Everyone Experiences Stress and Anxiety

GROUP EXPECTATIONS: 

  • You are expected to attend consistently and to participate in a constructive manner.
  • Group runs 9:00 AM through 12:00PM, there are two 10 minute breaks.
  • Maintain Confidentiality. It is essential that everything said in group therapy is kept private by all group members and leaders. 
  • Respectful to others.  Expected to listen attentively, refrain from disruptive behavior, and tolerate differences in personal opinion and opposing value systems. 
  • No cellphones.

​ICEBREAKER - What are some things that make you feel stressed? How are you coping with these things?


Place a checkmark next to any of the following problems you have experienced in the past 30 days:

□ Sleep problems (for example, difficulty falling asleep, waking up off and on during the night, nightmares, waking up early and being unable to fall back to sleep).
□ Headaches
□ Stomach problems
□ Chronic illness
□ Fatigue
□ Moodiness 
□ Irritability 
□ Difficulty concentrating 
□ General dissatisfaction with life
□ Feeling overwhelmed

If you checked two or more of these items, you may need to make some changes in your life to reduce the level of stress. Becoming more aware of stress is the first step to reducing it. You may have been accustomed to turning to substance use in times of stress. Learning new ways to cope with stress is part of the recovery process. 

ANXIETY is a part of our bodies’ natural alarm system.

Anxiety is a part of our bodies’ natural alarm system, the “fight or flight” response, which exists to protect us from danger. These natural body responses are not harmful — but they are really uncomfortable!

The most pure form of the “fight or flight” response is a panic attack, which involves a rush of anxiety symptoms, many of which are listed below, usually peaking in about 10 minutes. In these cases, the body is trying to tell us something dangerous is happening right now!”

Other forms of anxiety that are less acute but often just as debilitating, such as chronic worry, involve symptoms similar to the “fight or flight” symptoms of panic attacks. However, in these cases, it is as if the body is saying something dangerous is going to happen sometime in the future… so watch out!” The differences between the two are the intensity of the response and the context in which it is triggered.

For this discussion will refer to all anxiety symptoms as being related to the “fight or flight” response. The most common anxiety symptoms are listed below. 

Handout

Anxiety is as vital to our survival as hunger and thirst.

Why can’t I just get rid of my anxiety?
Anxiety is as vital to our survival as hunger and thirst. Without our “fight or flight” response we would not be as aware of possible threats to our safety. We also might not take care of ourselves or prepare adequately for the future. When our body’s “fight or flight” alarm is triggered, a domino effect of chemical changes and messages are sent to various parts of the brain and body, producing these symptoms. This process is programmed to last only about 10 minutes, unless it is triggered again.


​Why Does My Body Do This?

There is a reason! We have evolved over millions of years to better protect ourselves. Our brains have learned to automatically signal danger when it is present or we perceive that we may be harmed in some way. Each symptom of anxiety has a specific evolutionary purpose: to help us “fight” or “flee.” Try to figure out how each symptom of anxiety is used by our bodies to protect us when we are in danger, by matching the evolutionary purpose with the anxiety symptoms. Some in the right-hand column may be used twice, and there may be multiple answers for some symptoms.

Take a minute to explore the list, and then write down the ones that apply to you. 
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What are some positive things you notice about yourself when you're feeling anxious?
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Who are the people in your life who provide you with support during anxious times?
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Can you describe a situation where you successfully managed anxiety using a coping strategy?
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“How do I know if I have an Anxiety Disorder?”

An anxiety disorder is diagnosed when someone experiences anxiety symptoms and these symptoms:

  • the symptoms interfere with a person’s life aims.
  • the symptoms happen too often or with too much intensity, given the actual danger of a situation.
  • the symptoms are not explained by other factors, such as a medical problem or substance abuse.

What triggers anxiety and how the brain comes to believe these triggers are dangerous. 

Our brains are designed to keep us safe. The anxiety part of the brain, the amygdala, is like a radar that is trained to spot dangerous objects and situations. When this “radar” spots something that could be dangerous, it tells the brain to begin the “fight or flight” response, producing the uncomfortable feelings we get when we are anxious.

Nearly anything can be trained to trigger the “fight or flight” response. Psychiatrists, psychologists, psychiatric nurses, and clinical psychiatric social workers have tried to find ways to tell the difference between different types of anxiety triggers. Anxiety disorder diagnoses come out of this attempt. While a diagnosis is not a perfect way of describing a person’s experiences, it can help us to know what types of treatments may be effective. Different groups of triggers and the diagnoses most frequently associated with them are listed below. Some of these categories overlap, and it is possible for one person to have more than one diagnosis.


What if I don’t know what triggers my anxiety?

For the sake of treatment, it is important to learn to identify what it is that makes you anxious. For some people it is very clear; for others, anxiety seems to come from “out of nowhere.” To identify what makes you anxious, ask yourself the following questions:

  • “When I feel scared or nervous, what is going on around me or what am I thinking about?”
  • “Am I worried about having more anxiety in the future?”
  • “Am I afraid of body sensations that remind me of intense anxiety attacks?”
  • “Do I ever try to do more than I can handle or create unrealistic expectations for myself or others?”
  • “Am I worried that I will not be able to cope if bad things happen in the future?”

Exercise - My anxiety triggers are:

List here the objects, situations, events, or places that tend to trigger your anxiety. Use the questions above if you are having trouble figuring out what makes you anxious.

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Anxiety 'FUEL'

When we feel anxious, we typically want to do something to make ourselves feel better. Most of these behaviors feel natural because our bodies also want to keep us safe. However, some of these behaviors can make things worse; by adding “fuel” to the anxiety “fire.” We can add fuel gradually over time or dump lots on all at once. In all cases the anxiety “fire” gets bigger.

What behaviors are in danger of causing the anxiety to get worse? Anything that teaches the amygdala (the anxiety center of the brain) that something is dangerous. Remember our spider example? Let’s say that every time this man sees a spider he tries to avoid it by getting away. What does this teach him? That the spider is dangerous, of course!

Each time he avoids the spider, his amygdala gets more feedback that the spider is dangerous. Next time he sees the spider, his anxiety “alarm” will be louder, or it may go off more quickly than before. The process by which the brain learns that something is more dangerous over time is called sensitization. It is also called reinforcement of the anxiety because the anxiety response gets stronger and stronger. Reinforcement can happen both in the short term (when the danger seems to be present) or in the long term, as we discuss below.

Whether in the short run or over time, anxiety feelings, fearful thoughts, and protective, “safety” behaviors work together to keep our anxiety “fire” burning. Each feeds off the others, and any one of these can act as the “match” to get the fire started. Our goal is to work on these thoughts and behaviors to help extinguish the fire as much as possible.