Introduction

Understanding Anxiety Disorders

How to stop anxious Thoughts? A Practical Guide
Later action or life hygiene (or a proper name)
My Plan for Managing Anxiety: Putting it all Together
Worksheets

Introduction :
Welcome to the Anti-Anxiety Notebook, intended to help increase your understanding and
knowledge about anxiety. The goal is to provide you with some skills to recognize and manage
symptoms you may be experiencing. We hope you find it helpful.

We’re glad you’re here

Anxiety can sometimes serve a purpose in helping us deal with life’s difficulties. It can sometimes
help us respond to threat, and anxiety can also drive us to focus on our challenges and solve
problems. When it spirals out of control, however, anxiety can impair our ability to think logically and
deal with adversity using logic and rational thinking.

This workbook aims to help you to:

-Understand what anxiety is, what causes it and what keeps it going.

-Recognize whether you may be experiencing symptoms of anxiety.

-Find ways to manage or overcome your anxiety

I-Understanding Anxiety Disorders

Anxiety is an unpleasant feeling that we all experience at times. It is a word often used to

describe when we feel 'uptight', 'irritable', 'nervous', 'tense', or 'wound up'. When we are anxious

we normally experience a variety of uncomfortable physical sensations.

As well as this, anxiety affects us mentally too. For example, when anxious, we often worry for

large periods of time, so much so that our worry can feel out of control. These worries are often

about a variety of issues and commonly our mind jumps quickly from one worry to another.

Anxiety also influences how we behave. For instance, when we feel anxious, we often avoid

doing things that we want to because we are worried about how they will turn out. Although
short experiences of anxiety are part and parcel of daily life, it becomes challenging when

anxiety begins to follow people around and is a regular feature in their lives.

Some of the most common anxiety disorders include:

Generalized Anxiety Disorder: Chronic and unrealistic worry that feels difficult to control about
everyday things (i.e., things that do not worry most people)

Social Anxiety Disorder: Chronic worry solely related to social situations

Panic Disorder: Characterized by episodes of “panic” that include things like: adrenaline surge, fear
of losing control, chest pain, racing heart, shortness of breath, dizziness

Phobias: Specific fears that are excessive in nature and often lead to avoiding that which is feared
(e.g., public speaking, heights, tunnels, etc.)

Obsessive-Compulsive Disorder: Excessive rumination (thinking) with repetitive behaviors to reduce

anxiety

How did I develop anxiety?

Life Events:

Often we develop anxiety following a series of stressful life events. This is especially true if we
experience many different pressures all at once. For example, if someone has work pressures,
financial difficulties, and relationship problems, all at the same time, it is perhaps unsurprising that
they become anxious. When thinking about it in this way, anxiety is often the result of feeling as
though we cannot cope with the demands placed upon us.

In addition, people can learn to be anxious based on their life experiences. For example, if someone
has faced workplace bullying in the past, they may be more likely to suffer anxiety when beginning a
new job.

Thinking Styles:

Some people may have a thinking style that lends itself to experiencing anxiety. For example, anxious
people have a tendency to expect that the worst possible scenario will always occur. They also feel
like they must constantly be on guard in case something bad happens. They believe that by thinking
about all the things that could go wrong, they will be better prepared to cope if it happens. However
thinking in these ways mean they are on regular alert and find it difficult to relax and 'switch off'.

Evolutionary Reasons:

We also experience anxiety because of its evolutionary benefits. Put another way, although anxiety is
largely an unpleasant experience, it also has positive benefits that have been useful to humans over
the centuries. For example, when we are under threat or feel in danger (e.g. hear a burglar), we
automatically become anxious. As a result, our heart beats more quickly which supplies blood to our
muscles (which helps us run away from or fight the burglar); we sweat (which cools us down during
this process); and our breathing changes (which ensures oxygen is delivered to our muscles quickly,
again preparing us for a quick response). When looking at anxiety in this way, you can quickly see
how it can be very useful in certain situations.

Biological Reasons:
It has also been suggested that anxiety has familial ties. In other words, if someone in your
immediate family is an anxious person, there is an increased chance that you will have similar
personality traits. In reality it is likely that a combination of all these factors influence someone's
anxiety levels.

However, in some ways it is less important to know what causes anxiety, and more important to
know what stops us overcoming it.

Do I have symptoms of anxiety?

If you experience symptoms of anxiety it is likely that you will recognise many of the feelings,
physical symptoms, thoughts and behaviour patterns described below.

Please tick the boxes which regularly apply to you.

If you have ticked a number of these boxes you may be experiencing symptoms of anxiety.
However don't be alarmed, this is very common and there are things you can do to improve
your situation. You will find some useful strategies in this workbook.
The anxiety thought patterns:
Some people have a style of thinking which lends itself to experiencing anxiety. For example,
it appears that some people are more likely to overestimate the likelihood of bad things
happening than others. It is easy to see how regularly presuming the worst in this way would
make someone feel anxious. Unfortunately, when we do feel anxious, we become even less
likely to think as clearly as we would like and a vicious cycle occurs.
First you need to be able to recognize an unhelpful thought. Being aware of the common
patterns that unhelpful thoughts follow can help you to recognize when you have them.
Here are some of the common patterns that our unhelpful thoughts follow:
Predicting the Future:
When we are feeling anxious, it is common for us to spend a lot of time thinking about the
future and predicting what could go wrong, rather than just letting things be. In the end
most of our predictions don't happen and we have wasted time and energy being worried
and upset about them.
For example:

 Assuming you will perform poorly at your job interview.

 Spending the week before an exam predicting you will fail, despite all your hard
work studying and your previous good grades.
Mind Reading:
This means that you make assumptions about others' beliefs without having any real
evidence to support them.
For example:

 My boss thinks I'm stupid.

 People think I'm weird.

Such ways of thinking naturally make us apprehensive.

Catastrophising:
People commonly 'catastrophise' when they are anxious, which basically means that
they often blow things out of proportion.
For example:

 They assume that something that has happened is far worse than it really is
(e.g. that their friend is going to dislike them because they cancelled a night
out).
 They may think that something terrible is going to happen in the future,
when, in reality, there is very little evidence to support it (e.g. I'm going to get
into serious trouble for calling in sick).
Focusing on the Negatives:
Anxious people often have a tendency to focus on the negatives which keeps their
anxiety going.
 For example:

 They focus on the one person at work who doesn't like them, ignoring that
they are very popular with the rest of their colleagues.
Should Statements:
People often imagine how they would like things to be or how they 'should be' rather than
accepting how things really are.
For example:

 I should have got an A in History.

 I should never be anxious.
Unfortunately when we do this, we are simply applying extra pressure to ourselves that can
result in anxiety. Instead it can sometimes help to accept that things can't always be perfect.
Over Generalising:
Based on one isolated incident you assume that all others will follow a similar pattern in the
future.
For example:

 When enrolling on a college course, you meet a future classmate who you
find irritating. As a result, you worry that everyone in the class will be the
same and you won't make any friends.
What If Statements:
Have you ever wondered "what if" something bad happens?
For example

 What if I have a panic attack at the party?

 What if I don't make friends when I start my new job?
This type of thought can often make us avoid going places or doing the things that we would
like.
Labelling:
Do you find that you attach negative labels to yourself?
For example:

 I'm weak.
 I'm a waste of space.
 I'm always anxious.
Not having enough free time to relax and do the things we enjoy, can also contribute to
our higher anxiety levels. On the other hand, having too much free time can mean we have
lots of opportunities to engage in worry and feel anxious.
II-How to stop anxious Thoughts? A Practical Guide:
1-The Power of Mindfulness: Be Aware of your thoughts
When looking more closely at anxiety, you can begin to see that our thoughts, feelings,
behaviors and physical symptoms all interact and combine to keep our anxiety cycle going.
To break the anxiety cycle, you need to stop the trigger. become aware (Mindful) of your
anxious and irrational thoughts and feelings that drive your behavior, can help you think of
more helpful, rational alternatives to them. Regular practice will help you implement this
approach naturally so that you can stop your anxiety from spiraling out of control.
When you’re having anxious thoughts or feeling anxious, worried, or uncertain, before you
start attacking yourself or another person, you simply mentally note to yourself that you’re
“just worrying.” use the anxious thoughts Worksheet Provided, write down what are your
thoughts and what are your feelings and why you think you’re feeling this way.
By doing this you step back from being caught up in the thoughts and so they no longer get
taken over by them. You can see that they are simply thoughts in the mind and you don’t
have to buy into them, like any other mindfulness exercise, it is important not to fight your
feelings or thoughts. There is no need to criticize or judge yourself for feeling worried or
anxious. There is also no need to try to force the thoughts out of your head. In short – avoid
any struggle with the thoughts. Struggling with thoughts is a bit like struggling in quicksand.
It only makes you sink deeper.
(work sheet)
2-Provide an Anchor Thought for an anxious brain.
Mindfulness trains and strengthens the brain to stay in the moment. Of course, there will be
some times, mostly at the beginning, when it doesn’t interrupt your negative thoughts. The
solution for this is to Have a positive thought which is so powerful, that it pulls you out of
your current mindset, keep repeating it.

For example, an athlete will use an anchor to get back into “the zone” so they can regain
peak performance in a game. It may be a visual image of shooting the perfect basket or
knocking the ball out of the park. A professional speaker will have a routine they do before
going on stage to remind them of the positive states they want to be in while presenting.
This routine is their way of setting up an anchor—or a positive state. You can use this same
concept at any time to help you get out of a chaotic state.

Here’s a guided visualization to help you create your own anchor to a

powerfully calm and peaceful emotional state—or any other positive state
you’d like to access in times of stress. If you’d like to use a physical object as
your anchor, be sure to have it with you at this time, or you can work with a
visual image in your mind.

1. First, sit comfortably and close your eyes.

2. Begin by taking a few slow, deep breaths to center yourself.
3. Think of a highly positive experience in the past when you achieved an
incredibly calm and peaceful state, or whatever type of emotional state
you would rather feel when you’re overly stressed out.
4. Have an object like a pendant in your hand or visual image in your
mind that will help you remember that feeling.
5. Now, think of the experience that brought that calm state into being.
See the experience through your own eyes, hear the sounds around
you, notice any comforting smells or tastes, and feel into it emotionally
—as if it is happening now. Make it compelling and feel yourself
accessing the desired state as you hold the object or visualize the
image that you are linking it to.
6. See if you can find other similar and equally positive experiences to
link to this object or image as well.
7. Now use your senses in whatever way is best for you to link the object
or image to these feelings of peace, calm, and harmony.
8. Use your breath to secure the anchor by taking a three-second inhale
through your nose, and exhaling for six counts out your mouth while
making a “ha” sound. Use the exhale to energize the anchor. You may
energize it through visual, auditory, or kinesthetic sense. Do this four
times.
 9. When you see, hear, feel, or sense the connection has been made (you
will know this because you are feeling the desired emotional state
now), slowly open your eyes and come back into the room.
10. You have now created a tangible or visual link to this powerfully
calm emotional state that you can use anytime you need to move from
chaos to calm in an instant.
11. Write down your anchor thought on the worksheet, whenever
you’re spinning out and you need to come back to this state, stop, close
your eyes, take a few deep breaths and touch the object or see the
visual image that you anchored.

Allow yourself to return to the calm, peaceful state and remain there for as
long as you need—use your “ha” breaths to reconnect if you need to—and
then re-emerge when you’re ready
3-Stand up straight :
For immediate relief from anxiety, stand up, pull your shoulders back, plant
your feet evenly and widely apart, and open your chest. Then breathe deeply.
This posture, combined with deep breathing, helps your body remember that
it's not in danger right now, and that it is in control (not helpless). If you can't
stand up (i.e. you're in your car), just pull your shoulders back and open up
your chest. The most important thing is to stop hunching and breathe deeply.

4-Grounding Exercises
When people become overwhelmed with distressing thoughts or feelings, including intense
anxiety, activities that keep your mind and body connected (called “grounding”) can be
helpful in regaining a sense of stability and mental focus. The following are a number of
grounding exercises to choose from to help firmly anchor you in the present moment and
provide you with space to choose where to focus your energy. You may need to try
multiple different exercises to find one or two that work best for you.
1. Remind yourself of who you are now. State your name, age and where you are right now.
2. Take ten slow deep breaths. Focus your attention on each breath on the way in and on the
way out. Say the number of the breath to yourself as you exhale.
3. Splash water on your face or place a cool wet cloth on your face.
4. Pay purposeful attention as you hold a cold (non-alcoholic) beverage in your hands. Feel
the coldness, and the wetness on the outside. Note the taste as you drink. You can also do
this exercise with a warm beverage.
5. Find a “grounding object” to hold, look at, listen to, and/or smell. This could be a soft
object such as a pillow or stuffed animal, a smooth stone you found on the beach, a picture of
a beautiful scene or loved one, and/or any other object that represents safety or comfort.
6. Listen to music. Pay close attention and listen for something new or different.
7. If you wake up suddenly during the night and feel disoriented or distressed, remind
yourself who you are and where you are. Look around the room and notice familiar objects
and name them. Feel the bed you are lying on, the softness of the sheets or blankets, the
warmth or coldness of the air, and notice any sounds you hear. Remind yourself that you are
safe.
8. Feel the clothes on your body, whether your arms and legs are covered or not, and the
sensation of your clothes as you move in them.
9. While sitting, feel the chair under you and the weight of your body and legs pressing down
on it.
10. If you are lying down, feel the contact between your head, your body and your legs, as
they touch the surface you are lying on. Starting from your head, notice how each part feels,
all the way down to your feet, on the soft or hard surface.
11. Stop, look, and listen. Notice and name what you can see and hear nearby and in the
distance.
12. Look around you, notice what is front of you and to each side, name first large objects
and then smaller ones.
13. Get up, walk around, take your time to notice each step as you take one then another.
14. If you can, step outside, notice the temperature, the sounds around you, the ground
under your feet, the smell in the air, etc.
15. “54321” Grounding Exercise:
o Name 5 things you can see in the room with you.
o Name 4 things you can feel (tactile; e.g. “chair on my back” or “feet on floor”)
o Name 3 things you can hear right now
o Name 2 things you can smell right now
o Name 1 good thing about yourself
16. Write and/or say grounding statements
o This situation won’t last forever
o This too shall pass.
o I can ride this out and not let it get me down.
o My anxiety/fear/sadness won’t kill me; it just doesn’t feel good right now.
o These are just my feelings and eventually they’ll go away.

5-Sniff lavender oil

Lavender oil has a lot of healing properties. It promotes a feeling of calm and supports deep, restful
sleep. It can even help with headaches.

To help reduce anxiety, keep a bottle of lavender oil at your desk (or in purse if you have one).
Breathe it in and/or massage it into your temples when you need a boost of peace. Bonus points for
combining the sniffing with deep, even breaths.

6. Go for a brisk walk or do 15 minutes of yoga

Exercise is a long-proven way to lower anxiety. In addition to boosting your level of feel-good
neurotransmitters, a brisk walk clears your mind and gets you breathing more deeply again--and
anxiety is intimately linked to shallow breathing.

Studies also show that people who exercise vigorously on a regular basis are 25 percent less likely to
develop an anxiety disorder.

6- Listen to relaxing Music

III-Later action or life hygiene (or a proper name)

1- challenge your unhelpful thoughts -Alternative Response

Worksheet

2- Problem Solving

3- Reducing avoidance

4- Sleep Hygiene

5Grounding Exercises--Meditation, mindfulness, Controlled breathing

6-other strategies: Relaxation, Muscular relaxation and exercice

1- challenge your unhelpful thoughts with Alternative Response

The following section will help you begin to recognise if you are thinking about things in an unhelpful

or unrealistic way, and discuss how you can start to make changes to this. By doing so, you can learn

to see things in a more realistic light which can help to reduce your anxiety levels. You might have

unhelpful thoughts about all kinds of things.

Try to apply these questions to the unhelpful thoughts that you notice. It can help to reduce your

anxiety levels. You can use this technique to test your thoughts are realistic and balanced.

Alternative BEHAVIORS:

1. What could I do in the moment that would be more helpful?

2. What’s the best thing to do (for me, for others, or for the situation)?

3. If my feared situation happens, how will I cope? What coping skills can I use to handle my

feared situation? What have I done in the past that was successful?
4. Am I needing to work on acceptance, letting go of control, being okay with less than perfect, or

having faith in the future and myself?

5. Breathe: Focus your attention on your breathing. Imagine you have a balloon in your belly,

inflating on the in-breath, deflating on the out-breath.

Alternative FEELINGS:

1. What might it feel like if I acted/thought differently?

2. When I’m not feeling this way, do I think about this situation differently?

3. Are there any strengths or positives in me or the situation that I might be ignoring?

4. What else might this anxiety be related to? Is it really about feeling _______?

5. Tell yourself: “This feeling will pass. It’s a normal body reaction.”

(challenge your unhelpful thoughts with Alternative Response)

2- Problem Solving

You might find it more difficult to cope if you have lots of problems that you can't seem to get on
top of. This can have a clear impact on our anxiety levels. Struggling with unresolved problems
can often make us feel worse. We can end up worrying or ruminating over our problems without
finding a way to resolve them. This can make us feel even more upset, and can end up interfering
with our sleep.
It can help to develop a structured way of working through a problem. Beginning to overcome
some of your problems might help you to feel better. You can improve your problem solving
skills by learning to apply the steps outlined here.
Identify your problem
The first thing to ask yourself is “what is the problem?” Try to be as specific as possible.

For example:

"I owe $400 to my friend”

"I am going to miss this deadline."

Come up with possible solutions

 Try to list every way that you can think to overcome your problem. Don't worry about

how unrealistic an idea seems. Write down anything and everything. The best
solutions are likely to be the ones you think of yourself. This is because nobody really
knows your situation as well as you do.
It may help to consider:

How you might have solved similar problems in the past.

What your friends or family would advise.

How you would like to see yourself tackling the problem.

Choose a solution
Next you need to select the best solution from your list. Think carefully about each
option. It is useful to go through all the reasons 'for' and 'against' each idea. This will
help you to make a good decision and select the best solution.
After this you may find that you are still unsure. Perhaps a couple of approaches seem
equally good. Try to pick one to begin with. If it doesn't work then you can always go
back and try out a different one later.
Break down your solution
To help you carry out your chosen solution, it can be useful to break it down into
smaller steps. This can make it easier and more manageable to follow through. The
number of steps required will vary depending on the solution and how complex it is.
For example: Someone with debt may have decided to try and resolve their problem
by getting a part time job. This would require several steps.
1.
Buying a newspaper with job adverts.

Choosing which jobs to apply for.

Creating a CV.

Sending out their CV.

5.
Buying interview clothes.

Preparing answers to potential interview questions.

Try out your solution and review the outcome

Follow the steps required to carry out your solution. Simply take them one at a time.
Go at your own pace and don't allow yourself to feel too rushed.
Once you have completed all the steps, you should then review the outcome. If you
have successfully resolved your problem then great. If the problem still exists then
don't give up.
1.
Is there another solution on your list that you could try?

Is there a different solution that you have yet to consider?

Can you ask someone else if they have any ideas or advice?

Can you combine any of your solutions?

It is useful to remember that not all problems are within our control. This can make it really
difficult if not impossible to resolve using the steps above. Perhaps you will have to wait,
or ask someone else to take action instead. In such a situation, try not to worry. Nothing
can be gained from worrying about something that you have no control over.

(worksheet)
3- Reducing avoidance
4- Sleep Hygiene
What is Sleep Hygiene? ‘Sleep hygiene’ is the term used to describe good sleep
habits. Considerable research has gone into developing a set of guidelines and
tips which are designed to enhance good sleeping, and there is much evidence to
suggest that these strategies can provide long-term solutions to sleep difficulties .
1. Get regular. Go to bed and get up at more or less the same time every day,
even
on weekends and days off!
2. Get up & try again. Go to sleep only when tired. If you haven’t been able to fall
asleep after 30 minutes, get up and do something calming (not stimulating) until
you feel sleepy, then return to bed and try again.
3. Avoid caffeine & nicotine. Avoid
consuming any caffeine (coffee, tea, soda, chocolate) or nicotine (cigarettes) for at
least 4-6 hours before going to bed. These act as stimulants
and interfere with falling asleep
4. Avoid alcohol. Avoid alcohol for at least 4-6 hours before bed because it
interrupts the quality of sleep.
5. Bed is for sleeping. Do not t to use your bed for anything other than sleeping
and sex, so that your body comes to associate bed with sleep.
6. Electronics Curfew. Don’t use back-lit electronics 60 minutes prior to bed, as
the
artificial light prevents hormones and neurons that promote sleep.
7. The right space. Make your bed and bedroom quiet and comfortable for
sleeping. An eye mask and earplugs may help block out light and noise.
8. No naps. Avoid taking naps during the day. If you can’t make it through the day
without a nap, make sure it is for less than an hour and before 3pm.
9. Sleep rituals. Develop rituals to
remind your body that it is time to sleep, like relaxing stretches or breathing
exercises
for 15 minutes before bed.
10. No clock-watching. Checking the clock during the night can wake you up and
reinforces negative thoughts such as “Oh no, look how late it is, I’ll never get to
sleep.”
11. Keep daytime routine the same. Even if you have a bad night sleep it is
important that you try to keep your daytime activities the same as you had
planned. That is, don’t avoid activities because you feel tired. This can reinforce
the insomnia.

other strategies: relaxation+ Muscular relaxation

It is important to make time to relax and do activities that are enjoyable. This can help to reduce your

anxiety levels by calming the body and mind. It can also help you to sleep. Without taking the time to

unwind, it is easy to feel overwhelmed and stressed.

Relaxation can involve doing something that you enjoy, or just being by yourself. Good examples
might be reading a book or having a bath. Exercise is also particularly effective at helping us to
relax. What you do does not really matter. Try to choose something that you will look forward to
and that gives you a break. Doing an activity that you enjoy will also give you less time to spend
worrying. Here is a list of activities that might help you to relax.
Suggestions:

Do some exercise (e.g. swim, cycle)

Read a book

Watch your favourite TV show

Go to the cinema

Do something creative (e.g. draw, paint)

Visit a friend or family member

Have a bath

Try to add some of your own ideas into the box below. You will know what works best for you.
Try to find time to relax every day. This might seem difficult, but it is worth making time for. It
can help you to feel a lot better. There are audio relaxation guides available that you might find a
helpful support.
There are also some exercises described in the next few pages. They are specifically designed to help

you to relax. However, you should stop the exercise if at any time you begin to experience discomfort

or pain.

III- My Plan for Managing Anxiety: Putting it all Together

1. My primary anxiety symptoms include:

a. Cognitive:

b. Emotional:

c. Physical:

d. Behavioral:

2. Some of my unhelpful ways of thinking are: (e.g., all or nothing thinking, catastrophizing,
etc.)

3. My situational and cognitive triggers are: (e.g., unfamiliar situations, negative thoughts,
etc.)

4. The most helpful grounding technique(s):

5. The most helpful relaxation exercise(s):

6. The best time and place to practice relaxation exercises:

7.When I feel overwhelmed, it is helpful for me to:

8.Positive changes I can make to help my sleep include: (e.g., no TV 30 minutes before bed,
wake up at the same time daily, turn phone off, etc.)

9.MY GOALS: Name 2 goals you would like to achieve over the next few months, related to
anxiety and self-care. Think: specific, achievable, and measurable.

a.Name 2 goals you would like to achieve related to ANXIETY (e.g., Thinking about
thestrategies you find most helpful, what would you like to try, how often, when, etc.?)
i.______________________________________________________________________

ii.______________________________________________________________________

b.Name 2 goals you would like to achieve related to SELF-CARE: (What will your self-care
look like over the next few months? These could be goals related to nutrition,exercise, sleep,
schoolwork, leisure activities, etc.)
i._______________________________________________________________________

ii.________________________________________________________________________

How can I remind myself about my plan and goals?

__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
_______________________________________________________________________________

___________________

Final Word
We hope that you found some of the ideas in this booklet useful. You can continue to use the

techniques you found helpful long into the future and they should continue to benefit you. If some of

the ideas are not particularly helpful at first, it is perhaps worth sticking with them for a few weeks to

give them a chance to work. If however you feel your situation remains largely unchanged or if you

did not find this booklet useful, you should speak to your GP who can tell you about the other

options available which you could find helpful.