Type A ?

or

Anxiety Disorder

Mike Mombrea, M.F.T.

EAP Counselor

Optum Behavioral Solutions

March 17, 2011

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Agenda

Define 3 major categories of anxiety and their

symptoms

Describe the relationship between anxiety, the brain

and nervous system

Identify techniques for managing anxiety

Demo of 2 techniques

Summary

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Goals

You will learn:

How anxiety affects the brain & nervous

system

Self-help techniques that reduce anxiety

When medication can be helpful

How the brain can change itself

Additional Resources

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Generalized Anxiety Disorder Symptoms

A six month period of unrelenting exaggerated

worry

Awareness that worry is unfounded, yet unable

to control

Feeling a sense of dread or doom so that daily

life is robbed of pleasantness

Worry that interferes with ability to perform

simple tasks such as work and other

responsibilities

Feeling keyed up all of the time, restless,

fatigued, constant muscle tension and sleep

disturbances

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Social Anxiety Disorder Symptoms

Intense worry for days, weeks or even months

before an upcoming social situation

Extreme fear of being judged by others,

especially people you don’t know

Excessive self-consciousness and anxiety in

social situations

Fears that you will act in ways that will

embarrass or humiliate yourself

Avoidance of social situations that limits your

activities or disrupts your life

Blushing, shaking or sweating in social

situations

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Panic Disorder Symptoms

A discrete period of intense fear or discomfort in

which a number of the following are experienced:

Fear of having a panic attack

A strong urge to get away from a situation

A sense of impending doom

Pounding or racing heart

Chest pain or discomfort

Shortness of breath

Dizziness, unsteady feeling or faintness

Trembling or shaking

Feeling of choking

Fear of dying

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When Medication Can Be Helpful

If you experience panic attacks a few times

per week or more

If you cannot draw your attention away

from worry even for short periods of time

If you feel sick to your stomach with dread

much of the time and find it interferes with

eating and sleeping

If you immediately flush, have shaky legs, a

quivering voice, a palpitating heart at the

thought of someone observing you or in

preparation for a business meeting.

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Anxiety & the Brain…

“Fight or Flight”

• As humans evolved, we developed a

“Negativity Bias” that sensitized us to

threat.

• This brain function is located in the

Amygdala, the hardware that processes

emotion and anxiety.

• The Amygdala is the “smoke detector”

of the brain.

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…Anxiety & the Brain

This inherent “Negativity Bias” results in our

tendency to scan for bad news, overlook the

good news (Velcro vs. Teflon), and be on

alert.

The right amount of anxiety keeps us on our

toes …

…but when anxiety becomes too high it can

interfere with our ability to focus and work

effectively.

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Sympathetic Nervous System (SNS)…

• The Amygdala alerts the SNS to prepare

for action.

• Too much SNS activity in the absence of

opportunities for rest and relaxation (R& R)

activates our smoke detector making us

more sensitive to threats (i.e., failure,

rejection, etc.).

…resulting in increased worrying and

chronic stress.

When the SNS is in overdrive, trying to go

to sleep can be like having your foot on the

gas and brake pedal at the same time.

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…Sympathetic Nervous System (SNS)

Chronic SNS stimulation disturbs:

• Gastrointestinal System

• Immune System

• Cardiovascular System

• Endocrine System

When these systems become unstable, we become

more sensitive to threat and anxiety cascades

through the body.

Disturbance of the physiological systems may result

in a state of anxiety experienced as panic “for no

reason.”

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Parasympathetic Nervous System (PSNS)…

• This part of the nervous system kicks in to calm

down actions in the body.

• We can benefit from initiating conscious,

purposeful forms of relaxation to calm down,

such as breathing slowly and deeply.

• Incorporating opportunities for relaxation and

rest into your schedule will prevent the SNS

from going into overdrive.

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…Parasympathetic Nervous System (PSNS)

Self-help Relaxation Techniques

• Deep Breathing

• Progressive Relaxation

• Meditation

• Visualization

• Mindfulness with Shifting Awareness

• Soothing music

• Taking a bath

• Taking regular breaks

• Make time for family and friends

• Plan vacation time

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Practice Exercise…

Deep Breathing

5 cycles of:

• Counting to 3 while inhaling

• Counting to 3 while exhaling

5 cycles of:

• Counting to 3 while inhaling

• Counting to 5 while exhaling

5 cycles of:

• Counting to 3 while inhaling

• Counting to 7 while exhaling

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…Practice Exercise

Mindful Attention

• Get in a comfortable position sitting upright with feel flat on the floor

• Allow your eyes to close gently

• Slowly bring your attention to the gentle rising and falling of your breath

• There’s no need to control your breathing; simply let the breath breathe itself

• Bring an attitude of acceptance to whatever you are experiencing

• There’s nothing to be fixed, no particular state to be achieved

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…Practice Exercise…

• Sooner or later, your mind will wander to thoughts, worries, bodily sensations or daydreams

• This is what minds do

• When you notice that your mind is wandering, gently escort your attention back to your breath; going in and going out

• See the wandering of your mind as an opportunity to bring patience and generosity to your experience

• Make space for whatever comes up without resistance and without judgment including any discomfort that arises

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…Practice Exercise

• The purpose is not to feel better, but to get better at feeling all that arises, accepting whatever comes up

• If you notice yourself worrying, gently bring your attention back to your breathing

• You are more than the thoughts and feelings that arise

• You deserve to be at your very best for yourself, your family, your profession and your community

• Now bring your attention back to your breathing one final time

• Slowly open your eyes

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Physical Fitness & Exercise

Exercise boosts brain power!

• Exercise helps to regulate the 3 chemicals in the brain associated with mental health (Serotonin, Norepinephrine and Dopamine).

• Exercise increases blood flow to the brain and uses up adrenaline that stress creates.

• Research is increasingly linking exercise to improvements in memory, reasoning, attention, problem solving and abstract thinking.

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Nutrition & Diet

• Our food contains the building blocks of the brain chemicals (neurotransmitters) that regulate mood.

• Dark green leafy vegetables help the brain build new brain cells.

• Eating regular meals provide nutrients are available to you consistently.

• Getting enough sleep allows your body to use the nutrients to build and repair brain cells.

• Limiting Caffeine, Alcohol, Tobacco & Sugar (CATS) helps you control the things that make your body anxious.

Remember - Food feeds your brain!

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Summarizing

• Relaxation & Rest (R&R) activate the PSNS bringing your mind and body into balance.

• Lack of (R&R) increases Negativity Bias (sensitivity to things going wrong, creating anxiety).

• Getting enough sleep (7 – 8 hours) is an integral part of maintaining this balance.

• To sustain the effectiveness of the important work you do…

• …Relaxation + Rest + Exercise + Proper Nutrition = Brain Health!

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Additional Health Resources for Cisco Employees & Families

OptumHealth Behavioral Solutionswww.liveandworkwell.com

Confidential Employee Assistance Program (EAP) services for Cisco employees and their families

LifeConnections Fitness Center powered by Plus One

http://wwwin.cisco.com/wpr/empserv/fitness/us/ca_sanjose/

Onsite fitness center located in SJC-Q. Offers multiple specialty areas for exercise, group fitness, stress management, one-on-one personalized instruction, teambuilding, and social networking.

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Additional Health Resources for Cisco Employees & Families

LifeConnections Health Center www.ciscolifeconnections.com

Onsite medical facility for Cisco employees and their families

Alere, formerly Matria Healthcarewww.alerehealthconnections.com

Online health information, condition management and health coaching services

HealthConnectionswww.cisco.com/go/health

Cisco’s health-enhancement program, with information and resources to take charge of your health in the areas of nutrition, fitness, sleep, life balance, preventive care, and condition management

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References & Recommended Readings

• The 10 Best-Ever Anxiety Management Techniques, Margaret Wehrenberg, W.W. Norton & Company, 2008

• Brain Rules: 12 Principles for Surviving and Thriving at Work, Home and School, John Medina, Pear Press, 2008

• The Mindfulness & Acceptance Workbook for Anxiety, John Forsyth & Georg Eifert, New Harbinger Publications, 2007

• Get Out of Your Mind & Into Your Life, Steven Hayes, New Harbinger Publications, 2005

• Buddha’s Brain, Rick Hanson & Richard Mendius, New Harbinger Publications, 2009

• The Brain That Changes Itself, Norman Doidge, Penguin Books, 2007

• The Relaxation & Stress Reduction Workbook, Martha Davis, Elizabeth Robbins Eshelman, Matthew McKay, New Harbinger Publications, 2008