The document explores anxiety and stress, defining anxiety as a feeling of apprehension and fear, often arising from imagined dangers, while fear is a reaction to real, imminent threats. It outlines various anxiety disorders, including Generalized Anxiety Disorder, Panic Disorder, and Social Anxiety, along with their symptoms and management strategies such as medication, therapy, and healthy coping mechanisms. Additionally, it emphasizes the importance of support, time management, and positive thinking in managing anxiety and stress effectively.

1. Anxiety and Stress
“MAN IS NOT WORRIED BY REAL PROBLEMS SO
MUCH AS BY HIS IMAGINED ANXIETIES ABOUT
REAL PROBLEMS”
-EPICTETUS
“ITS NOT STRESS THAT KILLS US, IT IS OUR
REACTION TO IT.”
-HANS SELYE

2. What is Anxiety?
 Anxiety is a feeling of apprehension or fear. This arises out of the
anticipation of danger.
 Sometimes the cause of anxiety is known and sometimes unknown
or unrecognized.

3. Then what is fear?
 In case of fear, the object of fear or stimulus is present.
 The threat is real, imminent and objective danger, which threatens
life and survival.
 The fight or flight or freeze response is activated. (Sympathetic
Nervous System)

4. Is Anxiety always bad?
 Not really !!
 But, why?
 Anxiety helps us get our work done. It pushes us to do our work;
when undone would get us into trouble.
 Ex: Exams!!

5. Physical and Psychological Symptoms
of Anxiety
Physical Symptoms: Muscle twitches, fearful facial expressions, tremors, restlessness,
palpitations, tachycardia, constriction in chest, sweating, dry mouth, hyperventilation,
dizziness, hot or cold flushes, gastrointestinal symptoms etc.
Psychological Symptoms:
Cognitive Symptoms: Poor concentration, distractibility, hyperarousal (threshold), vigilance
(scanning), negative automatic thoughts, depersonalization and derealization.
Affective Symptoms: Unpleasant and vague sense of apprehension, inability to relax,
irritability, feeling of impending doom (when severe)
Other Symptoms: Insomnia, Increased sensitivity to sound and exaggerated startled
response.

6. Anxiety Disorders
 Anxiety disorders are a group of disorders. They include:

GAD
Panic
Disorder
OCD
Specific
Phobia
Social Phobia

7. Anxiety Disorders
 Generalized Anxiety Disorder (GAD): Excessive, uncontrollable and irrational worry
about events or situations. This worry comes from the worse anticipation of events. There
can be negative thinking (What ifs). These people typically anticipate disaster.
 This worse anticipation is about everyday events, such as health, money, death, family,
friendship, interpersonal relationships, employment or work etc.
 Physical symptoms and cognitive symptoms are present.
 Panic Disorder: These are episodes of acute anxiety. These episodes come out of the
blue (sudden) and may be recurrent as well. They last for a few minutes and is
characterized by severe anxiety. Can also be present with Agoraphobia.
 These episodes are characterized by only physical symptoms.

8. Anxiety Disorders
 Obsessive Compulsive Disorder: This disorder is characterized by obsessions and
compulsions.
 Obsession is an idea or image that intrudes our conscious awareness repeatedly.
Patient tries to resist these thoughts; he/she fails to do so.
 Compulsions are the behaviors that follow the obsessions. These compulsions reduce
the anxiety associated with obsessions. These behaviors are repeatedly done,
consuming most of day in these compulsions.
 Specific phobia: In this kind of anxiety disorder there is a presence of a stimulus. But,
anticipation of the phobic stimulus present there could lead to consistent phobic
avoidance.
 It is the irrational fear of objects or situations.
 Example: Arachnophobia (spiders), Acrophobia (fear oh high places), claustrophobia
(closed spaces) and Zoophobia (animals).

9. Social Anxiety
 It is different from just being shy.
 It is an Irrational fear of social interaction or activities like performing activities in the presence of other people,
social interaction with people, giving presentations and speeches etc.
 Person might be afraid of criticism from others, embarrassing oneself etc.
 Fear of group participation and activities, being observed, meeting new people, eating or drinking in public.
 Causes significant distress and significant functional deficit- social, occupational etc.
 Maladaptive Coping strategies may include alcohol and other drugs) is used to overcome Social Anxiety
 People with social anxiety can actively try to cope through avoiding social interactions, social places and events.
 Some other symptoms are- self-conscious in social situations and feel embarrassed and awkward. Give
excuses to avoid, sweating, feeling nauseous, stiff body ( rigidity) increased heart rate when they are in social
situations or when performing.

10. Causes
 Several aspects lead to anxiety. There is no one specific cause.

• Biological- Brain Chemistry imbalance
• Genetic
• Stress at home, family issues
• Stress at work/school
Anxiety
• Low self-esteem
• Poor coping skills

11. How to manage Anxiety
 Clinically: Anxiety disorders can be managed through medication
prescribed by Psychiatrists.
 Other alternative to medication is Therapy. Like CBT- Cognitive
Behavior Therapy. Thoughts lead to behavior. So, here the stimulus is
thoughts and the response is anxiety.
 Medication, Yoga, Exercise can also relieve Anxiety.
 For specific phobia, systematic desensitization is used-

12. Exam Anxiety Management
 Ask for help! There is nothing wrong in asking for help. Consult a trained psychologist or a
Psychiatrist. Talk to your teachers or family. You may no be in a position to help yourself,
but others can!!
 Eat healthy, exercise.
 Sleep well. 8 hours of sleep is absolutely necessary.
 Understand the concept instead of byhearting. This helps you remember better and help
you apply your knowledge better.
 Time Management is key. Keep a schedule on what you will study day-to-day and for how
long. But, try and keep it a little flexible.
 Have confidence in yourself. You can do it, if you try.

13. Coping with Exam Stress
 How do people normally cope:

Avoidant coping strategy
Problem solving approach
Emotion coping strategy

14. Managing the work
 If you procrastinate starting to study. Introspect why. This introspection helps you
understand yourself. After this awareness, you could try to search for solutions to
solve this.
 Anxiety could lead to avoidance behavior (procrastination), but it only results in
more severe anxiety. So, Try a problem solving approach.
 There could be a lot to study. So, organize and manage your time. Break down the
huge chunks of work into simpler ones.
 Try to start your work willingly. If this is not possible, there could be a reason for
this as well. Think about it.

15. Coping with stress emotionally
 Take a break. Don’t feel guilty about it, you deserve it. Do something you love, do
something that relaxes you. It does not mean avoiding the work. Starting with a relaxed
mind helps you grasp it better. (Mental Resources).
 Don’t worry about it. Think about it.
 Don’t engage in negative thinking. No what ifs. Starting a thought with ‘what if’ might
only lead to a negative thought follow up.
 Engage in positive self-talk.
 Being calm, hopeful and optimistic about it helps.

16. Relaxation Techniques
 Progressive Muscle Relaxation
 Guided Imagery
 Biofeedback
 Aromatherapy
 Music therapy
 Nature therapy- nature walks

17. “
”
Adopting the right attitude can make
a negative stress into a positive one.
-HANS SELYE
Thank you

18. “
”
References
A Short Textbook of Psychiatry, 2011- Neeraj Ahuja, 7th edition
DSM- V, American Psychiatric Association
Website: National Institute of Mental Health: Social Anxiety Disorder: More Than Just Shyness-
https://www.nimh.nih.gov/health/publications/social-anxiety-disorder-more-than-just-
shyness/index.shtml#:~:text=Social%20anxiety%20disorder%20(also%20called,to%20make%20and%20keep%20frie
nds.