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Managing worry, anxiety and stress
Strategies to help you cope

Dr Karyn Hood, Clinical Psychologist, Toronto

Stress is so commonplace that it has become a way of life for many Canadians. Not surprising perhaps, given the multiple demands, hassles, deadlines and responsibilities that most people deal with on a daily basis. When you’re constantly operating in “stress mode” however, it can take a great toll on your mind and body.

Stress isn’t always bad—it does have a function. It is the fuel that can propel you to perform well under pressure and motivate you to excel at a task—like when you are preparing for a big presentation or deadline at work or school. It is also the innate biological response that mobilizes you to action to avoid danger or harm---like when you swerve to avoid an accident on the highway. There are times however, when stress or anxiety can overwhelm you and significantly interfere with the quality of your life.

How do you know when your stress or anxiety levels are too high?

When you become so overwhelmed by anxiety or stress that you feel paralyzed or fail to take action, it is unproductive and unhealthy. One byproduct of stress is the tendency to worry and fret about things. Worry in particular becomes problematic when it becomes excessive and consuming--winding us up physically, and interfering with our sleep or ability to relax. Unbridled worry or stress can also make it hard for us to detach from our thoughts and prevent us from engaging in effective problem solving. Excessive worry often leads to worry about things outside of our control, and can stimulate catastrophic thinking about predicted negative outcomes.

Managing Worry

Over time, extreme worry and anxiety can take a significant toll on your mind and body, and negatively impact your health and well-being. Given the negative consequences of excessive worry and anxiety, it is important to have positive ways of coping with this less adaptive response. Below are a number of simple cognitive and behavioural strategies that may assist you in managing your worry or anxiety:

Let’s say for example, you become more anxious and worried in anticipation of an upcoming presentation at work and that this level of anxiety has started to interfere with your sleep and ability to “turn your mind off” and relax. What can you do? The following suggestions can be extended to any stressful event where you find you are struggling to cope.

· Look at the worst-case scenario. A good way to reduce your concern about the outcome of a situation, involves asking yourself "What is the worst that could happen?" and “If the worst did happen, how would I handle that?” With this technique you want to envision some of the worst-case scenarios or “what ifs?” in anticipation of a feared event like giving a presentation (e.g., you blank out for a minute when you are speaking). You then want to mentally generate a plan of how you would manage in the event that the worst case is realized (e.g., take a minute to collect your thoughts or consult your notes and then continue).

· Consider the odds. You might also ask yourself “How likely is it that the worst will happen?” and assign a probability value of 0-100%. For example, given that I have practiced the presentation, and have notes to refer to, how likely is it that I will completely blank out? When you really look at things this way, you may assign a lower probability of your worst fear occurring. This sort of more objective thinking tends to deflate anxiety and reduce the sense of doom, while increasing your sense of competence and ability to handle even very difficult outcomes.

· Look at the evidence. Another related technique that can quell your anticipatory anxiety, is to “Look at the Evidence” that defeats your worst fear. Often when you look at a feared event in a more systematic fashion you begin to realize there is very little proof to support the likelihood of your worst fear occurring. In the above example, when you really consider how many times you have done a talk and how many times you have actually blanked out, or been unable to continue, you may realize there is little evidence to support your worst fear.

· Clear your mind. If you find that you are actively worrying about the presentation for days before and it is interfering with your sleep or ability to relax after-hours, you may find it useful to do a “mind dump”. This involves writing out the worries or problems on your mind as a way of clearing your head and allowing your brain to stop processing information so you are able to relax. It is important however, to avoid using this technique to actively problem solve before going to bed, but instead just record the concerns as issues to follow up on the next day. You might also find this technique useful if you wake in the night and are worrying about issues related to work.

· Look at your lifestyle: There are also a number of lifestyle changes that might improve your overall health and response to stress and anxiety. When we are busy or stressed, we often forfeit our regular more balanced habits like working out, getting to bed in good time or eating well. This is a flawed approach however, since during stressful periods, maintaining a regular eating and sleeping schedule, and incorporating more regular forms of physical exercise provide a positive distraction for our worries and provide a good outlet for stress.

· Limit your vices. Reducing your intake of substances such as alcohol, and stimulants like caffeine (including coffee, tea, energy drinks etc.) may also help to reduce your level of physiological arousal and therefore reduce any distressing physical symptoms of anxiety in general, or related to a specific stressor.

· Schedule “Worry Time”. Limit your worry. You may find that Sometimes limiting your worry to a set time in the day (e.g., set aside a half hour/day to worry or write down your worries) might assist in getting the concerns out of your head, and prevent them from persisting or interfering with the rest of your day or your sleep.

· Try Cognitive Behaviour Therapy (CBT). Some people find it useful to consult with a psychologist for a few individual sessions of CBT to improve their responses and ability to cope with stress and worry. CBT is a proven approach for dealing with anxiety and stress. During this type of work, you will be encouraged to examine, challenge and understand your perceptions and behaviours about your ability to effectively manage stressors. Appropriate exercises and coping strategies will be enlisted to help you replace less efficient ways of coping with stress and anxiety with more adaptive thoughts and behaviours.

To learn more about how you can manage your anxiety and stress using cognitive behaviour therapy (CBT), or about other psychological services provided by Dr. Karyn Hood, C Psych, you can call 416 275 2020 or visit www.drkarynhood.com.

Dr. Karyn Hood is a Clinical Psychologist who obtained her PhD in clinical/counselling psychology from the University of Toronto. She completed her clinical training at the Centre for Addiction and Mental Health (CAMH) and University of Toronto Counselling Centre.

Dr. Hood is an experienced clinician with extensive experience in Cognitive Behaviour Therapy (CBT) and Interpersonal Therapy (IPT) for depression and anxiety, and has been providing psychotherapy to adults and groups for over 10 years. Dr. Hood has worked with clients on a wide range of difficulties including stress and anxiety, mood disorders, sleep, relationship difficulties, weight/health issues, and adjustment issues. She has delivered a number of talks and professional workshops, and has been published in peer-reviewed journals. Her research interests include vulnerability and resilience in depression, anxiety and stress. Dr. Hood is a licensed member of the College of Psychologists of Ontario (CPO) and has a private practice in downtown Toronto.

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