoidance  Common sense says if doing something makes you more tense, you should avoid it  So-called common sense can be unhelpful!  Face up to your problems  If you ignore them they will feed the anxiety and may get bigger  This may be hard in the short-term, but it will help in the long-termMonday, 14 May 2012
  • 35. Alcohol  Some physical symptoms of anxiety (nausea, sweating, shaking) may be related to too much alcohol  Heavy drinking makes anxiety worse, and can cause slowed breathing and heart-rate in the short-term Driving Limit 80mg in 100ml of blood – not easily translated into a number of drinks, depends on age, weight, gender, metabolism We all need at least two days a week without alcohol Consider reducing drinking or stop altogetherMonday, 14 May 2012
  • 36. Caffeine  Strong links between intake of caffeine and anxiety  You find caffeine in:  Tea and coffee  Fizzy drinks, e.g. coke, diet coke, red bull  Chocolate  Cold and flu remedies/painkillers  Caffeine tablets, e.g. pro-plusMonday, 14 May 2012
  • 37. Progressive muscle relaxation  PMR teaches you how to relax your body and mind  Allows you to become aware of how anxiety affects your body  Relaxation is a skill and benefits from practice  Lets have a go Prevention is better than cureMonday, 14 May 2012
  • 38. Break  15 minute breakMonday, 14 May 2012
  • 39. Strategies to manage anxiety  Prepare yourself  work out which situations cause you anxiety  use relaxation before you have to face up to them  Stay in control and face the anxiety  younow have a way of fighting back when anxiety threatensMonday, 14 May 2012
  • 40. ? Questions ?Monday, 14 May 2012
  • 41. Handouts  ‘25 ways to cope’  Problem solving  Sleep problems  PMR  Breathing  Unhelpful thinking stylesMonday, 14 May 2012
  • 42. What Next???  Online Resources  Bibliotherapy  Voluntary Organisations  Stress Control GroupMonday, 14 May 2012

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