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Understanding Anxiety

Types of Anxiety

Social Anxiety – When you’re a teen you start being more aware of what other people think. There seems to be a “right” thing to wear, or say, or do. There also seem to be things that you shouldn’t do—things that could be embarrassing, or lose you points with friends. This can lead to social anxiety.

General Anxiety


How Does Anxiety Affect the Brain

3D Brain – Use your touch screen to rotate and zoom around 29 interactive structures. Discover how each brain region functions, what happens when it is injured, and how it is involved in mental illness. Each detailed structure comes with information on functions, disorders, brain damage, case studies, and links to modern research.

Executive Functioning – These five areas of the brain allow for attention, working memory, planning, organizing, forethought, and impulse control. They include the Cerebellum, Occipital Lobe, Parietal Lobe, Frontal Lobe, and the Temporal Lobes.

Frontal Cortex (PFC) – allows for analysis and decision making. Creates intentions. This is the area that we use when making decisions about how we feel and what we should do with this information.

Anterior Cingulate Cortex (ACC) – allows for rumination, cooperation and contributes for problem solving and making effective transitions. Sometimes it is called the Cingulate Cortex or the Cingulate Gyrus. This system allows your to shift to a new experience without anxiety. This is like the gear shift to a new thought and perspective and behavior. When we have anxiety, it is this area of the brain that needs to be given a bit of space and time to allow for adjustments to your surroundings. This area allows for quick problem solving.

Basal Ganglia – several clumps of neurons that surround the Limbic system that allows for your general level of energy to be set. This is the overall alertness of a person. It also sets up automatic responses to a a cue. Habits…this is your short hand to behavior so you don’t have to think so much about common tasks. Think – riding a bike – doing it without conscious thought. The challenge is that this system will at times set you up for responding to anxious settings in similar ways, no matter the “threat.”

Insula – this is where we register physical sensations where we understand how our bodies are physiological sensations. This information is added to your memory of the event. If you feel anxious, upset, and in pain, we will store these memories away for later. Even joy and pleasure.

Limbic System – there is no thinking here. But it supports the Hippocampus. This area notes the event, helps rehearse and retrieving long term memories. This system will activate the Sympathetic Nervous System (SNS) or fight or flight system. Amygdala is completely developed at birth. Here we hold the memory of the importance of an event. Is it safe or not safe. It is your 24/7 smoke detector for risk and safety. It signals the body to respond. It determines the level of risk. And sends a nervous system response very very fast. Once it learns that something is dangerous, it never unlearns it. It is with you all of your life.

30 second Exercise – Close your eyes and think about newly mowed grass. Ok, now think about the first thing that came to your mind? Maybe the smell? Why? It is the most important context of a memory that you have. What came up next? Maybe something visual? What did you think about next? Maybe it was a sense of pleasure or not pleasure. Most of us is pleasurable. This is an example of implicit memory. When I think about grass, I feel good. Then we begin to remember stories that validate that feeling. But the immediate is implicit memory. The adding of a story is a part of the frontal cortex. The hippocampus will help retrieve these details.

GABBA will slow the firing of neaurotransmitters. while Glutamate and Acetylcholine will excite firing. Medication attempts to rebalance these firings. However, these medications affect memory and become addictive and ineffective. Treatment is focused on attempting to increase the ability for GABBA to work more effectively.
Serotonin – helps us modulate our responses, but has a different affect in different areas of the brain and the system’s purpose. SSRI and SNRI focus on balancing serotonin in different mental systems.
Norephinephrine – the brain’s energizer bunny that allows the person to remain alert or vigilance. Without the balance of GABBA can create dread and worry. This is released when, for example, when there is a trigger of stress. This chemical will be pumped into the body to activate systems.
Dopamine – When dopamine is pumped into the system through the Reward pathway, or the nucleus accumbens, gives a sense of pleasure. For example, I decided to do something in my frontal cortex, glutamate is transmitted in thinking to activate systems to act or move into activity. And if it turns out well, dopamine is released to give a positive warm feeling that creates motivation to do it again. When someone praises you, you get dopamine. When we interact with other people, we get a lot of dopamine, especially laughing with other people. Therefore, laughing is a great natural way to counteract anxiety and depression. Some experience low motivation because of a low number of dopamine receptors. This will be expressed by the person saying that they do not find pleasure in relationship with other persons.

Dopamine within the frontal cortex allows for focus on a topic. When there is a strong release of dopamine in the frontal cortex, it can cement cues within the amygdala permanently. While this happens the Hippocampus is taking in the information and storing it in the amygdala for it to record the pain and cues together to be used in the future. The cues do not always make sense to the person, but it does not rely on narrative meaning to be stored. It can just be stored with images and smells.

Most anxiety can be managed well without medications. Techniques can be added to help support the management of anxiety, but is about skill building. Pills don’t teach skills. Applying skills long term will more permanently change the brain.

Dopamine and Messaging – Every time interest is activated, a shot of dopamine is released. When this is done over and over again, the signal that a message is being sent offers the shot of reward.

Features that support social anxiety
1. Amygdala volume – having a slightly enlarged amygdala can increase the tendency to perceived threat. This is called for a preference for negativity.
2. Insula sensitivity to acetylcholine results in an intolerance to anxiety sensations.
3. Lower number of dopamine receptors that lowers motivation for social connection.

This creates treatment that is best approached with three goals: Increase tolerance for anxiety, decreasing the perception of threats, and increasing the motivation to participate in social engagements.

Strategies for Reducing Anxiety

Navigating challenges can be stressful, and sometimes deep breathing isn’t the solution that works for you. When you need other ideas, move through the following techniques until you develop a list of possibilities.

Exercise. Recommendation of 52 hours of aerobic exercise over 6 months. Improves resilience to stress and decreases the impact of stress.

Sleep. Adults need 7.5 to 8 hours of sleep. Check out to better understand sleep. Consider help with insomnia with CBTiCoach app.

When using Technology, Plan the Ending Before Beginning. Before you begin using your phone, watching a movie, or playing a video game, plan the ending before you begin. Include in this time, use a transition time between that activity and the next activity. Things that could work like read a book, listen to music, do something with your hands, clean your room.

Try an inversion. For centuries, Yogis have understood the calming power of bringing the head below the level of the heart, otherwise known as inversion. Whether it’s relaxing in child’s pose, bending over to touch your toes, or practicing a headstand, inverting the body has a restorative effect on the autonomic nervous system, which controls the body’s response to stress.

Visualize a quiet place. Research has shown that visualization is beneficial for a range of populations to reduce stress levels. Ask your child to close their eyes and picture a calm, peaceful place. Then, gently guide them to slowly start to build up a picture of how it looks, smells, and feels to be there.

Do the “Downward Facing Dog” pose. Just like inversions help reset the autonomic nervous system, the yoga pose known as Downward Facing Dog in particular has the added benefit of activating several muscles in the arms, legs, and core. This stretch helps muscles begin to burn additional blood glucose that is made available by the body’s fight or flight response.

Paint it out. Not only does painting give the brain something to focus on other than the stressor, but participating in visual arts has been linked to resilience to stress in general. If the thought of dragging out the tempera gives you stress, have your child try “painting” with shaving cream on a plastic shower curtain in the yard. Not only is clean up a breeze, but your child will smell great when they are finished.

Jump rope. Set a timer for 2 minutes, put on some music, and challenge your child jump to the beat of the song. If your child isn’t able to jump rope, playing hop scotch is a great alternative.

Take a hot bath. After a long day at work, there is nothing more relaxing than laying in a bathtub of hot water with the lights turned down and no interruptions. The same holds true for kids. Use bath time as a chance to help your little one unwind from the activities of the day. Introduce a few simple bath toys and allow your child to relax as long as they need to.

Watch fish. Have you ever wondered why there is always a fish tank in hospitals and medical centers? The University of Exeter in the UK did, and found that watching fish swim in an aquarium reduces blood pressure and heart rate. Better yet, the larger the fish tank, the greater the effect. The next time your child needs to calm down, take them to the local lake, hatchery, or aquarium for a little fish-watching therapy.

Count backwards from 100. Not only does counting give your child a chance to focus on something other than what is bothering them, counting backwards offers an added concentration challenge without overwhelming their brain.

Repeat a mantra. Create a mantra that you and your child can use to help them calm down. “I am calm” or “I am relaxed” work well, but feel free to get creative and make it something personal to you and your child.

Breathe into your belly. Most of us breathe incorrectly, especially when we are in a stressful situation. Have your child think about their belly like it is a balloon. Tell them to breathe in deep to fill the balloon, and breathe out to deflate it. Repeat this simple process 5 times and notice the effects.

Go for a run. Running has been shown to reduce stress, and can sometimes be more effective than a trip to the therapist’s office. Going for a 10 minute jog can not only affect your child’s mood immediately, its effects on their ability to cope with stress can last for several hours afterward.

Talk it out. For children who are able to verbalize their feelings, talking about what is bothering them gives them a chance to let you know what is going on while processing it for themselves. The trick is to resist the urge to “fix” the problem. Your child needs you to listen and ask appropriate questions, not offer unsolicited advice.

Write a letter in the voice of your BFF. We would never talk to our best friend in the same critical way we talk to ourselves. The same is true for our children. Tell them to be kind to themselves, and ask them what they would tell a best friend to do in their situation.

Create a vision board. Have your child cut out words and pictures from magazines that speak to their interests, desires, and dreams. Then have them glue these pictures and words onto a poster board to display in their room. Not only does the process of creation allow them to think about what they want from life, displaying things they love gives them an opportunity to focus on what is really important when they are upset.

Give or get a bear hug. Hugging allows your body to produce oxytocin, a naturally occurring hormone in your body necessary for immune system function. Not only does a 20 second hug reduce blood pressure, increase feelings of well-being, and reduce the harmful physical effects of stress, both you and your child will reap the benefits!

Walk in nature. According to Stanford scientists, walking in nature has been proven to improve cognition and reduce stress. Even if you do not have time to spend the 50 minutes researchers did, taking a 15 minute walk in nature works can be just what your child needs.

Take up pottery. Much in the way playing with putty fires electrical impulses in your child’s brain, sculpting with clay or throwing pots can have a similar effect. It also has the added benefit of being considered “active learning”, a powerful condition that allows your child to learn through exploration.

Write it out. For older children, journaling, or writing their feelings down can have a profound effect on their mood, especially if they can do so without the fear of having it read. Give your child a notebook to keep in a safe place, and allow them to write about how they feel, assuring them you will not read it unless they ask you to.

Gratitude, gratitude, gratitude. A cousin to “write it out”, gratitude journaling has been linked to better performance in the classroom as well as a reduction of stress outside of learning environments. Having a separate notebook only for things your child is grateful for will give them the freedom to keep their journaling activities separate.

Name your emotion. Often when children become overwhelmed, it is because they have difficulty identifying the negative thoughts they are having. Whether your child is quick to anger, panic, or obsess to ensure things are perfect, ask them to give this feeling a name, and help them talk back to it. For instance, by asking your child, “is Mr. Perfect bothering you again?” you can work together to help them challenge their perfectionism, rather than fight them over it.

Roll a golf ball under your feet. Rolling a golf ball under your child’s feet can not only improve circulation, but there are pressure points on the bottom of the feet that relieve stress and relax the muscles of the feet and legs. Roll over the entire sole of your child’s foot using various pressures for maximum benefit.

Play music. Music has a profound effect on mood, sleep, stress, and anxiety. Use a variety of musical styles to set the tone in your home, car, or your child’s room.

Go for a walk. There’s a real reason people go for walks to clear their heads. Not only is the fresh air and exercise restorative, but the natural rhythm walking creates has a self-soothing quality. Take your child on a walk, and they may even open up to your about what is on their mind.

Knead the bread. Grandmothers around the world will tell you that the process of bread making is a tremendous stress relief. Simple recipes are abundant online that allow your child to get their hands dirty turning and pushing dough. The best part is that at the end, you have homemade bread to show for it!

Get on a bike. Bicycling for children has largely become a thing of the past. With the introduction of bicycle lanes and paved trails in urban areas, bicycling is safer than ever and can be a powerful form of self-soothing. Not only is it easy on the joints, it promotes balance, exercise, and can be done with the whole family.

Take a coloring break. It’s not without good reason that restaurants give children coloring; it gives them something to focus on, and can be a great mindfulness activity that reduces anxiety. Make a trip with your child to pick up some crayons and markers, and get them excited about filling in the pages of a coloring book.

Watch a Tedtalk on stress. A great one to start with is the very popular Tedtalk on How Stress can be your Friend by Psychologist Kelly McGonigal.

Self-Soothing or Calming Techniques

One of the principle skills that will support our success in therapy, is your ability to remain in difficult conversations so we can experience a different or positive outcome. I’ve offered a number of ways to improve your ability to regulate and prevent emotional flooding. Use this as a buffet, choosing what works for you. The sources come from a wide range of research-based approaches that in some cases have been adopted by high stress fields such as law enforcement, military, and medical professionals.

Touch – being able to feel safe with other people is probably the single most important aspect of mental health. Safe connections are fundamental to meaningful and satisfying lives. Touch, in the right way, calms down the body. This action tells another physically that I believe you, you are ok.

Yoga – only mediation tends to be very difficult for people because they become disturbed. When there are too many thoughts in your own head makes it hard to sit quietly. Yoga is a way to introduce this internal focus that also has movement and another element. Stretching for girls is what something people think.

Team Play – for some, team sports is a best predictor for healthy outcomes, especially for boys because it helps you experience different emotions and then teach them how to walk through those feelings in a healthy way. When you go through those emotions, even if they are bad, and being able to survive them together – that’s being a team.

Fitness/Exercise – often times, this is not enough because there will be points in your life that you will not be able to exercise. The nature of trauma is mental immobility or encouraging you to freeze – the energy it takes your body and brain to hold this frozen position is very high and can be exhausting. When you become fit, you feel able to expend energy. Exercise also is a natural source for increased GABA in the brain, which is used to regulate the energy and slows down the brain.

The Wet Noodle – take your awareness down your body and if it comes into contact with constricted muscles. Counting to 10 and then exhale. Now, the trick it to take this on the road and use it while you are interacting with others. Start to practice doing this while you are experiencing those things that are threatening.

Soft-Palete – this is focused on the back of the top of the mouth. Say a lot of “R”s you can find the point to try to relax these muscles. It is built off the idea of the way the vagus muscle works and how it goes from the top of the palette to the pelvic floor. Think Tibetan monks chanting and why this is calming, and more importantly centering.

Tighten muscles and release or relax – this is an easy way to find the contrast between tightening and release, so you know the difference. This is a step toward being able to release it without the tightening.

Peripheral Vision – used for special forces. If they are doing any activity and moving to combat. Especially snipers. Before looking into the scope, they attend to peripheral vision. Our threat response takes our vision into the bullseye. So we intentionally focus our attention on the peripheral. Focus on a point in the distance at eye level or a bit higher. Then hold your fingers at 70 degrees and slowly move your fingers back 180 degrees and count to 10 seconds and relax.

Video Resources

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Bessel Van Der Kolk and Yoga
Peripheral Vision Training
Simple Breathing Techniques
Soft Palate to Trigger Calm

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