GROUP EXPECTATIONS: 

• You are expected to attend consistently and to participate in a constructive manner.
• Group runs 9:00 AM through 12:00PM, there are two 10 minute breaks.
• Maintain Confidentiality. It is essential that everything said in group therapy is kept private by all group members and leaders. 
• Respectful to others.  Expected to listen attentively, refrain from disruptive behavior, and tolerate differences in personal opinion and opposing value systems. 
• No cellphones.

Anxiety is more than feeling stressed or worried. While anxious feelings are a common response to a situation where we feel under pressure, they usually pass once the stressful situation has passed, or ‘stressor’ is removed. Unless those feelings don't go away. The problems associated with chronically elevated cortisol levels include:

• Suppressed immunity
• Hypertension
• High blood sugar (hyperglycemia)
• Carbohydrate cravings
• Fat deposits on the face, neck, and belly
• Reduced libido
• Bone loss

What is the Vagus Nerve?

• The vagus nerve is a key part of your parasympathetic “rest and digest” nervous system. It influences your breathing, digestive function and heart rate, all of which can have a huge impact on your mental health.
• The word "vagus" means “wanderer” in Latin, which accurately represents how the nerve wanders all over the body and reaches various organs.
• Vagal tone is an internal biological process that represents the activity of the vagus nerve – having higher vagal tone means that your body can recover faster after stress.
  • In 2010, researchers discovered a positive feedback loop between high vagal tone, positive emotions, and good physical health. In other words, the more you increase your vagal tone, the more your physical and mental health will improve, and vice versa. “The vagal response reduces stress. It reduces our heart rate and blood pressure. It changes the function of certain parts of the brain, stimulates digestion, all those things that happen when we are relaxed.”

If you’re vagal tone is low, increase it by stimulating your vagus nerve. You can do this naturally through the following steps.

• Cold Exposure - Acute cold exposure has been shown to activate the vagus nerve. Researchers have also found that exposing yourself to cold on a regular basis can lower your sympathetic “fight or flight” response and increase parasympathetic activity through the vagus nerve.
  • Try finishing your next shower with at least 30 seconds of cold water and see how you feel. Then work your way up to longer periods of time.
  • TIPP Skill
    • Temperature - dip your head into a bowl of ice water for 5 seconds. This slows the heart rate. 
    • Intense Exercise - helps soothe the body’s urge to “Do something now!”. It also has mood-boosting benefits, both during and after the physical activity. You’re not a marathon runner? That’s okay, you don’t need to be. Sprint down to the end of the street, jump in the pool for a few laps, or do jumping jacks until you’ve tired yourself out. Increasing oxygen flow helps decrease stress levels. Plus, it’s hard to stay dangerously upset when you’re exhausted.
    • Paced Breathing - Even something as simple as controlling your breath can have a profound impact on reducing emotional pain. There are many different types of breathing exercises. If you have a favorite, breathe it out. If you don’t, try a technique called “box breathing”. Each breath interval will be four seconds long. Take in air four seconds, hold it in four seconds, breathe out four, and hold four. And then start again. Continue to focus on this breathing pattern until you feel more calm. Steady breathing reduces your body’s fight or flight response.
    • Progressive Muscle Relaxation - Refocusing your mind on tensing and releasing various muscle groups throughout the body provides an excellent distraction from your racing thoughts.
• Deep and Slow Breathing - stimulates your vagus nerve. Most people take about 10 to 14 breaths each minute. Taking about 6 breaths over the course of a minute is a great way to relieve stress. Explore breathing in deeply from your diaphragm. When you do this, your stomach should expand outward. Your exhale should be long and slow. This is key to stimulating the vagus nerve and reaching a state of relaxation. See the diaphragmatic breathing meditation located toward the bottom of this page.
• Singing, Humming, Chanting and Gargling. The vagus nerve is connected to your vocal cords and the muscles at the back of your throat. Singing, humming, chanting and gargling can activate these muscles and stimulate your vagus nerve.
  1. Gargle water before swallowing it.
  2. Gently Touch Your Lips - your lips have parasympathetic fibers spread throughout them, so touching them activates the parasympathetic nervous system. Take one or two fingers and lightly run them over your lips.
• ​Probiotics - researchers state that gut bacteria improve brain function by affecting the vagus nerve. In one study, animals were given a probiotic Lactobacillus Rhamnosus, and researchers found positive changes to the GABA receptors in their brain, a reduction in stress hormones, and less depression and anxiety-like behaviour. 
  1. Sources include - Yogurt, Sauerkraut, Kimchi, Kombucha, Pickles and Traditional Buttermilk. 
• ​Omega-3 Fatty Acids - Omega-3 fatty acids are essential fats that your body cannot produce itself. They are found primarily in fish and are necessary for the normal electrical functioning of your brain and nervous system.
  1. Sources include - Cold-water fatty fish, such as salmon, mackerel, tuna, herring, and sardines. Nuts and seeds (such as flaxseed, chia seeds, and walnuts). Omega-3 dietary supplements include fish oil, krill oil, cod liver oil, and algal oil (a vegetarian source that comes from algae).
• Exercise - has been shown to stimulate the vagus nerve. Many brain health experts recommend exercise as their number one piece of advice for optimal brain health, a personal exercise routine can include:
  • ​Lift weights 1-4 times per week.
  • High-intensity interval sprinting 1-2 times per week.
  • Walk as much as I can (ideally 30-60 minutes every day).
    Walking, weightlifting and sprinting are exceptional forms of exercise, but you should choose a sport or exercise routine that you enjoy, so that you will stick with it consistently.
• Massage - Research shows that massages can stimulate the vagus nerve, and increase vagal activity and vagal tone. The vagus nerve can also be stimulated by massaging several specific areas of the body. Foot massages (reflexology) have been shown to increase vagal modulation and heart rate variability, and decrease the “fight or flight” sympathetic response. Massaging the carotid sinus, an area located near the right side of your throat, can also stimulate the vagus nerve.
• Visualization - stimulates the parasympathetic nervous system. Picture yourself in a peaceful place that you love. It could be the ocean at sunset, a mountain stream, a beautiful lush forest, a secluded beach, a field of wildflowers, or any place you enjoy and feel relaxed. Use all your senses as you visualize the place in this imagery. Hear the sounds of the waves, feel the breeze on your face, and smell the scent of the flowers. 

​Conclusion. By stimulating the vagus nerve, you can send a message to your body that it’s time to relax and de-stress, which leads to long-term improvements in mood, wellbeing and resilience. 

Anxiety is a part of our bodies’ natural alarm system, the “fight or flight” response, which exists to protect us from danger. These natural body responses are not harmful — but they are really uncomfortable!

The most pure form of the “fight or flight” response is a panic attack, which involves a rush of anxiety symptoms, many of which are listed below, usually peaking in about 10 minutes. In these cases, the body is trying to tell us “something dangerous is happening right now!”

Other forms of anxiety that are less acute but often just as debilitating, such as chronic worry, involve symptoms similar to the “fight or flight” symptoms of panic attacks. However, in these cases, it is as if the body is saying “something dangerous is going to happen sometime in the future… so watch out!” The differences between the two are the intensity of the response and the context in which it is triggered.

For this discussion will refer to all anxiety symptoms as being related to the “fight or flight” response. The most common anxiety symptoms are listed below. Take a minute to explore the list, and then write down the ones that apply to you.

Why can’t I just get rid of my anxiety?
Anxiety is as vital to our survival as hunger and thirst. Without our “fight or flight” response we would not be as aware of possible threats to our safety. We also might not take care oF ourselves or prepare adequately for the future. When our body’s “fight or flight” alarm is triggered, a domino effect of chemical changes and messages are sent to various parts of the brain and body, producing these symptoms. This process is programmed to last only
about 10 minutes, unless it is triggered again.

​Why Does My Body Do This?

There is a reason! We have evolved over millions of years to better protect ourselves. Our brains have learned to automatically signal danger when it is present or we perceive that we may be harmed in some way. Each symptom of anxiety has a specific evolutionary purpose: to help us “fight” or “flee.” Try to figure out how each symptom of anxiety is used by our bodies to protect us when we are in danger, by matching the evolutionary purpose with the anxiety symptoms. Some in the right-hand column may be used twice, and there may be multiple answers for some symptoms. 

An anxiety disorder is diagnosed when someone experiences anxiety symptoms and these symptoms:

• the symptoms interfere with a person’s life aims.
• the symptoms happen too often or with too much intensity, given the actual danger of a situation.
• the symptoms are not explained by other factors, such as a medical problem or substance abuse.

What triggers anxiety and how the brain comes to believe these triggers are dangerous. 

Our brains are designed to keep us safe. The anxiety part of the brain, the amygdala, is like a radar that is trained to spot dangerous objects and situations. When this “radar” spots something that could be dangerous, it tells the brain to begin the “fight or flight” response, producing the uncomfortable feelings we get when we are anxious.

Nearly anything can be trained to trigger the “fight or flight” response. Psychiatrists, psychologists, psychiatric nurses, and clinical psychiatric social workers have tried to find ways to tell the difference between different types of anxiety triggers. Anxiety disorder diagnoses come out of this attempt. While a diagnosis is not a perfect way of describing a person’s experiences, it can help us to know what types of treatments may be effective. Different groups of triggers and the diagnoses most frequently associated with them are listed below. Some of these categories overlap, and it is possible for one person to have more than one diagnosis.

For the sake of treatment, it is important to learn to identify what it is that makes you anxious. For some people it is very clear; for others, anxiety seems to come from “out of nowhere.” To identify what makes you anxious, ask yourself the following questions:

• “When I feel scared or nervous, what is going on around me or what am I thinking about?”
• “Am I worried about having more anxiety in the future?”
• “Am I afraid of body sensations that remind me of intense anxiety attacks?”
• “Do I ever try to do more than I can handle or create unrealistic expectations for myself or others?”
• “Am I worried that I will not be able to cope if bad things happen in the future?”​

Exercise - My anxiety triggers are:

List here the objects, situations, events, or places that tend to trigger your anxiety. Use the questions above if you are having trouble figuring out what makes you anxious.

1.
2.
3.

When we feel anxious, we typically want to do something to make ourselves feel better. Most of these behaviors feel natural because our bodies also want to keep us safe. However, some of these behaviors can make things worse; by adding “fuel” to the anxiety “fire.” We can add fuel gradually over time or dump lots on all at once. In all cases the anxiety “fire” gets bigger.

What behaviors are in danger of causing the anxiety to get worse? Anything that teaches the amygdala (the anxiety center of the brain) that something is dangerous. Remember our spider example? Let’s say that every time this man sees a spider he tries to avoid it by getting away. What does this teach him? That the spider is dangerous, of course!

Each time he avoids the spider, his amygdala gets more feedback that the spider is dangerous. Next time he sees the spider, his anxiety “alarm” will be louder, or it may go off more quickly than before. The process by which the brain learns that something is more dangerous over time is called sensitization. It is also called reinforcement of the anxiety because the anxiety response gets stronger and stronger. Reinforcement can happen both in the short term (when the danger seems to be present) or in the long term, as we discuss below.

Whether in the short run or over time, anxiety feelings, fearful thoughts, and protective, “safety” behaviors work together to keep our anxiety “fire” burning. Each feeds off the others, and any one of these can act as the “match” to get the fire started. Our goal is to work on these thoughts and behaviors to help extinguish the fire as much as possible.