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Overcoming Anxiety

What is Anxiety?
    You enter a large room crowded with strangers. Everyone seems to know somebody except you. You wonder if others can see how anxious you are, how out of place you feel. As you entertain such thoughts, your heart begins to race, and your palms begin to sweat. Your head feels encased in shrink-wrap. You feel an urge to bolt from the room.

    Anxiety is part of our natural defensive system – a close cousin to fear. With fear, however, the threat is more readily identifiable. For instance, someone is waving a gun. A dog is barking, crashing against the cyclone fence.  Like fear, anxiety is the body’s red warning light that something is amiss. The brain releases adrenaline. The pupils dilate. The heart pumps out blood like an engine on steroids, gearing the body to stand up and fight, or perhaps to run faster than we ever imagined.

    A manageable amount of anxiety can actually enhance our performance — by motivating us to prepare for a test, to drive with care, or to gird ourselves for a difficult confrontation. Anxiety also might carry important information. For instance, if I’m anxious at home, it might be helpful to reflect on what’s wrong in order to figure out ways to change it. Perhaps my roommate makes me uncomfortable or maybe I need to have a conversation I’ve been avoiding. The problem, however, is when our anxiety becomes disproportionate to the situation or is so paralyzing that we are unable to perform.

    Anxiety is a common feeling usually involving worry about the future. It can range from a vague feeling of uneasiness and discomfort to intense feeling or terror and impending doom. Anxiety produces an increase in various physiological and mental processes. That increase can motivate us to more thoroughly prepare for performance situations like examinations and athletic competition, but it can also become so intense that it interferes with our ability to function normally in every day activities. Such is the case when we become overly anxious during an examination and cannot recall a concept we thoroughly studied the previous evening. Constant anxiety may signal an anxiety disorder.

What determines when anxiety changes into an anxiety disorder?
    Anxiety which persists over an extended period of time with frequent periods of high intensity is indicative of an anxiety disorder. In such a condition, anxiety is present most of the time without any apparent reason, or the anxiety is so uncomfortable that you stop some of your everyday activities, or you experience frequent bouts of anxiety which are so intense they terrify and immobilize you.

What are some common anxiety disorders?
Generalized Anxiety Disorder
- excessive anxiety and worry for at least 6 months with accompanying symptoms of restlessness, feeling keyed up, being easily fatigued, difficulty concentrating, irritability, muscle tension, and sleep disturbance.
Panic Disorder - intense fear or terror that strikes suddenly and repeatedly with no warning, accompanied by symptoms such as a pounding heart, chest pains, dizziness, nausea, shortness of breath, shaking, tingling, sweating, fear of going crazy and fear of dying.
Phobias - a marked and persistent fear of specific objects or situations, or a fear of social or performance situations where we might suffer embarrassment or humiliation.
Obsessive-Compulsive Disorder - persistent unwelcome thoughts or rituals we seem driven to perform which markedly interfere with our normal daily routine.

How is anxiety different from fear?
    Fear usually involves uneasiness and apprehension directed toward some concrete, external object or situation. Also, fear is associated with events or situations that could happen. Anxiety, on the other hand, is more of a subjective state of uneasiness and apprehension in response to a vague and sometimes unrecognized danger. With anxiety, we cannot always specify what it is we are anxious about. Often, anxiety tends to be out of proportion and unrealistic.

Is there any value in worrying?
    We sometimes feel worrying about something helps us better prepare for dealing with it. What usually happens however is that worrying increases our anxiety which in turn can interfere with daily functions like thinking clearly and making decisions. Did you know the phrase “Do not Fear” is used in the Bible 365 times, one for each day of the year.

When is Anxiety a Problem?
    We all become anxious from time to time.  It becomes a problem when it interferes with life in the absence of real threat, or goes on too long after the danger has past.

What if I just avoid the things that make me anxious?
    Avoiding situations that make you anxious might help you feel better in the short term.  The trouble is the anxiety keeps returning, and has a habit of spreading to other situations.  This can lead to you avoiding things like shops, crowded places, lectures or tutorials.  So although avoidance makes you feel better –
   • Relief is only temporary – you may worry about what will happen next time.
  • Every time you avoid something it is harder next time you try to face it.
  • Gradually you want to avoid more and more things.

How can I Reduce & Overcome Anxiety?
    Since some anxiety is natural and normal, the goal of any treatment is not to eliminate anxiety but to lessen it. Some strategies are very simple and easily learned. Other avenues are traversed gradually and entail a process of self discovery, with or without a professional guide.

    For those who have difficulty with anxiety, stress often has a cumulative affect. Therefore, if you’re anticipating a source of stress rising, say as you head into exam week, it’s advisable to try to lower other sources of stress whenever possible. For example:
• Postpone a difficult conversation
• Be sure to get enough sleep & exercise
• Wait to move until exams are over

    One way to overcome anxiety is to cultivate feelings and experiences that are incompatible with it. For instance, experiences that build up feelings of self-confidence, well-being, and relaxation offer an antidote to anxiety. Sometimes simple exposure to anxiety-provoking situations can eventually “extinguish” the anxiety response. For example, if you’re anxious among large groups of people, you might seek out more large social situations. Or if public speaking is your bane, take a class that requires frequent class presentations. Nonetheless, sometimes exposure to what makes us anxious is insufficient or too overwhelming, and then other tools may be needed.

    Perhaps the first step in addressing your anxiety is to ask: where is my anxiety coming from? By engaging in a process of reflection, sometimes we can figure out what the problem is and then strategize ways to resolve it.

Mind-Body Relaxation Strategies
    Since anxiety rises with stress, ways that you can develop to lower and better manage your stress will also have a beneficial affect on your anxiety. Some well established stress-reducing activities include physical exercise, going on a walk, talking to a friend, listening to or playing music, yoga, and other forms of creative expression. It’s very helpful to end the day with at least 30 minutes of relaxing activity, which allows us to unwind and more easily fall asleep. If the world situation is getting you down, you might consider going on a “media fast.” The world will stumble along just fine without you reading or watching the news for awhile.

    Like any skill, Mind-Body techniques for lowering stress and anxiety are more powerful the more often you practice them. This is especially true when you are first learning the technique. If you only make use of a strategy when you are feeling extremely distressed, its effectiveness may be reduced.

Deep Breathing: When we are anxious, our breathing tends to be shallow and fast. In contrast, deep and slow breathing tends to relax us at a physiological level. Begin this practice by lying down or sitting in a comfortable chair. Place your hand on your stomach area. Now, as you slowly breathe in, draw the air all the way down into your diaphragm. Feel your hand rise as the breath comes in. You can gently count 1,2,3, 4 as you breathe in. Breathe out to a count of 1,2,3, 4 and hold on the out breath for another 4 seconds. Repeat this practice for 3 – 5 minutes.

Breath Meditation: One simple and effective meditation is to choose a word or two that evoke qualities of experience that you would like to cultivate. For instance, words like courage, trust, peace, well-being, or love. Choose whatever words seem most appropriate at this time. Let’s say the words you select happen to be openness and trust, now as you slowly breathe in, imagine breathing in openness, opening up your mind and heart, opening to your feelings, opening to goodness, opening to love, etc. Then, as you breathe out, imagine yourself deeply trusting, letting the sense of trust wash through you, bathing your muscles and tendons, your bones and internal organs all the way down to the cellular level.

Body Scanning: Find a quiet room and lie down on a sofa or bed. Take a few deep breaths, letting your attention withdraw from the outer world and to focus in on your body. Now bring your full attention down to your feet. First, allow your toes to relax, then the ball of your feet, then the soul and heel. Very gradually move your mind’s eye up through your body, allowing each part to relax completely, until you reach the top of your head. You can cultivate feelings of relaxation by gently saying to yourself, My feet are relaxing . . . my knees are relaxing, and so on. It’s very important to bring and keep as much of your attention as you can on what your body is actually experiencing. For instance, you may notice sensations of tingling, heaviness or warmth. Whatever sensations arise, just allow them to be as you continue to move up through your body. To the extent that you can relax your body in this way, then your mind also will become relaxed.

Cognitive Strategies
    Human beings have inner monologues that shape and color our experience. These monologues have been likened to tapes that play automatically, often without our awareness.

    Affirmations can be an effective cognitive strategy to help alleviate anxiety. The idea here is to re-record our negative messages with more affirming monologues. Affirmations can help immunize us against anxiety by building up our confidence and self-esteem. While the best affirmations are those you devise yourself, examples might be: I am a worthwhile, compassionate person. I can  lean as much from my mistakes as from my successes. While these may sound corny or artificial, are they any less grounded in reality than such statements, I am stupid . . . Everyone thinks I’m worthless . . . ? If we have a choice about our inner monologue, then why not construct a monologue that builds up our sense of self rather than tears it down?

Another cognitive strategy consists of giving ourselves simple reminders when our anxiety begins to build, such as:
• I can trust that things will turn work out.
• I can trust myself to able to handle whatever contingency arises.
• I will relax my expectations when reality has a different agenda – surprises make life more interesting.
• The future is as interesting and fulfilling as I make it.
• I can’t please everyone. Other people are responsible for their own happiness as I am for mine.

Thought Stopping Exams, people, dogs, cars, authority figures, crowds, snakes, large classes do not make you feel anxious - your thoughts do. Change your thoughts and you can change your feelings. Simple …Well, not really - if it was that simple, we would be able to do it all the time. Truth is, our responses to events become conditioned and like any habit, we respond without even being aware of a preceding thought.

    In order to stop thoughts our first task is to become aware of them. We have to slow down and begin to pay attention to our drift into anxiety. Then we have to implement thought stopping and/or alternate thoughts.

Thought stopping is a skill that requires commitment and practice, practice, practice. Here are some quick tips to help you begin to control your thoughts:
• Do not waste time wondering why you think negatively.
• Develop some simple words, phrases or actions that help change the direction of your thoughts.

Words and Phrases
» Stop!
» I can cope.
» I am okay.
» I have done it before, I can do it again.
» Okay, just slow down. You will be alright. You are going to be okay.
» This will pass - give it time.
» Just relax.
» I can accept this - it is unpleasant, not dangerous.

» Talk to someone.
» Breathe deep and slowly.
» Carry a lucky charm - touch it.
» Visualize a peaceful scene.
» Focus on external happenings - the wind, the sun, birds, noises.
» Sit down. Touch the earth. Touch a tree.
» Look at the ants working.
» Turn up the radio. Sing out loud. Hum a tune.
» Perform physical work.

Keep Practicing. Don't wait for a major crisis to occur before you start to practice.

Prevention is Better Than Cure
• Exercise - Yoga, Aerobics, Walking
• Gardening
• Bushwalking
• Spending time alone

Should I take medication to lower my anxiety?
    Many factors enter into an intelligent decision about whether to take medication for anxiety. Some psychotherapists believe that mainstream society has been moving too far in the direction of viewing psychological problems as primarily biological, prescribing medication as a rote response to any psychological complaint. This problem has mushroomed in recent years as medications have been allowed to be advertised in the media.

    If you’re thinking about medication, it’s important to consider both the risks and rewards. One potential benefit includes immediate symptom relief, which may be especially helpful when anxiety becomes crippling. Medication might also be useful when ones anxiety reaches a level where it is difficult to perform in school or in everyday life. Some of the risks include drug side effects, treating the symptom rather than getting at the cause, and missing out on an opportunity to grow personally by relying on an external substance to change how you feel.

    Medication and psychotherapy need not be mutually exclusive. Many students make use of both. If you have questions about anxiety medication, you might raise them with your physician.

What about “self medication”?
    It’s quite common for people to seek unhealthy ways to cope with anxiety. Substance abuse, shopping, eating, sexual and other addictions often mask deeper discomforts and distress. Activities that in moderation can be quite pleasurable become problematic when they are compulsive and preclude other ways of finding release and comfort. If you think that you may be “self-medicating” in this way, it would be important to raise this with your counselor.

How can I address the deeper roots of my anxiety?
    Anxiety can originate from a variety of emotional sources. Sometimes we experience anxiety or even panic attacks when we are on the verge of a major life change. Changes and transformations often trigger feelings of loss and related fears, including the loss of identity, loss of support and comfort, and loss of meaning. By talking through such feelings with a supportive listener or counselor, they often diminish in intensity.

    A related source of anxiety arises when we are warding off painful experiences or feelings. Often we are unconscious that we are doing this. By becoming aware of and working through the painful events and feelings that we carry, they tend to lose their energy and capacity to fuel anxiety and other problems.

   Much anxiety arises from our relationship with ourselves. If we like ourselves and feel effective in the world and with other people, this helps to “immunize” us against problematic anxiety. If you are someone who struggles with self-esteem, you shouldn’t despair. The path to self-acceptance is a journey that has been taken by many before you. But this journey does involve time and effort. Sometimes life itself provides the tools we need to traverse this path. Often, a healing relationship with a therapist or another caring individual can help us unlearn and repair the harm that came to us and then became a part of us.

Resource:NNU Counseling Center:  For appointments dial 208-467-8466