This document discusses anxiety, its causes and symptoms. It describes anxiety as a natural fight or flight response to perceived threats that allows us to protect ourselves. Prolonged anxiety can be physically and emotionally draining. The document provides tips for managing anxiety such as relaxation techniques like deep breathing, muscle relaxation, and grounding. It also discusses strategies for challenging anxious and negative thoughts through awareness, rational thinking, positive affirmations and realistic perspectives.

1. Anxiety
/aNGˈzīədē/
(noun)
a feeling of worry, nervousness, or
unease, typically about an imminent
event or something with an
uncertain outcome.

2. What is Anxiety?
Anxiety is actually an automatic, "built-
in" response to perceived threats that
allows us to do what is necessary to
protect ourselves whenever we
encounter danger. Often called "fight-or-
flight arousal", this response involves a
series of changes in our bodies that
prepare us to take immediate action to
deal with a threat or crisis
(AnxietyHappens.com, 2015)

3. Figure 1
Source: ImroveHealthcare.org. (2014). Ansiety symptoms. Retrieved from
http://www.improvehealthcare.org/anxiety

4. The longer your fight or flight response
remains active, the more draining,
physically and emotionally (Bailey, 2010)

5. How to Handle Anxiety
• Take a time-out
• Eat well-balanced meals
• Limit alcohol and caffeine
• Get enough sleep
• Exercise daily
• Take deep breaths
• Count to 10 slowly
• Do your best
• Accept that you cannot control everything
• Welcome humor
• Maintain a positive attitude
• Get involved
• Learn what triggers your anxiety (ADAA.org, 2015)

6. Relaxation Strategies
• Calm Breathing
• Progressive Muscle Relaxation
It’s important to realize, however, that
the goal of relaxation is not to avoid or
eliminate anxiety (because anxiety is not
dangerous), but to make it a little easier
to ride out these feelings (Smith & Segal,
2015)

7. Deep Breathing
Diaphragmatic or deep breathing:
Trauma survivors often hold their
breath or breathe very shallowly. This in
turn deprives you of oxygen which can
make anxiety more intense. Stopping
and focusing on deepening and slowing
your breathing can bring you back to the
moment (Young, 2009)

8. Grounding Technique
Grounding is about learning to stay present in
your body in the here and now. Basically it
consists of a set of skills/tools to help you
manage dissociation and the overwhelming
trauma-related emotions that lead to it.
Processing done from a very dissociated state is
not useful in trauma work. Neither is the goal to
be so overwhelmed by feelings that you feel re-
traumatized. Once you are present, you also
need to learn other means of managing the
feelings and thoughts associated with traumatic
memories. (Young, 2009).

9. Grounding Technique
Grounding often takes the form of
focusing on the present by tuning into it
via all your senses. For example, one
technique could involve focusing on a
sound you hear right now, a physical
sensation and/or something you see.
Describe each in as much detail as
possible (Young, 2009).

10. Grounding
5 Things You Can See
4 Things You Can Touch
3 Things You Can Hear
2 Things You Can Smell
1 Thing You Can Taste

11. Realistic Thinking
Effectively managing negative
emotions involves identifying
negative thinking and replacing it
with realistic and balanced thinking
(GlassIsEmpty, 2014).

12. Cognitive Distortions
• All-or-Nothing Thinking
• Overgeneralization
• Mental Filter
• Disqualifying the Positive
• Jumping to Conclusions
– Mind Reading
– Fortune Telling
• Magnification & Minimization
• Emotional Reasoning
• Should or Must Statements
• Labeling
• Personalization and Blame (Burns, 1999)

13. • Thought Awareness
– Thought awareness is the first step in the process of
managing negative thoughts, as you can only manage
thoughts that you're aware of.
• Rational Thinking
– Feelings of inadequacy
– Worries about performance
– Problems with issues outside your control
– Worry about other people's reactions
• Positive Thinking & Opportunity Seeking
– Affirmations (Smith, 2015)
Realistic Thinking

14. Affirmations
Affirmations are positive,
specific statements that
help you to overcome self-
sabotaging, negative
thoughts. They help you
visualize, and believe in,
what you're affirming to
yourself, helping you to
make positive changes to
your life (Smith, 2015).

15. Remember, affirmations are
positive statements that help you
challenge and overcome negative
thinking and self-sabotaging
behaviors (Smith, 2015).

16. Examples of Self-Sabotaging
Behaviors
• Procrastination
– Knowing you should be working on something, but putting it off again and again.
– Starting projects, but never quite finishing them.
– Feeling unmotivated or unable to proceed, even when there are lots of exciting
opportunities.
• Unfulfilled Dreams
– Dreaming of doing something, but never doing anything about it.
• Worry
– Fretting over things that really shouldn't matter.
– Fearing that if you fail others will think less of you.
– Worrying that if you're successful, your friends won't like you any more.
– Doubting yourself and your abilities even though you "know" you are very capable.
– Feeling stressed and anxious, and perhaps suffering from unexplained depression or panic
attacks when trying to achieve something important to you.
• Anger
– Using aggressive rather assertive communication and not taking steps to change this.
– Destroying relationships with others (family, friends, co-workers) with anger, resentment or
jealously.
• Feelings of Worthlessness
– Exaggerating other people's achievements, and diminishing your own.
– Taking even unfair or misguided criticism to heart.
– Letting others put you down (Smith, 2015).

17. Positive Affirmation Tips
• Affirmations should be formed in the
present tense, as if they're already
happening.
• The power of affirmations also lies in
their repetition.
• Affirmations are more effective when
they're thought or said with feeling
(Smith, 2015).

18. Examples of Positive
Affirmations
• I am strong.
• I am energetic
• I am trusting
• I am intelligent
• I am relaxed
• I am joyful
• I am smart
• I am creative
• I am forgiving
• I am friendly
• I am a good person
• I am generous
• I am loving
• I am kind
• I am brave

19. References
• ADAA.org. (2015). Tips to manage anxiety and stress.
Retrieved from http://www.adaa.org/tips-manage-anxiety-and-
stress
• AnxietyHappens.com. (2015) The flight-or-fight response.
Retrieved from
http://www.anxietyhappens.com/WhyAnxiety/fight_or_flight_
response.htm
• Bailey, E. (2010). What is “fight or flight” and how does it relate
to anxiety? Retrieved from
http://www.healthcentral.com/anxiety/c/1443/119324/flight-
anxiety/#sthash.6mdoCwNT.dpuf
• GlassIsEmpty. (2014). Realistic thinking strategies. Retrieved
from https://glassempty.wordpress.com/2014/07/17/realistic-
thinking-self-help-strategies/
• NIHClinicalCenter. (2012). TIPS – Deep breathing exercise
(companion to anxiety video). [YouTube]. Retrieved from
https://www.youtube.com/watch?v=ExvXmsr--M

20. References
• Smith, C. (2015). Thought awareness, rational thinking,
and positive thinking. Retrieved from
http://www.mindtools.com/pages/article/newTCS_06.ht
m
• Smith, C. (2015). Using affirmations: Harnessing positive
thinking. Retrieved from
http://www.mindtools.com/pages/article/affirmations.ht
m
• Smith, M. & Segal, R. (2015). How to stop worrying: Self-
help strategies for anxiety relief. Retrieved from
http://www.helpguide.org/articles/anxiety/how-to-stop-
worrying.htm
• Young, K. (2009). Staying present during trauma
therapy: Grounding techniques. Retrieved from
https://drkathleenyoung.wordpress.com/2009/09/08/sta
ying-present-during-trauma-therapy-grounding-
techniques/