HPI Anxiety 101 Workshop

It is 1.00 pm, May 26, 2020 and we are settled in for a virtual workshop (via Zoom) on anxiety, facilitated by Lee Thomas, MSW from DefineU Mental Health Programming. We are in the middle of a global pandemic, and there is a lot of uncertainty and anxiety in the air. Most of us are unsure of what we are feeling. Probably, anxious. But what is anxiety? What does it look like? Is anxiety the same as anxiety disorder? How does one cope in such situations? Being mentally healthy is a skill that needs to be learnt and managed. For this and more, please, read on 😊.

Firstly, anxiety does not equal anxiety disorder, as many people perceive it to be. There are different types of anxiety disorders, and the most common being generalized anxiety disorder, social anxiety disorder, panic disorder, agoraphobia, among others. Anxiety becomes anxiety disorder when it starts having a tangled impact in one’s life. Anxiety is intrinsically related to the fight/flight/freeze responses which everybody experiences at some point. These responses are regulated by two nervous systems which work in opposition to each other: the sympathetic nervous system (activated) and the parasympathetic nervous system (rest and digest). Chronic stress or anxiety kicks in when the sympathetic nervous system is continually activated to a fight/flight/freeze response.

So, what does anxiety look and feel like? Anxiety can manifest itself as four major distresses:

• Physical – characterized by gastro-intestinal upsets like (diarrhea, nausea, or heartburns), tense or sore muscles, difficulty sleeping, etc.

• Emotional – manifests as feelings of anger, fear, sadness, frustration, guilt, embarrassment, and numbing, which is a protective shutting down mechanism.

• Behavioral – could include signs like withdrawal from people or activities, not enjoying activities one previously enjoyed, increase in substance use (substances can include illicit and non-illicit substances like alcohol, coffee, and caffeine, which act as short-term anti-depressants)

• Cognitive – this is majorly thoughts and thinking patterns.

Anxiety starts as thinking patterns, which automatically pop up in the mind. I found this particularly interesting. There are seven most common anxious thinking patterns, abbreviated as ANTS (Automatic Negative Thoughts):

• All-or-Nothing thinking (also known as black-and white thinking) – this is when one always thinks on the extreme, e.g. things must be done perfectly or not done at all.

• Catastrophizing – this is the idea of one thing happening that leads to a cascade of other wrong things, which result into a major bad thing.

• Filtering – in a day, a variety of good, bad, and in-between things can happen. Filtering happens when one tends to focus on the bad things that happened when reflecting about the day.

• Generalizing – this is taking one thing and making it general. One tends to use phrases like “always”, “never”, “everyone”, “no one”. An example is when one says, “this always happens to me”.

• Jumping to conclusions – this is almost like catastrophizing, but this involves more of mind reading or presuming things.

• Personalizing – this happens when one is always blaming themselves for the things happening. Examples of phrases often used are, “it is because of me”, “it is my fault”, “if only I had done things differently, then this would not have happened”.

• Should*ing – this is when you know you should be doing something but not living up to it.

Everybody experiences these ANTS, in varying degrees. It is most important to note that our thoughts are not the reality and our feelings are not factual.

Okay! I have these ANTS. So what do I do about them? Catch it Check it Change it.

Firstly, notice the thought (identify the thought, feeling, or distortion), challenge it (with curiosity and compassion, examine the thought, find evidence for and against it) and lastly, replace it (brainstorm for alternative thoughts, teach your brain to chart new paths anytime there is a negative thought, then replace it with a more helpful one — neuroplasticity). Examples of other questions worth asking oneself are:

• What would I say to a friend who was feeling or having these thoughts?

• What aspects of these thoughts and feelings are within my control?

• What is my impulse? Can I do the opposite?

• Will this matter in 5 hours? 5 months? 5 years?

Valuable information right there! Time was limited but that was one insightful workshop. Many thanks to Lee Thomas and the HPI coordinators, Affan Siddiq and Blanca Pina for organizing this. This was, indeed, very timely!