Anxiety, Stress and Exam Pressure Dr Joanne Robinson, Chartered Clinical Psychologist DClinPsychol, CPsychol.

Anxiety Phobias Panic Attacks Post Traumatic Stress Disorder Obsessive Compulsive Disorder Generalised Anxiety Disorder Separation Anxiety Social Anxiety

Anxiety: Fight, Flight, Freeze & Flop Adaptive response: Changes to physical feelings, thoughts & behaviour Must be a perception of DANGER Or that we are THREATENED or VULNERABLE This can be physical, social or mental

Stress

Physical Signs

Physical Impact Sleeping difficulties Tiredness Aches & Pains e.g. Headaches, backache, knots in stomach Feeling sick Shaky Fast heart rate Dry Mouth Needing the toilet Dizzy Sweating

Cognitive Impact Concentration (Short Term) Memory Making Decisions Confused, annoyed over small things Procrastination Negative thinking e.g. always thinking the worst, low self confidence Constant worrying THINKING ERRORS

Thinking Errors The Downers Blowing things up E.g. negative glasses, positives don’t count Blowing things up E.g. all or nothing, magnifying the negative, snowballing Predicting Failure E.g. the mind-reader, the fortune-teller, Feeling Thoughts E.g. emotional reasoning, dustbin labels Setting yourself up to fail E.g. Shoulds, musts, can’t, shouldn’t Blame me E.g. feel responsible

Behavioural Impact Avoidance Refusal to go to school Walking out Arguing Obsessiveness – spending more time on work, checking Time Management Taking thing out on other people Eating more or less than usual Sleeping more or less than usual Self Harm, Alcohol & Drug use Disengaged from social activities, friends, family members

Thoughts Physical Feelings Behaviour Emotions Emotional Impact Worried, Panicky Edgy Irritable, aggressive Withdrawn Low mood

Thoughts-Feelings Diary

Exercises What’s on your plate? Riding the Wave

Exam Stress: Facts 92% feel anxious about revision & exams 14% turn to alcohol 8% use self harm Childline, 2011

A Teenager’s Perspective It’s very hard to write this as it’s an awkward subject, but I’ll give it a go. I’m in top set (set 1), Year 11 and it’s really hard to manage the expectations teachers put on you. And the pressure to get things right just adds to the stress. Comments like “you must do this otherwise you’ll fail” aren’t helpful. I know I need to do well. I have those expectations of myself. The constant reminders of course work and upcoming exams keeps the stress and anxiety alive. Also the pressures from home don’t help. For example, my brother has 2 degrees and was studying for a PhD. He was an example to the family and I don’t want to fail my Dad. The concept of failing adds to the constant anxiety, which keeps you up all night and then you’re more tired, which makes the stress worse.

Young Person’s Perspective

A Teenager’s Perspective

Pocket Health Series (Robinson, 2014) Exam Stress It can be easy to feel overwhelmed by the pressure of exams. You’ve worked hard all year and you want to do well. It is normal to feel some stress – this is actually important and can help you stay focused and alert. However, too much stress can have a negative impact and may lead to changes in your thoughts, feelings and behaviour. Recognise the symptoms of stress and take action. Here are a few tips to help you through your exams… Let’s Relax Time for a break? Let’s RELAX… Sit comfortably. Rest your arms by your side and close your eyes. Take a deep, slow breath in through your nose and feel the air go all the way down in to your stomach. Slowly breathe out through your mouth and imagine all that tension and stress leaving your body. Breathe in 1, 2, 3, 4…and slowly breathe out 1, 2, 3, 4, 5, 6, 7, 8…Breathe in…and breathe out.    

Mindfulness A skill that takes time to develop “here and now” Observing your experience in sensing mode Describing details Participating Fully Being Non-Judgemental Focusing on one thing at a time

Thank you for listening! Any Questions? Reflections? Email: info@drjoannerobinson.co.uk