This document discusses anxiety, its causes, symptoms, and interventions. It begins by reviewing the objectives of exploring anxiety symptoms, impacts, and prevention/intervention strategies. It then discusses how anxiety can be debilitating and a trigger for addiction relapse, depression, and other issues. The document outlines biological, psychological, and social factors that can contribute to anxiety. It provides details on symptoms of generalized anxiety in adults and children. Finally, it discusses various biological, psychological, and social intervention strategies to reduce anxiety, including improving sleep, nutrition, cognitive restructuring, relaxation techniques, and developing supportive relationships.

1. Impact of Anxiety and
Interventions
Instructor: Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC
Executive Director, AllCEUs
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2. Objectives
 Review the symptoms of anxiety in adults and
children
 Explore the impacts of anxiety
 Identify strategies for prevention and intervention
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3. 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
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4. 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)
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Serotonin: A Common
Neurobiologic Substrate in
Anxiety and Depression. EISON,
MICHAEL S. PhD

5. 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
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6. 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
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7. 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
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8. 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
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9. 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
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10. Social Impacts
 Social withdrawal
 Reduced support system
 Difficulty taking perspectives
 Reduction in leisure activities
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11. 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
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12. Biological Interventions
 Supportive Care
 Medication
 SSRIs/SNRIs
 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
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13. 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
Unlimited CEUs $59 | Specialty Certificates $89 | Live Webinars $5 | Addiction Counselor Certification training $149
Activities
Contributing
Comparisons
Emotions (opposite)
Pushing Away (Thought
stopping)
Thoughts (cognitive
distractions)
Sensations
Imagery
Meaning
Prayer
Relaxation
One thing in the moment
Vacation
Encouragement
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14. 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
Unlimited CEUs $59 | Specialty Certificates $89 | Live Webinars $5 | Addiction Counselor Certification training $149
Activities
Contributing
Comparisons
Emotions (opposite)
Pushing Away (Thought
stopping)
Thoughts (cognitive
distractions)
Sensations
Imagery
Meaning
Prayer
Relaxation
One thing in the moment
Vacation
Encouragement
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15. 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
Unlimited CEUs $59 | Specialty Certificates $89 | Live Webinars $5 | Addiction Counselor Certification training $149
Activities
Contributing
Comparisons
Emotions (opposite)
Pushing Away (Thought
stopping)
Thoughts (cognitive
distractions)
Sensations
Imagery
Meaning
Prayer
Relaxation
One thing in the moment
Vacation
Encouragement
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16. 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
Unlimited CEUs $59 | Specialty Certificates $89 | Live Webinars $5 | Addiction Counselor Certification training $149
Activities
Contributing
Comparisons
Emotions (opposite)
Pushing Away (Thought
stopping)
Thoughts (cognitive
distractions)
Sensations
Imagery
Meaning
Prayer
Relaxation
One thing in the moment
Vacation
Encouragement
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17. 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
Unlimited CEUs $59 | Specialty Certificates $89 | Live Webinars $5 | Addiction Counselor Certification training $149 17

18. 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
Unlimited CEUs $59 | Specialty Certificates $89 | Live Webinars $5 | Addiction Counselor Certification training $149
Activities
Contributing
Comparisons
Emotions (opposite)
Pushing Away (Thought
stopping)
Thoughts (cognitive
distractions)
Sensations
Imagery
Meaning
Prayer
Relaxation
One thing in the moment
Vacation
Encouragement
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19. 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
Unlimited CEUs $59 | Specialty Certificates $89 | Live Webinars $5 | Addiction Counselor Certification training $149 19

20. Summary
 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
Unlimited CEUs $59 | Specialty Certificates $89 | Live Webinars $5 | Addiction Counselor Certification training $149
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21. Resources from New Harbinger
Unlimited CEUs $59 | Specialty Certificates $89 | Live Webinars $5 | Addiction Counselor Certification training $149
These books represent a wide array of ways to deal with anxiety.
My favorite authors are Matthew McKay and Edmund Bourne, but I tend to be
more cognitive behavioral in my approach
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