Anxiety Education

What is Anxiety?

Throughout your day, you probably experience worry, dread, or fear in response to or anticipating certain events. Worry is a regular part of life. Anxiety occurs when these everyday worries go into overdrive. Instead of having a small amount of dread for a particular event, a person with anxiety may start to experience a constant dread with no known ties to a specific event. Anxiety can also look like an inappropriately large amount of dread for a specific event.

Use this example to better understand anxiety. Imagine you have a math test coming up on Friday. All week, you have been thinking about it and preparing for it. It would be natural that on Thursday night, you start feeling some butterflies in your stomach and general nervousness until test time. These worries flow freely through your body, and you complete the test without any hiccups. After the test, your worries disappear. This is an example of worry.

Now imagine that it's the week leading up to the test, and you feel your heart racing, you can't sleep, and you are irritable and on edge to the point where you cannot focus at school or with your family. All you can think about is your exam; you have a tiny voice in your head telling you, "No matter how much you study, you are going to fail," even though you have a high grade in the class. The night before the test, you experience an episode of hyperventilation, dizziness, and nausea, feeling like you are unable to calm down. Evening walking into the exam, you have a pit in your stomach that you can't shake. These worries are no longer proportional to the "problem"; they are affecting your functioning and physical well-being; this is an example of anxiety.

Anxiety doesn't always happen in response to something you are worried about. Some people who have anxiety live with constant dread and worry, unable to tie it to any source. In this type of anxiety, the person often experiences negative automatic thoughts. Automatic thoughts are thoughts that pop into your brain without your conscious control. Typically, they are negative and do not reflect the truth. Examples of these thoughts could be: "All my friends hate me," "I cannot succeed," or "Something bad is about to happen to me." Automatic thoughts are different for everyone, and even individuals without anxiety experience them from time to time. However, when an individual is experiencing anxiety, these thoughts are loud, can feel constant, and often go to the extreme negatives. Hearing these thoughts all day drives an individual into a continuous state of fear and dread; they tend to start believing the thoughts that affect their behavior and quality of life.

Common myths about anxiety

"Anxiety is just a fancy word for nervousness" - MYTH; yes, anxiety and nervousness have overlapping feelings and origins. However, anxiety is a life-impacting mental health illness that many people face. Anxiety should not be swept into the same category as nerves. Instead, it should be treated with the same importance as a physical illness or injury.

"Anxiety is a sign of weakness" - MYTH, many people have anxiety. Anxiety symptoms are not a shortcut to getting out of hard things; anxiety comes from psychological and biological misfiring in the brain and body out of the individual's control. Anxiety does not make a person weak; instead, acknowledging it and standing up for what you need makes you stronger.

"Anxiety will go away on its own" - MYTH. While people may go through periods where they experience more anxiety than other times, anxiety does not just go away. Many times, it takes work to acknowledge, address, and reframe the brain to overcome anxiety. Treatment looks different for everyone; while some people may be able to manage anxiety solely using self-help strategies, others may need to lean on professional help or medication. Once symptoms are managed, anxiety still doesn't really go away forever; many people will live their whole lives with anxiety. It is important to note that anxiety flare-ups are not failures; some days may be better than others, but learning to manage symptoms and take back your life is an integral part of the process.

Types of Anxiety

Anxiety looks different for everyone who experiences it. In fact, there are seven broad types of anxiety that researchers have identified to help better explain each unique experience.

This manual provides general information for dealing with feelings of anxiety in daily life. It does not attempt to treat a specific anxiety disorder. These disorders are briefly outlined below to provide a greater understanding of the topic of anxiety. These descriptions should not be used as standards for diagnosis; if you believe you or someone you love qualifies for one of these disorders, contact your healthcare professional for information and help.

Generalized Anxiety Disorder (GAD) - Excessive worry and dread over numerous things and throughout daily life. GAD is characterized by constant uneasiness and worry, typically tied to things that don't deserve the amount of worry occurring.
Social Anxiety Disorder - A remarkable fear of social situations in which an individual dreads embarrassment or scrutiny from others. It typically involves being fearful of meeting new people or talking in front of many or unfamiliar individuals.
Panic Disorder - Anxiety that results in sudden episodes of intense worry and bodily response of panic. The episodes are called panic attacks. Panic attacks can be tied to an event or occur at random. An individual may feel unable to breathe, think, speak, or calm their body. Some individuals may even feel they are having a life-threatening medical event such as a heart attack or stroke.
Obsessive-Compulsive Disorder - Uncontrollable obsession (or thoughts) surrounding specific topics or ideas paired with a person's compulsion to perform particular behaviors in an attempt to calm the mind or avoid a negative situation or fear.
Post-Traumatic Stress Disorder - This disorder is tied to the occurrence of a traumatic event; an individual continues to feel worry, dread, and bodily responses to the event despite the event being in their past and not occurring again.
Separation Anxiety Disorder - Primarily found in younger children, an intense fear of separating from a familiar person or place.
Specific phobias - An disproportionate fear of an item, animal, or event. A person fears a particular thing/event and will attempt to avoid it at all costs.

You can experience times of anxiety without having a specific disorder. Even if you don't believe you have an anxiety disorder, the information provided below can assist you in managing stressful and fearful times in life. It can also equip you to help others experiencing anxiety around you.

What does anxiety feel like?

Anxiety looks and feels different for all individuals. Anxiety affects your body in three major ways: physical sensations, cognition (or thinking sensations), and behaviors. These are common signs and symptoms of anxiety disorders to help you better identify anxiety in your body.

Physical

Heart racing
Hyperventilation
Headache
Stomachache
Muscle pain
Joint pain
Tingling in hands and fingers
Flushing of the face
Sweating
Trouble sleeping
Restlessness
Butterflies in the stomach
Ringing in the ears
Brain fog
Inability to concentrate

Behavioral

Refusing or avoiding stressful situations (refusing to go to school or a class)
Shutting down in the face of stressful things
Overreacting to stressful events (emotional reactions or preparing obsessively to avoid failure or danger)
Episodes of panic or overwhelm (crying, shaking, hyperventilating, brain fog)

Cognitive

Negative thinking (automatic and unconscious thoughts pop into the brain, typically negative or fear-inducing in nature. Ex. "You will fail this test." "Nobody likes you.”)
Perfectionistic attitude (thoughts of needing to be perfect, extreme fear of failure)
Catastrophizing thoughts (intense and pessimistic thoughts of possible outcomes. Ex. "If I fail this quiz, I will fail the class, then I will not be able to graduate, and I will end up with a job or home.”)
Self-doubt or poor self-esteem
Racing thoughts
Feeling like people are talking or looking at you
Seeking reassurance (Ex. "Is this good enough?")
Feeling like the world is moving in fast forward or slow motion
Worrying about the future, feeling impending doom

Recognizing anxiety in others

Is your teen or friend acting different all of a sudden? Did you know behaviors and physical changes in others could be a sign of anxiety?

Red flags to look out for in those around you:

Poor self-care—Coming to school looking disheveled and/or dirty. Maybe their hair isn't brushed, or they are wearing pajamas more than they used to.
Lack of joy or amusement—Some individuals may seem less happy in their day-to-day lives; maybe an activity that used to bring them joy they now avoid or find less amusement in.
Skipping meals or overeating—Anxiety can affect a person's appetite; look for changes in the amount and type of food a person is eating.
Sleeping more or less—Sleep patterns are one of the first things to change when anxiety is ramping up; if your friend is telling you they have been up all night or you notice your teen napping more than usual, this could be something to look into.
Complaining of physical pain/illness—If your teen or friend seems to be getting sick more or feeling unexplainable pains, this could be a sign of anxiety.
Social withdrawal—Even if a person isn't struggling with social anxiety, you may see a change in social behavior patterns due to anxiety. They might lack the energy or desire to engage in social interactions or withdrawal from friends and family.

Don't hesitate to speak up if you see these signs in someone you care about! Be gentle, of course, but ask them how they are doing. If you don't feel like you can go to the individual directly about your concerns, tell a trusted adult or professional, maybe a school counselor, teacher, or parent.

What is test anxiety/academic perfectionism?

A specific and common anxiety for teens is test anxiety or academic perfectionism. While this is not an official anxiety disorder, it is a common occurrence within the teen/adolescent population. It is described as an intense fear of failure and/or holding inappropriately high standards for academic achievement. For adolescents, high school and academic achievement are major parts of life. Due to societal pressure and looming college applications, the importance of academics can get skewed, resulting in unattainable standards and pressure.

Test Anxiety - Extreme fear, dread, and worry of failing an exam, typically when failure is not a common practice or predictable result for this student. Worrying about an exam is a regular part of being a student. Test anxiety occurs when the worry is paralyzing and results in physical and cognitive symptoms before or during an exam. A student with test anxiety might hyperventilate or shut down during an exam. It can result in poor test performance despite proper preparation. Test anxiety can also look like a student over-studying for an exam, driving themselves to an extreme, pulling an all-nighter, or missing meals to prepare for an exam despite having a high grade in the class or a good grasp of the concepts.

Academic perfectionism - Like test anxiety, this is an extreme fear of not attaining a self-set high academic standard. Typically, this looks like an already high-performing student going to extremes, striving to achieve 100% in classes and reacting fearfully in the event they may receive an A over an A+. This thought process typically results in test anxiety, over-examining their work, spending excessive/inappropriate time on smaller assignments, and reacting over the top or inappropriately to poor marks on school work.

While school is important, students should do their best. School should not and is not everything. When achieving high grades starts to impact your physical health, this is an indicator that you may need help. Your life is never more important than a grade or a college acceptance. Be kind to yourself. If you are experiencing unwanted and extreme stress over grades, classes, or anxiety, reach out to teachers, parents, or someone you trust. You are enough; grades DO NOT define you.

Interview

Do you think you have anxiety or know someone with anxiety? What can you do to help?

Anxiety manifests differently in everyone; it is important to note that what might help one person deal with anxiety might not help another individual. There are many ways to help manage anxiety, from at-home solutions to therapy, meditation practices, medication, and many more. Finding the right coping strategies for yourself and your loved ones takes time and work. This anxiety toolkit has general tips and tricks combined with hands-on activities and worksheets to help teens (and adults) work through anxiety and anxious thoughts. These resources were created using a cognitive behavioral therapy (CBT) lens. CBT is a therapeutic practice focused on identifying negative thinking patterns and maladaptive behaviors. CBT helps you identify thoughts and assess if they are helpful and truthful; using CBT activities, you can retrain your brain to use more productive thought patterns. It also looks at behaviors and helps you determine whether they reduce anxiety or produce it. The great thing about these worksheets is they can be done at home by yourself. While there are therapists who practice CBT, its general concepts can be used in the absence of a professional and on your own terms. Explore the following resources and try them for yourself! Download and print out the worksheets that speak to you!