Anxiety Training Tips

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By: Bridget Eickhoff

Anxiety, worry, and panic are felt by many of us at some point in our lives. After attending a training by David Carbonell, Ph.D. on chronic anxiety, I picked up some helpful tools that I would like to share.

The more you oppose unwanted thoughts, feelings, and sensations the worse they can become

A big reason behind anxiety symptoms is self-protection. People often interpreted anxiety as a signal for danger, meaning fight, flight, or freeze; but what if that was a false signal. What if this feeling is intense discomfort that will eventually pass if it is not forced to be silence. Next time you are experiencing anxiety check-in with yourself and if you indeed are in danger or is this discomfort? If it turns out to be discomfort allow yourself 5-10 minutes to worry, you may be surprised how different it feels to allow the worry to have its time rather than continue to suppress it.

 

The Rule of Opposites

Think of yourself swimming and trying to avoid a large wave coming your way. You may ask yourself “what is the best way for me to avoid this wave?” Your instincts may say to swim away from the wave and hope you can be faster, but in reality the easiest way to avoid the wave is to swim under it. The same can apply to feelings of anxiety and worry. During a panic attack your gut may tell you to hold your breath or take in more breaths at a time, when what is shown to help is taking deep belly breaths. Next time you find yourself beginning to feel anxiety or panic, try to recognize how your gut tells you to react and think about what the opposite might be.

 

The next time you are experiencing high anxiety or a panic attack be AWARE

Acknowledge and accept the feelings

Wait and Watch – recognize what the sensations in your body and your thoughts (this could be a good time to try doing the opposite of your usual)

Action – make yourself comfortable while waiting for it too pass

Repeat – go through steps a-c and try to think to yourself it will end no matter what I do

End of intense anxiety or panic attack

 

Our therapists at CARE Counseling are trained and competent in working with those experiencing symptoms of anxiety. Your counselor will be able to help explore with you common patterns of negative thinking, help you develop successful coping skills, and teach calming strategies.

 

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11 Ways to Stop a Panic Attack

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Panic attacks can be scary and can hit you quickly. Here are 11 strategies you can try to stop anxiety when you are experiencing a panic attack.

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This Is When to See a Mental Health Professional About Your Anxiety

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It seems everyone is talking about anxiety these days, and that’s not a bad thing. Shining a light on mental health helps reduce the stigma that keeps many people from seeking support.

At the same time, it can be hard to know if the worries and racing heart you experience at the thought of, say, meeting new people, is run-of-the-mill stress, or if you’re actually experiencing some level of anxiety and could benefit from seeing a professional.

“I can’t tell you how many people I see who say, ‘I don’t know if I should be coming in here,’” clinical psychologist Robert Duff, Ph.D., author of Hardcore Self Help: F**k Anxiety., tells SELF. “On a broad scale, [talking about anxiety] is positive, but I don’t blame anyone for the confusion.”

Figuring out how serious your anxiety is can be tough because anxiety is a normal and essential part of being a human.

“Anxiety is a reaction to a situation we perceive as stressful or dangerous,” Monique Reynolds, Ph.D., licensed clinical psychologist at the Center for Anxiety & Behavioral Change in Rockville, Maryland, tells SELF. This produces a stress response in your body—specifically, your brain’s hypothalamus triggers your sympathetic nervous system to release norepinephrine (aka adrenaline) and cortisol (a stress hormone) to get you out of harm’s way.

This is actually a good thing when there is a real threat of danger present. “A major part of our brain’s job is to keep us alive, and fear and anxiety are a big part of that,” Reynolds says. For example, the anxiety you would feel at seeing a truck hurtling towards you would make you move from its way more quickly.

But if you have anxiety, that stress response can kick in when it shouldn’t. “You feel very much the way you do when in a dangerous situation…[but] there’s no real danger there,” Duff says. Instead of being helpful, this misfiring of your fight or flight reaction can hinder you.

While a little anxiety can also help you to perform at an optimal level under stress, giving you a burst of adrenaline and hyper-focus to finish a business proposal before deadline or nail that dance number at a performance, living in a constant heightened state of anxiety can be distracting at best and debilitating at worst. When anxious thoughts are interfering with your life and causing you significant distress, that isn’t something you should just chalk up to nerves and push through. That’s something you can get help with.

Anxiety is the most prevalent mental illness in the United States, and it comes in various forms.

Anxiety affects about 40 million American adults each year, according to the Anxiety and Depression Association of America (ADAA). But it’s not as cut-and-dry as saying that anxiety is simply when you feel nervous all the time. This mental health condition comes in many forms.

Generalized anxiety disorder (GAD) is characterized by having excessive worries and fears for months, according to the National Institute of Mental Health (NIMH). Per the ADAA, GAD affects 6.8 million U.S. adults each year. Panic disorder involves spontaneous bouts of debilitating fear known as panic attacks, along with intense worry about when the next attack will come, according to the NIMH. Per the ADAA, it affects 6 million American adults each year. Social anxiety disorder (also known as social phobia) happens when you have a marked fear of social situations in which you might be judged or rejected, as well as avoiding these situations or experiencing symptoms like nausea, trembling, or sweating as a result.

Then there are other issues that are closely related to anxiety, like obsessive-compulsive disorder, which involves intrusive thoughts and urges, and posttraumatic stress disorder, which happens when people have a prolonged stress response to harrowing situations.

These are just some of the various anxiety and anxiety-adjacent disorders out there. That these issues can present in myriad ways can make it even harder to know if what you’re experiencing is anxiety that could benefit from outside help.

“Some people feel they can control their anxiety, some feel it’s something they ‘should’ be able to manage, some feel shame, some fear they might be ‘crazy,’ and others downplay how much their anxiety is impacting them,” Reynolds says.

If anxiety interferes with your daily life—whatever that might look like to you—that’s reason enough to see a mental health professional.

“When your world starts to become limited because of anxiety, that is a good signal that it’s time to seek treatment,” Reynolds says. “What is it doing to your life, your relationships, your sleep, health, work, and ability to learn and pursue things that are important to you?”

This “functional impairment,” as Reynolds calls it, can show up in different ways in different people. Is anxiety making you avoid doing things with loved ones because you’re too nervous to go outside? Do you skip school or work out of fear of what people may think of you? Can you not get enough sleep because you’re up all night worrying about the next day? Is your anxiety over certain tasks, like paying bills, leading to procrastination so extreme it comes with consequences, like getting your lights turned off?

Keep tabs on whether you’re blowing up at people, too. Anger and irritability can sometimes be a sign of anxiety. “We often forget that fight or flight includes ‘fight,’” Reynolds says. “If you have a shorter fuse or are always on edge for triggers, it could be related to anxiety.”

So, too, could physical issues. “We think of ourselves as these disembodied heads floating around,” Reynolds says. “We forget that there is a big feedback loop between the nervous system and the body.” Every part of you, from your head to your stomach to your feet, has nerves to regulate important processes, which is why your sympathetic nervous system’s stress response can be so far-reaching. You even have an entire nervous system reserved for gastrointestinal function, known as your enteric nervous system, which may help explain why there’s such a strong link between issues like irritable bowel syndrome and anxiety.

Constant fatigue can also kick in if your anxiety is in overdrive. “The physical reaction to anxiety, by nature, is supposed to be short-term. The body is supposed to come back down to baseline,” Duff says. “But a prolonged period of anxiety depletes your resources and exhausts you.”

“If your anxiety is bothering you and you are suffering, you deserve to get help,” Duff says. That’s true whether or not you think your anxiety is serious, whether or not you think you meet diagnostic criteria you read online, and whether or not your friends and family treat your anxiety with the weight it deserves. And if your anxiety is getting to the point where you’re worried for your safety, call 9-1-1 or the National Suicide Prevention Lifeline (it’s available 24 hours a day, seven days a week at 1-800-273-8255), or go to the emergency room, Reynolds says.

Seeing a therapist can be anxiety-inducing on its own, but it’s worth it. Here are a few ways to make it easier.

Knowing what to expect at your first therapy session may make the experience less scary. Although every professional is different, you’re likely to get a lot of questions at the first visit. Ultimately, your psychologist or therapist’s goal is to learn what troubles you’re having so that they can create a plan to help you build the skills you need to address your anxiety.

They’ll also want to figure out which kind of therapy best matches your needs. Different forms, like cognitive behavioral therapy, which aims to help people change negative thought patterns, work for different people.

Since the cost of therapy can be prohibitive, know that there are resources to help you find affordable treatment, like the National Alliance on Mental Health’s HelpLine at 1-800-950-6264. The HelpLine is available Monday through Friday, from 10 A.M. to 6 P.M., and you can explain your specific situation to the staffer or volunteer who answers. They may be able to refer you to local organizations that offer more affordable treatment. You can also try the Substance Abuse and Mental Health Services Administration (SAMHSA) treatment locator tool, which can help you find mental health providers who take various forms of insurance, offer payment assistance, or use a sliding scale. Resources like GoodTherapy also allow you to limit search results to therapists who use sliding scales.

And don’t stress about meeting some arbitrary threshold of anxiety for your appointment to be worth the effort. “Somebody with anxiety [may] think there is a risk to seeing someone. ‘If I go and don’t have an anxiety disorder, there’s something bad about that,’” Duff says. “That’s not true. If you are suffering and seeing some of these signs, that’s enough.”

It may be that all you need is a few sessions, or you may meet weekly for months or years based on your goals. Your psychologist or therapist might decide medication would help you live your healthiest, happiest life, or just having someone to talk to might work for you. Also, if you decide you’re not really into the person you’re seeing but you still want help, there’s absolutely nothing wrong with trying someone else, Duff says.

Ask yourself what kind of life you want to live and what’s holding you back from achieving it, Reynolds says, adding, “If there’s anything related to fear and anxiety, it’s a great sign that maybe you need support around those things.”

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Anxiety + Diabetes

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WRITTEN BY: Kristi Caporoso, MSW, LSW

State(s) of Fear

Anxiety has become one of the most commonly diagnosed mental illnesses in the United States. It seems everywhere you turn, someone is talking about it. Whether it’s their child or themselves that are afflicted, everyone and their mother seems to suffer from some level of anxiety. There has been a particular uptick in the level of anxiety reported in children and adolescents. While mental health professionals are trying to put their finger on what exactly is contributing to this – technology, political climate, homework – you don’t have to dig deep to find a reason for increased levels of anxiety in those living with Type 1 diabetes. To begin unpacking this issue, first let’s take a look at what the “A” word actually means.

What is anxiety, exactly?

A certain level of anxiety is healthy – necessary, even. It is what prevents us from engaging in dangerous behaviors, and what keeps us motivated to accomplish the things we need to do. The dictionary definition of anxiety reads as follows: “distress or uneasiness of mind caused by fear of danger or misfortune.”1 When this distress gets too high, or is disproportionate to the situation provoking it, the person tends to suffer from anxiety instead of benefitting from it.

Some of the more common forms of anxiety disorders are:

Generalized Anxiety Disorder (GAD)

A prolonged state of worry or tendency to worry about any and everything. GAD can have physical manifestations, such as GI problems and difficulty sleeping.  Someone living with GAD will have a tendency to view everything through a lens of anxiety, and be bombarded with “what-ifs?”

Panic Disorder

Panic disorder can occur after a person experiences one or multiple panic attacks, and is living in constant fear of the next one occurring. Everyone experiences panic attacks in different ways, but the most common symptoms are shortness of breath, feelings of impending doom, de-personalization (that feeling when you are floating outside your body), and heart palpitations, to name a few.

Social Anxiety Disorder

Basically what it sounds like, social anxiety disorder is when people experience extreme discomfort and anxiety around other people. This anxiety is rooted in the fear of what others think of you, or of embarrassing yourself or looking foolish.

Diabetes & Anxiety

T1D and anxiety are made to exacerbate one another. The fears and thought patterns that fuel anxiety are inherent to managing diabetes. On the flip side, struggling with anxiety can wreak havoc on your blood sugars. The more time I’ve spent working with and trying to pick apart anxiety disorders, the more I’ve realized how counterintuitive diabetes management is to anxiety levels.

What ifs

Running through the back of every anxious mind is a pestering whisper of what if? “What if I die?” “What if I embarrass myself?” “What if I fail?” These persistent questions can be crippling. However, when managing diabetes, it is often necessary to ponder what if. For example, I am about to pre-bolus for my dinner on my way home, but what if I get stuck in traffic? I am preparing for a run by adjusting my dosage and snacking, but what if it rains?

At the forefront of diabetes management is planning. Unfortunately, planning often invites what ifs, and what ifs can easily manifest into anxiety. When you are living with anxiety, it is often difficult to differentiate between rational or helpful what ifs and irrational, detrimental ones. Considering the rain or traffic while planning your insulin dosage can be productive, while repetitively pondering the possibility of going low and passing out during your exercise routine is not.

Living in the present

Similarly, planning for diabetes care can interfere with being present in the current moment. In recent years there has been growing evidence of the efficacy of mindfulness-based stress reduction (MBSR) and meditation for treatment of anxiety2. Much of our worry is rooted in what may or may not happen in the future. But it is hard to focus on the present moment and often difficult to be spontaneous when you’ve got insulin on board (IOB), sensors with downward-pointing arrows, and a fixed amount of juice in your handbag. Even the actual practice of meditation can be interrupted by alerting insulin pumps and CGMs. As mentioned above, diabetes management involves a lot of planning. And a lot of planning means a lot of future-oriented thinking.

Checking

Much like planning, with diabetes checking is essential. Checking you blood sugar, checking your IOB, checking your low supplies. But for someone with anxiety, checking can spiral into an obsessive ritual. People suffering from obsessive-compulsive disorder (OCD) have certain rituals they perform to quiet obsessive thoughts that repeatedly run through their mind. Because checking is so essential for diabetes management, it’s easy for someone susceptible to anxiety to fall into a pattern of over-checking. Picture this: you feel anxious about going low, check your sensor data and see no downward arrows. You feel a temporary wave of relief. But moments later, those thoughts recur. They get louder and louder in your head, until you have to check your sensor again – still no downward arrows. You see how this can fall into a negative thought-behavior cycle.

Where do we go from here?

Fortunately, much like type one, anxiety is manageable. But it takes work. If you feel like anxiety is interfering with you or your child’s everyday life, consider seeing a therapist. There are many therapists who have experience working with people with chronic illness. And if they don’t, BT1 has a helpful guide to teach them about type 13.

Where to start: finding a therapist

Your primary care doctor or pediatrician may have some referrals. Or, if you feel comfortable, ask around. It’s more than likely that many people in your life see a therapist and you have no idea. Or, if you have private insurance, you can try calling the “Member Services” number on the back of the insurance card and asking for referrals to local in-network behavioral health providers. There are also many ways to locate a therapist online:

If you have Medicaid (or Medical, or your state’s equivalent), your state’s Division of Mental Health and Addiction Services should have resources for local community mental health centers that accept this insurance. Your therapist or primary care doctor will also be able to suggest if you should consult a psychiatrist. A psychiatrist can prescribe medications for behavioral health concerns.

While diabetes and anxiety may make a great pair, you don’t have to constantly live at their mercy. As you learn to accept and manage your anxiety, you’ll learn how to live well with it. It won’t be easy, and there’s a lot of trial and error. Of course, having type one means you’re used to that! And always remember, you’re not alone in this.

REFERENCES

  1. HTTP://WWW.DICTIONARY.COM/BROWSE/ANXIETY?S=T
  2. HTTPS://WWW.MINDFUL.ORG/JON-KABAT-ZINN-DEFINING-MINDFULNESS/
  3. HTTPS://BEYONDTYPE1.ORG/T1D-GUIDE-MENTAL-HEALTH-CARE-PROVIDERS/

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Don’t Get Crushed By Anxiety

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By Laura Greenstein

Have you ever felt hesitant about approaching someone you met eyes with? Or felt nervous talking to someone you’re interested in? Or felt a knot in your stomach while finding the courage to ask someone on a date? Most likely, you’ve experienced at least one—or maybe all—of these feelings, because anxiety and dating are a difficult pair to separate.

Dating enhances several of our deepest fears: rejection, being judged, getting emotionally wounded. It can be challenging to overcome these fears and put yourself out there. In fact, our dating culture has shaped itself aroundthese fears in an attempt to make the process of dating “easier.” But in many ways, this evolution has made dating more complicated and anxiety-inducing than ever. Take, for example:

Meeting People Online

Many online websites and apps have been created so people can screen potential suitors before ever having to physically meet them. For those who engage in online dating, there is a multitude of new concerns to contend with: Is this person real or are they just “catfishing” (using a fake profile)? How are they going to perceive me based on my profile? What questions can I ask to get to know them? This is all before the anxiety of actually meeting the person.

Knowing “The Rules”

It has become the norm to refrain from showing too much interest in someone you’re getting to know. This standard has produced a set of unspoken “rules” for any person engaging in modern dating culture. Some of these rules include:

  • Don’t double text (i.e. send an additional text before the person responds to your first text). This makes you seem too eager.
  • Don’t call someone. This will likely be met with distaste and confusion because phone calls are essentially obsolete.
  • Don’t respond immediately to a text message. This makes it seem like you were sitting around waiting for them to text you.
  • Don’t “like” any old posts or photos on their social media. Otherwise, they will know you were “Facebook stalking” them, or intently monitoring or looking through their Facebook updates or history.
  • Don’t let them see you typing for too long on systems that show the other person when you are typing a message (e.g. iMessage, Facebook Messenger, etc.). Then they will know you were putting a lot of thought into saying the perfect thing.

If someone breaks these rules, they are typically perceived as desperate and unattractive. So if we like someone, we have to bury it away. It’s almost a competition of who can be less interested. How can our pride be hurt if our attitude is: “Oh I wasn’t really that into you anyway”?

Dealing With “Trendy” Rejections

The way people reject those they are casually dating is constantly changing based on what’s “in.” For a while, the trend was “ghosting,” or abruptly ignoring the person on every channel of communication. This causes the person rejected to anxiously wonder when the other person will respond and what they did so wrong. Similarly, there is also the “slow fade,” which is the same thing, except more drawn-out.

As if those trends weren’t bad enough, there’s a new one coined “breadcrumbing,” which is not being interested in someone, but continuing to lead them on. People who do this are trying to keep a person interested while they seek out other options.

How Can We Make This Easier?

With all these challenges (and more), it’s important to maintain your mental health when trying to connect with someone. And it’s important to remember that dating isn’t hopeless—even if you experience a mental health condition that makes it even harder. Here are a few things you can do to reduce your anxiety while dating:

❤️ Accept Yourself First

As cliché as it sounds, it is essential to love yourself and be happy with who you are before you add another person to the mix. A lot of dating anxiety happens because of insecurities within ourselves. Learning to be content and fulfilled while single before looking for a relationship is extremely helpful towards dating in a healthy way. When your happiness isn’t dependent on your search, you won’t put as much pressure on the situation or feel as anxious about every person you meet.

“Your relationship with yourself sets the tone for every other relationship you have.” – Robert Holden 

❤️ Be You Always

Once you have accepted yourself, you will feel comfortable being open and honest about who you are. You will respect yourself and won’t waste your time playing the usual games to pique someone’s interest. If someone doesn’t like you or the fact that you are open with your feelings, then they’re not the type of person you should be with anyways.

❤️ Dismiss Exaggerated Thoughts

Thoughts that rev up anxious thoughts need to be either ignored or thought through in a logical way. For example: “I’ll be alone forever” is not a rational thought. Yes, you may have to wait to find someone, but most likely, you will not be alone for the entirety of your life. Being able to recognize that a thought is exaggerated can be helpful in minimizing your anxiety.

❤️ Know It’s Okay to Feel Anxious

It’s okay to feel nervous, awkward and uncomfortable when first meeting someone. And it’s also okay to tell them that when you meet them—chances are they feel the same way. After all, it’s human nature to feel nervous at the prospect of finding a partner.

 

Laura Greenstein is a communications coordinator at NAMI.

 

https://www.nami.org/Blogs/NAMI-Blog/April-2017/Don-t-Get-Crushed-by-Anxiety