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University Counseling Service (UCS) Mental Health Newsletter - April 2016
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School Can Be Stressful!
 
Between school, work, family, friends, and every day, and unusual life events, you are pulled in different directions. Moreover, all these responsibilities take away from the time you might need to care for yourself, so it's easy to see how easy it can be to feel stress.

Stress is a normal reaction to life-changing events. While we all can get fearful, stressed out or anxious at times, most of us bounce back. But stress that is so frequent, intense, and uncontrollable that it hinders daily routines may be a sign of an Anxiety.
 
Stress, Fear and Anxiety: What is the Difference?
 
Fear = A feeling of doom, unease, or apprehensiveness in response to imminent danger.  Fear is the body’s way of telling us “real danger is present, do something to save yourself!”
Stress = The body's response to adverse or emotionally demanding events.  Stress is the body’s way of motivating us to act when something needs our attention to get done.
Anxiety = A feeling of doom, great unease, or apprehensiveness when no danger is imminently present.  Anxiety is our brain’s mistaken way of warning us of a danger that is not actually there which generates a response out of proportion to what is happening.
Anxiety is fear when there is no actual danger present!  Getting anxious because you may not do well on a test activates a fear response that is not needed.  Stress is more reasonably the response to a difficult test.  Having anxiety makes things worse as  it is a level of feeling and response not necessary for the situation:  A test is challenging and critical, but not truly dangerous.  With no specific threat of actual danger, anxiety is a free-floating, vague feeling, which is why it can be difficult to pinpoint and about which to decide to do something.
An example may be the best way to illustrate the differences between stress, fear and anxiety.
The Science of Anxiety (A Short Video)
The Science of Anxiety
Regular Feelings of Anxiety vs a True Anxiety Disorder
Occasional Anxiety is a Normal Part of Life

In general, anxiety can be a normal reaction to stress.

Anxiety. Can initially motivate you to accomplish your assignments, to study harder for a test and it can warn you when you’re in a dangerous situation. It informs you to be extra vigilant about your environment — to fight or flee. And then. . . . .An anxiety disorder, however, involves intense and excessive anxiety, along with other debilitating symptoms.

Stressor. Anxiety can occur in response to a stressor, such as an exam, an upcoming interview, a fight with a friend or a new job. When you struggle with an anxiety disorder you’re anxious almost or all of the time.

Intensity and Length. Many people are on edge before an exam, but a person with an anxiety disorder might be anxious several weeks beforehand, and will experience intense symptoms right before and during the exam. Also, normal anxiety is fleeting, while an anxiety disorder is ongoing and the feelings can last weeks or months.


Examples of Anxiety Disorders
  • Generalized Anxiety Disorder (GAD): Excessive, uncontrollable worry about everyday issues, including school, work, money, friends, and health.
  • Social Anxiety Disorder: Avoidance of everyday social situations due to extreme anxiety about being judged by others or about behaving in a way that might cause embarrassment or ridicule.
  • Panic Disorder: Severe attacks of terror, which may feel like you're having a heart attack or going crazy, for no apparent reason.
  • Specific Phobias: Intense fear reaction that leads to avoiding an object, place, or situation such as riding in elevators or driving on bridges. Those with specific phobias typically recognize that the fear is irrational and inappropriate for the circumstance.
  • Obsessive-Compulsive Disorder (OCD): Persistent, recurring thoughts (obsessions) that reflect exaggerated anxiety or fears and manifest as repetitive behaviors or rituals (compulsions); for example, the uncontrollable need to scrub hands repeatedly or the insistence on absolute neatness and order.
  • Posttraumatic Stress Disorder (PTSD): Avoidance, detachment, difficulty sleeping and concentrating, and reliving a traumatic event or experience several months or years after it has occurred.
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Andrea Short Shares Some Insights with Us on
"Managing Anxiety"

Andrea is Health & Physical Activities Skills Coordinator in the Dept of Health & Human Physiology
 
Life is stressful, we all know that!  At the back of everyone’s mind are the ways in which we can “cure” stress and anxiety.  Although there is no antidote, and everyone will experience stress every day of their lives, the ways in which we may manage our symptoms of stress can prevent it from escalating into anxiety.  Before we can list the HOWs in the steps to symptom management, we should first take a look at what anxiety is:
 
WHAT is anxiety?

Anxiety, as defined by the Merriam-Webster dictionary, is “an abnormal and overwhelming sense of apprehension and fear often marked by physiological signs, by doubt concerning the reality and nature of the threat, and by self -doubt about one’s capacity to cope with it” (Merriam-Webster Dictionary, 2015).   It is easy to see, then, that it is not the event that will mark the anxiety, but rather one’s inability, be it actual or imagined, to cope with the event. 
Take, for example, the loss of a job.  The loss of the job is the event, and this situation may cause the emotion of worry: “What will I do now?”  This emotion could snowball into anxiety: “Will I be unemployed?  I could lose my house!  How will my children eat if I don’t have any money?!”  Generally, this person may feel like they cannot survive and cope without the job that they had, or may fear they cannot get another job.

 
WAYS in which we can manage anxiety:

First, we can proactively combat anxiety through taking control of our lives.  This usually entails simple life management techniques:
  • time management: being able to prioritize events in your life, and knowing how much you can actually take on
  • money management: to prevent the stress and overwhelming feeling of never having enough, and taking a look at how you actually spend your money
  • refining study skills: to foster learning, memory, and concentration to ease the load of academics
  • personal health: diet and exercise to help foster well being

    A prime example of how life skill management may help ease anxiety is that of a poor grade on a test. Perhaps you slept in a few times and missed the class, and perhaps you had to work late a few nights so you did not study as much as you would have liked. You go in to take the midterm and realize that you are unprepared!Your mind starts racing, “I don’t know any of these answers! Everyone else seems to, why am I struggling? I knew I shouldn’t have taken this class. I’m not smart enough and now I am going to fail the class. ”Through employing a few time management techniques, you could have spread out the study time, used smaller pockets of time for learning, and felt more confident and in control of the outcome of your midterm.

Secondly, there are ways to reactively alleviate some of the physical symptoms of stress and anxiety.  These are physical signs that your body produces in reaction to the anxiety, and may include: headaches, fatigue, irritability, and muscular tension.  Left unchecked, these symptoms could lead to longer term, chronic issues: high blood pressure, IBS, ulcers, and depression.  Some techniques for alleviating the symptoms of anxiety include:
  • Breathing techniques: deep, slow and controlled breathing helps to regulate the heart rate, improve respiratory function, and remove waste products.  To practice diaphragmatic breathing: put a hand on your belly.  Fully inhale through your nose for a count of five.  Work to inhale deeply inhale so that your hand smoothly rises up and falls with each breath.  Exhale through pursed lips, as if you are blowing out a candle, for a count of five.  Practice for 5 minutes per day.
  • Meditation: When people think of meditation, they typically think of lying uncomfortably on the ground, trying to think of nothing, when all thoughts are focused on their to-do list!  Meditation should be thought of as the complete concentration of all senses on one particular thing.  There are many types of meditation, each with a focus on the outcome of relaxing.  Walking meditation is an example: How does the ground feel under your feet?  What does it smell like on your trail?  Do you hear birds in the trees? Be aware of your thoughts, and any external stimuli, but let them float by you. 
  • Visualization:  One of my favorites, like taking a mini vacation in your mind.  Lie back and empty your mind.  Use the first breathing technique to begin settling your breathing and your thoughts.  Take one special place you would like to be, such as a beach, or the woods, or nestled beside a warm fire on a cold day.  Let your thoughts fill in all the gaps for all your senses:  Visualize the feel of the warm sand on your legs, or the crackling of the fire, or the smell of freshly cut grass.  Let yourself just be in this spot, in this moment, as long as you can.
By taking the time to manage our day to day activities, we can more effectively control our lives.  For the inevitable stressors that sneak in, take the time to practice relieving the symptoms of stress to prevent it from snowballing into anxiety!
Bibliography: Merriam-Webster Dictionary. (2015). Retrieved from http://www.merriam-webster.com
Are You Dealing With Too Much Stress or Anxiety?
Do a Check UP From Your Neck Up!!
 
Take this brief Anxiety Screening http://screening.mentalhealthscreening.org/HAWKS
Courtesy of University of Iowa Student Health and Wellness

http://www.mentalhealthamerica.net/anxiety
 
Anxiety & Stress Busters

Whether you have stress, anxiety, or an anxiety disorder, these strategies will help you cope:
 
Exercise.  Physical activity helps your body and mind. Go to the gym. Go for a walk. Do yoga. Play Frisbee. Just get moving!
Eat a balanced diet.  Don't skip meals. Eat from all of the food groups and stay away from caffeine (minimize soda, energy drinks, and coffee). Caffeine can trigger anxiety and panic attacks.
Limit alcohol and stay away from illegal drugs.  Alcohol and drugs aggravate anxiety and can cause panic attacks.
Get involved. Being active in your community creates a support network and gives you a break from everyday stress.
Do your best instead of trying to be perfect. We all know perfection isn't possible, so be proud of however close you get.
Take a time-out. Take a deep breath and count to 10. Stepping back from a problem lets you clear your head. Do yoga. Meditate. Get a massage. Learn relaxation techniques. Listen to music.
Put things in perspective. Think about your situation. Ask yourself whether it's really as bad as you think it is or if you may be focusing on limited information or evidence.
Talk to someone.  Don't bottle up emotions to the verge of explosion. Reach out to your friends, roommate, partner, family, or a counselor when you're feeling overwhelmed.
Find out what triggers your anxiety. Take notes or write in a journal when you're feeling anxious or stressed, and then look for patterns.
Avoid unnecessary stress (if possible), such as a stress inducing person or situation
 

Dr. Mike Evans Offers His Tips for Managing Stress
11 minute Sketch Video


Quick Links
Student Health and Wellness Stress Management Consultation: http://studenthealth.uiowa.edu/wellness/stress-management/
Managing Speaking Anxiety: https://counseling.studentlife.uiowa.edu/self-help/30-ways-to-manage-speaking-anxiety/
Managing Test Anxiety: https://counseling.studentlife.uiowa.edu/self-help/managing-test-anxiety-40-steps-to-success/
Stress Management: https://counseling.studentlife.uiowa.edu/self-help/stress-management-/
Stress Management Strategies: https://counseling.studentlife.uiowa.edu/self-help/stress-management-strategies
Mobile apps for those with anxiety related disorders: www.adaa.org/finding-help/mobile-apps
Wunderlist, to Help Stay Organized: www.wunderlist.com
Study Effectively: https://counseling.studentlife.uiowa.edu/self-help/study-effectively
How to Prepare for Exams: https://counseling.studentlife.uiowa.edu/self-help/how-to-prepare-for-exams
How to Take Exams: https://counseling.studentlife.uiowa.edu/self-help/how-to-take-exams
Breathe2Relax (Android): https://play.google.com/store/apps/detailsid=org.t2health.breathe2relax&hl=en

Breathe2Relax (iOS): https://itunes.apple.com/us/app/breathe2relax/id425720246?mt=8
Suggestions for Intervening with an Anxious Friend
  • Be empathic and understanding
  • Don’t minimize the severity of anxiety symptoms
  • Avoid critical or shaming statements
  • Encourage coping strategies which don’t rely on avoidance of anxiety-provoking stimuli
  • Challenge expressions of hopelessness
  • Don’t argue about how bad things are
  • Don’t become angry even though your efforts to help may be resisted or rejected
  • Advocate for treatment of anxiety
  • Consult with a mental health professional if an anxious friend refuses necessary treatment
Adapted from “Understanding and Treating Anxiety,” University of Illinois Urbana-Champaign Counseling Center.
Rap it Up

The Good News: There is Help for Anxiety
 
So what does this mean for University of Iowa students?  At the University Counseling Service, we see a lot of people with anxiety.  We estimate that around 40% of our clients meet the criteria of an anxiety disorder, and many more experience occasional to significant anxiety.  The good news is that because the staff at the UCS see many people with anxiety, we have lots of ways to help people with anxiety!  We have clinicians that are proficient in Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT), both of which are science-based treatment methods to decrease the negative impact of anxiety on your life.  We also run therapy groups during the summer and fall which can help with social anxiety; in fact, for social anxiety, group therapy is the best mode of treatment!  A general therapy group or the ACT on Life group can be helpful in alleviating anxiety.  You can also schedule a consultation appointment with someone at the UCS to discuss stress management techniques. 
 
Here are some additional options on campus to get help with anxiety:
 
Stress-Management Techniques
Stress Management Consultation: Student Health and Wellness 319-335-9304.  Learn More: http://studenthealth.uiowa.edu/wellness/stress-management
 
Learn to Manage Stress AND Get Credit With These Courses:

Relaxation Techniques HPAS: 1210: (Also offered this summer!) Learn methods to combat stress in everyday life.  Course topics include reactive techniques used to help reduce the physical symptoms of stress, such as irritability, concentration problems, fatigue and insomnia.  This course will also cover some proactive tips to help reduce stress in everyday life, such as time management, assertiveness training, and anxiety coping mechanisms such as breathing, progressive muscle relaxation, meditation, yoga, visualization/imagery, and other techniques. Register: https://myui.uiowa.edu/my-ui/home.page

Mindfulness Foundations: Just This Moment or The Rest of Your Life PSQF:1027 – 3 Credits
A course for undergraduates interested in learning personal, professional, and academic aspects of mindfulness. Students have opportunity to apply learning to individual interest areas including:  Education, psychology/counseling, human relations, healthcare, and business.
More info here: https://www.uihealthcare.org/content.aspx?id=245482;
Register: https://myui.uiowa.edu/my-ui/home.page

More Mindfulness Classes on Campus – Not for Credit:
University of Iowa Hospitals and Clinics Mindfulness Programs
Informational sessions and registration in May for summer session www.uihealthcare.org/mindfulness

-Mindfulness-Based Stress Reduction (MBSR)
Enrolled UI students are welcome to participate in MBSR programs offered at UIHC, as described on our website and are eligible for 50% off.

-Mindfulness-Based Cognitive Therapy (MBCT) for Prevention of Depression Relapse
Students may participate in the MBCT program—see website for more details. Many insurance plans cover this group if the participant has a diagnosis of depression and/or anxiety.
Click here to see the previous month's issue on Mindfulness
counseling.studentlife.uiowa.edu

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