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Overcoming Anxiety & Panic

It’s estimated that almost 1-2 percent of the general population will experience an anxiety attack in any given year and 5 percent of the population will experience an anxiety episode at some point in their life. In recent years several professional athletes have spoken to the media about their challenges with anxiety/panic disorders. NFL Philadelphia Eagles offensive line-man Brandon Brooks, NBA Cleveland Cavaliers star Kevin Love, and ATP player Mardy Fish, have shared their experience with this mental health issue.

Elizabeth McMahon, PhD is a clinical psychologist who specializes in helping people overcome anxiety related issues. Dr. McMahon has been practicing for over forty years. Since 2010 she has incorporated Virtual Reality technology as a tool and works with the National Mental Health Innovation Center to improve treatment options for anxiety.

SZ: What were the deciding factors for you to become a specialist in helping people with anxiety?

EM: During my first years in practice, I treated pretty much everything, but as I kept reading the professional journals, I was struck by the growing evidence of effective treatment for anxiety. The more I read, the more interested  I became, until I ended up specializing. It is so exciting because overcoming panic and anxiety changes a person’s life.

SZ: Have there been break throughs in the last few years that make treatment easier or provide faster relief and healing for clients?

EM: Absolutely. The biggest, most exciting breakthrough is Virtual Reality Therapy (VRT). Combined with cognitive-behavioral therapy (CBT), VR makes learning and practicing anxiety management easier and more engaging. In VR, clients can face their fears gradually in a controlled, individualized fashion, in the privacy of the therapy office with therapist guidance and support. Facing and overcoming  fears is less scary, more acceptable, and very, very effective.

SZ: In your recently published book “Overcoming Anxiety and Panic interactive guide”, you simplify for the reader the two areas of the brain most involved in creating and overcoming panic. Can you give a short explanation of how the Reacting brain and the Thinking brain work in panic?

Self help guide to understanding triggers and patterns of anxiety.

EM: The Reacting Brain is left over from caveman days. It automatically triggers panic when it thinks you face some kind of danger.  It prepares you physically to run or fight and it sends a message of “DANGER!!!” so you focus on finding the threat. This is a life-saving response our minds and bodies are built to have – but it has one big drawback. The drawback is that things other than actual danger can trigger the Reacting Brain. For example unrealistic expectations of yourself, self-criticism, stress, or bad past experiences can trigger this response when you don’t need it.

I think of the Reacting Brain as a Devoted, but Dumb, bodyguard. it is well-intentioned and has fast reflexes – but it is rather stupid!

The Thinking Brain, on the other hand, is Smarter, but Slower. It is conscious, verbal, and logical. The Thinking Brain is what you use to evaluate the situation realistically. You use your Thinking Brain to decide what to do based – not your child-like primitive brain. The more you use the Thinking Brain, the more it calms down the Reacting Brain.

SZ: How are symptoms of worry differentiated from being nervous, or panicked?

EM: Worry, nervousness, and panic are all forms of anxiety. They just differ in intensity and immediacy.

Worry is more focused on the future. Examples of worries are: “What if I mess up?”, “What if I let the team down?”, “What if I am so anxious I can’t play?”, “What if I have a panic attack?”. Worry can range from mild to very distressing. Panic has a more immediate focus. Examples of panic thoughts are: “I can’t breathe!”, “I can’t think!”, “Any minute now I might throw up, or pass out, or go crazy!”, “I am out of control!” The fear is more intense. The danger seems more immediate. Nervousness can fall anywhere in the middle. Worry, nervousness, and panic are all anxiety. Understanding anxiety helps you know what to do – no matter what form your anxiety takes.

SZ: Is there an increased challenge working with 12-20 year old clients as the area of the brain that provides self control on the whole doesn’t communicate well yet with the part of the brain that controls fight or flight.

EM: The higher levels of the brain continue to develop into the mid- or late-20s, so it is true that the Thinking Brain is less developed. At the same time, the Thinking Brain does exist and the more clients use it, the stronger it gets. It may be especially important for 12-20 year old clients to understand that they can do things to strengthen their Thinking Brain. This is why learning about anxiety is so important. Dr. Charlotte Tilson, a child and adolescent psychologist, and I are creating a version of Overcoming Anxiety and Panic interactive guide for teens and young adults. We hope to finish and publish this book by mid-late 2020.

SZ: What is your advice to a person thinking about taking first steps to overcome their anxiety/panic cycle?

EM: First of all, congratulations. You can feel very hopeful. We understand how anxiety works and how to make it less of a problem. Learn what is happening and how to break the cycle. Remember that the Reacting Brain is just trying to help, but it is not very bright so don’t automatically believe the anxious thoughts. Use your rational Thinking Brain to question and re-evaluate your fears.

If you have Overcoming Anxiety and Panic interactive guide, start with the first section. It will help you map out your personal anxiety cycle. Then follow the step-by-step process to break free.

SZ: Dr. McMahon thank you for taking time out of your busy schedule for this interview. You’ve written a very user friendly book to help people start to understand and manage the natural process of anxiety, identify individual triggers and how to calm down the chain of reactions when the Reacting brain is set in flight.

Questions for Nick Kyrgios

Australian tennis talent Nick Kyrgios joined the ATP tour in 2013 and in 2018 reached a ranking of #13.  Kyrgios is known for moments of tennis brilliance when focused and playing well. He has a large base of support from fans and players.  Kyrgios is equally known for struggling with frustration and emotions on the court when matches are not going his way. Nick’s natural athletic talent sometimes is out of synch with his mental management and day to day business of the game. Physical gifts are a prerequisite at the world class level and typically fall short of being a champion when not accompanied by mental training.  Professional athletics is a grind that player’s have to love, or make peace with, and manage week to week. As a sport counselor when athletes come to see me, we begin by exploring basic issues that include motivation, values and goals for making a commitment to the sport. If there is a disconnect in these areas we look at what may be getting in the way of the player being the athlete they see themselves as being. The follow question are an example of what I would ask Nick Kyrgios.

1) What is your motivation to play professional tennis? World class level requires full commitment to training and competing. Nick your website says, “We live a very special life and are very lucky, I just love to compete and go out there and have fun and that’s why I play. My parents worked hard and fought to help me get where I am.” Yet at the 2019 Wimbledon second round post conference you said, “I am not the most professional guy. I won’t train day in and day out. I won’t show up everyday.”   Competing with the best in the world requires full commitment to the mental/physical pieces of the game. What do you want out of your professional time in this sport? There are many articles suggesting you need help with anger management. I think time management is a better idea to focus on. The life of a professional athlete often has a short life span. Nick has struggled with injuries, but work with a physiotherapist and managing his playing schedule to take time off that builds in both physical and mental rest seems important for future success.

2)  Why would you be upset if Nadal receives occasional preferential treatment?  Nadal has been competing on tour for eighteen plus years and has won at this point nineteen Grand Slam singles titles. During that time he has had occasional outbursts of frustration on the court, and disagreements with referees but for the most part he manages his emotions under duress and plays out his matches win or lose and accepts defeat with tolerance.  Nadal seems to be able to avoid verbally abusing referees, spitting, tanking matches and calling out opponents in post-match tweets. Champions earn their place and reap the rewards of their talent by playing even when they aren’t having their best day, when they aren’t feeling their best. They rate high on the Grit Scale.

You’ve said that other player’s receive preferential treatment. You were handed down a suspension for 16 tournament weeks for your on court behavior in Cincinnati. but if during the next six months you don’t earn any additional code violations you will be able to keep playing unless your conduct oversteps the conditions the ATP has set forth.

When a swathe of smashed racquets are left behind from your matches time and time again it demonstrates a poor representation of professional tennis. No other sport allows for equipment to be intentionally broken during a match/game without consequences. No other sport permits a participant to verbally abuse a referee. Yet, the ATP has given you room to keep playing in this six-month probation period.

The NKFoundation website says,  “NK Foundation endeavors to create a safe place where underprivileged youth can frequent to play the sport they dream about and take shelter if needed. Our facility will have tennis courts, basketball courts, a pool, a gym and dorms that will provide refuge to children that don’t have access to play they sport they desire.” Have you given some thought about how you will react and work with the kid at your facility that acts out when losing, or pouts and withdraws emotionally when losing? The kid that spits on other kids out of frustration or smashes equipment at your facility? You have a fantastic opportunity to become a role model for these kids you care so much about. This is your quote, “My purpose is to give every dream a sporting chance…..when I work on the NK Foundation and our Melbourne facility I cast my mind forward to all the disadvantaged kids I will be helping. I’m playing for them now.” In the upcoming 2020 playing season it will be interesting to see if you will make the leap forward to handling pressure and being a leader for these kids to look up to.

3)  What do you envision for your professional future?  Professional tennis will survive with or without your participation.  The next generation of players are exciting, powerful and hungry to win Grand Slams. You could probably raise money for your foundation by playing exhibitions which would take the pressure off of competing week to week. But the more success you have on the ATP tour in the next few years the more marketable you will be for future exhibitions. My guess is you are a competitive person and would prefer not to be a footnote in the sport history books. You have purpose, talent and fans. I hope you get the support you need to figure out how to participate competitively,  plan time off to rest your body and mind, add some mental skills to manage your emotions on court and allow yourself to see how far you can develop your talent. It would be a bonus for tennis and those kids that mean so much to you to fully immerse yourself in the game. Best of luck to you in 2020.

Influencer Elizabeth Beecroft - Passion for Wellness

Nice article by Elizabeth Beecroft chronicling her athletic and personal mental health journey which over time lead to a collaboration with Nike by You and the unique design on Nike Air Max 270 React. Cool looking shoe with a message. A portion of the proceeds from the sale of this shoe will go towards the American Foundation of Suicide Prevention.