Your Brain on

Anxiety

Wendi Kozlowski, LPC-S

Clinical Manager - Round Rock
Pathlight Mood and Anxiety Center

Wendi Kozlowski, LPC-S

 N O N - D I S C L O S U R E S TAT E M E N T
The authors whose names are listed immediately
below certify that they have NO affiliations with or
involvement in any organization or entity with any
financial interest (such as honoraria; educational
grants; participation in speakers’ bureaus;
membership, employment, consultancies, stock
ownership, or other equity interest; and expert
testimony or patent-licensing arrangements), or
non-financial interest (such as personal or
professional relationships, affiliations, knowledge
or beliefs) in the subject matter or materials
discussed in this manuscript.

Wendi Kozlowski, LPC-S

Wendi Kozlowski, LPC-S

 Learning Objectives
• Define Anxiety and understand different presentations for
children/adolescents and adults

• Gain an awareness of what is happening in our bodies when we are

anxious

• Identify helpful therapy modalities

• Walk away with tools to use in the moment

Wendi Kozlowski, LPC-S

Defining Anxiety
Feeling Anxious?

• Group definitions and experiences with anxiety.

• What does anxiety look like?

• Physiological, behavioral, and psychological reactions
• 3 factors that contribute: biology, cognitive-emotional influences, and chronic stress
• Fight, flight, freeze, fold responses to perceived threats

• What does anxiety look like in children/adolescents?

• Withdrawn, sporadic attendance, tantrums, aggressiveness, restlessness, fatigue, back pain,
sweating, and a multitude of different physical ailments (tummy, head hurts)
• Often confused with ADHD or mood disorders/Anger - anxiety responses vary.

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Wendi Kozlowski, LPC-S
Defining Anxiety
What lies beneath behaviors

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Wendi Kozlowski, LPC-S
Defining Anxiety
What’s normal?!

Anxiety disorders are the most common disorder to occur in childhood

and adolescence
• 13 of every 100 children (ages 9 – 17) is dealing with an anxiety disorder
• Symptoms typically begin at age 6, traceable back to elementary school
• Of this 13%, only 18% seek mental health treatment.
• That calculates out to only 2/100 kids who receive treatment!
• How does this statistic affect our classrooms/relationships/etc. ?
• Often effective help isn’t found until early adolescence, when academic
requirements become more challenging.

HOWEVER…..Developmentally:
School-aged kids haven’t fully learned self-control. They are still
developing their social skills.
• Learning how to make friends, how to handle aggression, how to control their urges
and emotions.
• If we don’t think within normal developmental milestones, these tasks can turn into
sources of stress and a failure to meet (unrealistic) expectations.
• Remember, we are teaching “adult level” skills!
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 Defining Anxiety
Other Important Facts
• Like depression, women are twice as likely to be
affected, compared to men.

• The effects of chronic stress have been linked to a

weakened immune system, weight gain (due to
extended cortisol release), and heart disease.

• The wear and tear caused by chronic stress or

anxiety could be tied to an increased risk of
depression and dementia.

• Anxious people:
– Overestimate the likelihood of negative future events.
– They underestimate how much power they have over
changing negative situations
– They over-plan to accommodate all possible future scenarios.
– They fail to lower pessimism after success (faulty re-
calibration of prediction error)
– They have a hyper-focused attentional system – more likely to
interpret most neutral events/comments as negative.
– They are blind to available safety options.

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Wendi Kozlowski, LPC-S
 Defining Anxiety
Wait, so we need anxiety? How much is too much?

Cornell University Center for Teaching and Learning (2008)

looked at the correlation between anxiety and performance:
• Too little anxiety results in a lack of motivation.
• Conversely, high anxiety negatively affects memory and
concentration.
• Moderate levels of academic anxiety create the motivation needed
to drive academic performance.

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Wendi Kozlowski, LPC-S
 What’s happening to me?!
“Paper Tigers”

• The feeling of anxiety is part of your body’s stress response. Your fight/flight/freeze/fold
response is triggered, and your system is flooded with norepinephrine and cortisol.
– These chemicals are designed to give you a boost in perception, reflexes, and speed in dangerous situations.
– They increase your hear rate, get more blood to your muscles, get more air into your lungs, and in general
get your ready to deal with whatever threat is present. Your body turns it’s full attention to survival.

**A variety of problems arise when our

bodies never turn off our fight/fight
response and we live with the physical
and emotional effects of anxiety on a
day to day basis.

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Wendi Kozlowski, LPC-S
What’s happening to me?!

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Wendi Kozlowski, LPC-S
 What’s happening to me?!
The Amygdala

• The AMYGDALA is an almond-shaped structure deep in the brain that is believed to be

a communications hub between the parts of the brain that process incoming
sensory signals and the parts that interpret these signals.

• Alerts the rest of the brain that a threat is present and triggers a fear or anxiety
response.

• The emotional memories stored in the central part of the amygdala may play a role in
anxiety disorders involving very distinct fears: such as fears of dogs, spiders, or flying.

• Part of our emotional, “reptile brain”

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Wendi Kozlowski, LPC-S
 What’s happening to me?!
The Hippocampus

• The HIPPOCAMPUS is the part of the brain that encodes threatening events into
memories.

• Studies have shown that the hippocampus appears to be smaller in people who were
victims of child abuse, those who served in military combat, and those who experience
chronic stress/anxiety.

• Crucial for processing long-term and contextual memories. Unfortunately, in crisis, all
types of memories become limited EXCEPT memories that support the anxiety, trauma,
or stressor.

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Wendi Kozlowski, LPC-S
What’s happening to me?!
Your Brain on Anxiety

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Wendi Kozlowski, LPC-S
What can I do about anxiety?
Changing perspective

(4) Attribute the unpleasant experience to an

unpleasant quality about your character.
• If you have a bad case of diarrhea, does that say anything about
the quality of your family relationships?
• If you are experiencing discomfort in your joints, does that
invalidate an opinion you may have about the wonders of life?
• Indigestion, heartburn, joint pain, loss of certain faculties, etc. are
all the result of biological processes that occur without your
conscious involvement.
• These are purely physical sensations arising in your body that have
nothing to do with the quality of your character. As a result, there is
no connection between them and the inner qualities of your being
and character.
• You having explosive diarrhea tells me absolutely nothing about
who you are as a person.

It’s time to truly start looking at anxiety and

other mental health issues from this mindset!

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Wendi Kozlowski, LPC-S
What can I do about anxiety?
Helpful Therapy Modalities

• CBT (Cognitive Behavioral Therapy)

• DBT (Dialectical Behavioral Therapy)

• ACT (Acceptance & Commitment Therapy)

• ERP (Exposure & Response Prevention)

• Mindfulness

• Expressive Modalities (Art, Music, Movement,

Yoga)

• Equine Therapy or Animal Assisted Therapy

• Play Therapy for younger children

• Family therapy and/or Parent Coaching

• Crisis intervention when needed

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Wendi Kozlowski, LPC-S
What can I do about anxiety?
Tools to use in the moment

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Wendi Kozlowski, LPC-S
What can I do about anxiety?
Tools to use in the moment

• S LOW DOW N
– intentionally start here then connect to the body (5 senses check in)

• Chair/Wall push ups

• Smell a flower, blow out a candle / Smell pizza, blow to cool it off

• Sensory items (pillow, blanket, vest, objects.)

• Hug something

• Blow bubbles

• A-Z lists (start easy, get harder – written or verbal)

• Grounding exercises (all my neighbors, 1-20, 1-2-3-4-5 Senses)

• Tense and relax each muscle group

• Technology Apps (CALM, Meditation Jar, etc.)

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Wendi Kozlowski, LPC-S
What can I do about anxiety?
Resources

When in doubt, reach out!

Red Flags: When anxiety gets in the way of functioning: vomiting/disruptive physical symptoms, sleep disturbances, or if anxiety is
keeping the person from going to school/work or affecting relationships

Levels of care:
• Outpatient therapy
• Intensive Outpatient/Partial Hospitalization (Pathlight)
• Residential Treatment
• Acute Care

Community Resources:
NAMI Austin - https://www.namiaustin.org/
Pathlight Mood & Anxiety Centers- http://www.pathlightBH.com
Austin Child Guidance Center - https://www.austinchildguidance.org/
Texas Health & Human Services (HHS) - https://hhs.texas.gov/services/health/mental-health-substance-abuse

**Mobile Outreach Team Williamson County: 512-943-3545; CIT: 512-218-5515

**Mobile Crisis Outreach Team Travis County: 512-472-4357; CIT: 512-854-3445

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Wendi Kozlowski, LPC-S
What can I do about anxiety?
Resources – Pathlight Virtual Support Groups
Mental Health Support Group for People of Color
Open to community members and ERC/Pathlight alumni (Adults, 18+)
Every Monday at 7:00 p.m. ET
As we listen and learn what our community needs through these trying times, this support group is intended as a closed space designated for BIPOC (black, indigenous, people of
color) where attendees can feel supported without having to explain themselves. This peer support group will provide support for the unique mental health challenges that individuals in
this group may be facing. This support group will be run weekly, on an ongoing basis. Please note, the group is a supplemental support and is not a replacement for higher levels of
care, therapy, or medical advice.
Please email Tatum.Carter@ERCPathlight.com with any questions you may have about the group.

Virtual Family & Community Support Group - For Loved Ones of Adults & Adolescents with Mood and Anxiety
Disorders
Open to caregivers, support persons, family, and community members (Adults 18+)
Every Wednesday | 7 p.m. ET
Join fellow support persons and family members for a weekly virtual Support Group offering support, education about mood and anxiety disorders, and connection with other individuals
with shared experiences. Participation in the group is online, free, and open to anyone supporting someone with a mood or anxiety disorder. Participants can attend as often as they
would like with no pressure to attend group every time. A four-week commitment is encouraged. Please note, the group is a supplemental support for families, and it is not a
replacement for behavioral health treatment, therapy, or medical advice.
Please email Samantha.Lach@ERCPathlight.com with any questions you may have.

Virtual Anxiety and Depression Support Group

Open to community members and Pathlight alumni
Every Wednesday | 8 p.m. ET
This group is a friendly, safe, and supportive place for alumni and community members to share information and experiences. You can connect with other people experiencing anxiety
and depression and related disorders, ask questions, and learn tools to care for yourself and others. Please note, the group is a supplemental support and is not a replacement for
higher levels of care, therapy, or medical advice.
If you are interested in joining the group, please email Carol.Dworaczyk@ERCPathlight.com for the consent form and log in information.

Virtual Insight Alumni Anxiety and Depression Support Group

Open to Pathlight alumni (Adults 18+)
Every Wednesday | 7 p.m. ET
Join fellow Pathlight (formerly Insight) Mood and Anxiety alumni for support, education, and connection in navigating the twists and turns of recovery. Participation in the groups is online
and there is no cost to attend. Participants are asked to commit to attending for six weeks to make full use of the group, and you can start at any time. Please note, the groups are a
supplemental support and are not a replacement for eating disorder treatment, therapy, or medical advice.
If you are interested in joining the group, please email alumni@ERCPathlight.com for the consent form and log in information.

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 References

American Academy of Child & Adolescent Psychiatry. (2013) The Anxious Child. Facts for
Families, Number 47. Retrieved from
https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/Facts_for_Families
_PaPag/The_Anxious_Child_47.aspx

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental

Disorders DSM-V). (5th ed.) Washington, DC: American Psychiatric Association.

Beidel, D., Taylor-Ferreira, J., & Turner, S. (1999). Teaching study skills and test-taking
strategies to elementary school students. Behavior Modification, 23, 630-646.

Gasparovich, Lindsay (2008). Positive Behavior Support: Learning to Prevent or Manage

Anxiety in the School Setting. Retrieved from
http://www.sbbh.pitt.edu/files/other/anxiety_lng_newsletter.pdf

Huebner, D. (2006). What to do when you worry too much: A kid’s guide to overcoming
anxiety. Washington, DC: Magination Press.

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 References

National Alliance on Mental Health. (2008). Anxiety disorders in children and

adolescents. Retrieved from http://www.nami.org.

Peleg-Popko, O. (2002). Children’s test anxiety and family interaction patterns.

Anxiety Stress and Coping, 15:1, p.45-59.

Substance Abuse and Mental Health Services Association. Children’s mental

health facts: Children and adolescents with anxiety disorders. Retrieved from
http://mentalhealth.samhsa.gov/publications/allpubs/CA-0007/default.asp.

Vardell, Don. 2015. Residential Anxiety Treatment. Fairfax, VA: Independent

Educational Consultants Association (IECA) Insights.

Wilson, Reid and Lynne Lyons. 2013. Anxious Kids, Anxious Parents: 7 Ways to
Stop the Worry Cycle and Raise Courageous & Independent Children. Arlington,
VA: Health Communications Inc.

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 THANK YOU!!
Wendi Kozlowski, LPC-S
Wendi.Kozlowski@ERCPathlight.com
512-767-6071

Wendi Kozlowski, LPC-S