Introduction To Anxiety
Introduction To Anxiety
1
for you to know
Anxiety is a common feeling that most everyone experiences at some time
or another. We know a lot about anxiety and have many different ways to
treat it. This book will teach you a wide variety of techniques that you can
use to both reduce and manage your feelings of anxiety.
Just as there are many ways to describe anxiety, there are also many different reasons
anxiety appears. Speaking very generally, the two main reasons are (1) situational—
where something happens in our life that makes us feel anxious (anything from a hard
homework assignment to a natural disaster) and (2) chemical—when the particular
amount and movement of our brain chemicals are configured in such a way as to cause
the feeling of anxiety. The good news is that whatever the cause, there are steps we can
take to shift our anxiety from a higher to a lower level.
1
activity 1 Q about anxiety
Decades of research show that anxiety is best managed with psychotherapy (talking to
someone trained in helping people manage emotions) and/or psychotropic medication
(medication designed specifically to adjust our brain chemicals). Self-help tools, like this
book, also help people learn ways to manage anxiety, either by themselves or with the
guidance of a counselor or therapist. Depending on your particular situation, you might
use therapy, medication, self-help tools, or some combination of these.
When anxiety is triggered by life situations, we can learn to manage it both by work-
ing on what we can change and working on how we think. For example, if you feel anxious
because you’re starting a new math class and last year you did poorly in math, you can
change your study habits or get tutoring help so you do better this year. Your anxiety will
be lower if you work on your math skills. You can also work on the way you think about the
class. Instead of telling yourself, “I did poorly last year, so this year will be the same,”
you can tell yourself, “This is a new year, a new class, and a new teacher—just because
I did poorly last year doesn’t mean it will be the same this year.” Your anxiety will be
lower if you use positive self-talk.
When anxiety is triggered by our brain chemicals, we can learn to manage it both by
working in psychotherapy and self-help and working with medications. (Research shows us
that over time, working in psychotherapy changes our brain chemicals the same way
that medication does.) For example, working with a therapist or counselor regularly will
help you practice new ways to think about yourself and your life that will form new
neural pathways in your brain and affect your brain chemistry positively, lowering your
anxiety. Working with a medical doctor to find a medication that is right for your body and
brain can also help your anxiety go down.
2
activity 1 Q about anxiety
try this
Think about how long in your life you’ve been affected by anxiety. Tell your story here.
On the timeline below, note the significant times you remember being affected by
anxiety.
birth present
day
Do you think your anxiety has been more situational or chemical (or a combination of
both)? Explain why.
3
activity 1 Q about anxiety
What thoughts and feelings do you have about using medication to help manage anxiety?
Would you be willing to try using anxiety management techniques to help change the
neural pathways in your brain to reduce your anxiety? Tell why or why not.
What does it feel like to think about taking steps to get your anxiety under control?
4
your fight-flight-freeze
response 2
for you to know
Anxiety arises when we believe we’re being threatened in some way. The
fight-flight-freeze response is our body’s automatic reaction to anxiety. It’s a
survival response designed to protect us from danger.
Since prehistoric times, human bodies have shared the fight-flight-freeze response with
other animals. This survival response is triggered when the part of our brain called the
amygdala senses any kind of danger. The amygdala sends out an “alarm” that signals
certain hormones to be emitted. These hormones affect our bodies in ways that make
them ready to protect us. For example, our muscles tense, our heart rate goes up, and our
pupils dilate—all to help us either fight the danger, flee from it, or freeze to stay hidden.
When we’re in real danger, such as if a car is about to hit us or a hungry bear is com-
ing our way, the fight-flight-freeze response will help keep us alive. But in reality, the
majority of the time we feel anxious, it’s only about something we believe to be danger-
ous, such as talking to someone we don’t know at a party, turning in a history report,
or arguing with a friend. Even though our life isn’t being threatened at those times, our
protective amygdala still registers a threat and goes into action—and then there we are
sweating, shaking, or having our mind go blank and feeling scared or embarrassed,
which can cause anxiety to shoot up even higher.
5
activity 2 Q your fight-flight-freeze response
try this
In the space below, draw a picture of yourself standing at the door of your bedroom first
thing in the morning. Outside your bedroom door, draw or write a list of anything you
might be confronted with on an average day that could cause your amygdala alarm to
be triggered. This could include anything from seeing acne on your face or playing in
the orchestra to learning to drive or someone bullying you.
6
activity 2 Q your fight-flight-freeze response
List the potential threats you’ve identified in order of how anxious they make you feel,
with those that make you feel most anxious at the top of the list and those that make you
feel least anxious at the bottom of the list.
7
activity 2 Q your fight-flight-freeze response
Describe what happened the last time you remember your fight-flight-freeze response
being triggered.
Describe any changes you’d like to try making in how your amygdala alarm system
works.
* Very Important: If you are experiencing real dangers or threats to your life, talk to an adult you trust
about how to get help.
8
how you experience anxiety
3
for you to know
The way you experience anxiety may be different from the way your friend
or relative experiences it. Increasing your awareness of how you experience
anxiety can help you manage it.
Marcus, Daniela, and Emily all experience anxiety. But they all experience it in different
ways.
Marcus has a hard time sleeping. He finds it hard to fall asleep because his mind is often
filled with worrisome thoughts about a lot of different things. Even when he does fall
asleep, he wakes up frequently through the rest of the night. Once in a while, he’ll wake up
suddenly in the middle of the night with his heart racing and a feeling of panic.
Daniela has no trouble sleeping, but she tends to get “knots” in her stomach during the
day and feels irritable and tense a lot of the time. She frequently snaps at people for no
good reason and then feels bad afterward.
Emily experiences anxiety as an overall agitation. She finds it hard to concentrate, feels
jumpy, and can’t sit still. She notices that her heart pounds and her breathing is shallow
when she’s worrying about something. She feels a lot of apprehension about life in general.
Recognizing their anxiety symptoms helps Marcus, Daniela, and Emily know what’s
happening when they feel this way. When they realize that these symptoms are caused
by worry or stress, they can choose coping techniques to manage them, relieve the anxi-
ety, and help themselves feel better. Learning and practicing the techniques in this book
can help you do the same.
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activity 3 Q how you experience anxiety
try this
The words and phrases below describe normal ways that people experience anxiety.
Circle any of those that you’ve experienced.
10
activity 3 Q how you experience anxiety
Think about the ways you experience anxiety. In the picture below, make notes or marks
on the parts of the body where you feel anxiety symptoms. Use different colors, textures,
lines, or shading to help express your feelings more precisely.
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activity 3 Q how you experience anxiety
When you look back at your body outline, what are your thoughts and feelings about
how you experience anxiety?
According to the picture, where and how do you feel anxiety the most?
How do you think noticing your symptoms when they first begin might be helpful for
you?
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your anxiety patterns
4
for you to know
When you understand the thoughts and situations that trigger your feelings
of anxiety, you can better help yourself to prevent and manage it. A behavior
log can help you learn about your anxiety patterns.
Alex thought he always felt really anxious around other people and in social situations.
He was afraid he would say or do something that would make him look stupid or make
people laugh at him. He thought he always had to be a little guarded to keep from doing
or saying something embarrassing. There were only a couple of people with whom he felt
comfortable enough to be himself. Alex would have liked to be able to relax enough to meet
more people, but he didn’t know how.
His counselor told Alex it could help him to explore how different people and social
situations affected him. She asked him to try keeping a behavior log to make him aware
of the times and situations when he experienced anxiety. A copy of part of Alex’s log is
shown on the next page. Alex was surprised to realize that he was highly anxious only
in certain situations with certain people—usually peers whom he perceived as smarter
than himself. He realized that there were also many times when he felt confident, mainly
with adults, but also with peers that he felt were at his same intellectual level. This new
knowledge helped give him the courage to better handle the times he did feel anxiety and
to take small risks to meet new people.
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Alex’s Behavior Log
Day Time Situation What I’m Thinking My
Anxiety
Level
Saturday 6 p.m. Meeting my parents’ friends who These people are nice and easy low
have come to our house. I have to talk to.
a 15-minute conversation with
them.
Sunday 2 p.m. At a baseball game with my dad. These kids are in Student Council medium
Run into some kids I know from Club with me. I’m surprised they
school. Talk for 5 minutes. came over to say hi. Maybe they
activity 4 Q your anxiety patterns
like me.
14
Monday 4 p.m. Watching my little brother These kids are cute. I know a lot low
after school. Helping him and his more than they do.
friends practice batting.
Tuesday 11 a.m. Working on group project in Everyone understands this stuff high
chemistry class. better than I do.
They probably think I’m stupid.
Thursday 3 p.m. Sitting on the bus with Nathan, If I open my mouth and say high
the smartest kid in the school. anything, I’ll sound dumb. I
better just sit here and stare out
the window.
Friday 7 p.m. Having pizza at David’s house. I’m glad David is my best friend. low
He’s fun, and we like the same
things.
activity 4 Q your anxiety patterns
try this
The following behavior log gives you a place to record observations about the times you
feel anxious. Make as many copies as you need (or download the log at http://www.
newharbinger.com/48633) and use them to record information about your feelings of
anxiety for at least one week.
15
My Behavior Log
Name Week of
16
activity 4 Q your anxiety patterns
What was it like to pay attention to your feelings of anxiety by keeping this log?
Did keeping the log tend to make you more or less anxious? Why?
Look back over your log. Describe any patterns you notice over time.
Describe any new information you learned about yourself from keeping this log.
How can you use this log to help you understand and manage your feelings of anxiety?
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5 prevention and intervention
Some people don’t understand why they should practice relaxation techniques before
they’re feeling anxious. To help you understand why it’s a good idea, think about your
teeth. Do you wait until you have a cavity to start brushing your teeth? Most of us brush
our teeth every day because it helps prevent cavities from forming. It’s the same with
anxiety. If you practice relaxation techniques every day, you can better prevent anxiety
from forming.
Some of the relaxation techniques you’ll learn in this book are best used for prevention,
before you feel anxiety, and some are best used for intervention, at the time you feel
anxiety. Many of the techniques can be used at both times. It’s important to remember
that the more you practice the techniques as prevention, the better you’ll be able to use
them for intervention.
try this
Put a “P” next to the phrases that describe activities done as prevention (before a situa-
tion or event) and an “I” next to the phrases that describe activities done as intervention
(at the time of a situation or event).
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activity 5 Q prevention and intervention
Asking your parents for a loan when you need extra money
Putting gas in your car when the gauge reads empty
Putting gas in your car when the gauge reads one-quarter full
Bringing a granola bar in your backpack in case you get hungry
Buying a granola bar at a vending machine when you get hungry
Paying your cell phone bill when your service gets turned off
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activity 5 Q prevention and intervention
1.
2.
3.
Describe three activities you have done in the past week that could be considered inter-
vention.
1.
2.
3.
Describe a situation in which your intervention would have been better if you had also
practiced prevention.
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activity 5 Q prevention and intervention
Describe any activities you already do to prevent your anxiety level from getting too
high.
Describe what you usually do to help yourself when your anxiety level gets very high.
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6 peace is already within you
When the renowned sixteenth-century artist Michelangelo was asked how he created
the exquisite and powerful statue of David from a solid piece of marble, he replied that
David was already in the stone; he simply chipped away the excess. Just like the statue
deep within the marble, you already have a core of peace deep within you. You simply
need to unearth it by peeling off the layers of anxiety that are covering it up.
You cover up your peace every time you think of or dwell on a stressful thought. The
thought doesn’t destroy your core of peace, but it can cause you to forget it if you con-
tinue to dwell on the anxiety.
22
activity 6 Q peace is already within you
try this
Shade in the pictures of the floating clouds below with pale blue or another light color.
The clouds represent your natural state of peace. Then take a few minutes to sit quietly,
breathe slowly, look at those peaceful clouds, and feel that deep relaxation within you.
Next, using a darker color, cover up the clouds by writing the names of people, situa-
tions, or things that make up the anxiety in your life. Write as many stressful things as
you can think of.
23
activity 6 Q peace is already within you
Tell what it was like for you to cover up the peaceful clouds with stressful thoughts and
words.
Think about how you cover up your own natural state of relaxation when you choose to
dwell on anxious thoughts. Describe a time when you remember feeling calm but lost
sight of that feeling when you began to think anxious thoughts.
As you go through the rest of the week, be aware of the times that you cover up your
natural state of relaxation with tension.
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the power of attitude
7
for you to know
Do you think? If the answer to that question is yes, then you already know
how to use a powerful anxiety management tool. Your thoughts create your
experience of life. Your attitude, or the way you think about things, is one of
the greatest tools you have to prevent and manage feelings of anxiety. And
since you are the only one who controls your thoughts, you have the ability
to create a peaceful experience or an anxious experience for yourself at
every moment.
Dion and John were training for their school’s big cross-country meet. They decided
to meet at the field house at noon on Saturday to run a ten-mile course through the
surrounding neighborhoods. Saturday turned out to be the hottest, most humid day of
the summer. The boys laid out their course and then started off. About one-third of the
way through, both boys were really feeling the heat, but they didn’t want to stop because
they needed the training. They kept running, getting hotter and thirstier with every step.
By the time they were two-thirds of the way through, all that either of them could think
about was a cool drink of water. When they finally hit the last stretch, they were hotter
than ever and their clothes were drenched with sweat. Upon reaching the school, they both
ran straight for the drinking fountain, only to find that it wasn’t working. There was no
drinking water at all except for a half-full water bottle sitting next to the fountain. Dion
had left it there before they started their run. Both boys looked at the same water bottle,
and both had very different reactions.
Dion said, “Oh man! I am so glad I left this water bottle here! It’s just half full, but
that’s better than nothing! Gee, are we lucky to have this!” Dion’s attitude made him feel
peaceful.
John looked at the very same water bottle and said, “Oh no! I can’t believe this is all
we have! This is terrible! I could drink ten full bottles myself, and all we have is a half of
one!” John’s attitude made him feel anxious.
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activity 7 Q the power of attitude
Each boy was in the very same situation, but each experienced it very differently for
reasons that had nothing to do with the situation itself. Their different experiences came
from within each of them—from their attitudes.
try this
In each pair of pictures below, two young people are in the same situation, but you can
tell by the looks on their faces that they’re experiencing it differently. Under the pictures,
write what each person might be thinking to cause their individual feelings.
26
activity 7 Q the power of attitude
What could you have thought to make the experience a peaceful one instead?
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activity 7 Q the power of attitude
Tell what you were thinking that caused you to feel peaceful.
What could you have thought that would have made the experience an anxious one
instead?
Read over the two situations you just wrote about. If possible, share them with another
person. Think and talk about the power of your attitude to affect how you experience
life.
As you go through the upcoming days, notice how your attitude about anything that
happens affects your anxiety level.
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worrying is worthless
8
for you to know
It’s common for people to worry about things they feel anxious about.
However, all the time and energy that’s spent in worry is actually wasted.
When you try to reduce your anxiety by worrying, all you do is make the
anxiety grow stronger.
Most people don’t realize why they worry. They think worrying is something that “just
happens,” or they say they “have to” worry about something. That isn’t true, of course.
Usually we start to worry because we feel anxious about a situation and want to do
something to try to prevent a negative outcome. If it’s a situation we have little or no
control over, there’s not much we can do and this makes us feel helpless. This triggers
worry because worrying is something we can do. People have worried about things for
centuries, but it’s never once had a positive effect on the outcome of a situation. If there
were any possible way that worrying would help you relieve anxiety, there would be
an exercise in this book teaching you how to worry and suggesting you practice it dili-
gently as both prevention and intervention.
What worrying does do is to drain you, both emotionally and physically. That makes
your situation worse because you have less energy to handle whatever it is that’s going
on. Then your anxiety level goes up again because you feel even more helpless.
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activity 8 Q worrying is worthless
try this
Rate your present anxiety level on the scale below.
0 1 2 3 4 5 6 7 8 9 10
Completely Moderately Highly
peaceful anxious anxious
Now think of a current situation that’s bringing up feelings of anxiety for you. Set a
timer for five minutes or keep an eye on a clock. Spend the next five minutes worrying
about this situation. Use all of your skills and past experience in worrying to worry as
hard as you can. Think about all the negative ways this situation could turn out. Put
as much emotional and physical energy as you can into worrying. Imagine you’ll be
graded on how well you worry, and try to worry hard enough to get an A+.
After the five minutes is up, rate your anxiety level again on the scale below.
0 1 2 3 4 5 6 7 8 9 10
Completely Moderately Highly
peaceful anxious anxious
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activity 8 Q worrying is worthless
What happens to your body and your mind when you worry so hard?
Describe any way that the worrying you just did will have a positive effect on the out-
come of the situation.
Describe something you could do instead of worrying that would be more productive
or would help you feel better.
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9 all-or-nothing thinking
Mateo was usually a top-scoring player in soccer. He often scored the most goals in any
game. He thought of himself as an excellent player. But if Mateo ever missed a goal, he’d
think, Now I’m a total failure. He also thought of himself as a really good cook, but
when he didn’t win the master chef competition at school, he told himself, Now I’m a
zero. When Mateo tried to help his mother wash some upper story windows and the
ladder scratched the side of the house, Mateo said, I’m worthless as a son.
This kind of all-or-nothing thinking caused Mateo to feel anxious before he took on
any task because he was always afraid of not being able to achieve perfection (one extreme)
and thus having to label himself as a failure (the other extreme).
try this
Nothing in life is completely one extreme (black) or the other extreme (white). Real peo-
ple and situations have different mixes of negative and positive. Reality exists in the
gray area between black and white.
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activity 9 Q all-or-nothing thinking
The boxes below show that there is a large gray area between the extremes of black and
white. For each category listed, put a mark to show where your own realistic experience
lies.
Grades
I get the lowest grades I get perfect grades.
there have ever been.
Friends
I am a totally selfish friend. I am always a perfectly
generous friend.
Family
I am a hateful family member. I am always a perfectly loving
family member.
Talents
I have no skills or talents for anything. I am gifted at everything I try.
Attitude
I have the worst possible attitude. I am always perfectly positive and upbeat.
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activity 9 Q all-or-nothing thinking
In which categories was it hardest to rate yourself in the gray area rather than the black-
or-white extremes? Why do you think this was?
What do you think might be hard about giving up all-or-nothing thinking and seeing
things more realistically?
Rewrite the all-or-nothing statements that Mateo told himself, replacing them with re-
alistic gray-area statements:
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activity 9 Q all-or-nothing thinking
Write three examples of all-or-nothing statements that you’ve made about yourself. Then
rewrite them, replacing them with realistic gray-area statements.
1.
2.
3.
1.
2.
3.
Tell which of the above statements makes you feel the most anxious, and why.
35
10 overgeneralizing
When Lauren asked someone she liked to the school dance, they said no. She thought, No
one will ever want to date me; I’m always being rejected. She began to feel anxious
anytime she was with someone she was attracted to.
When Lauren dropped her lunch tray in the school cafeteria, which had never
happened before, she told herself, It figures; I’m such a klutz. I’m always causing
accidents. Lauren became nervous about dropping food and dishes even when she was at
home clearing the kitchen table.
When Lauren babysat for the first time, the baby had an earache and wouldn’t stop
crying. Lauren told herself, I’ll never be good with children; I’ll make a terrible
mother. When she was called to babysit again, she got nervous just thinking about it and
turned the job down.
These kinds of overgeneralized thoughts caused Lauren’s anxiety level to go up in any
situation where her past experience hadn’t been perfect.
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activity 10 Q overgeneralizing
try this
The teens in the pictures below are having negative experiences. Next to each picture,
write an overgeneralizing statement they might make about their situation that would
raise their anxiety level. Use the words “always,” “never,” “no one,” “everyone,” “all,” or
“none.” Then, write a more realistic statement that could lower their anxiety level.
1a.
1b.
2a.
2b.
3a.
3b.
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activity 10 Q overgeneralizing
Look back at what you’ve written. Describe any patterns you notice in the subject areas
or situations that you overgeneralize about.
Now rewrite the statements, replacing the overgeneralizing words with more accurate
words.
Read both groups of sentences aloud to yourself, paying attention to your anxiety level
as you read them. Notice which statements make you feel more anxious.
38
“should” statements
11
for you to know
Using the word “should” is appropriate when there’s something we need
to do or a way we need to act in order to be responsible or courteous. But
“shoulds” can get out of control and raise your anxiety level when they’re
unrealistic or unimportant.
Brandon was frequently anxious because so many of his thoughts included the word
“should.” When he was riding the bus to school he thought, I should be using this
time to study. When he was at a chess club meeting, he thought, I should be in a sport
instead. It would be so much cooler. When his bike chain broke and he didn’t know
how to fix it, he thought, I should be more competent and know how to fix this
myself. When he failed a math test because he had gone to a baseball game instead of
learning the material, he thought, I should have studied harder for this test.
Brandon’s counselor helped him to think more carefully about his “should” statements
to see how realistic or important they were. Here’s what he discovered about his thoughts:
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activity 11 Q “should” statements
try this
Make a list of your own “should” statements. After each one, write more detail about
how realistic or important they are.
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activity 11 Q “should” statements
Tell where most of your “should” statements originated and why you think that is so.
Tell which “should” statement raises your anxiety level the most and why.
Go back to your list and cross out any “should” statements that are unrealistic or un-
important. Put a star next to the statements that are realistic or important. Choose one
statement to work on changing and make a conscious effort to do so in the coming week.
41