5/24/2019 1 Sarah Weaver MSN, FNP-C, HN-BC, IFMCP- Candidate AHNA National Conference June 2019 CENTERING AND SETTING INTENTION •Pause for a moment. Pick a focal point •Set aside any concerns regarding the past or the future. •These can be picked up later. •Gently close your eyes. •Breathe deeply and slowly. •Set an intention for the situation •Breathe mindfully, scan your body for tension and release • When needing to be connected with that feeling of love and compassion repeat again, “I am present to the moment.” OBJECTIVES Understand types of anxiety and how it manifests in our lives Anatomy of anxiety and risk factors Root causes of anxiety Holistic interventions ANXIETY IS COMMON AND UNTREATED 18.1% of adults have an anxiety disorder Only 36.9% of those with a disorder seek treatment https://www.nimh.nih.gov/health/statistics/prevalence/any-anxiety- disorder-among-adults.shtml/index.shtml
8
Embed
72 Sarah Weaver Anxiety Management AHNA 2019 (Sarah Weaver)
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
5/24/2019
1
Sarah Weaver MSN, FNP-C, HN-BC, IFMCP-Candidate
AHNA National Conference June 2019
CENTERING AND SETTING INTENTION
� •Pause for a moment. Pick a focal point
� •Set aside any concerns regarding the past or the future.
� •These can be picked up later.
� •Gently close your eyes.
� •Breathe deeply and slowly.
� •Set an intention for the situation
� •Breathe mindfully, scan your body for tension and release
� • When needing to be connected with that feeling of love and compassion repeat again, “I am present to the moment.”
� Eat foods rich in B-vitamins (nuts, seeds, dark green vegetables,
legumes, animal protein,
brewer’s yeast)
� Trial a caffeine wean
Strasser B, Gostner JM, Fuchs D. Mood, food and cognition: role of tryptophan and serotonin. Current Opinions in Clinical Nutrition & Metabolic Care: January 2016;19(1):55-61.
Grosso G, Pajak A, Marventano S. Role of omega-3 fatty acids in the treatment of depressive disorders: a comprehensive meta-analysis of randomized clinical trials. PLOS One. May 7 2014; http://dx.doi.org/10.1371/journal.pone.0096905
Benton D and Young HA. A meta-analysis of the relationship between brain dopamine receptors and obesity: a matter of changes in behavior rather than food addiction? International Journal of Obesity. 2016;40:S12-S21.
Effectiveness of Therapeutic Massage for Generalized Anxiety Disorder: A Randomized Controlled Trial: http://psycnet.apa.org/buy/2003-11000-001
CHECK IN
WITH YOURSELF� What do I need right now?
� Sleep
� Hydrate and eat
� Respite room/ A walk outside as a way to calm down and process
� Give yourself permission to do self-care
� Are you empathic?
� Plug into a support system
� Self-massage
� Yoga
� Visit a spiritual place
Marsh, A. (2016). Neural, cognitive, and evolutionary foundations of human altruism. Wiley Interdisciplinary Reviews: Cognitive Science, 7(1), 59-71.
ARE YOU PRACTICING PLAY AND LAUGHTER DAILY?
� Simulated laughter vs spontaneous
laughter
� May improve cortisol,
neurotransmitters, immune system
and inflammation response
� Significant differences in perceived
stress, psychological stress response,
fasting blood sugar, interleukin-6, and
tumor necrosis factor alpha between
the two groups after laughter program
Effect of laughter yoga on salivary cortisol and dehydroepiandrosterone among healthy university students: A randomized controlled trial: https://doi.org/10.1016/j.ctcp.2018.04.005
5/24/2019
5
Guided Imagery
• Start with eyes closed, breath even
and deep, any comfortable position
• Pleasant
• Imagine being in a calm environment
• i.e., natural setting, fond memory, secure place
• i.e., real or imagined
• Physiologically focused
• Imagine a biologic function
• i.e., WBC eating infected cells, tumor shriveling like a
balloon, circulation coursing through body
• Mental rehearsal/reframe
• Imagine an accomplishment or a
better outcome of current situation
• i.e., see yourself winning a race, hear applause, see yourself calm and smiling talking to a difficult person
• Receptive
• Do a body scan
• i.e., focus on area of pain and imagine it relaxing, warming,
cooling
A Randomized Controlled Trial for the Effectiveness of Progressive Muscle Relaxation and Guided Imagery as Anxiety Reducing Interventions in Breast and Prostate Cancer Patients Undergoing Chemotherapy: https://www.hindawi.com/journals/ecam/2015/270876/abs/
The effects of guided imagery on state and trait anxiety and sleep quality among patients receiving hemodialysis: A randomized controlled trial: https://www.sciencedirect.com/science/article/pii/S0965229918300621
MUSIC
� Music therapy has been
shown to effect NA,
ACTH, IL-6, leptin and
cortisol levels
� Choose music that suits
the patient – it doesn’t
always need to be
instrumental. Try rock,
gospel or oldies
� Meta-analysis shows
music decreases the use
anxiety, pain,
� Care channel, Healing
Arts programs, playing
your instrument
STAND LIKE WONDER WOMAN
� Amy Cuddy,
Harvard Professor
and Social
Psychologist found
that “Power Posing”
for 2 minutes will:
� Decrease Cortisol
by 25%
� Increase
Testosterone by 20%
AFFIRMATION
• A repetitive verbal instrument to produce something in one’s mind, can be considered a form of meditation or prayer. Examples of mantra:
• I am breathing in love and breathing out peace
• I love myself deeply and unconditionally
• It is what it is
• I have compassion for myself and others
Attributions and affirmations for overcoming anxiety and depression: https://www.ncbi.nlm.nih.gov/pubmed/19091166Self-affirmation activates brain systems associated with self-related processing and reward and is reinforced by future orientation: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4814782/
Self-affirmation Reduces Stress and Improves Problem-solving: https://www.healthline.com/health-news/mental-self-affirmation-decreases-stress-increases-problem-solving-050113
5/24/2019
6
Breathe
• Acts like a natural tranquilizer
• Free and always with you!
• Simple awareness is all that is needed
Relaxation techniques: Breath control helps quell errant stress response: https://www.health.harvard.edu/mind-and-mood/relaxation-techniques-breath-control-helps-quell-
errant-stress-responseThe Effect of Diaphragmatic Breathing on Attention, Negative Affect and Stress in Healthy Adults : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5455070/Effect of Modified Slow Breathing Exercise on Perceived Stress and Basal Cardiovascular Parameters: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5769199/
Cloud Breathing• Take a moment and focus all of your attention on your
breathing
• Visualize the air you are breathing in as fresh, pure and
energizing air, like white puffy clouds on a beautiful
sunny day
• Breathe in through your nose, allow yourself to feel the
sensation of the air traveling into your body and
energizing you
• Now, exhale and visualize the air that you are expelling is
dark, like that of a smoke stack, this symbolizes any stressors, worries, tension or frustrations you are
carrying with you.
• As you repeat this for a few moments the expelled air will begin to transform from dark to a lighter shade as you let
go of the negative stressors to move into a more relaxed
state.
Benefits of Breathing Techniques
• Relieves physical muscle
tension
• Allows the mental function
to slow and relax
• Body and mind connection
• Calms and centers
• Activates parasympathetic nervous system
• Releases natural wastes,
such as carbon dioxide
• Gives the internal organs a
gentle massage
• Increases the oxygen to all
cells
• Strengthens the lungs
• Slows your heart rate
• Lowers your blood
pressure
• Increases blood flow to muscles
• Improves concentration
• Reduces anger and frustration
• Boosts confidence
MASSAGE THERAPIES
� Effects may derive from stimulation of pressure
receptors leading to enhanced vagal activity and reduced cortisol levels
� Reduces pain, which decreases anxiety
� Self-massage is free and easy
A Meta-Analysis of Massage Therapy Research: http://psycnet.apa.org/buy/2003-11000-001Strine, T.W., Chapman, D.P., Kobau, R., Balluz, L. (2005). Associations of self-reported anxiety symptoms with health-related quality of life
and health behaviors. Soc Psychiatry Psychiatr Epidemiol, 40(8):680.
Massage therapy research review: https://www.sciencedirect.com/science/article/pii/S1744388116300214
5/24/2019
7
RESTORATIVE YOGA
MINDFULNESS
� A mental state achieved by focusing one's awareness on the present moment, while calmly acknowledging and accepting one's feelings, thoughts, and bodily sensations
� Changes brain activity, including in the amygdala
� Mindful eating
� Meditation
� Schedule weekly self-care
An Overview of the Research on Mindfulness‐Based Interventions for Treating Symptoms of Posttraumatic Stress Disorder: A Systematic Review : https://onlinelibrary.wiley.com/doi/abs/10.1002/jclp.22200
When science meets mindfulness : https://news.harvard.edu/gazette/story/2018/04/harvard-researchers-study-how-
� Lavender- linalool and linalyl acetate inhibition of voltage-gated calcium channels, reduction of 5HT1A receptor activity, and increased parasympathetic tone
� Orange
� Rose
Lavender and the Nervous System: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3612440/The Effect of Aromatherapy on Anxiety in Patients: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5111093/
5/24/2019
8
SUGGESTIONS
� Cognitive Behavioral Therapy and Support Groups are