Process - Physician - Fraser Health Authority

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Understanding Generalized AnxietyFrequently Asked QuestionsWho gets anxious?Everyone! Anxiety is part of the natural way that the mind and body are motivated to prepare and plan fora possible threatening situation or event.What’s the difference between anxiety and fear?Fear is a strong emotion that we feel when faced with immediate danger or threat, such as a fire. Fearmakes us “fight, freeze or flee” depending on which is the best way to cope with the threat. Fear is a selfdefensereaction that can save our lives. Anxiety is a more general nagging kind of fear about somethinggoing wrong in a situation that hasn’t happened yet, and may not even happen. Anxiety wonders “Whatif?” Anxiety is not about what will definitely, immediately happen, only about what might or could happen.When is anxiety a problem?A little bit of anxiety, occasionally, is not a problem at all. In fact, being a bit anxious before an exam or arace or a job interview has been shown to actually improve performance. Anxiety is only a problem whenit becomes excessive. Anxiety can be so debilitating that people are unable to write anything at all inexams; they become sick with worry; they even avoid places or activities that are unlikely to be harmful;they make more mistakes at work because they are too tense. Too much anxiety over things that couldhappen, but have not happened and may never happen, can interfere with a person’s ability to function athome or at work.Why do some people get overanxious?Some people are born with a more sensitive emotional system so they tend to become anxious insituations that might not bother other people. If a child with this inborn tendency is constantly told howdangerous the world is, that child will most likely feel more anxious. Traumatic experiences also maycontribute to increasing anxiety. Some people get overanxious because of the way they cope with theiranxiety. They try to avoid anxiety or they try to get rid of it, and it just gets stronger.What is the treatment?This kind of anxiety, when a person worries about a lot of different things to the point that their life isdisrupted or their health affected, is called Generalized Anxiety Disorder. Cognitive BehaviouralTherapy, which focuses on the inter-relationship between thoughts, feelings and behavior, has beenshown to be very successful in treating anxiety. This type of therapy will not help you get rid of all youranxiety because you need some for everyday life, but it will help you learn to manage and reduce youranxiety. You and your doctor may decide that medications may also be helpful.What can I do?At home, in your daily life, practice all the exercises that you have been given. Research shows that thepeople who have the most success with anxiety treatment are those who practice the most. Practicemeans doing things against the anxiety: taking very small risks; not avoiding places or activities; tryingnew things. When you initially go against your anxiety, you will feel a little more anxious. As you continueyou’ll discover that most of the time what you were anxious about did not come true. Your anxiety willstart to weaken until you feel little or no anxiety in situations that previously scared or worried you.Preparation by practicing coping skills is a potent antidote to disabling anxiety that is often highest whenanticipating fearful situations.Patient Empowerment Anxiety Manual VIHA.March.2010 83
Anxiety“System-Wide Explosion”Anxiety has a significant impact on people, physically, cognitively, emotionally andfunctionally.The following is a list of symptoms that people with anxiety may experience.To understand the extent of anxiety’s impact, circle the symptoms that apply to you.Body Feelings Mind BehaviourTense musclesAnxiousEasily distractedAvoidingNumbness, tinglingNervousPoor memoryAgitated, restlessFeeling hot or chilledFearfulCan’t think clearlyMulti-taskingFlushed faceWorriedCan’t make decisionsCan’t start thingsLump in throatFrightenedConfusionCan’t finish thingsTrembling, shakingTerrifiedRacing thoughtsSnap at peopleWeakness, unsteadyPressured“Spaced out”Frantically busyDizzy, lightheadedOverwhelmedObsessive thinkingSocial withdrawalSweatingFranticWorryingCry at least thingHeart poundingPanickedSelf-criticalHypervigilenceChest painGuiltyNegative thinkingOversleepingInsomniaShySuicidal thoughtsUnable to be aloneWeight lossUncertainFrightening imagesSeeking reassuranceNauseaSelf consciousNightmaresCompulsive behaviorsDiarrheaEmbarrassedSelf medicatingShortness of breathIrritableAddictionsDry mouthAngryPatient Empowerment Anxiety Manual VIHA.March.2010 84
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SteppedCareLevel 1PSP Mental Health
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Fold back this page before administ
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CBISCOGNITIVE BEHAVIOURAL INTERPERS
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Table of ContentsINTRODUCTION. . .
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IntroductionThe following modules h
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TipsTeachingSelling Strategies• E
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Flow ChartsThis module contains flo
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Patient NeedsTryThe Circle of Depre
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AnxiousSymptomsTryOverwhelmedChaoti
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Assessment ModuleThe Assessment Mod
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5 Energy levela. How would you rate
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15 Phobiasa. Any unrealistic or exc
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21 CAGEHow many drinks might you ha
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DIAGNOSTIC SCREENING WORKSHEET (CON
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Problem List Action PlanACTIVATIONR
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Self-Assessment QuestionnaireName:
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Self-Assessment ProfilePleaser: Hig
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Self-Assessment ProfileOver-Thinker
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Understanding Depression- Frequentl
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Depression: System-Wide CrashDepres
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Activation ModuleThe Activation Mod
Page 43 and 44: Depression’s Energy BudgetEvery d
Page 45 and 46: Small GoalsThe concentration, fatig
Page 47 and 48: Problem SolvingDepression can make
Page 49 and 50: Chunk the DayStrategies that give p
Page 51 and 52: Appreciation Exercise“Good for Me
Page 53 and 54: The Circle of DepressionCognitive-b
Page 55 and 56: Common Thinking ErrorsThe situation
Page 57 and 58: THOUGHT CHANGE PROCESS (CONTINUED)T
Page 59 and 60: Thought StoppingDepression often ma
Page 61 and 62: Good Guilt / Bad GuiltA world witho
Page 63 and 64: Setting LimitsMost of us like to be
Page 65 and 66: Is Anger a Problem for You?Tom arri
Page 67 and 68: Stress ResponseIntroduction to Rela
Page 69 and 70: Variation - Box BreathingABDOMINAL
Page 71 and 72: Body ScanPurpose• Body scan is a
Page 73 and 74: Stress BustersPurpose• Shorter te
Page 75 and 76: MindfulnessPurpose• Mindfulness i
Page 77 and 78: BreathMINDFULNESS MEDITATION (CONTI
Page 79 and 80: Healthy Habits for SleepingDepressi
Page 81 and 82: IT’S TRUE: YOU ARE WHAT YOU EAT!
Page 83 and 84: The Wellness WheelPHYSICALGROWTHSEL
Page 85 and 86: CBISCognitive Behavioural Interpers
Page 87 and 88: FLOW CHARTS……………………
Page 89 and 90: PANIC DISORDER• Anxiety “System
Page 91 and 92: The Many Faces of AnxietyPanic Diso
Page 93: Medical ConsiderationsMost Common M
Page 97 and 98: Resources for Self-HelpOnline Resou
Page 99 and 100: GAD: Self-Assessment QuestionnaireN
Page 101 and 102: GAD: Self-Assessment ProfileHard Dr
Page 103 and 104: How Anxiety WorksTHOUGHTSBODYFEELIN
Page 105 and 106: Panic CircleEvent (public speaking)
Page 107 and 108: Your Emotional Thermometer• Imagi
Page 109 and 110: Anxiety EquationAnxiety arises out
Page 111 and 112: 2. When something bad happens, I wo
Page 113 and 114: Coping CardsAnxious people often ma
Page 115 and 116: Problem SolvingAnxiety is strengthe
Page 117 and 118: Example: Kelly begins by making a l
Page 119 and 120: D.E.S.C. ScriptAssertiveness doesn
Page 121 and 122: Application forPsychiatric Medicati
Page 123 and 124: APPENDIX 2: WOMEN’S MENTAL HEALTH
Page 125 and 126: Pharmacotherapy in the Perinatal Pe
Page 131: FAMILY PHYSICIAN GUIDE | ADDRESSING
Page 134 and 135: Olanzapine (Zyprexa)Tablets, wafers
Page 136 and 137: Consortium forOrganizationalMentalH
Page 138 and 139: 3. Gather details on current andpre
Page 140 and 141: Task Two: ADVISE1. Provide meaning
Page 142 and 143: SUPPORTED SELF‐MANAGEMENT FOR DEP
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TABLE OF CONTENTSIntroduction 1What
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INTRODUCTIONTake a moment now to as
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WHAT IS DEPRESSION?The two most com
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WHAT CAUSES DEPRESSION?People becom
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WHAT CAUSES DEPRESSION?ThoughtsEach
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WHAT CAUSES DEPRESSION?EmotionDepre
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WHAT CAUSES DEPRESSION?ActionDepres
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WHAT CAN YOU DO ABOUT DEPRESSION?MI
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MORE ABOUT MEDICATIONMedication is
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ANTIDEPRESSANT SKILLSIn this sectio
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REACTIVATING YOUR LIFEStep 1: Ident
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REACTIVATING YOUR LIFESmall DutiesE
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REACTIVATING YOUR LIFEStep 2: Choos
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REACTIVATING YOUR LIFEStep 3: Set r
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REACTIVATING YOUR LIFEStep 4: Carry
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THINKING REALISTICALLYNegatively di
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THINKING REALISTICALLYStep 1: Learn
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THINKING REALISTICALLYStep 4: Pract
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SOLVING PROBLEMS EFFECTIVELYStep 1:
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REDUCING THE RISK OF RELAPSEPlan ah
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Congratulations! You have now made
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SUGGESTED READINGON DEPRESSION AND
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DIETThe Canada Food GuideGuidelines
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SLEEPStress, anxiety, and depressio
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CAFFEINECaffeine stimulates the sym
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CHALLENGING DEPRESSIVE THOUGHTSSitu
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PROBLEM SOLVINGACTION ADVANTAGES DI
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AnxietyDementiaDementiaBipolar155
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Practice Support ProgramGeneralized
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Montreal Cognitive Assessment(MoCA)
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Serial 7s: Administration: The exam
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Appendix CNAME OF PATIENTStandardiz
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Item 11Scoring WORLD backwards (ins
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Appendix CStandardized Mini Mental
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SCORING THE MOOD DISORDERQUESTIONNA
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FORM 4MENTAL HEALTH ACT[ Sections 2
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CommunityMHSU ReferralFormBounceBac
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REFERRAL FORMMental Health and Subs
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MENTAL HEALTH AFTER HOURSPLEASE LEA
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DOCUMENTATION REQUIRED UPON REFERRA
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Adult Eating Disorders ProgramRefer
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Medical History:Medical causes of l
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Who Are We?This is a specialized pr
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Fraser South Eating Disorders Progr
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Fraser South Eating Disorders Progr
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Fraser East:This program is part of
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Fact SheetPanic Disorder GroupDoes
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Fact SheetGeneralized Anxiety Group
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4 th Floor Sherbrooke Centre Tel (6
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Early Psychosis Intervention Progra
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*Additional Resources*For Informati
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Mental Healthand Addiction… suppo
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Fraser Health Mental Healthand Addi
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ADDICTION SERVICESAddiction Service
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ADDICTION SERVICESYouth Addictions
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ADDICTION SERVICES6. Long-term Resi
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MENTAL HEALTH SERVICESMental Health
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MENTAL HEALTH SERVICESDelta Mental
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MENTAL HEALTH SERVICES4. Community
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MENTAL HEALTH SERVICESMinistry of E
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MENTAL HEALTH SERVICES7. Residentia
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Mental Health & AddictionsHEALTHY L
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Client name: ______________________
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Client name: ______________________
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Taking Wellness to Heart! Metabolic
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Mental Health and Substance Use Rev
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Collaborative Care Process Map-Epis
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Fax the Special Authority Request t
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o o o o o o o • • • o o o o o
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Process - Physician - Fraser Health Authority

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