The World Seems Scary – Coping with Anxiety by Andres Jaramillo, LPC

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We all have things that make us feel anxious like giving a presentation or having a job interview but it may seem like in our daily life more and more we encounter extreme, awful, or scary things. It makes it easier for our minds to come up with negative, worst case scenarios that end up turning up the volume on anxiety.

What is anxiety?
It is a normal feeling we experience when we predict that something bad could happen.

Living in today’s constantly connected world, the possibility of something scary, awful, or threatening can pop in our head by just turning on the news or driving our kids to school.

Try these 3 things to turn down anxious feelings so you can continue doing the things you want to do.

1 – Relaxed body is tied to relaxed mind. Even seeing or hearing about awful, scary things – perhaps the news on the latest epidemic – can cause the “fight or flight” response to turn on. Our body makes physical changes like increased heart rate, sweating or tense muscles so it can be prepared to fight or run away from the danger.

When we do activities to purposely deactivate our fight or flight response, or relax our body, our mind plays follows the leader.

Try this, notice: 

  • 5 things you can see – notice shapes, colors, brightness, shadows.
  • 4 things you can hear – notice pitches, volumes, tone.
  • 3 things you can feel/touch – notice textures.
  • 2 things you can smell – notice hints of sweetness, bitterness, pungent, etc.
  • 1 thing you can taste – notice hits of spicy, sweet, sour, etc.

Notice and observe things you have never paid attention to before. Maybe say what you observe out loud, or just to yourself. You can mix it up anyway you like, perhaps you are at a restaurant and you can taste 5 things, or smell 5 things. It is just about using your senses in a purposeful, intentional way. By getting out of your head and engaging your body in a slow, mindful activity it is pretty much impossible to focus on the image that turned anxiety up in the first place.

2 – Remind yourself: What you feel is not always true. I feel like I am going crazy! Perhaps you’ve said something like this to yourself and if we are going to turn down the volume on anxiety, we need to challenge how our feelings “prove” that something is going to happen.
A quick peek at your latest social media feed and you see a story about a family who had a burglar break in their house and murder three people. Quickly shock, fear, horror, or sadness fills your experience. It is valid that you may feel that way but the mind, in its amazing abilities, will use those emotions as proof to make a conclusion that may not be true.
I feel scared so that means something bad is going to happen!

Try this:

  •  Take a few deep breaths – deep enough to see your stomach area expand and contract.
  • Acknowledge you are feeling scared – is it a knot in your stomach? Is it racing thoughts?.
  • Take a few more deep breaths.
  • Focus on the facts.

Facts themselves don’t increase anxiety, the perception that it could be a threat does. By placing time and breathing between what you saw/heard and making any decisions, you allow the intensity of the anxiety to subside like the tide on a beach. You will have a better chance to be calm and focus on the facts not the “coulds.”

3 – Accepting the unpredictable but be prepared. You can’t really know if someone will break in to your house, or use a gun in a violent way, or if you will catch the new virus going around but perhaps we can be prepared the best we know how.

If you have noticed that the news, your social media, or stories you heard from friends have increased your anxiety, you went through 1 and 2 above and you still feel uneasy, then maybe prepared action is the next step.
We have active shooter drills, we get trained in CPR, and we wear our seat belt with the mindset of accepting that we will never know IF something bad could happen and just being prepared anyway.

Have a plan:

  • Create a plan for what you and your family would do if [insert awful situation] happened.
  • Talk with your workplace to double check emergency plans.
  • Have a chat with your children’s school to understand what plans they have.
  • Talk with your doctor about your health concerns.
  • Join a neighborhood watch group.
  • Take a self-defense class.

By moving your focus from “What if’s” to accepting that life is unpredictable and doing your best to be prepared will increase your confidence and readiness just like when we plan and study for what we will say in a presentation or practice for our job interview. If we feel confident and ready, there is no room for anxiety.

Everyone experiences anxiety and yes, it is normal. If we have certain tools, like the three above, we can get through any situation that raises our anxiety and be ok even in today’s hectic, scary world.

An important note: Daily, normal anxiety is different than having an anxiety disorder.

If the anxiety you feel is unmanageable, has been going on for more than two weeks, and it is interfering with your daily life or relationships than perhaps you can think about visiting with a mental health professional and figuring out a best course of action.

6 Anxiety and Panic Coping Skills

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By Katelyn Millinor, LPC | Behavioral Health Quality Manager

For many, coping with change is hard enough, let alone the emotions many may face such as fear and anxiety due to changes in daily routines. Added stress from job loss and inability to cover expenses, illness, and or loss of a loved, one may cause anxiety and panic. Learn 6 tips to help you cope with these emotions and check out some of our highly recommended apps that may help decrease your anxiety.

Breathing slowly and deeply. Anxiety can cause you to breathe very quickly, which makes both the mental and physical symptoms of a panic attack or generalized anxiety even worse. When you start to feel panicky, be sure to take slow, deep breaths to soothe your mind and body. Be sure to breathe using “belly breathing” also known as diaphragmatic breathing.

Stop and think. When your thoughts start spinning out of control, tell yourself to stop. Organize your thoughts and decide what you need to do to get yourself calm again. This is a way to interrupt thoughts and refocus.

Think positively. Push negative thoughts out of your mind, and remind yourself that you are in control. Think about times when you’ve been able to manage situations successfully and reduce anxiety. Stay in the present moment.

Take a break. If you need to leave a situation, do so or tell someone you need to leave. Don’t be afraid to ask for help. Allowing yourself to become more upset will not help if what you really need is to take a walk and blow off some steam. Allow yourself to have space as needed.

Relax your muscles. Anxiety causes your entire body to tense up, so make a conscious effort to relax each muscle from your toes all the way up to your neck and face. This will alleviate tension.

Get physical. Exercise can combat stress and anxiety. It can also improve your overall health and immune system. Even a brisk walk can help.

Tips to remember:

  • Deep breaths.
  • Self-care.
  • Adequate sleep.
  • Exercise.
  • Talk to yourself.
  • Acknowledge your feeling.
  • Mindfulness.
  • Lavender hot baths.
  • Cut back on caffeine/nicotine/alcohol.
  • Stay present.
  • Good nutrition.
  • Muscle relaxation.
  • Slow down.
  • Picture your ‘safe place.’
  • HALT (hungry, angry, lonely, tired).
  • Close your eyes

Apps to help with anxiety:

  1. Calm
  2. Worry Kit
  3. Breathe2Relax
  4. Panic Relief
  5. MoodFit
  6. Headspace
  7. What’s Up
  8. Happify

Mother’s Day Celebration Tips During A Global Pandemic by Katelyn Millinor, LPC

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“All women are mothers because all women bring life to the world in some way.”

Holley Gerth

Mother’s Day is a time to celebrate the mothers of the family as well as those with whom we share a maternal bond. These people can include our mothers, aunts, grandmothers, sisters, role-models, teachers, care-givers, or others. We can also honor those that face the challenge of not being able to have their own children.


Most of the world has a special day or celebration for mothers. In Japan, carnations are a popular gift and considered a symbol of a mother due to their sweetness, purity, and endurance. In Ethiopia, mothers are celebrated with a three day festival which also marks the end of the rainy season. In Peru, celebrants also make special effort to remember mother’s who are no longer with them by gathering at cemeteries.


So, how do we celebrate our maternal figures while experiencing a global pandemic? There are still excellent ways to honor and celebrate even if you are social distancing, in quarantine, or unable to travel to see your mothers.

  • Play a virtual card game.
  • Interview her about her childhood.
  • Make a hand made card.
  • Write a thoughtful letter.
  • Put together a photo album.
  • Sing a song together.
  • Pick wild flowers.
  • Bake a cake or cupcakes together.
  • Use Skype or FaceTime to have a meal together.

NOAH wishes all our maternal figures a happy and healthy Mother’s Day!

Adverse Childhood Experiences and Child’s Brain Development by Dr. Patricia Avila, Pediatrician

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Did you know that suffering a potentially traumatic event during childhood also known as ACE or Adverse Childhood Experience can have long lasting negative effects on a child’s health, brain development, and life potential? 

Adverse Childhood Experiences can include experiencing violence, abuse, neglect, witnessing violence in the home, loosing a family member, mental health issues in a parent, substance/alcohol abuse by a parent, or instability from divorce or having a parent become incarcerated. 

These events lead to what is called toxic stress. Research shows that this toxic stress negatively changes a child’s brain and body by affecting the child’s brain development, hormonal system and immune system. These changes can persist for years and can lead to long term behavioral, mental, physical health problems.

The toxic stress from ACEs on brain development can impact a child’s potential to: 

  • Develop normally – leading to delays in development.
  • Focus and learn – leading to learning disabilities, dropping out of school, lack of future job opportunities.
  • Make decisions – leading to increase risk taking behaviors such as involvement in drugs and unprotected sex, unwanted or teen pregnancy.
  • Develop mental illness – leading to increase depression, anxiety, and rates of suicide.
  • Form healthy, stable relationships – leading to continuing this cycle of toxic stress in their children and families.

Research also shows that toxic stress from Adverse Childhood Experiences negatively affects a child’s body and can lead to chronic health problems like: 

  1. Obesity.
  2. Cancer.
  3. Heart disease.
  4. Autoimmune problems.
  5. Asthma and chronic lung disease.
  6. Headaches.
  7. Early death from general poor health.

The more of these events a child has suffered, the higher the risk of developing these long-term problems.

The GOOD NEWS is that we can do something about this! Research also shows that we can PREVENT and UNDO the harm done and the future harm on a child’s brain and body. There are some simple things that parents/caregivers can do at home to help regulate a child’s stress response and change the negative impacts of the stress hormones to keep them healthy and on track with brain development.

These include providing our children with: 

1. Supportive and nurturing relationships.
a. Tell them and show them how loved, special, and important they are.
b. Spend quality time doing activities that they enjoy. Simple activities like making art, dancing, cooking, playing games, reading, and singing together are excellent choices.
c. Keep connections outside the home with friends and family members.
2. Regular physical activity. Recommendation for 1 hour of physical activity which does not have to be all at the same time. These can include sports, dance parties, hula hooping contests, hiking, playing tag, chasing the family dog, or anything you can think of to get your child physically active.
3. Healthy meals.
a. Avoid high sugar foods/drinks. Avoid high fat foods or foods/snacks high in carbohydrates.
b. Include fruits and vegetables with every meal. 5-9 servings of fruits/veggies per day are recommended. Fruits and veggies provide nutrients that no other foods can provide.
c. Include foods rich in healthy Omega 3 fatty acids such as fish, nuts, avocados, flax seeds.
4. Restful sleep.
a. Keep a routine with a regular bedtime.
b. Make sure the bedroom is quiet, calm and free of distractions.
c. Avoid all electronics including cell phone, tablet, computer, and TV 1-2 hours prior to bedtime.
5. Getting mental health care for yourself as parent/caregiver and for your child.
6. Practicing mindfulness.
a. This can include meditation, breathing exercises, and prayer.
b. Talk with your child about how they are feeling physically and emotionally.
c. Practice talking about, writing down, or drawing what you are grateful for each day with your child.

All of these will build connections in their brains to help them succeed in school, behave in ways you would expect and become happier, healthier, and more successful.
When parents and caregivers manage stress in positive ways as well, your brain also changes in ways to make you happier and healthier.

Learn ways to manage your stress as a parent/caregiver:

  1. Know what is stressing you out. When you know what exactly it is, you can better deal with it.
  2. Ask yourself “can I do something about this?” If the answer is no, then let it go and focus on something else. If the answer is yes, break it down to small steps so that it is not overwhelming.
  3. Have faith. Think of other times you have overcome challenges. It has been proven that people who attend church, pray or practice other forms of spirituality have less stress.
  4. Relax. Use breathing exercises, meditation, listen to music, or take a nap.
  5. Form healthy habits for yourself by getting good sleep, exercising, and eating well.
  6. Take time for yourself like reading a book, picking up a hobby, or spending time with friends.
  7. Make connections with others. Have a support network that includes friends and family. Don’t be afraid to ask for help.
  8. You are never alone. Your child’s Pediatrician or Family Doctor can also be a great resource and support person for you. They can help give you ideas, resources, and help connect you with others who can help.

Additional resources:
Crisis Text Line Text HOME to 741-741 to connect with a Crisis Counselor. It is Free and is available 24/7.
National Domestic Violence Hotline 1-800-799-SAFE (7233) or text LOVEIS to 22522. Available 24/7.
Childhelp National Child Abuse Hotline 1-800-4-A-CHILD, 1-800-422-4453 or chat/text at www.childhelphotline.org. Available 24/7.

Amazing Brain Series of booklets to help parents/caregivers:
http://preventchildabuse.org/wp-content/uploads/2016/02/ABSapps.pdf
preventchildabuse.org/wp-content/uploads/2016/02/ABSwhateveryparent.pdfpreventchildabuse.org/wp-content/uploads/2016/02/ABStrauma.pdfpreventchildabuse.org/wp-content/uploads/2016/02/ABSteen.pdf

Other websites with great ideas for parents/caregivers:
https://childdevelopmentinfo.com/family-building/everyday-practices-to-make-your-child-feel-loved/#gs.4csgtk
https://childdevelopmentinfo.com/family-building/family-life-is-important-for-kids-mental-health-and-adjustment-to-life/#gs.4csmks

National Child Abuse Prevention Month by Katelyn Millinor, LPC

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April is National Child Abuse Prevention Month. This month and throughout the year NOAH encourages all individuals and organizations to play a role in making our community a better place for children and families. By ensuring that parents have the knowledge, skills, and resources they need to care for their children, we can help prevent child abuse and neglect by creating strong and thriving children and families in our communities. Research shows that protective factors are present in healthy families. Protective factors are conditions or attributes that lessen risk and promote healthy development and well being. 

Promoting the following protective factors is one of the most effective ways to reduce the risk of child abuse and neglect:

  • Nurturing and attachment.
  • Knowledge of parenting and of child/youth development.
  • Parental resilience.
  • Social connections and support.
  • Concrete support for parents.
  • Social and emotional competence of children.

April is a time to celebrate the vital role that communities play in protecting children and strengthening families. Focusing on ways to connect with families is the best thing our community can do to strengthen families and prevent child abuse and neglect. Visit www.childwelfare.gov for more information.

What is child abuse and neglect?
When a parent, guardian or custodian inflicts or allows the infliction of physical, sexual or emotional abuse, neglect, exploitation or abandonment.

  • Physical abuse includes non-accidental physical injuries such as bruises, broken bones, burns, cuts or other injuries.
  • Sexual abuse occurs when sex acts are performed with children. Using children in pornography, prostitution or other types of sexual activity is also sexual abuse.
  • Neglect occurs when children are not given necessary care for illness or injury. Neglect also includes leaving young children unsupervised or alone, locked in or out of the house, or without adequate clothing, food, or shelter. Allowing children to live in a very dirty house which could be a health hazard may also be considered neglect.
  • Emotional abuse of a child is evidenced by severe anxiety, depression, withdrawal or improper aggressive behavior as diagnosed by a medical doctor or psychologist, and caused by the acts or omissions of the parent or caretaker.
  • Exploitation means use of a child by a parent, guardian or custodian for material gain.
  • Abandonment means the failure of the parent to provide reasonable support and to maintain regular contact with the child, including providing normal supervision, when such failure is intentional and continues for an indefinite period.

What you can do:
Take an active role in your children’s lives. Learn about their activities and people with whom they are involved. Stay alert for possible problems.

  • Make sure your children know that they can talk to you about anything that bothers or confuses them.
  • Teach children accurate names of private body parts and the difference between touches that are “okay” and “not okay.”
  • Educate children about the difference between good secrets (such as birthday surprises) and bad secrets (those that make the child feel unsafe/uncomfortable).
  • Monitor children’s use of technology, including cell phones, social networking sites, and messaging. Review their friend’s lists regularly and ask about any people you don’t recognize.

How to Report?
A report of suspected child abuse, neglect, exploitation or abandonment is a responsible attempt to protect a child. Arizona law requires certain persons who suspect that a child has received non-accidental injury or has been neglected to report their concerns to DCS or local law enforcement (ARS §13-3620.A). You may be a child’s only advocate at the time you report the possibility of abuse or neglect. Children often tell a person with whom they feel safe about abuse or neglect. If a child tells you of such experiences, act to protect that child by calling the toll free Arizona Child Abuse Hotline at 1-888-SOS-CHILD (1-888-767-2445).

Statistics

  • Every year more than 3.6 million referrals are made to child protection agencies involving more than 6.6 million children.
  • About 1 in 4 girls and 1 in 13 boys experience child sexual abuse at some point in childhood.
  • The United States has one of the worst records among industrialized nations – losing on average between 4 and 7 children every day to child abuse and neglect.
  • At least 1 in 7 children have experienced child abuse and/or neglect in the past year, and this is likely an underestimate.
  • Children living in poverty experience more abuse and neglect. Rates of child abuse and neglect are 5 times higher for children in families with low socio-economic status compared to children in families with higher socio-economic status.

At NOAH, we offer behavioral health consulting and traditional outpatient counseling programs and services where these highly skilled and trained behavioral health staff work alongside our medical and dental teams to assess, diagnose and effectively treat the core-symptoms of our patients.

Meditation

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Meditation can help create a feeling of calmness when stress has you feeling anxious or tense.

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Keep Your Mind Grounded

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It is a daunting time as we are in the midst of a worldwide coronavirus pandemic and are listening to various news outlets, our local and federal government/agencies and various others all sharing the latest news related to COVID-19. The unknown can be a stressful time which can increase your anxiety and a fears. This video shares some ways in which you can keep your mind grounded when you need it most.

Creating a Positive Body Image by Stephanie Olsinski, MS, RDN

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In learning about eating disorders and how they can affect everyone, it is important to care for not only those affected but for yourself to ensure that you are always taking care of your health, both mental and physical. 

NEDA created a list of 10 Steps to Positive Body Image which is shared below:

  • Appreciate all that your body can do. Every day your body carries you closer to your dreams. Celebrate all of the amazing things your body does for you like running, dancing, breathing, laughing, dreaming, etc.
  • Keep a top 10 list of things you like about yourself such as things that aren’t related to how much you weigh or what you look like. Read your list often. Add to it as you become aware of more things to like about you.
  • Remind yourself that “true beauty” is not simply skin-deep. When you feel good about yourself and who you are, you carry yourself with a sense of confidence, self-acceptance, and openness that makes you beautiful regardless of whether you physically look like a supermodel. Beauty is a state of mind, not a state of your body.
  • Look at yourself as a whole person. When you see yourself in a mirror or in your mind, choose not to focus on specific body parts. See yourself as you want others to see you; as a whole person.
  • Surround yourself with positive people. It is easier to feel good about yourself and your body when you are around others who are supportive and who recognize the importance of liking yourself just as you naturally are.
  • Shut down those voices in your head that tell you your body is not “right” or that you are a “bad” person. You can overpower those negative thoughts with positive ones. The next time you start to tear yourself down, build yourself back up with a few quick affirmations that work for you.
  • Wear clothes that are comfortable and that make you feel good about your body. Work with your body, not against it.
  • Become a critical viewer of social and media messages. Pay attention to images, slogans, or attitudes that make you feel bad about yourself or your body. Protest these messages: write a letter to the advertiser or talk back to the image or message.
  • Do something nice for yourself; something that lets your body know you appreciate it. Take a bubble bath, make time for a nap, find a peaceful place outside to relax.
  • Use the time and energy that you might have spent worrying about food, calories, and your weight to do something to help others. Sometimes reaching out to other people can help you feel better about yourself and can make a positive change in our world.

Our Care Team at NOAH are here to help you create & manage your healthy lifestyle habits. Need help setting or sticking to your goals? Call 480-882-4545 today!

Signs of an Eating Disorder by Mina Goodman, RDN

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“There are some signs and symptoms of disordered eating that can be a bigger problem such as an Eating Disorder.”

National Eating Disorders Association (NEDA)

Eating disorders are a serious mental and physical illness that can affect anyone. It’s important to know what to look for when it comes to signs and symptoms of an eating disorder so that you are able to get help as early as possible and begin the recovery process. Not everyone will display the same signs and symptoms at once. It’s also important to note that there are both emotional, behavioral and physical symptoms to be on the watch for.

Common symptoms include:

  • Refusing to or discomfort with eating certain foods. This may lead to restrictions or food rules against whole categories of food (e.g., no carbohydrates).
  • Preoccupation with tracking weight, food, calories, carbohydrates, fat, and other nutrients.
  • Impaired immune functioning causing more frequent colds or illnesses.
  • Maintaining an excessive or rigid exercise regime – despite weather, fatigue, illness, or injury.
  • Signs of stealing, hoarding food, disappearance of large amounts of food in a short time period or a lot of empty wrappers and containers indicating consumption of large amounts of food.
  • Spending hours thinking about what food might be served at upcoming events.
  •  Intense anxiety, depression and/or distress if unable to exercise.

To learn more about eating disorders we recommend going to https://www.nationaleatingdisorders.org/warning-signs-and-symptoms. If you, or someone you know displays any of these symptoms, give us a call. At NOAH, we offer behavioral health consulting and traditional outpatient counseling programs where highly skilled and trained behavioral health staff work alongside our medical, nutrition and dental teams to assess, diagnose and effectively treat the core-symptoms of our patients.

What is an Eating Disorder? by Rhyan Geiger, RDN

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An eating disorder is a mental and physical illness that can affect people of all genders, ages, and weight. An eating disorder is a psychological condition that causes unhealthy eating habits to develop. At times it may present as an obsession with food, body weight or body shape. 

“20 million women and 10 million men in America will have an eating disorder at some point in their lives.”

National Surveys

The symptoms of an eating disorder can vary but the most common include:

  • A severe restriction of food.
  • Food binges.
  • Purging behaviors like vomiting or over-exercising.

In severe cases, eating disorders can cause serious health consequences and may even result in death if left untreated. At NOAH, we offer behavioral health consulting and traditional outpatient counseling programs and services where highly skilled and trained behavioral health staff work alongside our medical, nutrition and dental teams to assess, diagnose and effectively treat the core-symptoms of our patients.