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Be Well, Think Well: Services and Treatment for Anxiety

Overview

This resource, part of the Be Well, Think Well resource collection, provides information about managing anxiety, tips on how to face your fears, various types of therapies for anxiety, different relaxation techniques, medication for treating anxiety and depression, and way to find a therapist for an individual with autism.

Managing Anxiety

Anxiety is normal and helps keep us safe and lets us know if there’s danger. Having some anxiety is okay, but too much can be bad.

CHANGE HOW YOU THINK: Learning how to solve problems can help you feel more confident and less anxious- Learn that you can’t control everything, and that’s okay – Try to stay positive – Learn that everyone makes mistakes, and that’s okay too

BE ACTIVE: Exercise can help you relax – Spend time outdoors

TAKE A BREAK: Do something relaxing that you enjoy- Practice meditation – Listen to calming music – Watch funny movies, TV or videos -Read- Paint, draw or doodle -Play games – Take a warm shower or bath

TAKE DEEP BREATHS: Taking long, slow breaths in through the nose and out through the mouth can help you relax if you’re feeling anxious

GET SOME SLEEP: Getting plenty of sleep helps your body rest and handle stress better

 

LEARN WHAT MAKES YOU ANXIOUS: Write down when you feel anxious – Pay attention to where you are, what you are doing and who is with you – This can help show who or what makes you anxious

AVOID STRESS: Taking long, slow breaths in through the nose and out through the mouth can help you relax if you’re feeling anxious

TALK IT OUT: Surround yourself with supportive friends and family – Express your feelings and talk when things bother you

EAT WELL: Eating healthy foods like fruits and vegetables helps your body work better and handle stress and anxiety more easily – Reduce how much caffeine and sugar you eat – Avoid alcohol, cigarettes, and drugs

How to Face Your Fears

Some people have fears and things that make them feel anxious. It’s important to be able to manage these feelings so they don’t get in the way of everyday life.

1. Create a plan

Anxiety can make people want to avoid the things that make them scared or afraid. Avoiding these things doesn’t help people learn ways to cope with or face their fears. Make a plan to face your fears. Start with things that are less scary, then work your way up to bigger challenges. Over time, you will learn that you are able to control these worries and face your fears.

2. Know your supports

Family members, friends, teachers, and support staff can help you create your plan. They can also cheer you on and provide help as you work through your plan.

3. Start small

As you develop your plan, make sure you break it into small steps that are easier to reach. You can always push yourself to do more. It’s important to have success as you work on the next step.

4. Use your calming skills

Find ways to help you to stay calm as you practice facing your fears. There are lots of different ways to help relax and stay calm when feeling anxious. Things like taking deep breaths, listening to music, writing down your thoughts, talking to a friend or family member, or watching a favorite show or movie are some examples.

5. Reward yourself for trying

You don’t have to master each step on your first try. Fear is a hard thing to overcome. Give yourself a reward every time you try deal with your fear, even if it did not end the way you had hoped.

Therapies for Anxiety

Therapy can be useful to decrease anxiety. A psychologist or therapist provides therapy to treat mental health concerns like anxiety or depression.

Cognitive Behavioral Therapy (CBT)

CBT focuses on how thoughts, behavior, and feelings affect each other. Therapists who use CBT teach new ways to behave and think in order to lower anxiety. This therapy usually only lasts a short period of time, between 8 and 12 sessions.

Acceptance and Commitment Therapy (ACT)

ACT teaches people to focus on the present moment and pay less attention to thoughts that may be causing anxiety. ACT focuses on the person’s values and helping them identify ways to live in a way that is meaningful to them, rather than letting emotions and anxiety change their behavior. ACT treatments are usually between 10 and 15 sessions.

Cognitive Therapy (CT)

Our thoughts are often affected by past experiences and our
emotions. CT teaches the person to look at their thoughts in a more objective way. CT also helps to teach people to tolerate uncertainty as a way to help reduce anxiety. CT treatments may last up to 20 sessions.

Applied Relaxtion

Applied relaxation focuses on teaching coping strategies that help people relax quickly when they’re anxious. Applied relaxation is used during situations that make the person anxious, in order to interrupt and stop the anxiety from getting worse. Over time and with practice, the person can apply these relaxation techniques when they start feeling anxious, without having to think about using them. Applied relaxation typically lasts up to 15 sessions.

Relaxation Techniques

If you experience anxiety or stress, you may have heard someone recommend relaxation techniques. There are many types of relaxation techniques that are used to help anxiety and stress. Everyone is different and not all relaxation techniques will work for everyone.

Breathing is the only bodily function that we do both voluntarily and involuntarily, meaning that you breathe on your own without thinking, but are also able to change your breathing when you want to.

During times of stress, there may be changes in body functions – heart rate rises, sweating occurs, muscles tense, and breathing becomes rapid and shallow.

These physical changes, this can affect how people think and feel. If a person is anxious and their breathing becomes faster, this can make them feel even more anxious. To help get rid of those feelings, individuals can practice deep breathing, also called abdominal or diaphragmatic breathing.

Steps for Deep Breathing

  1. Be relaxed in a quiet, comfortable place with eyes closed.
  2. Place one hand on the chest and the other on the stomach.
  3. Take a slow, deep breath in through the nose for a count of between 5 and 10. The
    hand on the stomach should move first and further than the one on the chest. This shows that the diaphragm is pulling air deep into the lungs.
  4. Hold the breath for a count of between 5 and 10, but not so long to be uncomfortable.
  5. Exhale slowly through the mouth for a count of between 5 and 10. Gently squeeze the stomach muscles to completely remove the air from the lungs.
  6. Repeat this cycle four more times for a total of 5 deep breaths.
  7. Should be done at least twice a day to start, or whenever a person notices signs of anxiety

Anxiety and stress can cause a person to think negatively and imagine the worst happening. Imagery can help them focus on positive and pleasant memories and experiences and help combat negative thoughts. Focusing on these types of mental images can help the person feel relaxed.

Steps for Using Imagery

1. Be relaxed in a quiet, comfortable place with eyes closed.

2. Think of a calming place in your mind. Don’t just think of the place briefly, but imagine every detail about it. Go through each of the senses – sight, sound, touch, taste, and smell – and imagine what someone would experience in that place.

3. Here’s an example using a beach.

  • Sight – sun in the sky, sand under your feet, crystal clear water, calm waves rolling in
  • Sound – rustling waves, seagulls in the sky, wind blowing
  • Touch – sand or water under feet, warm sun on skin, wind on skin
  • Taste – saltwater in your mouth, cool glass of lemonade
  • Smell – ocean air and salt water, sunscreen

4. Imagine this scene for as long as possible or at least until anxiety begins to lower. If negative thoughts or imagines try to pop up, return thoughts to the calming place and try to stay focused on the relaxing image.

When people feel anxious, their muscles may get tense and make them feel stiff or sore. Progressive muscle relaxation teaches people to relax their muscles and lower tension. It also helps people learn to identify when they are experiencing stress so they can handle it better.

Steps for Using Progressive Muscle Relaxation

  1. Be relaxed in a quiet, comfortable place with eyes closed.
  2. Tense muscle groups, one by one. Use the diagram and instructions below as a guide, starting from the top and moving down the body.
    • Forehead: raise your eyebrows
    • Eyes: clench your eyelids tightly shut
    • Mouth: open your mouth wide to stretch the hinges of jaw
    • Neck and shoulders: raise your shoulders to touch your ears
    • Chest: tighten by taking a deep breath
    • Stomach: suck in your stomach
    • Arm: tighten your biceps and “make a muscle”
    • Hand: clench your fist
    • Buttocks: tighten by squeezing your buttocks together
    • Leg: squeeze your thigh muscles
    • Lower leg: tighten your calf muscle by pointing toes up
    • Foot: curl your toes under
  3. Hold the tension for 5 seconds for each body part, then release.
  4. Notice how the muscles feel when you relaxed.
  5. This should take about 15 minutes to complete, and be practiced twice a day to start.

A diagram used for Progressive Muscle Relaxation highlighting ways to move forehead, eyes, mouth, neck and shoulders, chest, stomach, arm, hand, buttocks, leg, lower leg, and foot.

Panic attacks can be scary. You might feel overwhelmed. You might feel like you can’t breathe. You might feel like you are having a heart attack. This resource will teach you strategies that you can use to help you cope with your panic symptoms. These strategies are called “grounding” techniques. Grounding techniques can help you calm down quickly.

Steps for using Grounding Techniques

1. Scan the Room
Take a look around you. Reminding yourself that you’re safe can reduce the panic and help you return to normal.

2. Relax Your Body
It’s sometimes easier to relax your body than it is to relax your mind. Relaxation techniques can help your body relax and calm your mind. Take slow, deep breaths. Breathe in through your nose. Pay attention to the feeling of your lungs getting bigger as you breathe in. Then breathe out through your mouth. Repeat this for a minute or two and feel the tension leaving your body.

3. The 5-4-3-2-1 Grounding Technique
During a panic attack, people can get stuck in their thoughts. Try to focus on things that are going on around you. Pay attention to all five senses. To do this, concentrate really hard. Name five things you can see around you. Name four things you can feel. Name three things you can hear. Name two things you can smell. Name one thing you can taste. Repeat until you’ve calmed down.

4. Picture a Calm Place in Your Mind
Think about a place where you feel totally calm. Maybe it’s a beach, a forest, or a special place you go that makes you feel calm. Take a few moments and take some deep breaths. Close your eyes. Imagine yourself in your calm place. Think about all of the details. Imagine the sights, smells, noises, and temperature. Really try to imagine what it would be like if you were there. Imagine yourself in your calm place for a few minutes before you open your eyes.

Medication for Treating Anxiety and Depression

Sometimes doctors will prescribe medicine to help with anxiety and depression.

Depression 

When people take medicine for depression, they usually take it for at least 6-12 months. It may take this type of medicine a few weeks to work. Once you begin to feel better, your doctor may want you to keep taking the medicine for another 6-9 months.

Anxiety

Some medicines for anxiety work the first time you take it. Others may take days or weeks to work. Some may even make you feel more anxious the first few days you take it. This can be normal and should go away after a few days.

REMEMBER!

  • Never stop taking your medicine without talking to your doctor
  • It’s important to not miss doses of medicine. Use reminders, such as alarms on your smart phone, or using a weekly pill container placed where you will see it
  • Never share your medications with others
  • Always talk with your doctor if you have any side effects
  • If you don’t feel like you’re getting better, talk to your doctor
  • Keep appointments and check ups with your doctor, they’re very important
  • Your doctor may ask that you do other things to help your physical and mental health. These may include therapy, healthy food, exercise, or a daily schedule with the right amount of sleep. It’s important to follow these as best as you can

How To Find a Therapist for an Individual with Autism

1. Contact the insurance company

Insurance companies can be a great starting point for the search for a therapist. You can typically search for local therapists through the insurance company’s online self-service portal or by calling the customer service number on the back of the insurance card. You can find out what therapists are nearby, what insurance they accept, and whether or not they’re accepting new patients. If the person has medical assistance, contact the Special Needs Unit for additional help.

2. Psychology Today

Psychology Today is another great resource for finding a therapist. Their therapist directory can match people to a number of qualified therapists nearby. Therapist profiles typically include what insurance plans they accept, how much they charge, and what the therapist specializes in treating, letting you know exactly what to expect before scheduling the appointment. However, it’s good to contact the therapist to verify the information on the website and make sure they have experience working with individuals who have autism before scheduling an appointment.

3. Ask a healthcare provider

Primary care physicians often have therapists or agencies that they partner with and can give a referral. An added benefit is that they may be able to answer some questions about the provider and the services that they offer before contacting them to schedule a session.

4. Do some research

When choosing a therapist it’s important to know that type of treatment they use. Some types of treatment are better than others depending on the mental health condition, and have research to support using those strategies. These are called Evidence Based Practices. Research the treatment types local providers specialize in to select a therapist that uses an Evidence Based Practice. A quick Google search can give plenty of information about which types of therapy are evidenced based.

5. Don't give up!

Sometimes the first therapist doesn’t work out, and that’s okay! The relationship between a therapist and client is a key part of treatment success and sometimes that relationship doesn’t develop. Don’t get discouraged if the person doesn’t connect with the first therapist, there are others out there and they can always try again with someone else!

6. Plan ahead

Therapy is a big commitment and can take a lot of time and energy, so it’s important to ensure that the therapist can meet the person’s scheduling needs. Think about things like: Do their hours accommodate the person’s schedule? How will they get there? Therapy should be an experience that is enjoyable and helps the person, not something that adds stress. Planning early on can help reduce stress and lead to a better experience.

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Name Description Type File
Be Well, Think Well: Managing Anxiety This resource provides some tips to help people manage anxiety. pdf Download file: Be Well, Think Well: Managing Anxiety
Be Well, Think Well: How to Face Your Fears This resource provides some tips to help people deal with fears. pdf Download file: Be Well, Think Well: How to Face Your Fears
Be Well, Think Well: Therapies for Anxiety This resource explains some common types of therapy that are helpful in reducing anxiety. pdf Download file: Be Well, Think Well: Therapies for Anxiety
Be Well, Think Well: Deep Breathing This resource provides information about one technique, Deep Breathing. pdf Download file: Be Well, Think Well: Deep Breathing
Be Well, Think Well: Imagery This resource provides information about one technique, Imagery. pdf Download file: Be Well, Think Well: Imagery
Be Well, Think Well: Progressive Muscle Relaxation This resource provides information about one technique, Progressive Muscle Relaxation. pdf Download file: Be Well, Think Well: Progressive Muscle Relaxation
Be Well, Think Well: Grounding Techniques This resource will teach you strategies that you can use to help you cope with your panic symptoms. These strategies are called “grounding” techniques. pdf Download file: Be Well, Think Well: Grounding Techniques
Be Well, Think Well: Medication for Treating Anxiety and Depression This resource gives general information about medicine for depression and anxiety, and important things to remember. pdf Download file: Be Well, Think Well: Medication for Treating Anxiety and Depression
Be Well, Think Well: Finding a Therapist for an Individual with Autism This resource gives information about different ways to find a therapist for an individual with autism. pdf Download file: Be Well, Think Well: Finding a Therapist for an Individual with Autism

This information was developed by the Autism Services, Education, Resources, and Training Collaborative (ASERT). For more information, please contact ASERT at 877-231-4244 or info@PAautism.org. ASERT is funded by the Bureau of Supports for Autism and Special Populations, PA Department of Human Services.