PW03. Stress & Anxiety

Aug 17

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Welcome to Self Care: Session 03.

Here you can download the session PDF below by clicking on the button, or continue scrolling to fill out the private digital version.

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For easy access to handouts or worksheets referred to in the session, please use the links below, or continue scrolling.

MINDFULNESS PRACTICES HANDOUT

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Session Digital Version

Entering your name, email address and hitting “Submit” after you complete the session sends a digital file, including all your responses, to you within the hour. Having a record of your thoughts will increase your understanding and help you learn. As you progress through CRAFT Connect you will be able to measure that progress.

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Think: How much stress am I feeling today and why?

SQUARE BREATHING ACTIVITY

Square Breathing Exercise is a powerful stress reliever. Start by getting into a comfortable seated position in a chair or on the floor.

Step 1: Once all of the air has been expelled from your lungs, start by inhaling to a count of four through your nose. Say the numbers to yourself in your head. By the time you reach four, your lungs should be completely full of air. As you inhale, imagine the air pouring into your lungs and making them and your abdomen expand. Make sure that you are practicing abdominal breathing when you do this. When you inhale, your abdomen protrudes out; your shoulders should not rise up. If you notice yourself breathing with your shoulders, this means that you are taking shallow breaths and are not practicing deep abdominal breathing.

Step 2: Hold the air in your lungs for a count of four. Again, say the numbers to yourself in your head, and count slowly. Picture the air filling up your lungs in your mind's eye.

Step 3: Breathe out slowly to a count of four through your mouth. By the time you are at four, all of the air should be out of your lungs. Picture it moving up and out of your lungs, through your windpipe and finally mixing with the air in front of you.

Step 4: Hold your lungs in an empty state for a count of four. Focus on the emptiness of your lungs and the smallness of your abdomen.

Step 5: Repeat steps one through four for a total of at least five minutes. (Anahan Wellness, Square Breathing, 2019)

Discuss: How are you feeling now?

1. Stress is a normal part of life. It is how the brain and body respond to any demand, such as a problem at work, a test at school, or an important decision. The right amounts of stress can help us focus, reach our goals, and protect our bodies. Stress helps keep us alive, but too much stress for too long can hurt us. If we are dealing with too much stress, we might get sick often, have headaches, feel angry, have drastic changes in our appetite, or experience a lack of focus.

2. Worry is also a normal and healthy part of life, but too much worry can cause anxiety. Anxiety is a feeling of excessive worry or nervousness. Stress and anxiety share many of the same symptoms. Anxiety doesn't fade into the distance once the threat is over. It hangs around and can cause significant barriers in our life. For example, stress can be helpful. If you have some stress about your job, you will likely come to work prepared and focused on your tasks. However, when stress levels increase, you may start to feel anxiety about your job, and you may not want to go to work because you fear something bad will happen or that you will not be good enough. (National Institute of Mental Health, NIH Publication No. 19-MH-8109, 5 Things You Should Know About Stress, 2019)

Discuss: How does understanding that stress and anxiety are a normal part of life help you better prepare to deal with them, when they come?

3. We can learn to recognize when we are under too much stress or anxiety and how to manage it. Your perception of what is happening in your own life is what is most important. Two individuals could have the exact same events and experiences in their lives. Depending on their perceptions, one could be feeling low stress, the other high stress.

4. “If we perceive something as stressful, our brains release hormones into the blood. These hormones change our behavior, mental experience, and physical functioning. If the threat is real, such as a lion that is about to eat us, these hormones will help save our lives, for instance by helping to deliver necessary oxygen to our legs so we can run. If the threat is imagined, such as thinking about a potential traffic jam each morning that will make us late for work, these same hormones flow through our bloodstreams. Over time, these hormones use critical energy, causing damage to our body and leading to psychological and physical problems.” (Grippo, A., Why Stress Is Both Good and Bad, 2016)

STRESS LEVEL ACTIVITY

Answering the following questions can help measure your individual stress level during the last month. Indicate how often you have felt or thought a certain way. Although some of the questions are similar, there are differences between them and you should treat each one as a separate question. The best approach is to answer fairly quickly. Don’t try to count up the number of times you felt a particular way; rather indicate what seems like a reasonable estimate.

Step 1: For each “How often have you” question choose from the following alternatives; 0 = never, 1 = almost never, 2 = sometimes, 3 = fairly often, 4 = very often.

1. Been upset because of something that happened unexpectedly?

2. Felt that you were unable to control the important things in your life?

3. Felt nervous and stressed?

4. Felt confident about your ability to handle your personal problems?

5. Felt that things were going your way?

6. Found that you could not cope with all the things that you had to do?

7. Been able to control irritations in your life?

8. Felt that you were on top of things?

9. Been angered because of things that happened that were outside of your control?

10. Felt difficulties were piling up so high that you could not overcome them?

Step 2. Determine your stress score by totaling the numbers. (Remember to reverse score questions 4, 5, 7 and 8.) Individual scores can range from 0 to 40 with higher scores indicating higher perceived stress. Scores 0 to 13 = low stress. Scores 14 to 26 = moderate stress. Scores 27 to 40 = high stress.

5. NOTE: YOU SHOULD SEEK HELP RIGHT AWAY IF YOU ARE OVERWHELMED, FEEL YOU CANNOT COPE, OR ARE USING DRUGS OR ALCHOHOL MORE FREQUENTLY TO COPE. YOUR DOCTOR MAY BE ABLE TO PROVIDE A RECOMMENDATION. YOU CAN FIND RESOURCES TO HELP YOU FIND A MENTAL HEALTH PROVIDED BY VISITING WWW.NIMH.NIG.GOV/FINDHELP. IF YOU OR A LOVED ONE IS HAVING THOUGHTS OF SUICIDE, CALL THE CONFIDENTIAL TOLL FREE NATIONAL SUICIDE PREVENTION LIFELINE AT 1-800-273-TALK (8255), AVAILABLE 24 HOURS A DAY, 7 DAYS A WEEK. LIFELINE CHAT IS AVAILABLE AT HTPPS://SUICIDEPREVENTIONLIFELINE.ORG. THESE SERVICES ARE AVAILABLE TO EVERYONE.

6. There are ways to reduce stress and anxiety you can do anywhere. (See the “Mindfulness Practices Handout" at the end of this session.) Like any new skill these techniques need to be practiced, as you do so your ability to relax will improve. Mindfulness is one of the most widely used coping skills. The practice of mindfulness involves being aware moment‐to‐moment, of our subjective conscious experience from a first‐person perspective. When practicing mindfulness, we become aware of how we think and what we think about. The skill of mindfulness can be gradually developed. Be patient with yourself and do not let the effort to practice become another stressor. If one technique does not work for you, try another.

5 SENSES ACTIVITY

Observe your surroundings for two minutes. During this time try to do the following:

Step 1: Bring your attention to five things that you can see. Pick things that you don’t normally notice like a shadow or a small crack.

(Let at least 15 seconds pass before moving on to the next step.)

Step 2: Pay attention to four things you are currently feeling, like the texture of your clothing, breeze on your skin, or the smooth surface of a chair you are resting your hands on.

(Let at least 15 seconds pass before moving on to the next step.)

Step 3: Listen, and note three things that you hear in the background. This can be the chirp of a bird, the hum of a refrigerator, or the faint sounds of traffic from a nearby road.

(Let at least 15 seconds pass before moving on to the next step.)

Step 4: Be aware of two smells you usually filter out, whether they’re pleasant or unpleasant.

(Let at least 15 seconds pass before moving on to the next step.)

Step 5: Focus on one thing that you can taste right now, at this moment. You can take a sip of a drink, chew a piece of gum, eat something, or notice the current taste in your mouth.

Discuss: What was your experience like? What did you notice?

7. Over the course of a week you may experience different levels of stress and at different times. You may feel moderate stress today and get back to a low the day after tomorrow. In addition to being Mindful, here are some ideas that may help you stay at – or get – back to the low level. (National Institute of Mental Health, NIH Publication No. 19-MH-8109, 5 Things You Should Know About Stress, 2019)

a). Recognize the signs of your body's response to stress. Signs such as difficulty sleeping, being easily angered, feeling depressed, and having low energy. b). Get regular exercise. Just 30 minutes per day of walking can help boost your mood and reduce stress. (See “Physical session”.) c). Turn off technology. Stress might come from maintaining a large network of Facebook friends, feeling jealous of their well-documented and well-appointed lives, the demands of replying to text messages, the addictive allure of photos of fantastic crafts on Pinterest, having to keep up with status updates on Twitter, and the “fear of missing out” on activities in the lives of friends and family. (Pew Research Center, Psychological Stress and Social Media, 2015) d). Speak kind words to yourself. Respond to yourself about stressful situations like you would with your best friend or your child. Give yourself a break. e). Help someone else. Serving others helps give us a better perspective on our life. Stop and think of others and look for ways to help. (See “Providing Strength to Others” session.) f). Try a relaxing activity. Some ideas for stress reducing activities are found in at the end of this session. Explore other ‘no-cost’ stress coping techniques, which may incorporate meditation, yoga, tai chi, or other gentle exercises. g). Examine your expectations. Reduce unrealistic self-expectations or worrying about what others think. Learning to control and challenge our inaccurate thoughts can reduce anxious feelings. Don’t expect everything to turn out the way you hoped. (See “Social Support” session.) h). Be grateful. Start each morning and end each evening by listing five things you are grateful for. Focusing for a few minutes on what is right, good, and positive about yourself and the world can make a huge difference. i). Stay connected with people who can provide emotional and other support. To reduce stress, ask for help from friends, family, community, church and health care professionals as needed. (See “Social Support” session.) j). Take one step at a time. Identify the immediate problem and take one step at a time to solve it. Remind yourself, “All I have to do right now is___________” For example, “All I have to do right now is wait for the bus.” Or “All I have to right now is do the dishes.” Decide what must get done now and what can wait. Learn to say no to new tasks if they are putting you into overload. Note what you have accomplished at the end of the day, not what you have been unable to do.

What else has worked for you?

Discuss. Share with the group ways you manage your stress or anxiety.

MANAGING STRESS & ANXIETY ACTIVITY

Coping ahead is a skill that can help manage stress and anxiety. In the table below write a few of the above ideas that you will try and make a plan for when and how you will use them.

Reducing stress and anxiety: Be grateful

When and how you will use this reducing stress and anxiety idea: Write what I am grateful for each day

Reducing stress and anxiety idea: