1. What is Anxiety? (Part 1 of the “Don’t Panic! Coping With Anxiety” workshop series) Brought to you by the Counselling Service ph: 9925 4365, email: counselling@rmit.edu.au

2. RMIT University©2009 Counselling Service 2 What is anxiety? A normal emotion experienced by everyone in the face of:  Threat  Danger  Stress Typically when we become anxious we feel:  Worried  Upset  Uncomfortable  Tense

3. RMIT University©2009 Counselling Service 3 Normal anxiety Feeling upset/uncomfortable/tense due to general stressors in life. For example:  Exams  Loss of a job  Relationship break-up  Car accident Feeling anxious in these situations is appropriate and can even be healthy if it enhances performance.

4. RMIT University©2009 Counselling Service 4 Problem Anxiety Affects you on physiological, behavioural and psychological levels and feels overwhelming. It may occur without a clear reason or focus. Problem anxiety is:  More intense and extreme (e.g. panic attacks)  Lasts longer (persistent and continual, long after the stressor has passed)  Is out of proportion to the situation  Results in you avoiding situations in which you experience anxiety  Interferes with your quality of life  Stops you functioning as effectively as you used to

5. RMIT University©2009 Counselling Service 5 Physiological symptoms:  Shortness of breath  Heart palpitations  Trembling/shaking  Sweating  Choking  Nausea or abdominal distress  Numbness  Dizziness/unsteadiness  Hot flashes or chills

6. RMIT University©2009 Counselling Service 6 Behavioural symptoms:  Being frozen/unable to act  Difficulty expressing yourself  Difficulty dealing with everyday situations  Avoidance of fearful situations  Withdrawal from others  Lashing out  Being passive/unassertive

7. RMIT University©2009 Counselling Service 7 Psychological symptoms:  A sense of apprehension/uneasiness  Fear of dying  Fear of going crazy or out of control  Feeling of detachment or being out of touch with yourself  Loss of confidence  Self-critical or perfectionistic thoughts  Worrying thoughts  Feeling defeated “what’s the point?”

8. RMIT University©2009 Counselling Service 8 But remember, you are not alone….  Anxiety disorders are common and affect one in 20 people at any given time.  There are effective treatments for anxiety disorders and research is yielding new, improved therapies that can help most people with anxiety disorders lead productive, fulfilling lives.

9. RMIT University©2009 Counselling Service 9 Anxiety Disorders Six of the main anxiety disorders are:  Generalized Anxiety Disorder  Panic Disorder  Social Phobia/Social Anxiety Disorder  Phobias, including specific phobias and agoraphobia  Obsessive-Compulsive Disorder  Post-Traumatic Stress Disorder

10. RMIT University©2009 Counselling Service 10 Generalized Anxiety Disorder Characterized by:  Chronic, exaggerated worry/ tension over everyday events, even when there are no signs of trouble.  Physiological symptoms (e.g. headaches, trembling, muscle tension, dizziness, hot flashes, feeling out of breath, or nauseated)  Unable to relax, highly strung or restless  Easily fatigued  Startling more easily than other people.  Irritability  Difficulty concentrating.  Trouble falling or staying asleep.

11. RMIT University©2009 Counselling Service 11 Panic Disorder Characterised by:  Unexpected/sudden and repeated episodes of intense fear that occur out of the blue, without any apparent cause and tend to last for a few minutes at a time.  Fear/worry about having subsequent panic attacks  Physiological symptoms that may include chest pain, heart palpitations, shortness of breath, dizziness, feeling of unreality, numbness in hands and feet, or abdominal distress.  These sensations often mimic symptoms of a heart attack or other life-threatening medical conditions. Sufferers are often not diagnosed until medical tests are carried out to rule out organic causes for the symptoms.

12. RMIT University©2009 Counselling Service 12 Social Phobia/ Social anxiety disorder One of the more common disorders that is characterised by:  Overwhelming anxiety and excessive self-consciousness in everyday social situations  Persistent, intense, and chronic fear of being watched and judged by others and being embarrassed or humiliated by one’s own actions.  Interference with work or school, and other ordinary activities.  Worry for days or weeks in advance of a dreaded situation.  Physiological symptoms including blushing, profuse sweating, trembling, nausea, and difficulty talking.

13. RMIT University©2009 Counselling Service 13 Causes of anxiety  Not one specific known cause, there are multiple factors  People “feel” their anxiety in different ways  The effects of anxiety will be experienced in different ways

14. RMIT University©2009 Counselling Service 14 Long-term, pre-disposing causes  Heredity (a genetic predisposition to developing anxiety)  Cumulative stress over time (Life Events Survey) that is persistent and builds up to a level that affects coping style.  Personality factors  Childhood circumstances

15. RMIT University©2009 Counselling Service 15 Significant life events associated with anxiety  Severe illness  Loss  Divorce/separation  Death in the family  Relocation

16. RMIT University©2009 Counselling Service 16 Personality traits associated with anxiety  Volatile  Excitable (easily aroused)  Reactive  Highly sensitive  Perfectionistic/setting high expectations on oneself  Self-critical  “All or nothing” ways of thinking  Inability to accept one’s “negative” emotions without judgement

17. RMIT University©2009 Counselling Service 17 Childhood circumstances associated with anxiety  Parents who communicate an overly cautious view of the world  Parents who are overly critical and set excessively high standards (growing up feeling “not good enough”)  Emotional insecurity and dependence (due to neglect or being distanced from parents)  Exposure to abuse or unpredictable/fearful situations (e.g. alcoholic parents)  Your parents suppress your self-assertiveness

18. RMIT University©2009 Counselling Service 18 Hypothesised Biological Causes  Panic attacks: Malfunction of the “fight or flight” response due to over stimulation of the Locus Ceruleus in the brain. Insufficient norepinephrine and/or serotonin.  Generalised anxiety disorder: Insufficient activity in the functioning of natural benzodiazepine/GABA system of the brain (Gamma Amino butyric Acid).  Obsessive Compulsive disorder: A deficiency in the amount of serotonin in the brain.  Medical conditions that can cause anxiety: hyperventilation syndrome, hypoglycaemia, hyperthyroidism, mitral valve prolapse, pre-menstrual syndrome and inner ear disturbances

19. RMIT University©2009 Counselling Service 19 Short-term triggering causes  Stressors that precipitate first experience of a panic attack:  Significant personal loss  Significant life change  Stimulants and recreational drugs  Conditioning by association or avoidance:  Anxiety experienced in a particular context is associated with that context  Avoidance of that context (to relieve anxiety) reinforces the association  Traumatic event that results in an association with anxiety/fear:  For example, the traumatic experience of being in a car accident may result in an association between driving a car and anxiety

20. RMIT University©2009 Counselling Service 20 Maintaining causes  Avoidance of phobic situations  Anxious self talk  Mistaken beliefs  Withheld feelings  Lack of assertiveness  Lack of self-nurturing skills  Muscle tension  Stimulants and other dietary factors  High stress lifestyle  Lack of meaning/sense of purpose in life

21. RMIT University©2009 Counselling Service 21 Final thoughts It is natural to question “why do I have anxiety”, but remember that:  Understanding what caused your anxiety is not necessary to overcome it. You can learn strategies to effectively reduce anxiety without being able to answer this question definitively.  There is not one single cause for anyone who experiences anxiety, therefore recovery means addressing the various layers and levels that contribute to your anxiety.