Copyright 2017 by Lorelei Woerner, OTR/L, C-IAYT

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Ashley Stafford
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3 Sympathetic Stimulation Pupil dilation Saliva production reduced Mucus production reduced Heart rate and force increased Bronchial muscle relaxed Peristalsis reduced Motility reduced Motility reduced Increased conversion of glycogen to glucose Decreased urine secretion Norepinephrine and epinephrine secreted Wall relaxed Sphincter closed Parasympathetic Stimulation Pupil constriction Saliva production increased Mucus production increased Heart rate and force decreased Bronchial muscle contracted Gastric juice secreted; motility increased Digestion increased Secretions and motility increased Increased urine secretion Wall contracted Sphincter relaxed

4 Brake Parasympathetic NS Learning mode Thrive Rest and digest Gas Pedal Sympathetic NS Protective mode Survive Fight or flight

5 : On body On mood On behavior Retain belly fat Headache Muscle tension or pain Chest pain Fatigue Stomach upset Sleep problems Increased HR Shortness of Breath Anxiety Restlessness Lack of motivation or focus Irritability or anger Sadness or depression Can t think straight Overeating or undereating Angry outbursts Drug or alcohol abuse Tobacco use Social withdrawal

6 Stress activates the amygdala which alerts to threat leading to release of hormones, including cortisol Short-term cortisol release prepares to sustain fight or flight Long-term exposure causes neurons to shrink and interferes with their ability to send and receive information Prolonged stress or trauma is associated with decreased volume in areas of the brain responsible for regulating thoughts and feelings, enhancing self-control and creating new memories In addition to hippocampal shrinkage, major life stress may shrink brain neurons in the PFC

7 Release of cortisol Stress Hippocampal Damage Negative thought patterns Impaired memory, learning

8 Fear is an emotional response to a perceived threat, which causes changes in brain and organ function, as well as in behavior. Fear can lead us to It is the basis for many unhealthy emotions and behavioral choices Differences in coping styles influence responses to fear. Proactive Style = reacting actively (fight/flight) Reactive Style = reacting more passively (freeze) In the face of fear, one may feel: A desire to hide, run, or freeze Stuck Uncertainty Unsafe Desire to run away Shame/guilt Self-doubt Procrastination Lack of Confidence

9 Anxiety is a typically about an uncertain outcome. Anxiety disorders cause over-whelming distress that interferes with daily life Feeling anxious is a normal emotion under certain situations

10 Fear Response to known or definite threat Objective External Clear and present object of fear Anxiety Response to imprecise or unknown threat Subjective Internal Mind s vision of possible dangers

11 The ANS distinguishes between positive and negative emotions, however fear and anxiety are responded to similarly. Thoughts and emotions create somatic signals of pleasure or pain. These internal networks affect the way you perceive reality, which further influences the emotions you experience Intense emotions (like fear, frustration, anxiety or anger) result in heart rhythms that are spiked and jagged. Because of neural connections between heart and brain, these intense emotions negatively affect the ability to think clearly. Whenever you feel loved and appreciated and generate internal feelings of emotional well-being, heart rhythms become synchronized and harmonious and the ability to think clearly is enhanced.

12 Emotions (personality) Autonomic Functions (physical) Perception of Reality (intellect)

13 Category Shift From DSM IV to V: DSM-IV category of Anxiety Disorders became 3 separate ones in DSM-V. These three categories are: 1. Anxiety Disorders (separation anxiety disorder, selective mutism, specific phobia, social phobia, panic disorder, agoraphobia, and generalized anxiety disorder). 2. Obsessive-Compulsive Disorders (obsessive-compulsive disorder, body dysmorphic disorder, hoarding disorder, trichotillomania, and excoriation disorder). 3. Trauma and Stressor-Related Disorders (reactive attachment disorder, disinhibited social engagement disorder, PTSD, acute stress disorder, and adjustment disorder).

14 Excessive anxiety that causes distress or impairment, or interferes with normal function Differentiated based on type of object or situation that causes fear, anxiety, or avoidance as well as the thought patterns associated with the fear or anxiety. To be considered an anxiety disorder, the fear or anxiety also has to be persistent (lasting usually six months or more)

15 Anxiety unpleasant emotional, cognitive, behavioral or physical experiences of stress Trait Anxiety enduring personality style Acute Anxiety time-limited anxiety that diminishes with resolution of the problem Anticipatory Anxiety predictive anxiety in response to future actual or imagined situations Chronic Anxiety anxiety that persists, developing around new stressors after immediate problems are resolved Free-floating Anxiety generalized anxiety, may be vague in origin Clinical Anxiety disruption in function due to anxiety

16 Feelings of panic or fear Uneasiness Problems sleeping Cold or sweaty hands or feet Shortness of breath Heart palpatations Not being able to be still Self-doubt Approval seeking Unexplained fatigue (yawning) Unexplained pain Slower than expected performance response, or under-performing High pitch to voice Dry mouth Numbness or tingling in the hands or feet Nausea Muscle tension Dizziness

nature: friendship, family and intimacy Keep from harm, including: security of body, employment, resources,

17 Becoming what we are capable of becoming, includes: accepting of facts, problem solving, lack of prejudice, spontaneity, creativity, morality Confidence, achievement, respect of others, respect by others Our tribal nature: friendship, family and intimacy Keep from harm, including: security of body, employment, resources, morality, the family, health, property Maintaining the physical body: breathing, food, water, sleep, homeostasis, excretion

18 No one cause Women develop it more than men Family history or anxiety and depression Younger adults more than adults (social) Low Socio-economic status Living in urban centers (as opposed to nature) Black, Asian, Native American, Hispanic have higher rates Smokers Life stress

19 Research shows evidence that anxiety disorders are not a result of a personal weakness or character flaw, but are caused by a combination of factors including changes in the brain and environmental stress: Genetics (Epigenetics) Environmental Psychological Developmental

20 Chest pain Heart palpitations Fatigue Shortness of breath Trouble concentrating Sweating Blank or fuzzy mind Nausea Irritable Trembling or shaking Muscle tension Fear of losing control Headaches Sense of impending doom Sleep Problems Mood swings

21 Dopamine -- increases with physical movement, and meditation. It plays a role in reward-motivated behaviors and memory formation. It boosts focus and concentration. Need to release before able to focus. Norepinephrine -- increases with stress. It has been linked with arousal and attentiveness. With a little bit of stress, can help with attentiveness Lack of stimulation seems to be the key to causing hyperactivity and distraction The paradox about people with ADHD is that they need the dopamine to feel calm.

22 Anti-anxiety medication Serotonin reuptake inhibitors Beta Blockers Sedatives (Valium) Psychotherapy & talk therapy CBT EMDR Tapping

24 Change involves learning and all learning generates change in the brain Thinking patterns actually change neurochemical and molecular charges in the neurons The complex network of neurons manages the flow of information that shape behaviors, and ultimately lifestyle choices. Thoughts spark emotion-driven action a thought or drive to act or not Therefore, you can CHOOSE to change your mind by choosing another way of thinking.

26 Strategies To Decrease Arousal Level Reduce novelty Reduce complexity/grade task Reduce verbal instructions, tone and volume of voice Reduce directions to your primary goal Decrease sensory stimuli Provide proprioceptive input Facilitate soft, low tone sounds

27 Coping With Fear Feeling Stuck Uncertainty Feeling unsafe Feel like running away Shame/guilt Self-doubt Procrastination Just start moving with small steps Evaluate what if scenarios Begin doing one thing/action, provide support Stand tall and take a deep breath Cultivate new beliefs Cultivate optimism by producing Develop new habits, start small Courage is not the absence of fear, it is acting in spite of it Mark Twain

28 FEAR Selfesteem Faith Optimism Action Results

29 Dealing with Anxiety State what is observed (seems like.) Validating what is observed (I understand It makes sense.) Give permission to feel anxious and examine it (you seem uncertain, want to review it?) Normalize the worry (neutral tone of voice) Long Exhale! ( The nose knows ) Celebrate smallest achievements (avoid no ) Optimistic about their response and abilities (visualize it and believe it) Observe student s motivational issues Adapt the activity for flow Use humor and playfulness Firm, calm neutral tone in voice

30 General Principles Apāna region focus to promote the relaxation response Bṛmhana practice: build up confidence in order to be mentally and emotionally stronger. Work on the region of jatharāgni (samāna vāyu) for metabolism and digestion of emotions May need to discharge the person before they can relax.

31 Initially langhana, nurturing, with mild bṛmhana elements Might need to discharge before they can relax Recommend a daily walk first thing in the morning ( 1/2 hour) Use a lot of rest in the practice, in and between āsana etc.

32 Long-term aims: implement as appropriate Active standing postures, with chanting in postures Vinyāsa such as sūrya namaskār Use langhana sounds such as namo namaha and santi and om to reduce anxiety. Especially with finger nyasam and mantra. Use bṛmhana sounds such as ha, ra, hṛām, the bīja mantra series for the sun when you are trying to build their confidence Consider sun visualization with postures and in meditation when trying to build their confidence

33 Diet and lifestyle Encourage exercise every morning when cortisol is highest Diet is fresh foods, warm foods, warm water, little or no stimulants (especially not in the morning)

34 X

Mental Health and Stress

Mental Health and Stress Learning Objectives Ø Define mental health and discuss the characteristics of mentally healthy and selfactualized people Ø Describe the various mental disorders and appropriate