Denver Health Medical Plan, Inc. > Health and Wellness > Mental Wellness

Anxiety

What is anxiety?
Anxiety can be a normal "alarm system" alerting you to dangerous situations. Your heart beats fast, your palms get sweaty, your mind races and you are prepared to either react or retreat (“fight or flight”). In this situation, anxiety can provide an extra spark to help you get out of danger. Anxiety can also give you the energy to get things done.
But sometimes anxiety can be out of control, creating ongoing worry or fear that isn't related to a particular event or situation, or is out of proportion to what you would expect. This kind of anxiety can disrupt your life.

What causes an anxiety disorder?
- May be caused by chemical imbalances in the body – severe or long-lasting stress can change the balance of chemicals in the brain that control mood. Also, people with certain anxiety disorders have changes in certain brain structures that control memory or mood.
- Anxiety can run in families, which means that they can be inherited from one or both parents, like hair or eye color.
- Certain environmental factors, such as a trauma or a significant event, may trigger an anxiety disorder in people who have an inherited susceptibility to developing the disorder.
Although symptoms can vary depending on the type of anxiety, general symptoms include:
- Feelings of panic, fear, and uneasiness
- Uncontrollable, obsessive thoughts
- Repeated thoughts or flashbacks of traumatic experiences
- Nightmares
- Ritualistic behaviors, such as repeated hand washing
- Problems sleeping
- Cold or sweaty hands and/or feet
- Shortness of breath
- Palpitations
- An inability to be still and calm
- Dry mouth
- Numbness or tingling in the hands or feet
- Nausea
- Muscle tension
- Dizziness
What are the different types of anxiety?
- Generalized Anxiety Disorder
  - Ongoing anxiety, for no apparent reason, that interferes with day-to-day activities and relationships and makes it hard to enjoy life.
- Phobia
  - An extreme, unreasonable fear in response to something specific such as a fear of crowds, bridges, snakes, spiders, heights, open places or social embarrassment.
- Panic Disorder
  - Sudden episodes of intense fear that develop for no apparent reason and that trigger severe physical reactions.
- Posttraumatic Stress Disorder
  - Anxiety that is triggered by a traumatic event – an event that causes intense fear, helplessness or horror. Typical symptoms include intrusive memories, avoidance and numbing, and increased anxiety or emotional arousal (hyperarousal).
- Obsesssive-Compulsive Disorder
  - Characterized by unwanted thoughts or behaviors that seem impossible to stop or control.
- Social Anxiety Disorder
  - A debilitating fear of being seen negatively by others and humiliated in public. It can also be thought of as extreme shyness.
What can I do to cope with my anxiety?
- Stop or reduce your consumption of products that contain caffeine, such as coffee, tea, cola, and chocolate.
- Ask your doctor or pharmacist before taking any over-the-counter medicines or herbal remedies. Many contain chemicals that can increase anxiety symptoms.
- Seek counseling and support after a traumatic or disturbing experience.
- Control your worry. Set aside a certain amount of time each day to concentrate on your concerns and try to come up with solutions to your problems. Try not to dwell on what "might" happen. Focus more on what's really happening. Then let go of the worry and go on with your day.
- Practice deep breathing:
  - Lie down on a flat surface.
  - Place one hand on your stomach, just above your navel. Place the other hand on your chest.
  - Breathe in slowly and try to make your stomach rise a little.
  - Hold your breath for a second.
  - Breathe out slowly and let your stomach go back down.
- Learn relaxation strategies such as muscle relaxation, yoga, or deep breathing.
- Exercise regularly. Exercise can give you a sense of well-being and help decrease feelings of anxiety.
- Get plenty of sleep. Sleep rests your brain as well as your body and can improve your mood.
- Avoid alcohol and drug abuse. It may seem that alcohol or drugs help you to relax. But in the long run they make anxiety worse and cause more problems.
- Confront the things that have made you anxious in the past. When the fear comes, accept it. Wait and give it time to pass without running away from it.
- Use medicine if it helps. Your doctor may give you medicine to help reduce your anxiety while you learn new ways to respond to the things that make you anxious. Many types of medicine are available. Your doctor will decide which medicine is right for you.
- Talk about your anxiety with your doctor. Your doctor can help you make a plan to cope with anxiety. Counseling can help you learn to express your needs and wants so you can feel more in control and hold in less of your anger and anxiety.
- The most important thing is to take action. Action can help you gain a sense of control over your anxiety.
Relaxation Techniques
- Exercise: Deep Breathing
  - Sit or lie comfortably, with loose garments.
  - Put one hand on your chest and one on your stomach.
  - Slowly inhale through your nose or through pursed lips (to slow down the intake of breath).
  - As you inhale, feel your stomach expand with your hand. If your chest expands, focus on breathing with your diaphragm.
  - Slowly exhale through pursed lips to regulate the release of air.
  - Rest and repeat.
- Exercise: Focusing
  - Select a small personal object that you like a great deal. It might be a jeweled pin or a simple flower from your garden.
  - Focus all your attention on this object as you inhale and exhale slowly and deeply for one to two minutes.
  - While you are doing this exercise, try not to let any other thoughts or feelings enter your mind. If they do, just return your attention to the object.
  - At the end of this exercise you will probably feel more peaceful and calmer. Any tension or nervousness that you were feeling upon starting the exercise should be diminished.
- Exercise: Meditation
  - Sit or lie in a comfortable position.
  - Close your eyes and breathe deeply. Let your breathing be slow and relaxed.
  - Focus all your attention on your breathing. Notice the movement of your chest and abdomen in and out.
  - Block out all other thoughts, feelings, and sensations. If you feel your attention wandering, bring it back to your breathing.
  - As you inhale, say the word "peace" to yourself, and as you exhale, say the word "calm." Draw out the pronunciation of the word so that it lasts for the entire breath. The word "peace" sounds like p-e-e-a-a-a-c-c-c-e-e-e. The word "calm" sounds like: c-a-a-a-l-l-l-l-m-m-m. Repeating these words as you breathe will help you to concentrate.
  - Continue this exercise until you feel very relaxed.

Exercise: Progressive Muscle Relaxation
- Lie on your back in a comfortable position. Allow your arms to rest at your sides, palms down, on the surface next to you.
- Inhale and exhale slowly and deeply.
- Clench your hands into fists and hold them tightly for 15 seconds. As you do this, relax the rest of your body. Visualize your fists contracting, becoming tighter and tighter.
- Then let your hands relax. On relaxing, see a golden light flowing into the entire body, making all your muscles soft and pliable.
- Now, tense and relax the following parts of your body in this order: face, shoulders, back, stomach, pelvis, legs, feet, and toes. Hold each part tensed for 15 seconds and then relax your body for 30 seconds before going on to the next part.
- Finish the exercise by shaking your hands and imagining the remaining tension flowing out of your fingertips.