Understanding & Overcoming Anxiety
Goal
To be able to understand anxiety, how it is impacting you, and how it can be overcome
What is Anxiety? (Greenberger & Padesky, pp. 174-175)
The word “anxiety” describes a number of problems including phobias (fear of specific things or situations, such as heights, elevators, insects, flying in airplanes), panic attacks (intense feelings of anxiety in which people often feel like they are about to die or go crazy), posttraumatic stress disorder (repeated memories of terrible traumas with high levels of distress), obsessive-compulsive disorder (thinking about or doing things over and over again), and generalized anxiety disorder (a mixture of worries and anxiety symptoms experienced most of the time). Anxiety also describes brief periods of nervousness or fear experienced when faced with difficult life experiences. Numerous cognitive, behavioral, physical, and emotional symptoms are associated with anxiety. This course is designed for general anxiety problems.
Cognitive Symptoms
- Overestimation of danger
- Underestimation of your ability to cope
- Underestimation of help available
- Worries and catastrophic thoughts
Behavioral Changes
- Avoiding situations where anxiety might occur
- Leaving situations when anxiety begins to occur
- Trying to do things perfectly or trying to control events to prevent danger
Emotional Symptoms
- Nervous
- Irritable
- Anxious
- Panicky
Physical Symptoms
- Sweaty palms
- Muscle tension
- Flushed cheeks
- Light-headedness
All of the physical, behavioral, and thinking changes we experience when we are anxious are part of the anxiety responses called “fight, flight, or freeze.” These three responses can be adaptive when we face danger. Unfortunately, we also experience these reactions when danger is not present, when danger is not as serious as you might think, or when too much anxiety interferes with good coping.
Identifying & Assessing Symptoms Exercise (Greenberger & Padesky, pp. 177-179)
Instructions: To help identify the symptoms of anxiety you are experiencing, rate the symptoms listed in the anxiety inventory table below. Circle one number for each item that best describes how much you have experienced each symptom over the last week.
Fill out this anxiety inventory once or twice per week as you complete this course to assess how your anxiety is changing and which interventions are most worthwhile. Score the inventory by adding up the numbers you circled for all the items. For example, if you circled 3 for each item, your score would be 72 (3 X 24 items). If you couldn’t decide between two numbers for an item and circled both, add only the higher number. To chart change, record your anxiety inventory scores in the tracking table on page 3. Mark each column with the date you completed the anxiety inventory. Then put an X in the column across from your score.
| Anxiety Inventory | ||||
|---|---|---|---|---|
| Symptom | Not at all | Sometimes | Frequently | Most of the time |
| 1. Feeling nervous | 0 | 1 | 2 | 3 |
| 2. Frequent worrying | 0 | 1 | 2 | 3 |
| 3. Trembling, twitching, feeling shaky | 0 | 1 | 2 | 3 |
| 4. Muscle tension, muscle aches, muscle soreness | 0 | 1 | 2 | 3 |
| 5. Restlessness | 0 | 1 | 2 | 3 |
| 6. Easily tired | 0 | 1 | 2 | 3 |
| 7. Shortness of breath | 0 | 1 | 2 | 3 |
| 8. Rapid heartbeat | 0 | 1 | 2 | 3 |
| 9. Sweating not due to the heat | 0 | 1 | 2 | 3 |
| 10. Dry mouth | 0 | 1 | 2 | 3 |
| 11. Dizziness or light-headedness | 0 | 1 | 2 | 3 |
| 12. Nausea, diarrhea, or stomach problems | 0 | 1 | 2 | 3 |
| 13. Frequent urination | 0 | 1 | 2 | 3 |
| 14. Flushes (hot flashes) or chills | 0 | 1 | 2 | 3 |
| 15. Trouble swallowing or “lump in throat” | 0 | 1 | 2 | 3 |
| 16. Feeling keyed up or on edge | 0 | 1 | 2 | 3 |
| 17. Quick to startle | 0 | 1 | 2 | 3 |
| 18. Difficulty concentrating | 0 | 1 | 2 | 3 |
| 19. Trouble falling or staying asleep | 0 | 1 | 2 | 3 |
| 20. Irritability | 0 | 1 | 2 | 3 |
| 21. Avoiding places where I might be anxious | 0 | 1 | 2 | 3 |
| 22. Frequent thoughts of danger | 0 | 1 | 2 | 3 |
| 23. Seeing myself as unable to cope | 0 | 1 | 2 | 3 |
| 24. Frequent thoughts that something terrible will happen | 0 | 1 | 2 | 3 |
Score (of total circled numbers) = _____
| Anxiety Inventory Tracking | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Score | ||||||||||||||||
| 72 | ||||||||||||||||
| 69 | ||||||||||||||||
| 66 | ||||||||||||||||
| 63 | ||||||||||||||||
| 60 | ||||||||||||||||
| 57 | ||||||||||||||||
| 54 | ||||||||||||||||
| 51 | ||||||||||||||||
| 48 | ||||||||||||||||
| 45 | ||||||||||||||||
| 42 | ||||||||||||||||
| 39 | ||||||||||||||||
| 36 | ||||||||||||||||
| 33 | ||||||||||||||||
| 30 | ||||||||||||||||
| 27 | ||||||||||||||||
| 24 | ||||||||||||||||
| 21 | ||||||||||||||||
| 18 | ||||||||||||||||
| 15 | ||||||||||||||||
| 12 | ||||||||||||||||
| 9 | ||||||||||||||||
| 6 | ||||||||||||||||
| 3 | ||||||||||||||||
| 0 | ||||||||||||||||
| Date: | ||||||||||||||||
Overcoming Anxiety (Greenberger & Padesky, pp. 184-189)
Anxiety can almost always be helped. The treatment approaches that have been shown to be most effective in reducing anxious feelings include cognitive restructuring, relaxation training, overcoming avoidance, and medication.
Cognitive Restructuring
Anxiety can be reduced by decreasing your perception of danger or by increasing your confidence in the ability to cope with threat. Evaluating anxious thoughts is helpful in order to more quickly and accurately evaluate the danger and its consequences. Anxiety may decrease if you examine the evidence and discover that the danger you face is not as bad as you thought. When threats or dangers are present, it is helpful to figure out what strategies will best help cope with them.
Relaxation Training
Relaxation can be accomplished through either physical relaxation or mental relaxation. Both methods can be equally effective. When we are physically relaxed, mental relaxation follows and when we are mentally relaxed, physical relaxation follows. Relaxation training can alleviate anxiety because it is difficult for the body or mind to be simultaneously relaxed and anxious. If you develop the ability to relax before and during stressful situations, then you can substantially reduce the frequency and severity of the anxiety you experience.
Overcoming Avoidance
Avoidance is a hallmark of anxiety. When we avoid a difficult situation, we initially experience a decrease in anxiety. Ironically, the more we avoid a situation, the more anxious we become about facing it in the future. In this way, avoidance in the long run actually feeds anxiety, even though it seems to help anxiety in the short run. To overcome anxiety, we need to learn to approach the situations or people we avoid.
Medication
The use of medication to treat anxiety is controversial due to the addiction potential many anxiety medications possess. They can also potentially interfere with developing coping skills to overcome avoidance and managing anxiety without medication. Medication to treat anxiety is appealing, however, since it produces relaxed, calming sensations. Some antidepressant medications are used to treat anxiety but they are not always effective.
Next Step
Learn more about how anxiety develops and is maintained by watching this video:
